Positive Role Model

Being Positive in a World of Negativity

It is every man's responsibility to protect himself. There was one night in 1996 that I lost sight of this responsibility, and a few months later, I tested positive for HIV. If I had it all to do over again, would I change anything?

I want to say yes, but honestly, I'm not so sure.

Before I explain why I'm not sure I'd change anything about that night in 1996, some context might be useful. For someone with HIV, two medical tests are important in determining the progression of the disease. Viral load is the number of HIV copies present in the blood (May et al, 2014). This measurement helps the doctor understand how quickly the virus is progressing. CD4s are the fighter cells of the immune system, white blood cells that destroy harmful bacteria and viruses that can cause infections (Doitsh and Greene, 2016). This measurement represents the immune system's ability to fight the disease, and it helps the doctor understand how much damage the virus has caused to the immune system. Most healthy people have a CD4 count that ranges between 800-1000. Someone with HIV is considered to have AIDS when their CD4 count falls below 200, which is the point at which the immune system becomes too weak to protect against opportunistic infections (Vogel et al, 2010). Without medication, most HIV+ people experience a decline in health as their viral load steadily increases until it measures millions of copies per milliliter and their CD4s steadily decrease until they have none left. For someone with a severely compromised immune system, even the common cold can threaten their life.

One Percent

Without a doubt, being HIV+ has fundamentally changed my life, but even after 25 years, it has never made me sick, and I've never taken HIV medication. I'm one of the lucky ones, part of the one percent. A long-term nonprogressor is an HIV+ person whose immune system is able to maintain low viral loads and high CD4 counts without using HIV medication (March, 2006). My viral load has never gone above 5,000, and my CD4 count has always been above 1,000. The immune system of a long-term nonprogressor prevents the HIV virus from exhibiting the heavy duty replication that allows it to attack the immune system. Representing about 1% of the total number of HIV+ people, we have existed since the beginning of the AIDS crisis. As a group, long-term nonprogressors have been the most intensely studied of all HIV+ people. This is because many medical researchers and scientists have believed that a thorough understanding of our ability to control HIV will lead to the development of better immune therapies or even a cure (Gaardbo et al, 2012). So far, none of these studies have moved us closer to finding anything, much less a cure. Still, it's nice to be part of the club.

Being a long-term nonprogressor gives me a perspective on the disease not many HIV+ people have. When I think about how my life has unfolded over the last 25 years, HIV has played virtually no part in it at all, and in some ways, it has actually made my life better.

Health Awareness: I'm the kind of person who doesn't go to the doctor unless it's absolutely necessary. If I was not HIV+, I would go to a doctor for annual check ups every few years. Because I am HIV+, I go to my doctor for extensive blood work at least twice a year. I know exactly what's going on inside my body because these tests provide me with a bird's eye view.

My Doctor: I've had the same doctor for 20 years. Seeing him at least two times a year for 20 years has enabled us to build a very solid doctor-patient relationship. If I didn't see him so regularly, we would be virtual strangers to one another. Instead, when I have an appointment with him, it's like I'm going to see an old friend.

Bareback Sex: Condoms ruin sex. They make it impossible to feel anything and take away all of the physical pleasure. They also destroy the intimacy. The lack of physical connection makes it impossible to achieve an emotional connection strong enough to create intimacy. Bareback sex restores all of the physical and emotional pleasure of sex. Because I am already HIV+ and a long-term nonprogressor, I can have as much bareback sex an I want without worrying about the consequences.

Resources: Many housing and other financial resources are available to HIV+ people from various public and private agencies. A few years ago, I could not pay my rent for two months and was close to being evicted, but my HIV status qualified me to receive a one-time payment to prevent an eviction. If I was not HIV+, I would not have qualified.

These are minor factors that have benefited my life in small ways, but my key point here is that, since becoming HIV+, I have lived a normal life. The virus has not affected my health or had any other negative impact on me or the way I live my life. But it has benefited me in a few small ways and enabled me to view the world in relation to the virus from an objective point of view.

If I had it all to do over again, would I change anything?

I'm just not sure.

The sex with Tony was good, really good.

