Hopefully, you have read our Piece called HIV 101 for the basics about this illness. We at GMJ buck the system and lay claim to it as a gay male disease. We do this because, yes, anyone CAN contract HIV, but overall, in the Western world, gay men do at disproportionate rates. These are facts. Control your feelings.
These rates are high enough to keep the bell ringing that education and services must be targeted toward our community first and foremost and not equally among the general population. By making these requests, we are also asking you, our brothers, to do the work to educate yourselves and practice forms of sex that reduce your risk of contracting this disease, and if you are HIV positive, work to control the virus and become undetectable so that you’re unable to infect others.
But, just as much as we have “enemies without,” we have them within. Willful ignorance and fear have created a culture of stigma and shame that is crippling our community. Laws are created that punish knowing your status, and privacy has gone out the window on the internet, a free form of communication era. We can do better. And it starts with a conversation.
Introduction:
Fear has always been known as a positive motivator. It activates our primal “fight or flight mode.” The notion has been that if we, the public, are made aware of an issue and afraid, it will garner a specific action or reaction. Fear sells even more than sex.
But, fear is more well known to paralyze and cripple an individual and sometimes a community, as it forces them into submission or to act on the goals of another party (like a deer in headlights). We don’t support fear in any shape or form because not only is it not a pleasant feeling, but it doesn’t produce the desired effect of behavioral change for the long term. That is the role of education.
Yes, fear of contracting HIV or some other sexually transmitted disease may get you to use condoms or PrEP for the short term, even for years and decades, but it will not last. You’ll start to feel forced and manipulated.
We prefer education over fear. We choose to provide evidence as a method of choice and risk factors that allow you to make the best decisions for yourself and your partners. If we’ve learned anything about HIV over the last generation, it should be that fear doesn’t work.
For example, we could do what the government and other non-profits do and add a laundry list of data and statistics to this article. Allowing you to see just how close you are to a quick death every time you have sex. We could show you graphs of how many gay males in your state contract HIV and how many of them are living with the virus but don’t know it. We could scare the holy hell out of you, but that wouldn’t be healthy for you physically, mentally or emotionally. This is a bad way of teaching you or any member of our community because there is only one number you truly care about: yours.
You’re here, reading this because you no longer want to live in fear. You want someone to finally give you an accurate and honest answer to your questions, not just a list or bullet points that don’t take in the complexities of your real life. Fear only breeds more fear, and then, we as individuals do our best to make ourselves feel safe by harming others…before they can harm us. This is how we went from assisting our brothers with HIV to hating them.
In the beginning, fear was stoked by the government and individuals alike. The fear came from straights, as GRID was a new cancer-killing off gays. The fear came from within because not only did we not know what HIV was or how it was contracted, but we didn’t even have a test to see who was infected. It could’ve been anyone, including you. Fear will forever be associated with this illness. That fear persists even now in the face of new medications and treatments because fear is where many find comfort. And what we fear, we hate and try to destroy.
So let’s first talk about how you cannot contract HIV, no matter what you heard or need to believe.
- Sharing eating utensils/drinking glasses
- Toilet seats
- Swimming pools/Saunas/Whirlpools
- Clothing
- Kissing/Saliva
- Coughs/Sneezes
- Tears
- Sweat
- Urine
- Human/bug Bites
- Shaking hands/hugging
- Living/visiting a home/office of someone with HIV
- Blood found outside of the body
- Sexual fluid on your skin
- Masturbation
- Sex toys
- Rimming
Bonus Round: Oral Sex
Oral sex is not considered to be a significant activity of infection in gay males. The tiny amount of research done regarding this act is polluted by the fact that oral sex is a standard act of foreplay, which leads to other sexual contacts such as anal sex. Also,…guys lie. So researchers can never honestly know if “he only sucked, never swallowed, and really has never done anal.”
There are some guys determined to believe that oral sex is a significant way to contract HIV. They won’t go anywhere near a dick without a condom or dental dam. No matter what they’re told, they must believe that sucking dick is going to kill them.
We joke, but this is important because guys who are still convinced of this method of HIV transmission also harbor some very outdated information about gay sex education in general. They usually do not see a doctor regularly (every 3 months) for proper STD screening or education themselves. Fear keeps them from taking charge of their lives, but we are sure they all have Internet access and are decrying every new advance as soon as the study hits their feed.
