COMMENT: EXPECT A MAN TO TELL YOU THAT HE IS HIV POSITIVE? YOU ARE CRAZY

Health, News by Paul Jeffrey on August 12, 2009 at 6:19 am

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Apparently, the sexual health of the gay community is entirely the responsibility of those relatively few men who know that they are HIV+. Only these people can be “guilty” of infecting their “victim”. Even the law, as it stands in the UK currently, says that you are not culpable so long as you remain ignorant about your own status. It is only an HIV issue; other infections don’t figure.

“If he’s HIV+, it’s his duty to tell me before we have sex. I shouldn’t need to ask”. Perhaps so, but your moral values will not protect you. Besides, if you are having unprotected sex with someone and not broaching the subject yourself, your actions imply that it is not an issue for you. It may be taken as an indication either that you are HIV+, or that you don’t care whether you are or not. Given the hideous reactions some HIV+ men have experienced as a result of revealing their status, and the subsequent unauthorised spreading of that knowledge to everyone they know, it is not surprising that many will be reluctant to volunteer the information. And if you do ask? You are expecting a man to reveal confidential medical information when you can’t rely on him to tell you his real age. For goodness sake, some men will even tell you during sex that they are straight! Perhaps none of these things is really your business.

The medical literature suggests that a significant proportion of onward infections originate from men who believe themselves to be HIV negative. Recent research found that more than 40% of gay men in five UK cities who tested positive were unaware, and 62.3% of those believed themselves to be negative, implying that around 25% of HIV+ men think they are negative. Under the illusion that they are protecting themselves, some of these men will insist on having sex only with HIV negative people. “Are you clean? Good, then we don’t need to use protection”. Coupled with emerging evidence that most of those on effective antiviral therapy might be non-infectious or at least very low risk, limiting your sexual partners to those who say they are negative makes no sense at all.

So if you are HIV negative and you want to have unprotected sex with a stranger, you’ll have to ask him what his status is. And you had better hope that he tells you he is positive, because that is the only answer you can believe. If you place the responsibility for your health in the hands of a person who wants sex, doesn’t know you, may never see you again, and clearly cares nothing for your welfare, you are an idiot. Use a condom or accept the consequences.

Paul Jeffrey

Fisher M. et al. HIV transmission amongst men who have sex with men: association with antiretroviral therapy, infection stage, viraemia and STDs in a longitudinal phylogenetic study. Sixteenth Conference on Retroviruses and Opportunistic Infections, abstract, 2009.

Williamson, LM et al. Sexual risk behaviour and knowledge of HIV status among community samples of gay men in the UK. AIDS 22(9): 1063-1070, 2008.

Vernazza P et al. Les personnes séropositives ne souffrant d’aucune autre MST et suivant un traitment antirétroviral efficace ne transmettent pas le VIH par voie sexuelle. Bulletin des médecins suisses 89 (5), 2008.

The views expressed are not necessarily those of HOMOVISION.TV

Tags: AIDS, business, gay, gays, health, HIV, People, sex, therapy, volunteers

Sergio Repka

Having re-read the whole thread, I could not find a single instance of anybody condoning lying; lying was presented as a fact of life, granted, because it is (not only in this area), and because the focus of the original article (as I understood it) was on the HIV- person's side of the equation, and what would be the wisest approach towards trying to remain HIV-. The moral / social duties of the HIV+ person were not looked into not because they were considered negligible, but because the article wanted to stress that, from the point of view of remaining HIV-, such duties unfortunately cannot always be relied on.

Nothing of which makes deliberately lying about one's HIV status in order to obtain bareback sex - or with actual harmful intent, as has been the case in at least one situation I know of - any less condemnable. (And here we come into a potential subject for serious discussion: what are the laws we have in this respect, do they work and how can they be made at the same time fairer and more enforceable; but I don't have the technical expertise to start such a discussion. The suggestion is here.)

However, apart from actual rape, I can't think of any situations where a HIV- person would be powerless to refuse unprotected sex. Lies from selfish pleasure-seekers or people with hidden agendas may be accepted as truth for various complicated emotional reasons (without going into the not infrequent scenario of willingly self-imposed impaired judgement), and one should definitely sympathise with the person who was misled into an unfortunate decision when that is the case, but at the end of the day a decision was made to go ahead and face the risk.

