trevorade: Refusing to Have Sex With HIV-Positive People
Thanks to LifeLube for this story.
I was having drinks with a friend of mine — we’ll call him Patrick here — this weekend when the subject of having sex with HIV-positive men came up. “Oh, I would never have sex with an HIV-positive guy,” he casually remarked — as if such a thing were already obvious. I was shocked not just by Patrick’s statement, but also by the categorical bravado in his delivery. To have sex with HIV-positive men, as he went on to explain, was to expose himself to unnecessary risk of infection. I’ve been replaying this conversation again and again in my head. How could he be so outrageously calculating in his cooIly expressed exclusionary strategy? Today I want to spend a few moments reflecting on these kinds of statements, because I think many people would uncritically read them as legitimate prevention strategies. I will argue here, however, that in reality that these kinds of strategies that are totally bankrupt in terms of actual risk reduction. Moreover, what I think this kind of statement actually tends to do is not actually promote any real reduction in risk, but rather to reinforce and reproduce harmful stigma against HIV-positive people.
Before we get into a discussion of the ethics of “serosorting” — the practice of choosing to engage in sex with only sero-concordant men — I think we should bracket my friend’s comments as existing only at the very periphery of this term’s broad meaning. While taken at face value, it does indeed seem that my friend is practicing serosorting. But correct me if I’m wrong here, but it seems to me that serosorting was more intended to describe men who were seeking to minimize risk of transmission while engaging in sex without condoms. For my friend, this wasn’t the goal of his strategy — condom use was still part of his risk reduction strategy with other HIV-negative men. This is a very important distinction. What I’m going to be talking about here is men who report consistent condom use, but who continue to latch onto serosorting discourses that discourage serodiscordant sexual practices.
Because of these important differences, I want to suggest that Patrick’s comments cannot possibly be said to be purely a method of risk reduction. To explain why I think this is so, we need to evaluate whether or not there is actually any risk worth avoiding by excluding HIV-positive men from your pool of eligible partners. Thus, to help illustrate this, let’s attempt to assess the risk of transmission between a known HIV-positive partner and an HIV-negative partner when condoms are used. There is no data to suggest that many HIV infections occur in these contexts, absent condom failure — rates of which are outrageously low (between 0.4% and 2.3%, depending on who you ask). If we take a generous account, let’s presume that rate is 2%. In a single incidence, then, the risk of potential exposure is 1:50.
But exposure does not equal transmission. You can be exposed to the virus and not actually seroconvert. Thus, we need to add into this equation the risk of transmission per sexual encounter in the absence of condoms,which vary depending on a number of factors: whether the poz guy is insertive or receptive, his viral load, genital ulcerations, etc. Let’s say the poz guy is doing the fucking, for example’s sake. The generic risk in this scenario for a receptive HIV-negative man is 1:122 — that is, statistically speaking, there is a 1 in 122 risk of seroconversion after getting fucked once without a condom by an HIV-positive man (see here for a summary of this data). If we multiply these two risks together, we get something like a 1 in 6000 probability — give or take. According to risks of death statistics, this puts a person’s risk of seroconversion in this abstract, theoretical scenario somewhere between their risk of death by electrocution (1:5000) and their risk of death by drowning (1:8942). Obviously, this is a gross use of statistics — but I think it helps illustrate the point: the risk of transmission between serodiscordant couples in one sexual encounter when using condoms is EXTREMELY low. Just about negligible. And this example likely grossly overestimates the risk, due to the fact that condom failure is not the same as sex without condoms. Many people will quickly realize the condom has broken, leading to a much smaller window of possibility for exposure. Thus, the 2% exposure rate included in this example is likely much, much smaller in practice.
Thank you for writing this article. I am up front about my status prior to a hook up and am turned down often enough, even though prior to disclosure I was very clear that I only played with condoms (non-negotiable). Many guys with HIV, HepC and other STI’s don’t even know they have them. Asking and making decisions based on the answer doesn’t make sense to me. I’ve lived with HIV for 15 years now without transmitting it. I appreciate hearing someone else articulate the argument I often have to make for myself.
THere have been s lot great points raised here, Back in the late 80′s I became a volunteer with THe Aid’s Council Of SA and became a carer for Hiv positive poeple, the benefit of doing this voluteerr work was to become educated and to give back something to my community and confront my fears that I had at the time.
