As an avid GrindR, BBRT, and Scruff user, I’ve been noticing that traditional, institutional media, including more contemporary outlets like the Huffington Post, have been expressing dismay at the “growing specter” of barebacking in the gay male community. This morning, a friend of mine posted the, statistically dubious, GrindR poll story along with his comment, “There is very little benefit from using scare such tactics if you want to dialogue about the negative potential of certain practices (e.g. barebacking) among HIV+ individuals…not to mention the piling on of shame and stigma that inevitably results.” Upon reading his status update, I commented a few times with my own insight and a confession.
I engage in bareback sex.
As an HIV+ gay man in 2013, I take all the information that decades of scientific advancement in relation to STD and HIV prevention have taught me, I assess the statistical significance of being HIV+ and adhering to antiretroviral therapy and transmitting HIV (there is none), and I write and speak about my HIV status publicly. On some of my online profiles used to find sexual partners, I specifically state a preference for other HIV+ guys, and on Adam4Adam, I checked the box that said “Anything Goes” rather than “Safer Sex Only.” On paper, it would seem that I am in a small minority of gay men who engage in bareback sex. After years of exposure, both literal and figurative, to gay sex in Philadelphia, I can faithfully say that, in practice, I am in a sizable minority, if not the majority, of gay men in that I don’t use condoms when I have sex. The only thing notable about me, however, is the fact that I’m not claiming something else out of shame or worry about what other people might think. Rather, I’m being open about my behavior and the fact that I assess risk and try to reduce it, not eliminate it, in my life.
In the 1990s, the Gay Men’s Health Crisis and other worthy LGBT and HIV/AIDS focused organizations beat a drum that was necessary during a time when good men were dying on account of a neglectful government, scientific ignorance, and pharmacological failure during the fight against HIV/AIDS. As a middle schooler, I remember the mantra, “If you don’t have sex with a condom, you will die” well. As an adult, particularly as a man living with HIV, I cringe at the insensitivity and logical alienation at its otherwise well-meaning message. After all, if having sex without a condom means I will die, naturally because I will get HIV, and I got HIV, does that posit, then, that I am the walking dead? Do I not live robustly, enjoy an active and healthy sex life, contribute as much as I can to my friends, and laugh as much as possible? Or, am I just a sick patient waiting for death to take me, atoning to my god for my sins, wishing that I could change my personal history?
In an ironic twist of fate that only reality, not fiction, could offer, after years of drunken, bareback sex, I found my sobriety and adhered to safer sex practices. Then, after a month of really bad gingivitis, I contracted HIV likely through oral sex. Yet, even I cannot prove that with certainty or affirm it without at least some doubt as to how, precisely, I contracted HIV. With this in mind, I insist that it is science, not stigma, that should guide our behavior as individuals worthy of sex lives in 2013. Just as going online, publishing an online profile, taking pictures that are both attractive and accurate (ahem), responding to messages, setting up a meeting time and place, and engaging in sex with another consenting adult all have deliberate action items that require and demand an individual’s implied consent and awareness of the reality facing the gay community, debating on whether or not to wear a condom and candidly admitting that you prefer not to but understand the potential risks involved is an adult, informed decision.
Now, I am not saying that there is no risk in bareback sex. Statistically, if you are HIV-, it is the easiest way next to intravenous drug use to contract HIV. Yet, even if you wear a condom for intercourse, you are also opening yourself up to a host of sexually transmitted diseases that care nothing about your condom use: syphillis, gonorrhea, chlamydia, herpes, crabs, scabies, and hepatitis.
With that in mind, as reasonable, rational adults, we should be open and honest with each other. Do we like to use condoms? No. Do we find them annoying? Yes. Should we try to mitigate our behavior through risk management, through adhering to practices that make HIV transmission, such as adhering to anti-HIV therapies if you’re HIV+, less likely? Yes. Should we somehow scare folks and imply that those who do not use condoms are behaving recklessly or part of a growing specter of deadly sex? Absolutely not.
In fact, the stigma attached to HIV is now its most deadly aspect; ignorance, terror at the potential for contracting HIV, and failure to realize that there is an entire life of sexual escapades and enjoyment after seroconversion lead to good men and women to not get HIV tests, to lie about their adherence to safer sex practices, to not seek treatment for a virus that has less impact on me, personally, than the fact that I smoke cigarettes, a far more deadly prospect in 2013 than being HIV+.
In 2013, nobody should contract HIV. Those of us with HIV should adhere to antiretroviral therapies to ensure that we cannot spread the virus, governments should equip community organizations and individuals with the resources necessary to provide antiretroviral therapies at free or no cost, and HIV negative individuals should take as much ownership of their personal health as the HIV positive. Just as I take Complera every morning to ensure that my life expectancy exceeds past 70 and the risk of my spreading HIV is statistically nothing, I expect those in the HIV negative community to take ownership and responsibility for their actions as well. This includes wearing a condom when they wish to remain HIV negative, understanding that they, not anyone else, are in total control of their actions, and being aware of the fact that it is common, and likely inevitable, for some sort of STD to be transmitted throughout the lifetime of an adult. This does not make people anything but human.
