Virus Zero

Friday, January 27, 2017

Dear Patrick: My AIDS medications have taken my viral load down so far it is almost zero. My doctor says I am “undetectable.” Since I cannot possibly give this disease to anybody, do I still have to disclose that I am HIV-positive? Especially if, technically, I am not poz any more? I am so tired of the Big Reveal, and the look on the other person’s face if they are disappointed or afraid. You don’t know how many times I have been rejected because a potential trick did not want to use a condom with me. I want to have some of my freedom back! Is that such a wicked thing to say out loud?

—Virus Zero


Dear Virus Zero: This is such a deeply personal decision that I don’t think I can tell you what to do. I can outline some of the arguments before and against “coming out” as POZ, and hopefully both you and my readers will take all this to heart and discuss it. Even if you are negative, as long as you are a sexually-active person, these issues are pertinent to your life.

The argument for “no, you don’t have to tell potential sex partners” is based on the precept that if there is no danger, there is no duty to warn. You don’t have to tell people that the movie theater might catch fire. If medical science says the risk of transmission is zero, your partners have nothing to worry about.

The alternative views are based on many alternative priorities. One view says medical science is limited and flawed. Science reverses itself all the time. So we can only call this view of what it means to have an undetectable viral load a theory. According to this view, your partner has a right to make an informed decision about whether or not to have sex with you based on all the information they might want to use to inform that choice. If somebody says, “What is your HIV history?” (a better question than, “Are you poz?”), you are obligated to tell them—or, at a bare minimum, to say, “I don’t feel that’s relevant to my sex life, and I don’t discuss it with people I don’t know well.”

As a sex educator, I’d like to point out that focusing on HIV to the exclusion of every other sexually-transmitted and blood-borne disease is not a very comprehensive way to protect your health. There are many STDs (like genital warts and herpes) that can’t be eradicated and may be communicable even if there are no visible signs of the disease. Often, the period when a disease is most likely to be transmitted takes place before the person with the STD knows they are ill. So talking about typical sexual behaviors may be more informative than examining your partner’s body or asking, “Are you healthy right now?” This could take the shape of a question like, “So . . . if you don’t want to use a condom with me, does that mean you usually don’t use condoms with other people you pick up?”

In my humble opinion, a smart cruiser behaves as if EVERY new partner is HIV-positive. There are always the cutie-pies who tell great big lies. Somebody can look and sound like a safe bet for unfettered fluid-bonding. But if he or she has been dishonest with you about their past behavior, eek. I could get more indignant about the fibbers if there wasn’t a whole bunch of people who wrap themselves in a rubber sheet and scream like a fire engine any time they find out they have had just a conversation with an HIV-positive person. I am sorry to hear that you have encountered so much rejection.

There are plenty of ways to have really good sex even if the two of you have different HIV statuses, especially if there is a strong, spontaneous feeling of attraction. I would rather have hot sex with somebody I really, really want than lukewarm sex with somebody “safe.” So I’ve learned how to get polymorphous perverse about sex, and create many alternatives for myself that feel good and keep viruses out of my bloodstream. It’s too bad that safer-sex techniques are currently being neglected by health educators. We have no idea how taking HIV medications to prevent infection are going to affect the health of this generation of young gay men. That doesn’t mean it’s a bad thing to do, but it does mean that using a latex barrier should still be on the list of options for having a healthy, lusty life.

There are a lot of guys who want to side-step this whole potentially humiliating or laborious process and just get down to the sweaty athletics. This has led to the development of a whole culture of men who sero-sort. Poz guys prefer to have sex only with other poz guys, and negative men do the same thing. But you, Questioning Reader, already knew that, I’m sure. I just mention it here because the creation of classes of people based on the presence or existence of a disease or genetic difference is a Coming Thing. In another decade, we will have a plethora of privileged vs. marginalized classes of people based on medical histories and genetic profiling. Somebody needs to write a science-fiction story about that world.

I hope I have made it a little easier for you to make a decision about this that is consistent with your own values. I personally (if this is relevant) would have to disclose. I am obsessive-compulsive about consent, and I know that gossip lays every private matter bare, sooner or later. It would absolutely kill me to have a partner I had gotten extra, extra close-and-wet with to come back to me later and say, “Wow, if I had known x about you, I would never have done that.” I think I would shrink to about two inches tall and never have sex again. Maybe it would help you to make this decision if you could imagine yourself in that situation. Could you defend your decision to a sex partner who was upset about it?

It may also be important to inform yourself about whether there are laws in your area that make it illegal for a positive person to have sex with someone who is negative without informing them. These draconian and stupid laws were passed during moral panics in the early days of the epidemic, and they are rarely enforced, but they scare the hell out of me nevertheless.