This week, we marked National Gay Men's HIV/AIDS Awareness Day — a day of observance started in 2008 by the National Association of People With AIDS. It’s a day to recognize how this massive, enormous, incalculable epidemic has affected men who have sex with men, how it’s become ingrained into our identity, how it’s an integral part of our sex lives.
That day, the Centers for Disease Control made history by officially declaring once and for all that "undetectable = untransmittable" — that there is no risk of sexually transmitting HIV when on treatment and undetectable. It's a historic moment for HIV activism, and an opportunity to defeat stigma of those living with the virus once and for all.
I’m coming up on my five-year anniversary with HIV. In these years, I’ve met the most amazing men. I’ve dated them, and loved them, and left them. I’ve had more sex than I could possibly count. These men have been good to me.
It’s impossible for me to wrap my mind around HIV, just as it’s impossible for someone 30 years my senior to wrap his mind around the magnitude of what he’s witnessed — the loss, the erasure, the rediscovery, the fun. We waged war against a plague. That’s too big to think about, so instead I’ll think about the young man out there who’ll test positive today. He’ll have a rough couple months, but then he’ll be OK. He’ll take his meds. He’s single. He’s available. Here’s 27 reasons why you should date him.
“Last month, the global medical and scientific community at the forefront of HIV research and care came together in Paris for the ninth International AIDS Society Conference, where they announced — unequivocally — that an undetectable HIV viral load means HIV is untransmittable."
— Dr. Julio Montaner, UBC-Killam Professor of Medicine; UBC-St. Paul’s Hospital Foundation chair in an AIDS Research Editorial, August, 2017
“If you diligently take your medicine and keep your viral load to below detectable levels, you will not be dangerous to your partner. We now have the scientific data to say you may be “infected” but you are not 'infectious'."
— Anthony S. Fauci, M.D., Director, NIAID, NIH, in a video interview on July, 2017
"This is a landmark development in the response to HIV and too many people are not hearing this message and receiving its full benefit. A person living with HIV with a sustained suppressed viral load poses no risk of transmitting HIV."
— Jesse Milan, Jr., President & CEO, AIDS United, March, 2017
We’re fun! We’re available. We’re poz. We’re the guy working out next to you at the gym, the cutie in the apartment above who you sometimes pass on the stairs, the guy you see often at your favorite Thai place.
Because the message isn’t out there loud enough. That, and people have been taught by right-wing scaremongering and the public politics of AIDS that HIV is something to fear and alleged breakthroughs should be distrusted. There’s an alarming population of people who distrust medicine thanks to social and cultural factors — many gay men among them.
Medicine isn’t perfect and big pharma is real, but all the rallying, organizing, research, and billions of dollars poured into a virus that hit us suddenly and brutally have accomplished something extraordinary: we are on the cusp of an AIDS-free world.
Other problems are at play that keep this information from being shouted from the rooftops. Sex education for youth is inadequate in the United States, and info specific to young queer people is nonexistent in most high schools. We assume you’re straight, and if we educate about sex, we educate straight sex to assumed straight students, leaving queer youth out in the cold — a glaring wrong, given the fact that HIV disproportionately affects men who have sex with men. Religious fervor and sex-phobia is still killing us.
Here’s more info on the campaign. If we’re taking our meds diligently, we’re not a threat to you. That’s true regardless of condom use — if you’re undetectable, you’re unable to transmit HIV even when you play bare. That’s true regardless if we cum in your ass or in your mouth. That’s true even if there’s a little bit of blood on the tip of his dick after a rough fuck. Undetectable = untransmittable.
Look, it’s not our job to teach you the realities of modern medicine, and a smart, self-respecting gay man should do the work on his own to educate himself on what his options are if he gets HIV, and what options are available to prevent it.
But we know you might not do that. When I was HIV-negative, I didn’t do that. I didn’t want to spend a few hours cruising the web, reading dense articles about antibodies when I could be watching TV. But then I became positive, and suddenly all these terms became significant to me — my life depended on them.
Dating people different from you makes you better — in all cases. Date someone who will help you grow.
That cute dude on your hookup app sending you woofs and hole pics is poz. In all likelihood, you don’t know who around you is HIV-positive until they say so, or until you see that little “+/u” (or some variation of that) on their Grindr profile (“+/u” translates to “positive and undetectable”), or until you see them categorized as “Poz” on Scruff.
Despite this being the reality — the fact that HIV-positive gay men are everywhere, particularly if you’re the slightest bit involved in your queer community everywhere in your life — you might not grasp how many of us there are until you start looking.
Serosorting — picking sex partners that have the same HIV status as you — is obsolete in the age of U=U. Why automatically refuse so many awesome, adorable guys in your world?
This hardly needs to be said, but all this science and data, all this anti-stigma campaigning, is not a cleverly-disguised attempt to infect others or spread HIV.
