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.
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.
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. :)
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.