Over the past months, media has swirled around former child star Danny Pintauro’s open discussion of his HIV status. Since first publicly disclosing to Oprah Winfrey on Where Are They Now? that he has been living with HIV for 12 years, his story has been covered on The View, US Weekly, People magazine, and just about every online media outlet you can name. As is often the case with highly stigmatized topics such as HIV, many of the messages put into circulation are either incorrect or highly sensationalized in order to increase hype.
The media storm around Pintauro has unfortunately revived some old, inaccurate HIV messaging that is not rooted in evidence and foments unnecessary fear within our communities. Let’s look closer at three of the more problematic messages currently circulating in the media:
Beware the blow job?
Pintauro has said that he got HIV by performing oral sex without a condom. Since then, he has shared extensive details about his condom use practices to explain why he believes that he did not get HIV through anal sex. As such, some media outlets are warning gay men about the dangers of oral sex, leaving many HIV prevention activists, including myself, concerned that our community will be unnecessarily subjected to fear and shame around blow jobs with no real benefit. So what is the risk of getting HIV by performing oral sex?
In 2014, the Centers for Disease Control and Prevention conducted a systematic review of existing research to estimate the per act risk of getting HIV through a range of sexual behaviors, including oral sex. While the CDC opted not to give a numerical estimate, they concluded that the risk of getting HIV from performing oral sex is low, citing a 10-year Spanish study of heterosexual couples with opposite HIV statuses where no new infections occurred after nearly 9,000 instances of giving head. This is much, much lower than risks associated with anal or vaginal sex; by comparison, the CDC estimated that bottoming without a condom carried a transmission risk of 138 per 10,000 exposures.
This does not mean that what Pintauro says is impossible. It is with just the right rare mix of circumstances. But based on the best information we have, getting HIV through oral sex is a highly unlikely outcome. However, if his story takes away from your joy of performing fellatio, or if the fact that we can’t say the risk is zero makes you feel nervous, PrEP and/or condoms are absolutely an option to add peace of mind. For many of us, however, condomless blow jobs are already a very logical safer sex activity that’s approved by medical professionals.
HIV-positive people are never able to have sex without condoms, no matter what
Also on The View, Raven-Symoné (inappropriately) asked Pintauro if he uses condoms when having sex with his husband. When he indicated that they don’t always use them because Pintauro is on medication and has an undetectable viral load, Candace Cameron Bure read a quote from an unnamed source saying that even on medications, an HIV-positive person is not keeping their partner 100 percent safe unless they are using condoms.
So is that true? Are people living with HIV never able to have sex without condoms?
In the two most definitive studies we have on the topic, HPTN 052 and the PARTNER study, there have been zero documented cases of someone passing HIV on sexually while their viral load was “undetectable.” In 2011, the groundbreaking study HPTN 052 found a 96 percent reduction in the risk of passing along the virus to an HIV-negative partner when the HIV-positive partner was undetectable. Earlier this year, the HPTN 052 team revised their findings to say that there was no evidence that an undetectable partner had transmitted HIV in the study. The PARTNER study in Europe reported last year that in 16,400 cases of anal sex between gay men of opposite HIV statuses, there have been no new infections when the HIV-positive partner is undetectable.
All of this means that being undetectable is one of the best tools we have to stop HIV transmission, with or without the use of condoms. In fact, combined with PrEP for HIV-negative individuals, these findings are giving hope to a number of heterosexual couples who hope to toss out the condoms and become pregnant even when one of the partners is HIV-positive.
Kinky sex and BDSM activities are unhealthy and eventually lead to drugs and HIV
Pintauro linked his exploration of BDSM activities to trying meth for the first time. In other conversations, he has tied his meth use in various ways to his eventual HIV infection. This part of Pintauro’s narrative is being used by critics to revive old assertions that BDSM and kinky sex are inherently unhealthy.
Although more research needs to be done, a growing body of literature is debunking the notion that BDSM practitioners are somehow unhealthier than other members of society. A 2013 study made waves online when it found that individuals surveyed from the BDSM community in the Netherlands scored higher on five key measures of psychological wellness compared to a control group. This is not to say that there aren’t individuals practicing BDSM who have higher psychological needs; however, there is little to suggest that, as a group, participants in BDSM are any more at risk of psychological disorders than those who practice only vanilla sex.
According to Christian Grov, associate professor in the CUNY School of Public Health, “BDSM and kink are part of the continuum of sexual behavior and are not inherently bad for an individual, nor is an individual who engaged in BDSM or kink inherently risky or even at risk.” Grov has been doing research on gay men’s sexual behavior for over a decade.
Researchers have noted that among gay and bisexual men there is some sort of association between so-called “extreme” sexual activities and meth use, but it’s unclear what causes what. Does kinkier sex lead one to try meth, as Pintauro believes it did for him? Or is it that someone who is open to being experimental with sex may already be a bit more likely to experiment with a drug that is so linked to sex, such as meth?
“What is clear is that meth reduces inhibitions,” continued Grov. “People may try things that they wouldn’t normally do if they were sober. Some people might think of those behaviors as kinkier, or to fall within the BDSM spectrum, but that doesn’t mean a person who uses meth and engages in more extreme behavior is all of a sudden part of the vibrant BDSM and kink community. In fact, the motto for many BDSM social groups is ‘safe, sane, and sensual.’”
With so much misinformation about sex and HIV impacting our communities, moving forward, we all need to play our part in stopping the transmission of inaccurate and sensationalist information about HIV and those of us living with the virus. And if he continues to speak publicly about his personal experience, Pintauro will need to make close partnerships with a team of experts in HIV advocacy to ensure that he is not inadvertently contributing to oppressive social scripts that exist around HIV infection and prevention.
But while Pintauro may currently lack sophistication in discussing many of the topics that he is being interviewed about, he is not the only one with a major responsibility to do better. We need for the members of the media to more responsibly cover topics related to HIV, check for accuracy, focus more on the resiliency and humanity of people living with HIV, and spend less time obsessing about how we got the virus and the darkness and tragedy in our stories.
And, finally, all of us have a responsibility to look at the ways in which we perpetuate unnecessary messages of fear and shame around gay men and sex. With the fantastic new options we have for HIV prevention, including PrEP for HIV-negative individuals and antiretroviral treatment for HIV- positive individuals, it’s time for us to finally focus on solutions to the ongoing HIV crisis and quit playing the fear, blame, and shame game.
Jeremiah Johnson is the HIV Prevention Research & Policy Coordinator for the New York-based Treatment Action Group.
Read about Danny's coming out, shaming on The View, and thoughts on Charlie Sheen here.