The Gay Sexual Landscape

In 1996, the world was still dealing with the AIDS crisis, and HIV/AIDS medical research theories heavily influenced the sexual behavior of gay men. In 1996, the medication used to treat HIV, mostly AZT and its derivatives, suppressed the progression of the virus, but it could not suppress that progression indefinitely. For many people living with HIV/AIDS, the often debilitating side effects of AZT made the prolonged march toward death excruciatingly painful. For many others, it was the medication that brought about their death. Condoms were the only effective way of fighting the virus, and safe sex ruled the day. The overriding advice from the HIV medical community focused on prevention ("always use a condom") because an HIV diagnosis marked the beginning of the end for most people who received one.

It was within this sexual landscape that I became HIV+. My future was bleak, at best.

The Status Quo

It was also within this sexual landscape that a certain status quo was established in gay bars and other hookup joints around the world. This status quo had existed since the beginning of the AIDS crisis and threatened to remain in effect well past 1996. Admittedly, I didn't give it a second thought until I became HIV+, and guys started rejecting me for sex because of it. Back in 1996, many HIV- gay men would not hook up with a guy who was HIV+. The underlying logic was that, by eliminating exposure to the virus (by only having sex with men who were HIV-), they also eliminated the risk of contracting the virus. On the surface, this seems reasonable, but the status quo had four major flaws:

It required blind trust. More often than not, the sexual partners of gay men are other gay men who they just met in a bar or some other social space. HIV- gay men everywhere assumed that every HIV+ gay man was truthful about their status. They relied on the word of a stranger to keep themselves safe. In reality, the status quo did nothing at all to reduce the risk they were taking.

It demonized HIV+ gay men. The status quo was a manifestation of an HIV-related stigma within the gay community. For much of the AIDS crisis, many HIV- gay men held negative opinions of HIV+ gay men, viewing them as a threat to the gay community with regard to health and the general perceptions of gay men held by society at large (Smith et al, 2012). Many HIV- gay men also believed that HIV+ gay men were more promiscuous and that they deserved the disease (O'Leary, 2014). For many HIV- gay men, the status quo provided a foundation upon which they could believe they were better than HIV+ gay men. The systematic rejection of HIV+ gay men as sexual partners happened in gay bars, sex clubs, and cruise spots everywhere. HIV+ gay men were constantly rejected for sex simply because they were HIV+ and honest about it. The rejection took different forms. Some HIV- guys were polite about it, waiting a few minutes after a guy disclosed his positive HIV status before quietly excusing himself to go to the bar, the bathroom, anywhere-but-there and never come back. Others were rude about it, instantly showing contempt and disgust at the very notion of having sex with someone who was HIV+. Whether they were polite, rude, or somewhere in between, the rejection almost always happened.

It rewarded bad behavior. Some HIV+ gay men found a way around the status quo. They lied about their HIV status. The same stupid faggots who would instantly reject any gay man who was honest with them would not even question the honesty of guys who were dishonest with them. Personally, I think the practice of being dishonest about something so important was despicable, but I understand why it was done. Tired of being rejected, some HIV+ gay men side-stepped the issue altogether. This became so commonplace that private bareback sex parties centering around this lie became popular. The host would invite HIV- bottoms and HIV+ tops, but he would tell the bottoms that everyone was required to take an HIV test and that everyone was HIV-. The tops conspired together to try to pass the virus on.

It created a schism. As time wore on and the status quo got more entrenched in gay sex spots everywhere, two particular patterns emerged. HIV- gay men tended to hook up only with other HIV- gay men (or at least men who told them they were HIV-), and HIV+ gay men tended to hook up only with other HIV+ gay men. This created a distinct divide in the community. Gay men very often form social circles from guys they've had sex with and shared common interests. So, HIV- gay men tended to have HIV- friends, and HIV+ gay men tended to have HIV+ friends.