Adult humans have sex. Mature, reasonable humans assess risk to their lives and behave accordingly, and they certainly do not fan the flames of hysteria by turning HIV+ men, or anyone who engages in an activity that is more popular than voting, into boogeymen in order to scare the hell out of the 16 year old gay boys who read these stories with rapt attention and who, in turn, then suffer from panic attacks and anxiety after every single sexual encounter regardless of their condom use.
This type of hysteria is one of the gravest sins possible; it takes scientific evidence, ignores personal responsibility in relation to health management and sexual behavior, and it marginalizes huge swaths of gay men just to get readership.
Then again, this is the same story the HIV+ community has been told for thirty years. The only difference today, however, is that we’re not buying it anymore or apologizing for being human.
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LOL! *PLEASE* rename this DUMB article “THE BATTLE CRY OF A FOOLISH WHORE!” because that’s what you are! Yolanda Foster here, and as all of America knows, I grow my own lemons, but did you know I also grow onions? Your face looks like a Walla Walla, but with a brown spot…unsuitable for my kitchen! I think you need to stop writing. Buy some goats, a spinning wheel and get a loom. These ramblings are getting all of us nowhere fast! You still have some nice years left although you look “rode hard and put away wet”. Go to the beauty parlor, get your face done and land yourself a hubby! I think you are so boring and you aren’t as bright as you think you are. I could go on all day, but I’m making David a frittata. Think about what I said.
Ladies and gentlemen,
Please see my article http://joshkruger.wordpress.com/2013/01/25/crystal-meth-and-me-the-writer-becomes-the-subject/ regarding the consequences of meth use. I believe that “Yolanda Foster” is another cautionary tale regarding the mental health effects of continued exposure to narcotics.
Thanks for reading, “Yolanda!”
Regards,
JK
HI! It’s me, YOFO! Why would you think I was on drugs? They are not the answer, Josh. Haven’t you learned your lesson? You are beyond self-absorbed, and it amazes me. You are cordially invited to “GET BENT!” YOFO OUT!! PEACE!!
Thanks for reading!
JK
Josh, I think your comments here are accurate for those that are compliant with anti-retroviral regimens. However, it is the unfortunate situation that even a two-day lapse in ART can lead to detectable viral loads. Left your ART home for a vacation weekend? Been parTying a little too hard and forgot your pills? Stressful times at work? etc. Two days is not hard to forget when life gets going.
If someone is considering sero-discordant sexual activity, they might consider someone they know well and who they trust is compliant with their treatments.
Phil,
I wholeheartedly agree with you that this perspective is reserved exclusively for those who fit the statistical criteria for effective antiretroviral treatment. Under the following conditions:
1. Starting treatment at VL under 100,000.
2. Adhering to triple therapy HIV treatment specifically as directed (in the case of Atripla, taking medication on an empty stomach or in the case of Complera, taking the medication on a stomach full of acid and at least a 400 calorie meal) not only increases bioavailability of the medication but it also establishes a good routine. Also, those on antiretroviral treatment should never skip doses or play fast and loose with their medicine. Personally, every single morning between the hours of 7 AM and 8 AM, I take my Complera. Whether I’m hungry or not is irrelevant; I force fed myself a meal of 400 calories. Whether I was up all night at the bathhouse or in a club in New York, I still do this. Like many people, I do not let my personal behavior or less than school-marmy actions effect whether or not HIV will kill me. Candidly, if someone wants to mess up their chances of living until 70 just because they’re too meth-addled to take a dose, I can’t help them.
3. Scientific evidence overwhelmingly agrees that I am correct under these conditions. I do concede, however, that I cannot speak to folks who have gone through the revolving door in and out of treatment for 10 years. Again, adherence is vital.
Just as I leave personal behavior up to the individual vis a vis sexual acts, I also leave personal health management up to the HIV+. If someone is HIV+ and refuses to adhere to medication, not only does this increase the possibility of virologic failure, but it also makes it much more likely that this person is going to develop drug resistance (by giving HIV the downtime outside of treatment to adapt.)
I do not, however, make any excuses for people who do not adhere to their medication, particularly in Philadelphia where we have NO waiting list for free medication and treatment under the SPBP where local organizations (an HIV+ person has a whole host of choices where they can get case management, too!) pick up the slack where Ryan White Funding might drop off.
Thanks for your thoughtful comment. I DO agree with you entirely that, just like sex between HIV negative people, serodiscordant or HIV+ on HIV+ sex opens up an individual to risk based upon both participants personal histories, including their health.