Some people still believe this. There’s this narrative of the “predatory HIV-positive guy” that floats through right-wing media outlets and occasionally plants itself into the minds of gay men — gay men who may be clueless about the realities of HIV today and who are likely clueless about their own HIV statuses.
Stop believing in this lie. We’re not predators. We’re not out to infect everyone. Most of us got HIV doing the same thing you did last weekend — bar-hopping, feeling good, going home with the stud in a muscle shirt, and fucking all night.
That stud probably didn’t realize he has HIV, because you can have the virus and be transmittable for some time before a test will read positive, although newer and better tests make that window period increasingly short. Maybe he simply hasn’t gone to get tested in a few months, and he assumes he’s perfectly fine.
He’ll get the bad news when he goes in for routine tests — as every gay man should — or when he gets sick. When he does, he’ll start medication as soon as he can. If he takes his meds successfully, he’ll be undetectable. When he’s detectable, he’ll be untransmittable. And he’ll be living with HIV — not a predator, not a sex fiend, just someone who had a fun night. It’s hard to even call it a “mistake,” since it’s one every sexually active person makes at some point. No one should be demonized forever for a “mistake” they make once.
We’re getting frequent tests — it’s part of our health regimen. I do bloodwork every three months. When I do, I do a full-range test for a list of sexually transmitted infections. Most poz guys I know do this.
There are guys who assume they’re HIV-negative who don’t get STI tests often, and then there are HIV-positive guys who do. If you’re trying to avoid potential infections, who is the safer option? Serosorting is really never okay — you shouldn’t refuse anyone for their HIV status, regardless if it’s positive or negative — but the reality of HIV care produces a very different picture of an HIV-positive person than the risky, contagious, diseased person you may have envisioned.
If you’re poz, you’ve been given one major opportunity to rethink your sex — the day you learn you have HIV. HIV forces you to do this, and in the process we often find kinks we never knew we had, fantasies we never knew we wanted fulfilled.
For a period, I was transmittable. For the months before I started my medication, I could infect my partners. The doctors demanded I do many things: take a sex break, or at least inform all potential sex partners of my infectious HIV status. They told me to use condoms no matter what. The responsibility came upon me to make these choices. I had to have the talk before sex. It was hard, but I got better at it.
Those early months without meds were filled with refusal, cruelty, and hurt. It’s a hard stretch for anyone, but it teaches you to rethink sex. Sex becomes something you can play with. The end result: there are many happy, healthy, well adjusted HIV-positive guys out there who are kinky and open-minded. We automatically bring something to the sheets that our partners have to reckon with, so if you have a bizarre fetish or fantasy you want to try, bring it on.
Not every poz guy is a good communicator, but if your poz potential boyfriend is on treatment, he’s at some point had to sit in a physician’s office and tell a stranger what he’s been doing, who he’s been doing it with, how much, how many, topping, bottoming, condoms, no condoms, what substances, and so on.
HIV care is filled with communication tasks like this — dialogues between doctor and patient, patient and pharmacist. So when we find ourselves sitting in front of you and you’re looking at us with those big brown eyes over your coffee, we’ve had practice: “Just want to say this before we go any further…”
Are you a mountain climber? We can do that. Voracious reader? We can do that too. Foodie? Fuck yeah. Cinephile? Absolutely. Cross-country cyclist? We’re game.
We may not always be game for anything, but the point is that HIV isn’t an impediment. There are incredible athletes and gym rats with HIV. It’s not slowing us down, not anymore.
Not everyone is good at sex — in fact most people aren’t. A recent survey showed that the average person has 7.2 sex partners in their lifetime, a number I surpass on a good Saturday night.
Gay men are masters of sex — quick and casual, passionate and intense, friendly and fraternal. Poz guys are no better than our HIV-negative brothers in the art of fuckery, but having HIV certainly doesn’t make us lag behind.
There’s this idea that guys who are poz must also be needless sexual risk-takers — bare players, cum junkies, piggy pigs — who “did it to themselves.” We must have been having sex recklessly, or so the thinking goes; otherwise how did we get HIV?
I don’t know one person who’s used a condom every time, and it’s nearly impossible to know the sexual history of every person you fuck. It only takes one sex experience to get HIV — one slip-up, one wild night. We’re not automatic risk-takers. We’re simply real people.
Many HIV-positive guys decide to play bare after getting HIV — many, but certainly not all. Why? Because the process of getting treatment and taking care of yourself after learning your status is a crash course in current healthcare. We learn the data of risk, we’re getting frequent tests, and all this new info gives us the ability to make informed choices on what sexual risks we’re willing to take.
Pre-exposure prophylaxis, or PrEP, is the other massive development in HIV. TasP is a triumph of medical science helping those living with the virus. PrEP is a triumph of medical science preventing its spread to those who are negative.