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Super Infection

For most of the AIDS crisis, the sexual behavior of HIV+ gay men was dominated by the threat of superinfection. The superinfection theory posited that an HIV+ person could be reinfected by a different strain of the virus, and the two strains could form a recombinant strain that was resistant to HIV medication, which would enable the disease to progress more rapidly (Smith et al, 2005). In other words, an HIV+ person who got reinfected would die faster. Throughout the AIDS crisis, this theory was pushed by HIV medical researchers as support to manipulate HIV+ gay men into believing that they needed to protect themselves from reinfection. It worked. Safe sex was everywhere, and condoms ruled the day. This theory began to fall apart in the late 1990s as some medical researches began to question its validity. As it turned out, it was a bunch of bullshit. It was later proven that HIV superinfection was exceptionally rare, with fewer than one hundred documented cases worldwide (Smith et al, 2005). In the end, HIV superinfection theory was nothing more than an attempt by the HIV medical research community to systematically control the sexual behavior of HIV+ gay men.

In 1997, three-drug antiretroviral cocktails entered into widespread use. These drug cocktails were extremely effective at fighting the virus, and the number of HIV-related deaths sharply declined. Suddenly, an HIV diagnosis was no longer a death sentence. These drug cocktails ushered in a new era of HIV/AIDS, marking the unofficial end of the AIDS crisis and the unofficial beginning of the AIDS epidemic. Although these cocktails were effective in fighting the virus, they couldn't kill it. They were not a cure. As the health of HIV+ gay men began to improve and the superinfection theory began to lose credibility, HIV+ gay men everywhere discovered the joys of bareback sex.

The Paradigm Shift

The term bareback has become highly contextualized, and today, it means far more than an unsafe sexual practice. The term reframes the experience of having unsafe sex, and in the midst of the AIDS epidemic, it brought about a paradigm shift in the way gay men have sex. Bareback sex restores the physical and emotional pleasure that makes sex so satisfying. Sex without condoms is hotter and more sensual than sex with condoms. HIV+ gay men realized this in the late 1990s, and no longer burdened by threat of superinfection, they abandoned condom use in droves. In doing so, HIV+ gay men had found a way to have hotter, more satisfying sex than HIV- gay men, and they had a trendy new name for it too. Bareback sex left HIV- gay men out of the sexual equation. HIV+ gay men still sought out other HIV+ gay men as sexual partners, and HIV- gay men still sought HIV- sexual partners. The difference, though, was that HIV+ gay men started rejecting HIV- gay men for sex.

And just like that, the big bad wolf was gone. The status quo was dead!

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Being Positive in a World of Negativity

When I became HIV+ in 1996, I was dating someone who was HIV-, so we started using condoms when I tested positive for HIV. Although we had an open relationship, I rarely tricked out. I knew what bareback sex was but thought it was simply a glorified way to refer to unsafe sex. It wasn't until three years later, when I was single again, that I became aware of the sexual revolution it had sparked and how wide-spread use of the word had become. By 1999, bareback sex was well on its way to becoming the defacto sexual practice among HIV+ gay men. For me, bareback sex allows me to have great sex on my terms without having to deal with the status quo. But make no mistake about it, bareback sex is unsafe sex, and there are risks associated with having unsafe sex. I remember the moment when I received my positive test results. I remember that sinking feeling in my stomach as I realized the worst had happened. My thoughts went back to the night in Sydney, the hot sex, the fun we'd had. Why did I allow a man I'd only just met fuck me without a condom? I assume every gay man who is given a positive HIV test result has a similar experience, a moment of realization, of reflection, the overwhelming feeling of regret, a wanting to go back in time to fix the mistake, the lapse in judgment. I would never want to have a part in putting someone else through that kind of experience, so I actively avoid having sex with HIV- men.

But, as I soon learned, it was not that simple.

Rafael: I was out drinking in the Castro with friends one night, and like most nights when I went out drinking with friends, I stopped at Detour, a seriously cruisy bar with a chain link fence in the middle of it, a laser light display that never failed to mesmerize, and the best music of any gay bar of its kind in the city. It was the end of the night, and I decided to have one last drink before heading home. That's when I met Rafael, a total hottie with a Brazilian accent. He was a horny fucker. I hadn't even finished my drink before he was pulling me toward the door. The sex was good, really good. Afterwards, I casually asked him how long he'd been HIV+. He casually replied, "I'm not." We had discussed not using a condom, and I just assumed he was HIV+. He didn't seem to be concerned about it, though. He told that he didn't like using condoms so he didn't use them. I don't know if he just didn't think about the risks or if he considered them but fucked bareback anyway. I had no idea these men existed.