I have always practiced safe sex as a way to protect both myself and my sexual partners. Condoms do break, come off in the throws of passion, so I want to protect future partners until I have been tested.
Would I have sex with a HIV Positive guy, the answer is yes, hopefully he would understand my concerns I have and we would do the best we can to play safe. just because a person is HIv positive does not suddenly make them less of human being, that they no longer matter, perhaps these are the things that disappoint me the most how others treat HIv people. they are still capable of being great friends, good lovers and should not be denied the same desires or needs we look for in life just because of their HIV status.
I think education is the key and confronting your own fears, the only way to remain 100 percent HIV free is not to have sex with another person which would be a very unforfilled live in my opinion.
I think Hiv Negative guys really need to look at life through the eyes of A HIV positive person and try and gain a greater insight into what they go through on a daily basis, a person’s hiv status does not define them as human being or make them less of a human being, they are still the same person they were it’s only other people’s perception of ignorance and fear should I say that stops them from seeing the beautiful person within.
I’ve had condoms fail on me more than 2% of the time. All of my friends report condom breakage way more frequently than 1 in 50 times they operate a condom. If someone doesn’t want to have sex with a HIV positive man, don’t “educate” him to justify your own conception of statistics. You can’t logically quantify your own life, and to throw around numbers and demand that people recognize your opinion as one which is only received after your eyes have been opened, is ignorant. Not having sex with a HIV positive man isn’t only about not becoming HIV positive. It’s obvious that sex with people who say they’re “negative” is a lot more sloppy than sex with someone who knows they’re positive and you take al the precautions. I don’t want to argue that fact. It might actually be less statistically dangerous to have sex with HIV positive men just like you are less likely to crash your car when you’re driving vs when you’re playing a car driving video game because you know it’s real. The fact is that people exist an array of emotional states changing throughout their lives, moment by moment in an infinite fractal we call the human experience. We do most things without consulting some hyper link of statistics so we can risk assess by numbers. It may be more likely that a person will drown than die dong activity XYZ, but to assume that “people” apply to statistics like some homogenous gel shows that most people don’t understand what statistics represent. The fact is that when you do an activity there is not moment where you stop and roll the dice and wait for an outcome. If you are going to get HIV you will and if you won’t, you won’t. There is no magical force which is embodied by these statistics which prevents infection or promotes it. A person doesn’t get infected because in his or her specific instance their epithelial lining was untorn, or most of the wbc in the square centimeter of their colon where semen happened to land were in a state of cellular differentiation where the receptor for endocytosis of the HIV virus wasn’t possible. The fact is that our circumstances, our decisions lead to definite outcomes and the ILLUSION of chance is an emergent property of the process of creating a mean between a series of data. NOW…to tie this back to actually fucking a HIV+ man…if your gut says don’t do it, then don’t do it. If someone insuinates that you’re making HIV+ people feel inhuman by not fucking them…well then either stop telling HIV+people that they’re nto human….seriously I doubt anyone ever said, “sorry, I can’t fuck you, you’re not human anymore” These are inferred emotions. These emotions, these conclusions, these connotations are nuance between the lines which do not apply homogenously to everyone who declines having sex with a HIV+ person. Once you have cancer, flying monkey upside down missing left toe syndrome, HIV, whatever…..you need to realize that you’re not entitled to a fuck just like fat people, young people, people w/ acne, people who have boring jobs, people who are superficial, any other class of people aren’t entitled to a fuck. If I won’t fuck you because you’re a smoker, I’m sure not going to change my mind because turning you down makes you feel inhuman. There are pricks out there who objectify people whith illnesses…I’m not really concerned with them. There are pricks out that that will hurt people emotionally just to make their self feel better. I’m talking about declining having sex with a HIV+ person and still recognizing that they’re the same as you…you just would really prefer not to have sex with them. Move on, it’s a preference. Don’t manipulate people with statistics.
A sizeable number of people with HIV do not realize they have it (the figure I usually see is 1/3 of those infected). That goes for many other STDs as well, such as herpes. The number of people who know their status but won’t be honest with you about it is impossible to estimate, but my experience suggests it’s not small either. Serosorting, then, only protects you from the people who know they have HIV and have enough courage of character to disclose it to you. How safe is this actually making you? It’s as though people actually prefer situations in which they can’t be sure of what their risks actually are to those in which they do. What sort of sense does that make?
