November 17, 2010
He didn't rape me and he did not trick me. It was through our unprotected sex that I became HIV positive. Since seroconverting, I have been very conscious of the language I use to discuss transmission, particularly my own. To say "he gave me HIV" obscures the truth, it was through a mutual act, consensual sex, that I became HIV positive. When speaking to him a couple months after my diagnosis I gathered that he knew he was positive when we had sex. But that is beside the point; my sexual health is mine to control, not his.
We are encouraged to think about prevention and transmission in terms of responsibility. Someone must be at fault. Culturally, we hunt for secret villains. Today's "down low" black man is but the latest boogeyman at which we've pointed our fingers -- the latest of the so-often racialized monsters at which we can direct HIV blame rather than have honest conversations about sex and relationships.
In recent weeks, another recurring villain has re-emerged: the HIV-positive criminal who callously infects others. Last month, long-standing accusations that baseball legend Roberto Alomar hid an alleged HIV infection from his wife and girlfriends returned to the news. This summer, German pop star Nadja Benaissa made international headlines as she was tried for failing to disclose her HIV status to sex partners. These stories rarely fail to steal the news spotlight, and often throw local communities into HIV panics.
There must be a reason they are so resonant, right? They are evidence that HIV transmission from knowingly positive persons is rampant, right? Wrong. The reality is that the vast majority of HIV infections occur between two consenting people who believe they are doing nothing more risky than making love -- or, at least getting laid.
People who know their HIV status are actually more likely to use condoms than not. The Centers for Disease Control and Prevention reports one snapshot study that found 95 percent of those living with HIV infection in 2006 did not transmit the virus to others that year. Another CDC study, released in September, found that while one in five "men who have sex with men" -- public health jargon for gay and bisexual men -- in 21 major cities has HIV, nearly half of those men (44 percent) don't know it. The agency estimates that the majority of new infections each year result from sexual contact in which the positive person does not know he or she has HIV.
HIV disproportionately affects African Americans, regardless of sexuality. They account for half of the people living with HIV/AIDS, but just 13 percent of the overall U.S. population. Studies also suggest African Americans are least likely to know their HIV status, with the younger being less aware. Similar patterns exist among men who have sex with men, of all races. No talking and no testing, just finger pointing.
The communication problems that help drive these trends don't stop with finding monsters to blame. People I love and talk to about my status do not always have the language or tools to express their grief and worry. They ask things like, "How could you be so irresponsible?" Or, "How could you fuck up like this?"
This language hurts, but more importantly it shifts the discussion from meaningful conversation about risk and vulnerability to simplistic directives: if only people used condoms, transmission would cease. But this idea relies on a complicated array of misconceptions and idealistic assumptions of equality, equal access to information, and how to use that information to stay HIV negative.
It is irresponsible to just tell people to use condoms without acknowledging that conditions like poverty, patriarchy and homophobia play roles in the so-called risks we all take. Even with people who have seemingly escaped these broader contexts -- say, a working-middle class white man such as myself -- stigma can prevail. Stigma that is produced by homophobia and general ignorance, yes, but also by American society's desperate need to discipline and punish, to affix blame on individuals rather than confront the systems in which individuals live. So the AIDS epidemic becomes a challenge of personal responsibility rather than a damning indictment of global public health. That personal responsibility, however, is tricky: I bore no responsibility for the epidemic, until I had HIV, when it became entirely my problem.
When I used to get tested at the city clinic, they would tell me that people stay negative by disclosing their negative status. Having a conversation is paramount -- negotiating whether and how you want to use protection, talking about the last time you were tested and asking the same of your partner. This dialogue cannot be taken for granted, but for many, before these conversations can happen, we need the tools to do so. So here, we lead by example. Three people of varying HIV status offer their own testimonies on how they think about their sexual health, and what it means.
Age: 28; HIV negative
I can't always say that I have cared much for my sexual health. I listened to the teachers speak about individual health but none of it seemed to do its purpose. I'm not so sure if I understood the power of owning my sexuality or knowing how to protect my physical and mental health. As I got older, I really started to look outside of what I deemed "me in between the sheets." I started to think about my sexual health as more than just physical. I declared I own this body; I must respect it. When I do or do not have sex it is my decision, and I must be active in that decision, not passive. I appreciate sex. Through this process I have learned that communication about health awareness with my partners has improved over the years as well. Sex is one of the most natural things we can do as humans.
Age: 24; HIV negative
As a survivor of domestic violence and the many forms of abuse that it carries, I know being in control of your sexual health is critical for feeling empowered and safe. It took me years until I finally felt that I was in control of my sexual health and decisions. When I made the choice to be celibate (for a specific time period), it was the first time I felt in control of my body. It was liberating for me since I was often forced into sex throughout my adolescence. After not having the ability to say "no" for such a long time, I know the importance of making that decision. There are structural reasons why women feel that they are not able to say no, and we need to work to change that. As a young feminist of color, I believe it takes much more than reproductive health care and education for us to feel in control of our sexuality -- it takes personal empowerment too. That to love and respect yourself means not only resisting coercion, but being comfortable enough to say yes when you want to have sex too.
Age: 31; HIV Positive
My relationship to HIV has been woefully simple and dramatically complex (with emphasis on the drama). When I tested positive, I knew it was not a death sentence. It was post 1996. I'd worked in prevention. I knew I was going to live. The problem became living and remaining a sexual being. As a youth organizer, I had been taught to integrate positive sexuality into youth work. I was taught, and believe, that sex is a natural part of our human experience and that we should teach and support each other in our explorations of sex and the ways in can enhance or relationships, friendships, and lives.With HIV I almost lost that others tried to take it away from me. Now I talk about it raw and uncut. I talk about the challenges but also reclaim space in the sexual community and use my own experiences, the good, the bad, and the multi-orgasmic to demand permanent space for all those living with HIV. To all the poz people in the world, I say, with love: fuck on.