“That’s a horrid question, of course I would.”
“What a ridiculous question, yes I would and I have.”
“I’d be very surprised if you find someone who is prepared openly to say he wouldn't. Only an asshole would find it a problem.”
These are some of the responses I received when I asked gay men if they would date a HIV positive man. The topic is mired in controversy, so much so that a number of people I spoke to found it outrageous that I was even asking such a question. Some things, they clearly felt, should be taken as a given, unquestioned, unspoken about. But as history has taught us, silence around HIV is not an option.
I will begin with my own experience: an event - some 15 years ago - which, in the words of the respondent above, potentially makes me an “asshole”. I’d met a guy in a bar, and we’d taken a short walk to the beach, where we sat holding one another as the dawn light splintered over the pier. He told me he was HIV positive. “I know this may change things,” he said. “Of course not, it’s fine.” But I lied. My head was immediately swirling with ideas, facts, fears - and yes, I’m not proud to admit: judgements. We began seeing one another, had sex several times; we never spoke about his status again. Whatever we had petered out when he told me he had issues to deal with. I didn’t press him. Truth be told: I didn’t know how to respond to his status, and by ending things he was, in a way, letting me off the hook. As long as we didn’t discuss HIV everything seemed ok. But it wasn’t. It was far from ok, because I couldn’t escape from what had been drummed into me as a child growing up in the 1980s - through brutal TV adverts, ill-informed teachers, a homophobic father: that HIV could make you sick, could kill and, despite all the information I knew to the contrary, I feared that by being with this beautiful, gentle man I was (in whatever small way) putting myself at risk. And how I despised myself for thinking this.
I’ll never know what may have happened between myself and this guy if we’d practiced what is arguably the most important thing in a serodiscordant relationship: talking. What I am now in possession of are scientific facts - information every HIV negative person who is considering dating a HIV positive man should be aware of. The Australian Opposites Attract Study of gay male couples of opposite HIV status “has so far seen no transmission from the HIV-positive partner within a two-year interim analysis.” The couples surveyed were practicing condomless sex, and most of the HIV-positive partners (84%) were on Anti-Retroviral Therapy, with virtually all of these having an undetectable viral load. The study shows that an undetectable viral load is in fact better prevention against HIV infection than the use of a condom. These findings are backed up by a larger study by PARTNER, which reported no transmissions among 16.400 episodes of anal sex (including condom-protected ones) in gay men. Both of these studies have the potential to revolutionise our preconceptions on what constitutes “safer sex”.
You’re more likely to be infected from sex using a condom with someone who isn’t on treatment than you are to be infected from sex without a condom with someone who is on treatment". Matthew Hodson, Chief Executive of London-based gay men's health charity, GMFA
Studies show that an undetectable viral load is in fact better prevention against HIV infection than the use of a condom.
The results of relatively recent scientific studies alone do not have the power to change attitudes - often deeply ingrained views which have been formed over many years; opinions which differ according to the age of the gay men who hold them, and their (frequently very valid) life experiences. The most common argument used against dating HIV positive men concerns exercising free choice. One older gay man who spoke to me expressed this very vocally: “There are a bunch of things that limit my desire for other men. Being HIV positive is one of them. I’m sober, and I find that young men especially are loathed to sleep with you if you don't drink or take drugs. It’s a similar thing; it’s about personal choice.” He added that Anti-Retroviral Therapy is not necessarily available to everyone: “Here in America if you can't afford the drugs that keep you undetectable, your sex life is severely limited.” When challenged on whether other gay men would see his stance as prejudice, he referred to the increasing numbers of young gay men who are infected with HIV through bareback sex: “The only ugly prejudice I've faced recently are men on PrEP who won't have sex unless it's raw.” A similar point was also raised by another man, who confided: “I have some friends that are HIV positive and treat it as an exclusive club, basically barebacking each other as they are already positive, which in itself is pretty reckless.” Are these men discriminating, or just expressing a genuine concern for the welfare of the gay male community? Perhaps it is born out of the anxiety that in silencing an individual’s personal decision not to date HIV positive men all we are achieving is stifling debate, and - more controversially still - idealising serodiscordant relationships, to the point that we are normalising the unsafe sexual practices that can lead to infection. In the words of another man: “We have to be careful not to suggest that HIV is not a problem at all; that there are no health complications connected to living with the virus for the rest of your life - which, despite what we’re increasingly being told, we know not to be the case.”
Since the devastation wrought by the AIDS epidemic of the 1980s and 1990s, hugely positive advances have been made in the treatment of HIV and the ways in which we discuss it. Of the men who offered their opinions for this article, the majority expressed a willingness to enter into relationships with HIV men: “We should see the person, not the virus”; “I tend to think that every gay man has the potential to have HIV. It makes no difference to me”; “If someone is/could be the love of your life, would any illness be a problem?” Perhaps the most important thing to consider when we meet anyone new is that gay men’s history has been dominated by victimisation and judgement. We have a shared responsibility to fight this - not add to it. And yet, as we mark another World AIDS day, enormous challenges face us which threaten to complicate this. The increase in HIV rates among young gay men is absolutely terrifying, as is the influence of the new phenomenon of ‘chem sex’. We need frank discussions in order to form effective strategies to tackle such problems before they implode.
We also need to speak honestly about the ways in which we can navigate - and celebrate - the hugely improved aspects of living with HIV in 2016; particularly new, safer types of serodiscordant relationships. We are all still feeling our way here, and opinions will inevitably vary, but the debate - as heated as it may get - must go on. There will be those who are apprehensive about the new options open to us. Reason with them, and try to understand that the place they speak from is more often one of fear rather than hate; it is not constructive to accuse those gay men who are fearful of bigotry - and fear, of course, is best diminished through education.
But in this new landscape it is crucial that we place those who are battling HIV first. They must not be demonised and tainted with the kind of stigma which we should have banished to the past: the assumption that through their illness they are in someway unclean, somehow unworthy of the love and support that a more meaningful relationship can bring. Continuing to challenge our own personal histories and baggage is pivotal; it’s certainly something I wish I’d had the courage to do in an open, constructive way 15 years ago, when I possibly threw away what could have been the start of real happiness. The key to successfully building any relationship is to treat everyone we meet as an individual, with their own unique backstory, as we leave the judgements at the door. It is, after all, with compassion, rather than fear, that we are most likely to transform our interactions with other human beings for the better.
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