When Donald Sterling dissed Magic Johnson for being promiscuous and unworthy, it was nothing new for people living with HIV. They’ve heard it all over the years. A lot of those misconceptions persist today, even (or maybe especially) among gay men. Our attitudes can be hurtful, stigmatizing, and even contradictory.
Let’s give HIV-positive gay men the chance to set the record straight, and break down ten things they would like the rest of us to know. This list may not represent the views of every positive guy, but they definitely echo many of their most common frustrations.
1. All positive guys are not barebacking drug addicts
It’s probably human nature to try and find fault in the actions of those becoming infected. If we see them as extremists it helps the rest of us feel more secure in our own choices.
And yet the truth is that the majority of new infections occur within “primary relationships,” such as a lover or boyfriend, and usually because one partner did not know he was infected and then transmitted HIV to his partner. That’s why there’s such intense focus on getting tested and doing it regularly. New infections are typically not the result of some insane night at a meth-fueled sex party or a boozy night at the baths. It happens, sure, but that doesn’t make good ‘ol fashioned sex any safer. Leather or lace, it’s all the same to HIV.
2. Living with HIV is not a toxic horror show of medications
Yes, HIV usually requires medications and doctor visits. So does every chronic condition. With so many options for HIV drug therapies, side effects have been reduced drastically and ones in development will reduce them even further. Poz guys are not weeping every morning as they chug down pills with their morning coffee.
3. HIV infection does not automatically turn guys into dangerous liars
One of the most unfortunate misconceptions about positive guys is that they outright lie about their status just to get laid, or worse, are on a mission to infect others. Can we dial down the rhetoric about intentional transmission, please? What is true is that positive men often have trouble disclosing because of the very stigma that results from sensational rumors like this one. It is unfair to blame all positive men due to the reckless behavior of a relative few.
4. “Drug and Disease Free, UB2″ is every bit as stupid and non-productive as it sounds
If you are using this dangerous phrase as a filter for potential sex partners, you could be doing yourself more harm than good. We know positive guys who are undetectable are not infecting their partners, so rejecting people based on their status can be more discriminatory than practical. Besides, labeling someone as damaged goods or unworthy sucks, and if you’ve been on the receiving end of this practice you know how demoralizing it can be.
"UB2″ also sets you up for a false sense of security, because as one British study suggests, the risk of sex with someone who thinks they are HIV negative is higher than sex with an undetectable positive person. This is because the viral activity in a newly positive person can be incredibly high, and he may not even know it.
Of course, either way you have to know who you’re dealing with. So hold off on any risky moves until you know him well enough to be sure he’s negative (get tested together!) or be sure he’s taking his meds and is undetectable.
If you are compelled to demand your sex partner’s HIV status up front, consider a more respectful way to do it (“I tested negative as of this date. What about you?”). Asking if he’s “clean” or “disease free” just makes you look like a dick, especially since you don’t know what STDS you may have if you are sexually active at all.
5. Our health and risk behaviors are up to us and no one else
After decades of scientific and treatment research focused on those with HIV, new options are now available to sexually active negative men, such as Pre-exposure Prophylaxis (PrEP). This advance puts negative guys in control of their own infection risks. Yes, there’s been some concern about the toxicity of Truvada, the PrEP medicine, although new reports suggest that these have been overstated. Your own health is always in your hands through the choices you make — and they have nothing to do with the status of your partner, whether known or unknown. The blame game has never benefitted anyone, and the playing field has always been level, whether we acknowledge it or not.
6. Guys with HIV are not promiscuous… or have a rotten sex life… or no sex life
All of these are usually false, if you’re using the typical sex life of a single gay man as a barometer. We all have our moments. Sometimes our dance card is filled, sometimes there’s a drought, and sometimes the sex we have sucks, and not in a good way. And just like the rest of us, positive guys are getting their share and having satisfying, balls-to-the-wall sex when they’re lucky. Judging guys for the degree of action they are getting feels like an old, worn argument against all gay men that we could really do without.
This is just another example of trying to distance ourselves from positive guys by judging them as different from ourselves. They’re really not. Some are prudes, some are sluts. After all, it only takes one time. And isn’t a slut just someone who has more sex that you do?
7. How they got it and who gave it to them is none of your business
The details of someone else’s infection isn’t your personal soap opera or cautionary tale, no matter your good intentions. If poz guys feel like sharing it with you sometime, they will. Chances are they came to terms with it long ago and it’s probably not very interesting, anyway. They probably had sex and got HIV. The details are not yours for the asking.
8. If you need an HIV educator, go find one
Having HIV doesn’t come with a master class in epidemiology and HIV transmission. Every person with HIV is not an expert or a prevention specialist — or an activist. They are simply living with the virus. And if they do find themselves having to educate you about the simplest facts of HIV prevention, don’t be surprised if they are the ones that decline to have sex. Nothing kills the mood like HIV 101. And most positive guys aren’t going to be put into the position of talking anyone into bed. They probably have hotter, more enlightened options on their smart phone anyway.
9. Positive guys aren’t going anywhere soon
Recent studies suggest that someone becoming infected with HIV today in the United States has the same odds of living a normal life span as anyone else. Some research even suggests a life expectancy that is longer than average, because people with HIV see a physician more often and other health concerns can be identified and addressed sooner. They are also more likely to avoid drugs and alcohol, eat well and exercise regularly, the keys to health and longevity.
Positive guys know this, and are living their lives with appreciation, joy, and an eye towards the future. There’s no reason for them to settle for second best. As infections continue and treatment improves, healthy HIV positive gay men are a growing population. It might be better to try and understand and respect them than hang on to outdated fears or biases.
10. Even more breakthroughs are coming
There is research underway that will continue to change the landscape and make life easier and less risky for both positive and negative. Rectal microbicides (lubes and douches that kill HIV on contact) are being tested. More medications to be used as PrEP are being developed, including injections that could offer protection from HIV infection for months rather than the regimen of a daily pill. Condoms are getting a makeover with new designs and sensitivity profiles. Before long, even modest risks of infection could be eliminated for those who take advantage of new technology. Treatments for HIV infections will become even less toxic and even more effective.
All this progress isn’t only significant in terms of HIV transmission rates. It could help bridge a viral divide that has troubled our community for well over a generation.
(I wrote this piece for Queerty. I love reaching their audience of young sexually active gay men who need information! — Mark)
This article is also found on Mark’s own blog My Fabulous Disease here.