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F**k Poz Guys!

February 19, 2014

Fuck Poz Guys!

Marc-André LeBlanc asks if you're a neg guy is it safer to have sex with poz guys or neg guys? Limit your condomless sex to poz guys with undetectable viral loads and avoid condomless sex with casual negative partners he suggests.

You heard me. FUCK POZ GUYS!

I'm talking to you, my HIV-negative brethren. Specifically, those of us who have not been able to maintain 100% condom use in the last little while. Either that is happening more and more often, or we're now admitting it more and more readily. But something's going on. The rates of condomless sex don't seem to be going down. They are either stable or even going up slightly in some places.

I'm also talking to those of you who manage to maintain 100% condom use. Keep it up! It's not easy, I know. I managed to use a condom every time for yeeeaaars. And that was not always an easy task. So kudos to you. According to some, you should get a parade, and I concur! And by the way, the message applies to you too: fuck poz guys! Keep on reading to find out why.

Now back to the first group: do you have boom-boom sex that doesn't always include a condom? Do you worry about becoming infected with HIV? Do you try to "serosort," meaning you try to only have sex with guys who have the same HIV status as you do? Maybe you only do that when you have condomless sex?

If any of this sounds familiar to you, then let me paint you a couple of pictures.

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Scenario 1: You ask your prospective partner what his HIV status is, and when he was last tested. You've both just assured each other that you're negative, so you decide to proceed without condoms. In it's briefest and crudest form, this can sometimes look like the following exchange on a hook-up site or app: "r u clean? yeah? me 2. wanna fuck bare"?

That guy you've just decided to have condomless sex with could be negative, as he believes. Except there's a good chance that he's done this before. And unless he's on PrEP and adhering to it and going to his regular check-ups, he might be unknowingly positive. In fact, he could be in acute infection, with sky-high viral load. And obviously, you could be too. How many times have YOU done this "r u poz? no? wanna fuck bare" dance? Maybe YOU'RE in acute infection and don't know it, even if you get tested regularly.

Scenario 2: You ask your prospective partner what his HIV status is, and when he was last tested. He's just told you he is HIV-positive. Assuming you don't run for the hills in a moment of panic, as it happens all too often, you continue to exchange a bit of information. Turns out he is on treatment and has an undetectable viral load. You both decide to proceed without condoms.

If you ask me, in terms of HIV, scenario 2 is a hell of a lot less risky than scenario 1.

HIV Positive tattoo

Trust me, I understand all too well the fear that goes with the idea of having sex with someone who is HIV-positive, let alone sex without condoms. I'm from the generation of gay men who were just entering adolescence when the AIDS crisis hit. This led to the unfortunate formula "Gay Sex = AIDS = Death" being emblazoned in our psyches. The message was reinforced for me when I watched my father, an out gay man, die of AIDS, gasping for breath right in front of my eyes when I was 20 years old. The fear of becoming HIV-positive was an incredibly effective motivator for me to avoid anal sex for years, and then to use condoms for anal sex each and every time, once I decided to try it.

But not all of us have managed to maintain condom use all the time. For all kinds of reasons, we have sex without condoms. Maybe rarely, maybe hardly ever, maybe sometimes, maybe often, maybe always ... And if you have sex without condoms as a negative guy, the risk is probably lower if you do that with a poz guy who has an undetectable viral load than with anyone else.

I know. STIs.

I know. Blips in viral load.

I know. Undetectable in blood does not always mean undetectable in semen or rectal or vaginal secretions.

I know. You know some negative guys that you trust are truly negative.

I'm not urging anyone to have condomless sex who doesn't already.

I'm not recommending an increase in condomless sex among those who already do it.

I'm not encouraging anyone to ignore STI risks.

I'm not suggesting you should assume that all men are liars.

And I seriously worry about contributing to the increasingly obvious "Detectability Divide," where having a detectable viral load is kind of like the new positive. Rarely acknowledged, discussed in hushed tones, and more readily stigmatized. It's kind of the reverse of what a positive guy said in a focus group I recently facilitated in Vancouver: "undetectable is the new negative." I would be horrified if I contributed to merely replacing serostatus with detectability as the new marker of stigma in our community. So let me be clear: there's no reason to avoid sex with someone who has a detectable viral load; just an additional reason to be more vigilant about reducing risk through other means, such as condoms and/or PrEP for example. All while having hot, steamy, satisfying sex.