This is not about "blaming the victim", but about reminding people to be alert at all times. Apologies if I sound a bit harsh here - I am thinking of my own repeated past foolishness, from which I happen to have escaped unscathed. Too many people I know and love haven't - and, almost down to a person, they are quick to describe themselves as "stupid" for going ahead unprotected.

Perhaps the problem is that there are several issues being discussed on this thread, each of which would require separate analysis. But we can all maybe agree on a few points: 1, people do have social / moral responsibilities to each other and to society; 2, unfortunately, some people do not care for those responsibilities; 3, because of that, the safest approach is to assume everybody (including you, if you haven't been tested recently) is positive; 4, having said that, not everybody is malicious or selfish, but a lot of people are scared of the subject, and therefore a lot of contagion takes place unawares and without guile; 5, this brings us back to 3.

Paul Shetler

i agree that - because of the fact that so many guys choose to lie about their status - "safe sex" every time you have sex is probably the only viable alternative if one wants to avoid any risk. i do assume that anyone i have sex with is positive and is very likely lying if they say otherwise (after all, only 20% of gay men who are positive will tell their sex partners that, preferring to expose them to a deadly virus than go without unprotected sex).

so i'm not arguing about the appropriate action given the lack of any moral compass amongst most gay men who are positive.

what i'm pissed off about is the language that explicitly condones that deadly deceit and the weird right-wing ideology behind it: the one that states:

1/ that we have no obligation to each other ("no such thing as society")

2/ that morality is so relative as not to exist (but nobody of course actually lives their lives that way, suspending any judgement about wrongs done to them - if you really think otherwise let's conduct an experiment where your flat is robbed)

3/ that it's perfectly ok to lie about HIV status (although i doubt the person saying that would be so sanguine about any other blatant lie that could affect his well-beihg or health)

4/ and that in true right-wing fashion attempts to implicate the victim in their own victimisation

yes unfortunately we all need to treat each other as liars who wouldn't care if our partners died just as long as we got to cum. but that's hardly something to celebrate. and it's vicious to attempt to blame victims of other people's deadly lies as if they somehow bore responsibility for believing what they are told.

if i sound angry it is because i am.

i know people who have lied about their status and infected others (i think you know at least two of them two, one of whom has infected a good friend of yours, sergio). i also know and love someone who bears no responsibility whatsoever for what happened to him and i deeply resent any implication to the contrary.

Sergio Repka

First of all, I believe it was Margaret Thatcher who said there was no such thing as society. I'd have to buy a wig if I wanted to pull that off, not to mention falsies. I think this is beginning to get a bit ad hominem, which makes no sense, and also I'd like to make clear I have been speaking for myself only - Paul will opine if and when he wishes.

Back to the argument. Of course there are bastards who knowingly choose to pass on infection, just as there are bastards who commit all kinds of other criminal activities. (If I'm not mistaken, there are laws against knowingly infecting others.) There are also, as has been pointed out, numerous people out there who simply don't know their status, or genuinely, albeit mistakenly, believe they are negative. These are people who one day will find out they are positive themselves and might then genuinely wonder who the bastard was that infected them, not knowing that that happened ages before, that the person who did it may have done it unawares, and that they themselves have likely passed it on already - again, unawares. This is of course a very different situation to maliciously choosing to pass it on, and there is nothing in what I said that condones such behaviour. Or, for that matter, that suggests I don't believe in society.

In any case, the whole spectrum of contagion situations has one thing in common: it can most efficiently be avoided if all parties involved keep to safe sex practices. If the HIV negative person refuses to go bareback, in most cases (save for breakage and the like, of course) this will be enough to protect him from the effects of possible malice. Or genuine ignorance. Or a million other triggers of silence, such as shame, embarrassment, you name it. The moral issues, when they apply, apply on top of this.

Where individual responsibility does come in, however, is that, indeed, it can help reduce the individual tragedies, and this in turn should do something towards diminishing the collective tragedy. It can all work together.