Josh: Another night, I found myself at Detour again. That's where I met Josh. We hooked up so fast I didn't even make it to the bar to order a drink. Josh was definitely hot for me, so we went across the street to his place and fucked as fast as we could. The sex was good, really good, but a few minutes after it was over, he was walking me to the door. He was literally handing my shoes to me while I was putting on my pants. All the way to the front door, he was telling me he would call me, but he never took my phone number. He was also telling me how turned on he was with my poz cum inside him. Wait, wait! Josh, didn't you tell me you are HIV+? "I find it easier to tell guys what they want to hear". Josh was a bug chaser, an HIV- gay man who actively sought out HIV+ gay men for sex in the hopes of catching the virus. I won't go into the psychology of how these men viewed the virus as a gift because, frankly, I just don't understand it. Anyway, the thing about bug chasers was that they really didn't care who they had sex with, as long as they had the bug. They were cum hungry, in a totally weird way. Most cum guzzlers were hot for cum because it was coming straight from another guy's dick. Bug chasers were hot for cum because it had the virus in it...and they always wanted it in their ass. I had no idea these men existed either.

Modern HIV medication has made it extremely difficult to be a bug chaser because it prevents the virus from transferring from the HIV+ person to the HIV- person. Just about every HIV+ gay man uses this medication, so bug chasing isn't nearly as popular as it used to be, but HIV+ gay men who do not use the medication still encounter them. I have never enjoyed having sex with a bug chaser and have always avoided it. Nowadays, I can see a bug chaser from a mile away, mainly because they always ask a very specific question. "Are you undetectable?" There are two types of guys who ask this question. HIV- men who want to bareback but wish to avoid risky bareback sex, and bug chasers. The first type of guy responds negatively when I tell them I am not undetectable, but bug chasers always respond positively. Either way, the possibility of a hook up ends the moment they ask the question. When the question comes from the first type of guy, it's insulting (they want someone else to use the medication, so they will be protected). When it comes from bug chasers, it's just weird.

Drew: This guy had been fantasizing about fucking bareback for a long time, and the night I met him, he was ready to make the fantasy a reality. I told him I was HIV+, and he seemed to understand the risks, so we went at it. The sex was good, really good. He was happy and joyful when he left. So was I. Several months later, I was at Powerhouse, another very cruisy gay bar in San Francisco, and I ran into him. I didn't immediately remember the details of the sex, but I remembered it had been good, really good. He walked up to me and started screaming. I'll summarize: he felt that I took advantage of him when he was drunk (I'm quite sure he wasn't drunk because I don't have sex with messy drunks). He had apparently tested positive for HIV and felt it was my fault. I have always been blessed with the ability to remain calm in very stressful situations. That ability was put to the test that night. When he finally calmed down, I was able to have a normal conversation with him. In the course of that conversation, he revealed to me that I was not the only guy he had barebacked with. But, according to him, I was the only HIV+ guy he had barebacked with. How did he know the other guys were negative? "That's what they told me." I explained to him that not everyone was honest about their HIV status and that it was possible he got it from me but it was also possible he got it from any one of the other men because you can't trust the word of a man you just met, especially when sex is involved.

