|by Salvatore Seeley|
|HIV: The New Sexual Terrain
I was chatting online with a man who wrote in his AOL profile "HIV neg UB2." I noticed his screen name because it reminded me of a handle I might use, it was something to the affect of "PlugMyHotHole," though, to keep his identity anonymous, not exactly. If you're on America Online, you've seen some variation of "UB2" in member profiles, like "Great Shape UB2," or "Honest UB2." I even saw "I am a man UB2."
I asked Hole, "If a trick tells you he's HIV negative, will you have unprotected sex?"
Bling! no it doesn't mean that at all
Bling! then what difference does his HIV status make?
Bling! there is this weird thing... see I'm more into anonymous hook ups... guys getting together for sex rather than socializing and sometimes when u KNOW a guy is poz... well it sticks in your head
Bling! I understand
After reading HIV neg UB2, I felt a little stunga blunt reminder that HIV excludes some people. But after a mere second of soul searching I realized we all have discriminating tastes. That's life. In today's thorny sexual terrain, frankness about what one wants with whomever is going to make you feel most comfortable is sound strategy.
I asked some others with "HIV neg UB2" in their profiles if they forego condom use with other negatives. All said no, but knowing a partner is "clean," "disease free," or "safe" eases their conscience. Yet they all had exceptions to their rules, like Hole. He told me he's done it raw with a dozen or so partners in his sexual lifetime.
Bling! yeah, sometimes, after I have gotten to know them and I trust them
Bling! I hear ya
Today, AIDS Is Different
Not long ago, the sexual code among gay men was to assume every partner was HIV positive and, for that reason, always to practice safer sex. After two decades of AIDS, no such common assumptions make sense. For one thing, when it comes to sex, doing something "always" NEVER works. Ten years ago, when it was often repeated that half of the gay men in big cities were HIV positive, and an HIV infection carried a dismal prognosis, such strategies were, at the very least, prudent.
Today, AIDS in America is different. The risks and consequences are different. Our perspective is different.
A phone survey conducted in 1998 by the UCSF Center for AIDS Prevention Studies (CAPS) estimated the HIV prevalence rate of 2800 men in Los Angeles, New York, Chicago and San Francisco at an average of 17 percent (LA & SF at 20%, NY & Chicago at 14%). No other studies (that I could find) determined HIV prevalence rates much higher than 20 percent.
Recent increases of anal gonorrhea and syphilis reported among gay men have not necessarily translated into increases in HIV infections. Since 1990, there have been roughly 40,000 new HIV infections per year in the U.S. New infections solely among gay men have also remained steady over the past decade at 1 to 4 percent annually, depending on the group of men studied.
Only a fool will argue that AIDS is over or that AIDS is, with certainty, a long-term manageable disease. In 1999, more than 10,000 Americans died of AIDS, and many more had HIV medications that failed. HIV keeps those who are positive in a constant state of limbo wondering how long their current treatments will keep them healthy and if new treatments will eventually prove to give them a normal life span. Until then, it's a day, a month or a year at a time.
The Rules Have Changed
How have the dramatic shifts in the epidemic of the past five years affected our sex lives? Do we behave differently or are we just more honest about what we do?
Treatments like Protease Inhibitors that have brought viral load counts down in many to low or undetectable levels have deterred some HIV infections and even affected the risks some gay men will take with each other. One HIV negative man told me he feels more comfortable having sex with an HIV positive guy that has an undetectable viral load because at least he knows what he's getting himself into (no pun intended). He told me, "A lot of guys might think they're negative but they're not, and so haven't started treatment, and so probably have a high viral load."
If the internet is any indication (which I believe it is), then many of us appear to have moved away from unrealistic HIV prevention mantras such as "Use a condom every time," to follow self-prescribed guidelines about what we may or may not find safe and/or desirable and with whom. My buddy "PlugMyHotHole" is a good example.
The national dialogue that occurred over the past few years regarding sex without condoms, or barebacking, created a space of greater honesty about gay men's sex lives. Nowhere is that more apparent then online. The internet facilitates an unprecedented candidness in our sexual wants and boundaries: Using profile identifiers such as HIV neg or poz only, bareback, safe only, uninhibited, w/s (water sports), "chem. friendly," (sex + recreational drugs), j/o (jack off), oral, fisting, etc. we are able to inch our way closer to sexual tranquility.
Unfortunately, not everyone is quite so forthright, especially when it comes to asking and disclosing HIV status during casual sex. Perhaps this is because sex is less conducive to discussing health than to heavy breathing and squealing. Regardless, HIV remains a part of our sexual consciousness even if some of us conveniently tuck this reality away while in the clutches of horniness, passion or drugs.
For the record, I understand some of you out there are very good at safer sex. You're confident in your practices and feel secure that you will remain HIV negative until this virus is wiped out. I applaud you. For the rest of us, sex and risk are often inseparable.
To many, talking about sex in any way other than the wholesale promotion of disease prevention is reckless and irresponsible. Obviously, I disagree. Talking about sex the way people have sex is the only way to understand sex. This is the key to healthier choices.
And yet, I wonder what would happen if gay men were hit once again with a flood of AIDS deaths like that which wiped out over 300,000 of us in the 1990's alone and nearly half a million of us since the start of the epidemic? What if our treatments failed and nothing better came along? What if the obituaries were once again filled with snapshots of smiling young faces? Would that be lesson enough to scare us into using condoms every time? Or would we continue to negotiate safety depending on individual circumstance, and take our chances in the name of lust, love and quality of life?
Is sex that important, that powerful? It appears to be so.
Sal Seeley is Program Director of CAMPsafe, an HIV outreach project of CAMP Rehoboth.
LETTERS From CAMP Rehoboth, Vol. 11, No. 3, Apr. 6, 2001.