Paul Shetler

i fully agree with gary - at the end of the day, it's the HIV+ man who can choose to pass his virus on. and it's not only the people he chooses to infect who have to live with the resulting infection; society at large has to pay the price as well in the form of increased medical costs and lowered sense of solidarity.

that is where the author's and sergio's right-wing libertarian argument falls apart: HIV and AIDS are not purely and simply individual tragedies that could be regulated according to principles of contract law and some mystifications about "individual responsibility." there is a social cost that's incurred as well, and it goes well beyond the purely monetary.

why should society (yes, paul and sergio: there is such a thing, and it's for that reason that we pay for things like HIV and AIDS research) assume a neutral stance between some bastard who chooses to knowingly pass on an infection (according to http://www.discodamaged.com/2009/08/hiv-detecto... only 20% of HIV+ men tell the truth about their infection before sex), which everyone must pay for and the poor schmuck who believes the lies that bastard says to get sex? the moral compass must distinguish between someone who knowingly chooses to infect others just to cum, and the people that liar deceives with his lies.

refusing to recognise that distinction is simply vicious.

Sergio Repka

The problem with any approach that lays more responsibility on either side of the equation is that, by extension, it will be letting the other side off - and, moral duties notwithstanding, people do lie, omit or fail to bring the subject up for a variety of reasons; and I, for one, don't really buy the idea that it is somewhat more excusable for a HIV-negative person not to "do his homework" because he might be afraid of losing the shag - agreed that lying and deceiving, when that is the case, is much nastier than just being an idiot, but that doesn't make me particularly sympathetic to carelessness. (I've had some experience of that in the past, and it was only sheer luck - and the occasional conscientious HIV+ person - that kept me from experiencing the consequences.)

Which is why I believe that any pressure to be sensible should be applied on the positive and the negative equally, without - for the purposes of awareness - singling the positive out for a bigger share of the responsibility. Being tough on shared responsibility is also more in keeping with the principle of innocent until proved guilty.

Gary L

Even where the partner who believes himself to be HIV- indicates to the HIV+ partner that he is willing to take a risk, it is STILL down to the HIV+ partner to exercise control and "due diligence" because it is he who is holding the loaded gun! It is a question or moral responsibility, and it is a responsibility that can't be divided equally down the middle here because the loaded gun is in the hands of the HIV+ partner. Regardless of the consequences, the positive man has a social duty to keep his virus contained.

The problem, as I said in my last posting, are the safe sex ads today which long ago abandoned "safe sex" as the rule and now only ever refer to "safer sex". This has given the green light for many gay men - poz and neg alike - who were looking for even the slightest permission to abandon condoms in the misguided belief that, like the HIV campaigns outrageously suggested, they could "Pull Out Like Porn Stars", "Cum Outside" and "Enjoy Fucking Without Condoms". Indeed, if you trace the upward trajectory of barebacking in recent years, you will see it correlates directly to the introduction of "safer sex" as a one-size-fits-all HIV message.

Clearly, those charities who foisted the safer sex message onto a generation of vulnerable and naive gay men have an awful lot of explaining to do and should be brought to account.

Paul Shetler

well paul, if we can't make moral judgements because "morality is subjective and varies with time and place" then why should someone else's life mean anything at all to me? after all, it's not MY life and if i don't have any moral obligation to anyone else it's impossible for there to be any imperative to treat anyone else well.

so why on earth should i give a damn about someone else's health or feelings or quality of life if they're HIV+ absent any "morality which is subjective and varies with time and place?" after all, if the ONLY thing you care about is the purely utilitarian "outcome" why not have the state simply mandate compulsory testing for HIV and then summarily execute anyone who tests positive. that would certainly "work" in terms of "outcome" if the only thing i care about is preventing infection - and it would have the added benefit of huge savings in the social costs associated with long-term healthcare for people who are HIV+.

if you don't think morality is important, then i think on the extremely narrow grounds of your argument, that proposal would be a much better alternative to the "excuse lying and deliberate infection" approach you advocate. and even better, the amoral approach i suggested does pay tribute to the thinking behind your amoral approach as well: it doesn't place ANY blame on anyone and certainly doesn't make any judgement of any sort about any behaviour whatsoever: it would just kill millions of people since their lives have no moral value compared to the health and strength of the state, which is mightier than any single individual or even sector of the population.

Paul Jeffrey

I have only contradicted myself if you believe that protecting others from infection equates to disclosure. The whole point of my article was that I believe using disclosure in place of safe-sex to be a foolish strategy. I would like to see a return to the attitude of the early 90s, when we assumed that everyone, including ourselves, might be HIV+ and took precautions accordingly, rather than blaming others for not acting in the way that we think they should.