Thanks for your thoughtful comment and for reading.
JK
one thought i would like to share: I think it’s time to take our (sexual-)partners – hiv-negative (or hiv-positive) in full responsability. because if i’m living with an undetectable viralload,no other STIs, completetly compliant and sucessfull treaten, so that there’s no risk to transmit HIv, i want the others to be clear and open about what THEY could transmit. knowing that STIs could be much worser for someone with HIV, i ask to be safe myself.
so i m asking myself and all responsables for campains and studies and HIV-politics:why the hell was the publication around the facts of noninfectuosiy NOT used to campaine for COMMUNICATION and RESPONSABILITY of the non-tested or HIV-negative ones? because it’s hard to accept that we can have condomless sex? or because scapegoats are strongly needed and people with HIV/AIDS are used to be used as it?
and last but not least: don’t let us fall in the trap of “new” categories of good and bad patients or people with HIV/AIDS. let’s be very careful what are the motivations and whom the strategies of “divide ed impera” helps to get where…
the individual freedom is in danger- if the noninfectuosity is only a goal for public health and when treatment isn’t first at all treatment for us. not prevention for others… ( i hope you can follow my attempt to express my thoughts. i have really to appologize for my poor english)
from far away, in solidarity
michèle
What a great comment. I love that you upend HIV stigmatization and, instead, say “What’s with all these HIV- people potentially transmitting STI’s to us HIV+ folks?!” Great point!
As with all aspects of sexual health, routine, common testing for STIs in addition to HIV is the best way for everyone, both HIV+ and HIV-, to stay healthy, happy, and sexually fulfilled.
Thanks for the thoughtful comment.
JK
and … at least here in my country(but also in others!) the nonifectuosity is still not considered enough when it comes to all question about HIV&law. it’s just absurd when we have to fear to be punished by law for something that in reality we can’t do.. or we can not travel around because of the false idea that we are “bio-guns”. i mean…i’m clearly against any criminalisation of transmission or exposure. but a minimum would be that society/politics and law accept and consider the noninfectuosity as reason to stop discrimination and stigma.
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The bottom line is CONDOMS SAVE LIVES…. AND impaired drug use
during sex just allows someone to be in the place where
infection/transmitting the virus can happen….
SHAME ON YOU FOR NOT HONESTLY TELLING YOUNG
People to just use condoms everytime- EVERYTIME !!!
Shame on you for disingenuously acting like you’re advocating on behalf of the LGBT community, which includes a large number of HIV+ folks, when you’re actually stigmatizing the HIV+ by not telling the truth. That is, when adhering 96% of the time or more to ARV, HIV+ folks have no risk whatsoever of transmitting HIV (as detailed in my piece, “Clean and Want to Stay that Way.”
Thanks for reading, though.
JK
sometimes i’m wondering where does it come from, that a lot people living with hiv/aids is convinced to preach “condoms-and-only-condoms- for- ever “? then i’m thinking about stigma and selfstigma and the only way out of it, is to make shure that “you” are better now, that you never would have any risk or joy as you had before the diagnosis. so you are a good person with hiv. telling the world that only condoms (and safersex, if sex at all!) are to consider for harmreduction. that you are healed from all negative behaviour that made you such a dangerous cesspool of viruses. it s better to be a marthyr and a good one, than to be honest, open and proud? and so in these time, knowing the facts about the non-infectuosity it must be very hard to stand against censorship and to tell all facts around te risks and non-risks of transmission. because “you” would loose your self-perception and your qualification as a full member of society (even with hiv..)…
maybe i’m too much european, or out-law for other reasons, i never had the idea to reach rehabilitation with condomizing everyone around me. i live prevention every day since so many years, but i see no reason to write it on my forehead to returen on my place in society. i was always part of it. and i was always part of a society in which censorship has no place and is considered as the opposite of democracy.
so please: let us be clear and open for all facts around hiv-transmission or risk of it. and everyone is free in his choice of harmreduction and safer- or unsafer sex practises ( together with the sexual-partners)
successfull art is a option , condoms are a option… but communication and access to information is a “duty”.
a clear no to any cencorship from my side.
and by the way: condom-use can be more risky than successfull art and non-infectuosity.
and as i said: don’t let “divide ed impera” interact in the communities.
Do or dont,..there is no try.
While I admire your determination to adapt to the HIV, I don’t believe unprotected sex should be advocated. First, the co-mingling of different strains of HIV can diminish the effectiveness of of pharmaceutical treatments. Secondly, the HIV negative participant in a bath house is not negotiating a quid-pro-quo relationship of sexual bonding and the adoption of a life changing disease. The HIV negative partner, like most HIV positive persons, is likely governed by an emotional intensity and not pure analytical reason. That being said, I admire your ability to fight and respect the dignity of your existence. But on this issue, your argument turns against the essential decency of your manhood.