Yet I still maintain that negative guys who don't always use condoms should seriously consider limiting that condomless sex to poz guys who have an undetectable viral load.

I understand that it takes time to wrap our heads around this. We have all been told and continue to be told so often that we should fear transmission, which is often presented as nearly inevitable. It takes a long time to wrap our heads around the fact that perhaps in some circumstances, we don't need to feel that same level of anxiety that we've been conditioned to feel.

But I think more and more of us are getting there. And I bet you if all of us neggies who sometimes have condomless sex only did it with poz guys who are undetectable, while being most adamantly consistent about condom use with other neggies and poz guys who have not yet achieved undetectability, this epidemic would be over damn fast. We would avoid the undiagnosed, including those who might be in acute infection. That's a brand of serosorting that makes sense to me.

How's that for an HIV prevention campaign?

"Wanna reduce your HIV risk as a negative guy? Limit your condomless sex to poz guys and avoid condomless sex with casual negative partners."

Go ahead, I DARE someone to promote it. :)




Fuck Positive Women
I want to acknowledge that the title for this article was inspired by the work of AIDS ACTION NOW and Toronto artists Allyson Mitchell and Jessica Whitbread. In honor of the Day With(out) Art 2011, AIDS ACTION NOW launched a poster series created by Toronto artists Allyson Mitchell, Kent Monkman, John Greyson, Daryl Vocat, Cecilia Berkovic, and Mikiki with Scott Donald. The posters were developed collectively with community members working to respond to HIV. An article about the project, and an image of the poster in question, can be seen here.

The content of FUCK POZ GUYS! was inspired by my reaction to a New York Times article about increasing rates of condomless sex among gay men. In this article, the author suggests that it's foolish for negative guys to think that it's relatively safe to sleep with men who have an undetectable viral load. I wrote a rant on the IRMA listserv in response to that statement, which morphed into this article.

This article was originally featured on PositiveLite.com.


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More Personal Views on HIV Prevention for Gay Men


This article was provided by PositiveLite.com.
 

Reader Comments:

Comment by: Robert (Missouri) Tue., Mar. 4, 2014 at 6:41 pm EST
First,thanks for starting this conversation.
I agree whole heartedly ,I've yet to find a comfort zone with this,even after twenty years poz.First am grateful to be alive,however those that don't understand that being infected affects almost every action one takes to proceed with living,is just either living in denial or ignoring the facts.like I said twenty years of finding this to be an unmanageable situation.If I tell a potential sex partner that I'm positive either they want nothing more to do with it(sex) or they do which always makes me wonder if they are too and lying or that they are not and the poosibility exits of either being liable or putting myself in line for reinfection or third they are on a suicide mission.If I don't tell them I find no matter how safe I feel like a liar myself,or that I'll have to say eventually anyway which breaks any trust that we possible have built,so round and round the mulberry bush I go,have yet to find a accepted answer(which in turn depression ,anxiety builds etc.)Bascillaly have resigned to masturbation which is not real fulfilling.Point is that yes this is still a very hard thing to deal with,and no perfect(or close)answers.It just becomes to complicated to take it on too.
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Comment by: Bob (Atlanta, GA) Thu., Feb. 27, 2014 at 1:19 pm EST
This article is smooth, but it ignores the obvious conclusion: if diagnosed poz men are less risky, mechanisms that isolate poz men only serve to increase infections while compounding the trauma of diagnosis.

Simply, mandatory disclosure must end. Mandatory disclosure is the information-age equivalent of the leper colony - humiliating, isolating, counterproductive. The idea that HIV needs special warning is creating more infections than it stops and is compounding the problems that accompany a diagnosis.

Obviously, it's easier to accept the conclusion that disclosure laws are counterproductive if we believe the premise, that diagnosed poz men aren't more risky. Every time we make a concession towards the premise, some new study is released and we start again. It's like Groundhog's Day. Every day ends with The Swiss Statement. Every day begins with "Detectable Viral Load Found in Semen of Undetectable Men". Clearly the latter isn't legitimate criticism of the former, but it is perceived to be. I suspect a crisis of confidence in HIV leadership. We can believe the latter claim as proof of risk because we never trusted the former.