Morality is subjective and varies with place and time, so I have tried to avoid this angle. What is "wrong" to one person is not to another. It's easy to say that someone else's sense of morality is corrupt. Who will this help? I don't condone lying, but as a pragmatist I see little difference between this and and deliberate ignorance. What matters is the outcome.

Paul Shetler

I agree with many of the comments made by the author and sergio, but where we differ is in moral emphasis. the author states that 'most' HIV+ guys are very careful not to transmit the virus, but contradicts that statement with the very title
of his article - and also in his statement that perhaps it's not the HIV- sex partner's business if his partner tells the truth or not about his status, that is where we disagree very strongly: if honesty means anything surely it means telling the truth about whether you are knowingly putting your sex partner at risk of mortal infection or not.

I always assume my partners are HIV+ and act accordingly for the simple reason that so many of them - including my ex-partner of 7 years - saw nothing wrong with knowingly lying about their status. their attitude was explained to me thusly: they wouldn't get sex otherwise, so they "had" to lie. i have no respect for that behaviour or any justification for it - unless we explicitly come out and say "there is no gay community, you and your life mean nothing toe,all
I care about is my cock or my overstuffed arse, you are just a means to my selfish end." and on that case, please don't come begging for money for a cure: we have no moral obligation to one another when you feel content to hold a deadly weapon and pull the trigger since that is what makes you cum.

And if that sounds harsh and unacceptable, them it's about tine for HIV+ men to take some responsibility for their own behaviour as well. both parties in the sex act bear responsibility for consequences - and that includes the HIV+ man too. anything else is morally bankrupt special pleading,

Sergio Repka

As so often in life, denial seems to be a key facilitator of misfortune here. Denial from all sides: no doubt from those who know their HIV-positive status, but also - and I suspect in greater numbers - from those who are "negative" just because they last tested in the last century (if at all), and from those who actually are - still - HIV-negative and simply do not want to think about it. Everybody assumes, particularly as sex with strangers is often the product of a wish for fantasy anyway and this kind of reality is rather sobering. But it is far more reasonable to assume someone with a carefree attitude towards unprotected sex to be HIV-positive than HIV-negative.

Paul Jeffrey

To clarify, I don't think community, honesty or caring are silly or outdated. In fact, the available research suggests that most men who know that they have HIV are very concerned to make sure they don't pass it on. But some people don't care, and as I said, a lot don't know their status. So your own health has to be your own responsibility. And I should say that plenty of HIV negative guys as well just want to get off without having to take any responsibility. If you are in the habit of barebacking, by the time you find out you are infected, you are likely to have passed your infection on to others. You can't leave the containment of HIV at the feet of diagnosed men. It won't work.

Paul Shetler

fully agreed with gary on this. gay sex industry businessmen have no interest in whether people live or die - it's all about money. unfortunately, it's up to each of us individually to take all responsibility for our own health - without any silly and outdated ideas about community, honesty or caring about others.

Gary L

Spot on! HIV apharteid is rife on sites like Gaydar and Manhunt. It is not just offensively discriminatory, but also reflects on the ignorance of the advertiser if he seriously expects that gay men in general tell the truth about their HIV status, let alone whether they even know for sure that they are negative! The only way to be sure is to play safe always - that way it doesn't matter what status your partner is. Undoubtedly it is the confusing mixed messages being transmitted in sexed-up HIV campaigns that are at the core of the complacency and indifference around barebacking today. As the saying goes ignorance kills, knowledge is power. Let's inject some sanity back into HIV prevention education!

Paul Shetler

i always assume that any one i have sex with is HIV+ regardless of what they do or don't say. it's sad, but i don't expect gay men to have any moral compass when it comes to caring enough about the people they have sex with to let them know if they are knowingly exposing their sex partners to a deadly virus.

so much for the idea of the "gay community". so much for the ideas that guided the first generations of the gay movement. it really is just all about selfishly getting off, isn't it?

Spike Rhodes

Another Great Article Homo Vision . Well said.

Shame it is such a true insight of our Gay Community.

As an Openly Positive Man for over 23 Years - I like many others have been on the receiving end of many varied reactions to our honest Policy , when declaring ones status if a sexual encounter was on the cards ...

For me it's always been about mutual RESPECT !

Spike Rhodes