LETTERS From CAMP Rehoboth |
CAMPsafe Summer 2000: A Question of HIV Re-Infection |
by Sal Seeley |
If you're lucky enough to be down here on Friday's, you might just get a glimpse of me making my condom runs! I get a chance to visit a lot of the bars, restaurants and guesthouses that gay men frequent. While on one of my runs last week, I happened to run into someone who saw my box of condoms. We started chatting about sex (what else is new between gay men) and got into the discussion of HIV re-infection among positive couples. The information I gave him surprised him. There seems to be a big belief among gay men who are positive that it's okay to have condomless sex with another positive person. Most information and advice about safer sex for people with HIV is all about one passing HIV on to other peopleeven if it doesn't say it straight out. There has been little information to help positive men make decisions about using condoms with other positive men. This is partly because not much is known for sure about the possible health implications of doing this. Research has shown, however, that positive men who have sex without condoms with a large number of partners go on to get AIDS faster than those who never have sex without a condom. Two main reasons have been put forward to explain why this might be the case: re-infection with different strains of HIV, and infection with other STDs. Either, neither, or both of these causes might be true. The following looks at these two possibilities. We know that there are at least two different types of HIV (HIV-1 and HIV-2). Most, if not all, HIV positive gay men in the USA probably have HIV-1, but not HIV-2. HIV continuously replicates itself in parts of the body. This results in small changes to the virus itself. This means that each person with HIV will have their own set or strain of viruses. If a positive man is exposed to another strain of viruses he may become infected with this strain in addition to the one he already has. There are three possible dangers if positive men get other strains of HIV: Some strains may be more virulent than others. A more aggressive strain could damage your immune system faster. A positive person's immune system may strike a balance with their own strain of HIV. Getting another strain of HIV may upset this balance and cause the onset of illness. People taking anti-HIV drugs are often taking a combination of drugs and having to stick to a complicated drug regime. They may develop strains of HIV that over time become resistant to these drugs and the combinations may be changed. Someone with HIV could possibly be re-infected with multiple drug-resistant strains so that some anti-HIV drugs they receive in the future will be ineffective. Drug-resisting strains may also be more damaging. Even if you think you got HIV from your partner, this does not mean you have identical strains of HIV, since these may develop over time in each person's body. You could therefore pass on to each other the different strains of HIV in exactly the same ways people get HIV in the first place, most easily by shagging without a condom. It is important to say that advice about re-infection with HIV is at present speculative. No one can say for sure yet whether re-infection actually takes place and if it does, whether it is harmful. You'll have to weigh advice based on these theories against other factors, such as how important using or not using condoms is to both of you and the likelihood of passing other STDs to each other. If either, or both, of you is having sex with other men who do not have HIV, you can obviously pass on HIV if you 'top' or 'bottom' without a condom. If you are having sex with other men you know are positive, bear in mind the points above. Some positive men may think, "I've got HIV so other STD's don't matter as much now" or "I've got HIV so I can sleep with other men who are HIV without using a condom." This is not true. It's not clear yet if getting re-infected with HIV damages your health. But we know for sure that other STD's also increase your chances of getting AIDS if you already have HIV. There are different types of Herpes, Hepatitis B, Kaposi's Sarcoma (type of cancer) that affect men who are HIV+ in a more life-threatening way than those who aren't positive. Talking with other positive men might help, as will talking with a doctor who knows about HIV. A counselor can help you discuss the pros and cons in the context of your relationship. As with all other decisions in your relationship, whether or not to use condoms if you have sex is for the two of you to decide, no one else. I just ask you to please be informed about your health and the risks that you might take. If you would like more information on re-infection among gay men, check out these websites: www.dircon.co.uk/powerhouse/ smgays/rough/rs15.htlm or www.cdc.gov or contact these agencies: CAMPsafe 302-277-5620, SCAC 302-644-1090, or P.L.ACTIVE 302-644-4791. News from CAMPsafe: I want to thank all of the volunteers and especially Cliff and Chris who made the last Tea-Dance a very special event. Our next Tea is August 20 at Cloud 9. The theme for this dance will bring alive those childhood fantasies; Cowboys and Indians. This month is a busy month for CAMPsafe. We will be at the Mr. Double L Leather contest, Miss Gay Pride, Drag Volleyball, the P.L.Active Swim for Life, and SUNDANCE. As always, help is needed. Please call me at 302-227-5620 to help with these events. |
LETTERS From CAMP Rehoboth, Vol. 10, No. 11, Aug. 11, 2000. |