Important note: Information in this article was accurate in 2002. The state of the art may have changed since the publication date.
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Washington Blade - October 4, 2002
Steve Weinstein
For many HIV-positive gay men who have decided that having unprotected sex with other HIV-positive men is worth the health risk, the hassles, negotiations and rejections involved in condom use still outweigh the fear of reinfection.
Several conversations and e-mail exchanges with HIV-positive men reveal a widespread ignorance about the new research findings. When confronted with them, responses range from mild interest to concern, along with near-uniformity that the men don't intend to change their behavior anytime soon.
Kevin, a landscape architect in New York, says he won't have unprotected sex with anyone, and the findings only reinforce his decision.
Ron, a lawyer who has been HIV-positive for over 10 years, asks his partners about their serostatus but often has unprotected sex. "I'm taking my chances, I know that," he said. "But it's hard when everyone else is doing it."
Glenn, a New York bartender only recently infected, admitted he has played what he called "Russian roulette" with partners and probably will again.
That attitude remains widespread, and it frustrates people like Brandon, who began the first "poz parties," which are popular New York City sex parties exclusive to HIV-positive men.
"People should have freedom of choice," said Brandon. "The last thing we want to do is have someone tell us what to do. But we all know about reinfection. We won't admit it publicly, but we have to deal with it."
Men who don't want to use condoms frustrate Brandon. "The only way to stop reinfection is if they're scared shitless," he complained. "They need a wake-up call. The solution is so simple, and yet we don't do it."
Good reasons for safe sex
There has always been a strong epidemiological case for safe sex among positive men, according to HIV experts.
Gregg Gonsalves, treatment and prevention director for Gay Men's Health Crisis, cited genital warts, herpes and other STDs that, in combination with HIV, weaken the immune system even further.
"Now there's an extra reason for using a condom," said Gonsalves. "You can get potentially infected with someone else's virus and get superinfected with the drug-resistant virus."
Gonsalves said that prevention efforts have been hampered by internalized homophobia and drug use. He called widespread drug use a "co-epidemic."
The widespread use of crystal methamphetamine, GHB and Viagra has had a two-pronged effect on AIDS: more gay men having unprotected sex, and a lot more of it with a lot more anonymous partners.
Today, there is a danger of glamorizing unprotected sex. Some adult filmmakers are marketing barebacking videos. Barebacking Web sites and chat rooms are proliferating on the Internet.
Protease inhibitors, anabolic steroids - used by HIV-positive men to prevent wasting - and buff models in drug ads all contribute to a feeling of invincibility to the virus.
"The next wave is coming," Brandon said. "There's no question about it.
The new infections and reinfection to a worse infection is going to happen, and there's nothing being done to prevent it in the gay community."
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