Being Alive; August 1996
Ferd Eggan

In the past two years, there has been increasing attention to the fact that HIV+ and HIV- men have different views of sexual transmission, and different behaviors based on our experience of AIDS. Campaigns have been developed to encourage HIV- men to remain negative. Some of these, like the very sexy, MTV-style ads just produced by APLA, aim mainly at validating the esteem and vitality of young gay men. Some have unfortunately left the implication that HIV+ men are to blame.

But it is clear that we need to develop prevention strategies that take into account that we are not all the same, and that condom protection is not just the easy, fun thing that everybody can do with the same goals in mind.

In Vancouver, all the Europeans and Australians said their data showed that new HIV cases among young gay men were going down, and they couldn't believe our US data that show they are going up. What they don't know is how our US society is so stratified by race and economics, and that it is young gay African-American, Latino, Asian/Pacific and Native American men who are now most at risk. Prevention workers in South Central LA or East LA know this. The City AIDS Coordinator's office and County AIDS Programs will sponsor a week-long technical assistance in January where many national experts from communities of color will spend time with community-based agencies helping them to improve programs where they matter the most.

Vancouver hosted a number of brilliant presentations about the gay communities of Australia and other homogeneous gay communities in Europe. Despite the differences between them and us, there are some very important lessons. In Australia, the government of New South Wales (Sydney) is sponsoring a program which they see as just catching up to where gay men have successfully figured out how to live in time of epidemic. That is, they teach gay men that if they are in a relationship, they can test for HIV twice, three months apart, and (if they have the same status) they can agree to have unprotected sex together.

This unprotected (but safe) sex must be only within the relationship; anytime one of them has a sexual encounter with a person outside the relationship, they must use condoms. HIV- men are thus assured they can stay negative, while enjoying what we all know is more enjoyable, that is, sex that allows full skin contact without endangering either partner. When people objected, the Australians argued that gay men are already doing this, and they were just advising them how to do it most safely.

Under this concept, HIV+ pairings can do what they are already doing, having condomless sex. I ask HIV+ readers, do you use condoms when you have sex with another HIV+ man? Do you usually ask about sero-status? If the Being Alive socials are any indication, many HIV+ gay men actively seek other HIV+ partners, and often express the desire to have an HIV+ life partner because they share some of the same central life concerns.

The long and the short of this is that the Australians make a distinction between unprotected (no condoms) and unsafe (no transmission) sex. The question of re-infection, they say, has never been answered. There is no proof that re-infection occurs, and no proof that it would matter if it did. The HIV+ gay men I talk to in LA say that, despite the possibility of more HIV or hepatitis, or the like, they do not always use condoms for their sexual encounters with other HIV+ men.

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