Truvada is currently the only drug approved for PrEP, although other drugs are being tested for it. It is a once-daily pill that prevents HIV transmission, regardless if your poz sex partner is detectable or undetectable, regardless of condom use, regardless of gender. As a preventative, it’s a powerful option for serodiscordant couples (one positive, one negative) and negative guys who enjoy barrier-free (condomless) sex.
PrEP evens the playing field between poz and neg guys and eliminates the fear that has existed between us for so long — a fear that’s muddied our sex lives and ruined our relationships. PrEP has changed the dating game.
There are many gay men who are aware of their HIV-positive status and are not on medication. This past weekend in San Francisco, I met a gay man who is homeless and addicted to hard drugs. He survives through paid hookups arranged on Grindr, needle exchange programs, and selling on the street.
Guys like him contribute to the spread of HIV, but to call them predatory, dangerous, and problematic is wrong and inadequate. Don’t link HIV to other social factors that contribute to its spread. Some of the most vulnerable parts of our populace — addicts, homeless queer youth, sex workers — get demonized for HIV while they live in a culture that offers few ways for them to get help. For many, their goal is to simply survive, not infect others.
Disclosure is important, but telling someone your HIV status is useless if you’re wrong. Medication and prevention regimens like PrEP are the real ways we stop the spread. Sweeping generalizations about positive people suggesting we’re prone to drug problems and “trouble” ignore the larger socioeconomic structures at play here that punish people most in need of help. It also ignores the many healthy HIV-positive folks on treatment who are actively working to save our own.
You can’t see HIV. The imagery we have of AIDS patients from the the height of the epidemic are scarred into our collective memory. We need to see and remember them, but we also need to acknowledge that today the appearance of HIV is different. I’m not sick — I’m HIV-positive. The frightening and painful images I had seen of AIDS are not what I see when I look at myself, and they aren’t what guys I date see, and they never will be.
HIV affects the young and old and everyone in between. Queer youth have greater risk of HIV infection than their straight counterparts, particularly if they live in remote places and lack support. On the other hand, two of my greatest friends/lovers, both in their 50s, got HIV only in the last few years. They survived the worst of the plague, then caught it on a wild night out. The virus doesn’t discriminate — you shouldn’t either.
One of the most offensive things I’ve heard from a white, privileged gay man is his refusal to date black men because he’s afraid of getting HIV. Queer men of color do have higher risk of HIV infection, but the virus does not discriminate — we do. The real discrimination happens in clinics and communities, school systems and gentrification, media and job markets — institutions that keep racism alive and keep queer people of color at greater risk.
This was the first thing the doctor told me: “You’re going to have to start watching what you eat.” She told me that an active, healthy lifestyle was better for my long term health. It’s an obvious fact, but it suddenly had new importance. Overnight, my long term health became something I had to take care of.
Take it from me: some HIV-positive guys are assholes. Some aren’t. The great thing is you don’t have to worry about his HIV. If he’s treating it, taking care of it, and including you as necessary in his health, you don’t need to spend much time fussing over his meds, his health, his levels, and so on. He’s got this. His kindness, his understanding, his gentleness, his ability to apologize, his willingness to talk — these are the things you need to look for. Find someone who does these things well, and you’ll be a lucky man, and that’s true regardless of his HIV status.
There are many sex-phobic, slut-shaming people who think positive guys can’t commit to anyone — because their sluttiness got them HIV in the first place. There are many things wrong with this argument. Being a proud slut — a free-living sexual aficionado — doesn’t impede your ability to commit to anyone; you simply need to define what “commitment” means with those you love. And again, HIV isn’t a virus that only affects the sexually promiscuous. It affects everyone. Don’t make assumptions about him based on his status.
The mechanics of sex do make bottoms more likely to get HIV than tops, but don’t assume he’s a bottom just because he has HIV. There are many poz tops in the world. I got fucked by one yesterday.
Don’t assume he plays bare. Don’t assume he only likes it kinky, or he only likes it rough, or he only plays in groups. Yes, sex changes for poz guys. But that doesn’t mean that we like a completely different kind of sex on the other side. If anything, it just makes us more open to new ways of enjoying it.
It happens suddenly. You see him in a friend’s photo on Facebook and check out his profile. He looks really cute. But you decide not to add him — you don’t want to look like a stalker — but then a few nights later you walk into your friend’s place and there he is. You act casual, but you’re burning beside him.
Then you see him in the gym. He says hi. Somehow numbers get exchanged, and suddenly you’re texting casually about coming over, cuddling, and sending winky faces. When he comes over, the first thing he says is that he’s HIV-positive and undetectable. He wants to make sure that’s okay before you go any further.
That’s when you kiss him.
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