He finally walked into my bedroom after a month-long back and forth online trying to find the perfect time for us to meet. After some intense foreplay, we were going “flip” for a while, if it had not been for the following exchange.
“Do you have any condoms?” he asked. His question caught me by surprise. Not only had we already discussed it during our chatting, it was really clear on my profile that I wanted raw sex; plus, he was on pre-exposure prophylaxis (PrEP).
“I do. But I’m sorry, this is not gonna work out for us. You’ve got to go.” My response was firm.
“What? Are you serious? Aren’t you worried about STI’s? My doctor says PrEP is not 100% sure against HIV anyway,” he replied.
Frustrated, I responded, “No. You really need to go.”
My frustration with this scenario is filled with stigma, the fight for knowledge, and the end to the hypocrisy we’re all surrounded by regarding sex. I am a person living with HIV who is a proud “barebacker,” and that statement in itself could bring as much backlash today as it did to Tony Valenzuela back in 1997.
Recently, I came across a 1999 article from POZ Magazine that detailed the story of Tony Valenzuela, who, like myself, was an HIV advocate who verbalized his preference for bareback sex—most notably, while giving a speech at the 1997 Creating Change Conference. He was immediately chastised and ostracized by his own HIV community.
Today, 23 years later, I fear the same pressure to stay silent, yet the desire for truth outweighs the potential for backlash. HIV stigma is ever present whenever we talk about “bareback sex,” which, from this moment on, I will refer to as “natural sex.” Yes, natural sex, because for me there’s nothing more natural than having sex the way it was intended without plastic between me and my lovers. I believe this distinction is important because of the negative connotations and feelings the word bareback provokes in me and many others. It has long been used in a way to portray natural sex as dirty and risky, to continue to police gay men and our sex lives.
When we find out a cisgender woman close to us is pregnant, our immediate reaction is usually one of celebration and happiness, especially if it was a wanted pregnancy. A pregnancy is most often a result of natural sex, and we don’t judge it by pointing out that the woman was “barebacking and taking loads.” But the same doesn’t happen when you’re having natural anal sex—there’s nothing ever to celebrate about that; in fact, only negative things can ever result from natural anal sex. Whenever I have publicly stated I enjoy natural sex with my partners, I’m often met with dirty looks of disapproval and immediate unsolicited litanies of sexually transmitted infection (STI) prevention, especially among peers in the HIV community. How can an HIV advocate “glorify” and “promote” “unsafe sex”?
Natural sex doesn’t have to be labeled as “unsafe” when it comes to HIV prevention. Since 2012, we have had PrEP, which is more effective than condoms, and undetectable equals untransmittable (U=U) has revolutionized the fight against stigma toward people living with HIV, who (with an undetectable viral load) do not sexually transmit to our sexual partners. It took nearly a decade after the 2008 Swiss Statement for the Centers for Disease Control and Prevention to finally admit the efficacy of HIV treatment as an HIV prevention tool. Yet, we continue to hear of health care providers denying the efficacy of both U=U and PrEP. They stress the importance of using condoms, mostly to prevent STIs when you are on PrEP or undetectable. What most people fail to realize is that condoms will prevent STIs only if they are used consistently, even during receptive oral sex. Personally, I would rather suck on a cactus than a condom-covered cock, and not once in my life has anyone ever offered to put one on before blowing me. Not once.
And as far as PrEP use goes, the evidence on whether it has a relationship to increased STIs is still an unsettled question. First, STIs have been increasing in the U.S. for more than a decade—longer than PrEP has been approved for use by the Food and Drug Administration. So PrEP didn’t make people stop using condoms. Some experts believe we are not having a spike of STIs due to changed behaviors on PrEP. But because of PrEP, we are tracking STIs alongside PrEP use, which doesn’t exactly mean PrEP is causing more STIs. Second, we may be having more detection and treatment of STIs, because PrEP users are getting tested more regularly than people not on PrEP. Even if PrEP users have higher STIs, it would only make sense because they may generally be more sexually active people, and that’s OK! Instead of shaming condomless sex, the real message should be that if you are sexually active, you should get tested every three to six months, period. No shame attached to your sexual practices, whatever those may be, or how many partners you have between tests. Just get tested. And if you have an STI, get treated.
Unfortunately, getting tested for STIs and HIV is still not normalized or widely available for everyone. The aim of local health departments and direct service organizations should be to provide more access to testing and treatment in the areas where it is needed the most by the people who need it the most. Racial disparities, socioeconomic status, sexual orientation, religious beliefs, immigration status, cultural differences, age, etc., are all variables that can prevent people from getting the services they need. In some states, health departments charge fees for HIV and/or STI screenings, making it harder for the poor, youth, the uninsured, etc. to get access to free testing and STI treatment. The message of safer sex should be more free testing, free treatments, and fewer hurdles to access.
Instead, our sexual choices for safer sex to prevent STIs are limited to a set of recommendations that might not fit well with a large portion of the population: Get to know your partners well, use condoms (or barriers), limit your sexual partners (hopefully to one who only has sex with you), and don’t use any substances during sex that could influence your decision-making. We know that is not how sex happens. More often than not, this set of prescriptions is not met before we have sex, yet we continue to hopefully enjoy sex in our lives.
Living with HIV should not feel like a burden to prevent us from enjoying healthy, natural sex experiences—because that’s what we all want, to feel connected to someone and to enjoy sex to the fullest without hurting anyone, including yourself. It is important to know yourself better than anyone, to be aware of your body and mind, and to be responsible for your own decisions. In simple words, if you’re having sex at all, no matter how, get tested and treated and inform your partners.
It should be as simple as that.