We thought a great way to approach this subject was to begin with logic. Think about this for a moment. If HIV was transmitted highly and only through oral sex, wouldn’t the number of guys with HIV be, like, really, really high? Even though you won’t believe us, here is some of the research we found:
So, why all the confusion and no one just coming out and saying “zero” risk? Yeah, we wish they would say it, too, but because of fear and a massive dose of homophobia, it ain’t gonna happen. (To be fair, scientists don’t like to say “zero chance” of anything.)
Exceptionally few governments on earth have ever had a genuinely healthy medical relationship with its gay male population. Gay male sex education isn’t taught in American schools, and in 11 states, it’s against the law!
By the way, The CDC only recently updated its website regarding oral sex, condomless sex, and the definition of UNDETECTABLE VIRAL LOAD, which we will discuss later. But first… Check this Out
CDC: There is little to no risk of getting or transmitting HIV from oral sex.
Thebody.com: The chance an HIV-negative person will get HIV from oral sex with an HIV-positive partner is extremely low.
HIV I-base: Oral sex is generally a low-risk activity. It is likely to be zero or close to zero in most circumstances.
GMFA.org: A very adult way of talking about oral sex, but it gets the point across.
YOU SHOULD NEVER HAVE ORAL SEX IF:
A. You have sores /cuts on your penis
B. You have sores/cuts in your mouth
C. You brushed your teeth within the last hour
He said he was HIV Negative. What does that mean?
We live in the digital age. As gay men, we can order sex as fast as our hetero friends get pizza. Hook-up apps make it easy; you only have to read a few (hundred) profiles. Once again, fear shows up in our lives without us knowing it. Fear of HIV, stigma, rejection, and knowing the truth make the above question a difficult one to answer. But, it could mean…
1. He is tested every 3 months regularly and is definitely HIV-free.
2. He hasn’t been tested recently, but the last time he was tested, he was HIV-negative.
3. He doesn’t know the last time he was tested, but he remembers being HIV-negative.
4. He’s never been tested for HIV and is afraid to find out.
5. He is HIV positive but doesn’t want to say so because of fear, rejection, or stigma.
You will only know if someone is truly HIV-negative if you are with them, as they receive negative test results twice over six months.
A “look-back” period is around three months as the body develops antibodies to the HIV virus. An HIV test doesn’t check for the actual virus but rather for antibodies produced to fight the infection.
This will take time to occur, in the mean time, the newly infected and those not being properly treated will have a very high viral load. Thus making them highly infectious.
Guys are infected by people who don’t know that they are HIV positive, not on medication, or do not have an undetectable viral load. (No, we aren’t going to give you the statistics on those who don’t know. It will not help you sleep any better.)
I am a top. Am I at risk for HIV?
The short answer is… maybe. It all depends on your sexual habits.
• Do you use condoms all the time?
• Do you know how to properly put on a condom?( Let our UK friends give you a lesson)
• Do you have any open sores or cuts on or around your penis?
• Are you on PrEP?
• And the most critical question: Does the person you are having sex with have HIV with a detectable viral load?
Researchers agree that tops have a significantly lower risk of contracting HIV from their receptive partner, and if condoms are used, the risk is zero. The reason there is so much confusion about this issue is that many gay men are both tops and bottoms or have switched sexual positions over time or with a particular partner. It’s almost impossible to gather information when your demographic is inconsistent or does not tell the truth. This also goes for oral sex.
I am a bottom. Am I at risk for HIV?
Once again, the answer is maybe. It will depend on your sexual habits as well.
• Do you make sure your partner has on a condom each and every time?
• Does the condom fit without being loose and does not break during intercourse?
• Are you on PrEP?
• Do you have any open sores inside of your rectum?
• Do you have any sexually transmitted diseases?
• Do you douche before anal sex?
• Does your partner have HIV with a detectable viral load?
For both the “top and bottom,” we listed the risk factors. No, we cannot tell you exactly how much you are or would be at risk, but we can say that there is some risk involved in all sex but there are ways to minimize them.