I wish guys would wake up and realize that this knee-jerk attitude against having relationships (and I said relationships, not just sex) with those with HIV just encourages men to lie about it, which does not make anyone any safer. There is a definite social stigma attached to people with STDs that goes far, far beyond the actual risks they pose, and it’s not helping the public health situation one little bit. All it’s doing is scaring people into hiding, lying, and avoiding treatment.
Gay men just do not want to face the fact that having sex means taking risks. This is not to say that you shouldn’t want to minimize them-any sane person does. But serosorting doesn’t do that. Putting a “D/D free” line in your personals ad protects you from STDs the same way the rhythm method protects you from getting pregnant. You can say you won’t screw someone with HIV all you want, but if you’ve had sex, chances are, you’ve already done so. We should *all* be assuming that *everyone* we have sex with has something. This is why we wear protection. If you won’t have sex with an HIV+ guy using protection because you’re afraid it will fail, then why are you having sex at all? Do you really think it will be safer with the next guy just because he didn’t tell you he had it?
Please. The chances of dying while skydiving are approximately 1 out of 100,000. Great, so lets all go skydiving! Wait a minute, I don’t feel the need to skydive, and there are plenty of other activities for me to do, so why expose myself to an unnecessary risk, however small. Yes, the risks of contracting HIV are low, but why expose myself to an unnecessary risk. No thank you.
don’t worry about the ones that tell you better worry about the ones that don’t tell you there status
Quite frankly, I don’t care if the risk is 1:1,000,000. It’s not worth risking my life. Sorry. Oh, and yes I always use a condom. The only exception is with my current partner, and that’s because we both went and got tested on the same day, and tested negative for everything. Before that, I was getting tested once every 3 months, just to be safe. No, I would not lie about my status, because that could be potentially endangering the life of someone else. So take your statistics and blow ‘em at someone who doesn’t mind putting their life at risk.
And for the record, I’ve met quite a few poz men, and they have all been wonderful people. There’s a couple that I love like brothers and sisters and would do anything for.
A slippery slope to travel because if someone said they were undetectable for ten years,Does that make them safer than someone who doesn’t test regularly. Is the chance of getting cancer and dying greater than it is for HIV nowadays. Is the honesty of the person more powerful in saying,I have HIV and I am taking meds,btetter than the person who says I have HIV but I am not taking meds.Who is safer one who has HIV and doesn’t tell or one who has HIV and says so…..Have you ever heard of a coin toss? Reality is a coin toss.
IT’S AN INDIVIDUALS CHOICE TO SLEEP WITH POZ OR NEG. NOT UP TO THE POZ MAN ITS UP TO WHO HE IS TRYING TO SLEEP WITH. iF A NEG GUY DOES NOT WANT TO SLEEP WITH A POZ MAN. NO PUSHING .ITS JUST NO.
SO… I am new to all this, I met this guy who is very up front and told me he is poz, we haven’t hooked up yet. Being new all I really want is to be close and maybe to oral. If we did anything else I would be top and use a condom… so am I safe??? he says he is not detectable, what does that mean/? Sorry for the maybe dumb questions
This is my question.Can one who is not not HIV positive have sex unprotected sex with one who is already infected with HIV just one time and would not infected?
NEVER TAKE A WORD OF SOMEONE. PEOPLE, ESP MEN, WILL DO WHAT IT TAKES TO GET SOME ACTION. (NOT ALL BUT ALOT, WOULD)
SO TO YOU WITH GOOD ETHICS AND PROTECTIVE PRACTICES, PROPS TO YOU, I HAVE TALKED TO MANY, MANY, MEN ON ALL KINDS OF CHATS, WHO SAY NEG OR SWEAR THEY ARE AND THEN TELL ME THE TRUTH AFTER I “WEAR THEM DOWN” WITH SOME REVERSE PSYCHOLOGY, ITS VERY SAD….
NEVER TRUST ANYONE YOU DONT KNOW, OR EVEN THOSE YOU DO….
SOME GET ANGRY THAT THEY WERE LIED TO AND WANT TO “GIVE BACK”