What's the fix? Maybe, like Groundhog's Day, it's for us to do something different, rather than repeat the same actions and hope for a different result. If arguments in favor of decriminalization and serointegration weren't so obviously self serving to the interests of HIV+, the rest of society would be less wary. This would require a reinvention of the entire discussion, less about sexy pics of men with biohazard tats, more dry discussions that we can't stop an epidemic by removing those least likely to spread the virus. For HIV "leaders" to do this with any semblance of legitimacy among the HIV+, they may also want to get back to the basics of HIV leadership. Perhaps fewer discussions about recreational ARV opportunities for HIV- and more demands for access to medicine for HIV+ would be an obvious start.
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Comment by: Marc-André LeBlanc (Gatineau, Canada) Wed., Feb. 26, 2014 at 9:49 pm EST
Thanks for your comments, guys!

David, I'm really sorry to hear you get those reactions. That makes me sad and mad!

Thanks John-Manuel for bringing up that important point.

Luke and Mark -- you warm the cockles of my heart!
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Comment by: Joseph (Toronto) Wed., Feb. 26, 2014 at 12:09 pm EST
Well written Marc-André and certainly worth consideration.

My concern would be two-fold:
1) Poz guys who lie about viral loads so they can convince others to bareback
2) Once Neg guys who like to bareback catch on to this they lie and say they are Poz with undetectable viral loads

I realize the number of people who would say they are poz when they are not is probably rare but not impossible.
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Comment by: Luke Storm (New York, NY) Tue., Feb. 25, 2014 at 10:57 pm EST
David Knight I am sorry for those HIV neg guys who have treated you that way. Gay men are not as smart as they think-- they still do not know that HIV poz guys on the meds are so so so much less likely to trasmit HIV than someone who has not been tested or says he is negative, and has been doing plenty of unprotected anal. I myself am neg and have had plenty of poz hookups and some poz boyfriends. In NYC, there is a therapist who hosts a Status Doesn't Matter group for negs and poz guys to get together. If it doesn't exist in your town, go to your nearest gay center or HIV organization and help create such a group, if you want. If these things get going in every city, everyone will be informed and able to enjoy sex without fear.
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Replies to this comment:
Comment by: Frank (Boston) Tue., Mar. 4, 2014 at 6:45 pm EST
In reference to Luke Storm New York, NY
The Status Doesn't Matter Group that you speak of is a BRILLIANT idea to address stigma and fear. I've been eluding to this idea for years. Where can I get more info as to what goes on at these groups, i.e format, exercises, information, etc.
I would imagine that there is a lot of tension in the beginning between Poz and Neg communities yet I think it's vital to build that bridge.
Any info would be helpful.
(Not a Therapist) Just a concerned hopeful Poz (activist) guy.


Comment by: Mark (Boston, MA) Tue., Feb. 25, 2014 at 5:36 pm EST
FINALLY! A bold, honest and TRUTHFUL editorial sex with HIV Undectable Men POZ (HUMP) - I am open about my status before I engage in any sex, firstly because I only have bareback sex and I only TOP! Yes, there are countless rejections, but quite a few men are more than eager and willing to engage, and whether or not that means that they are lying about their status (I won't judge), the fact remains that no one I have ever had unprotected sex with has have contracted HIV. Even my partner for 14 years! Thank you for being brave enough to post this, as it give those of us who fall into this tricky and often discouraging situation a little more "positive" feeling of ourselves.
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Comment by: David Knight (Myrtle Beach, SC) Thu., Feb. 20, 2014 at 8:54 pm EST
If you take a look at all the online dating sites you'll see that 98% of the men post as being "Negative" which is impossible. and to me they're a bunch of liars. When you are honest which I am on every dating site where I have a profile and say yes I'm HIV positive I never, EVER get even one contact. When I do contact someone, if they're kind enough to respond they say in such a mean tone to get away from them, they don't even want to touch an HIV positive man. What a piece of garbage they are.
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Comment by: John-Manuel Andriote (Norwich, CT) Thu., Feb. 20, 2014 at 3:37 pm EST
I definitely agree that Scenario #2 is safer--where the known HIV-negative guy tops the known and virally managed HIV-positive guy. I've long said that if gay guys simply stopped having unprotected anal intercourse--as the top or bottom--with men of uncertain HIV status, there would be a lot fewer new infections.

One thing that has unfortunately been lost in all these years of discussion about condom use: Not all men who have sex with men engage in anal intercourse. Reducing gay male sexuality to this one activity overlooks the fact that men have always given and received pleasure from one another in all sorts of other--spelled S-A-F-E--ways. I wish new HIV prevention efforts would reclaim and celebrate the health benefits of those activities rather than always and only talking about anal intercourse.
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