Extra Credit: Check this Out!
But he said he was on PrEP:
We discuss this medication as an option for your personal use. But, as more guys are going on PrEP, you will encounter more who say they are taking it, too. This is a judgment call only you can make. If he says he is on PrEP, this means:
1. He is on this medication, which requires three (3) check-ups yearly, which will also include tests for other sexually transmitted diseases.
2. Because he’s on PrEP, he doesn’t have HIV.
3. He wants to have condomless sex.
Now, depending on your sexual role of choice, condom, and/or PrEP usage, you have a choice to make. This information, if true, may decrease your risk factor to zero or may not change it at all. But at some point, you’ll need to start trusting yourself, your gut instincts, and other men. We’re not all liars.
He says he is HIV positive but undetectable. What does that mean?
Undetectable is the new black. In the “bad ole days” the only way we could track the health of someone with HIV was with a T-cell test. This fluctuating measure would give medical professionals and those infected an idea of how much damage the virus was doing to their overall health. But, now a so-called Viral Load Test is the gold standard as it literally tests for the amount of virus located within the blood. This is a much more sensitive and sophisticated test than the standard HIV test because it checks for the actual virus, not the antibodies.
But, of course, there are issues.
• Not everyone will reach this goal, even if they take their meds regularly.
• Not everyone is compliant and takes their meds regularly.
• Drug and alcohol usage is a significant factor in guys not being compliant.
• Mental health issues are a hurdle as well.
• Though rare, medication resistance may have developed and impaired his ability to become fully undetectable.
If he is genuinely undetectable, this means even without a condom during anal sex, he cannot infect you with HIV.
Does Undetectable mean Non-infectious?
This is a topic that many people do not want to believe, but here is science.
To be very clear: Undetectable does not mean HIV negative. It means that the treatment for HIV disease is working enough to drastically reduce the amount within the bloodstream and body to slow down, if not halt, the progression of the virus. If treatment is stopped, the virus will rebound!
It has taken almost two decades for the government and many medical professionals to come to the agreement that undetectable does equal non-infectious (#uequalsu). This means that a genuinely undetectable guy cannot transmit the HIV virus, no matter what, because he does not possess an amount significant enough in his body/fluids to do so. But I know you won’t believe us, so here are some more intelligent people who said it first. Click on the links below to read the complete reports and studies.
NAM aidsmap, one of the foremost sources of HIV information globally, strongly endorses the ‘Undetectable Equals Untransmittable’ (U=U) Consensus Statement issued by the Prevention Access Campaign.
NAM’s Executive Director, Matthew Hodson, says, “The scientific evidence is clear. Someone with undetectable levels of virus in their blood does not pose an infection risk to their sexual partners”.
“In terms of HIV prevention, if condom use is safer sex, then sex with someone who has maintained an undetectable viral load is even safer sex”.
“This understanding transforms the way that HIV is considered with enormous implications for what it now means to live with HIV and the best ways to prevent it. The preventative impact of effective HIV treatment underlines the importance of expanding access to treatment and of improving treatment uptake and adherence for all people living with HIV worldwide.”
“The PARTNER study provides good evidence that undetectable viral load might be a threshold below which sexual HIV transmission does not occur. The PARTNER study is important in that it included both gay and straight couples, that it measured risk in people who were not using condoms, and that it estimated absolute risks.”
“We are not dirty, we are not a threat, and we are not disease vectors. In fact, we are the solution. People living with HIV who achieve viral suppression and who become undetectable are the solution to the end of new HIV infections in the United States. … When we look back 20 years from now we will judge ourselves in terms of how well we responded to this opportunity.”
— Dr. Rich Wolitski, person living with HIV and acting director for the Office for HIV/AIDS and Infectious Disease Policy at the U.S. Department of Health and Human Services
{When Dr. Wolitski delivered his speech at the closing plenary of the 2016 United States Conference on AIDS (USCA), he received a standing ovation. He was referring to this year’s newest findings of HPTN 052 and the PARTNER study, which showed that people living with HIV who are undetectable are not transmitting the virus to their negative partners.}
This news is amazing for us. But it’s only as good as those who believe the science, get tested, and if POZ… gets treated and gets undetectable.