Ricky: This guy wanted to live a little, I guess. I met him online and invited him to come over. He got there, and holy fuck, he was hot, at least two full hotties. He was sweet, funny, and super sexy. We were both HIV+, so we went at it. The sex was good, really good. We fucked all night long, and when he left the next morning, we made plans for him to come over after work. Several hours later, I was sitting in my living room reliving the memories from the night before enjoying every second of every memory when the phone rang. It was him. My first thought was that he decided not to go to work after all and he wanted to come over. My heart lept a little at the thought of having some afternoon delight. Then I realized his voice was frantic, desperate even. As it turned out, he wasn't HIV+, and the realization of the risks he had taken the night before was weighing heavily on his mind. In other words, he was freaking out. He was calling me from his doctor's office, and he demanded that I do two things. He wanted me to call my doctor immediately to authorize the release of my full medical record, which would disclose to him, almost a complete stranger, my entire medical history including the results of every medial test I've ever taken. He also wanted me to explain to him why I wasn't using HIV medication because, as he told me, if I was he wouldn't be so worried about what happened. As I listened to his demands, which were basically thinly veiled accusations, my first thought was that I'd just met this guy, "Why the fuck would he think I'd release my medical records to him?" He told me he was HIV+. Had he not told me that, I would never have had sex with him. Although he did not state it explicitly, his words implied it was my fault his health was now in jeopardy. I was very well aware it was NOT my fault, but instead of pointing that out, I told him I was willing to speak to my doctor about releasing some part of my medical record but I would let my doctor decide what part and how much to release. I also told him that my decision to not take HIV medication was none of his business. He expressed his unhappiness with my decision to be "not at all helpful" at a time when he was in such distress. I finally hung up. I didn't even bother to call my doctor.

A few months went by, then one night my phone rings. It was Ricky, "Hey man, how's it going? We hooked up a few months ago and had such a great time. I hope you remember me. What're you up to tonight?" I hung up the phone without saying a word.

The Barebacking Subculture

Bareback was originally just a trendy name for a risky sexual practice, but today, barebacking has become a subculture of the gay male community and a way of life for many gay men. This did not happen overnight. During the AIDS crisis, becoming HIV+ was the worst thing that could happen to a gay man. Not only was he certain to die a slow, horrible death, but he'd also be stigmatized by many HIV- gay men and by society in general. This began to change when the three-drug cocktails were introduced in 1997, and HIV+ gay men began to live normal lives again. At about the same time, the superinfection theory began to lose credibility. HIV+ gay men everywhere began to embrace bareback sex as an alternative to the status quo. In 2012, even better HIV medication hit the market. Truvada is so effective it is used by HIV+ gay men to treat the virus and by HIV- gay men to prevent being infected with the virus. With the threat of infection now all but eliminated, HIV- gay men embraced bareback sex as furvently as HIV+ gay men had a decade before.

Understanding why so many gay men have bareback sex is easy. Understanding why barebacking developed into a subculture...that's not so easy to understand. There are several theories...

Intimacy Bareback sex restores the emotional intimacy that naturally occurs between gay men when they have sex. Emotional intimacy is a psychological event that occurs when trust levels between two people are high enough to foster the mutual sharing of one another's deepest selves (Viet et al, 2017). Barebacking allows gay men to share a psychosocial bond based on the shared experience of having sex without a condom, something that straight people don't have. From this perspective, the motivation for bareback sex is a deeply held desire for the most profound form of intimacy, a desire that goes beyond merely wanting to be close to another gay man and crosses over into a need for union.

Transgression Barebacking is a transgression from societal norms and rules. For most of the last century, society viewed gay men as sexual deviants, and part of the gay male identity developed from that outsider perspective (Hoppe, 2011). Over the last few decades, homonormativity has slowly crept into the gay male culture. Part of that homonormativity are the pervasive messages about safe sex, so having sex without condoms is a way of rebeling against the homonormativity of the gay male community (Dean, 2009). It gives gay men who bareback that outsider perspective again.

Coolness It used to be that being a gay man made you different but in a good way. It made you stand out from the crowd just enough to talk yourself into believing you were something special. With the growing acceptance of homosexuality in mainline culture, being gay has become a rather ordinary experience. Barebacking restores that sense of specialness. In other words, being a barebacker makes you cool.

Masculinity In the barebacking subculture, bareback sex is regarded as a distinctly masculine activity. Social identification with the barebacking subculture can be understood as a rejection of negative cultural representations of the desires and behaviors of gay men (Dean, 2008). By barebacking, gay men at once define what it means to be masculine and place themselves within that definition.

As with any subculture that develops within larger culture, many factors must exist for it to thrive and grow into something that is distinct and recognizable. Gay men who identify with the barebacking subculture are motivated by these and other factors.

The Attempted Reshift

Removing condoms from the sexual equation makes sex so much better it is almost like an entirely different experience. Unburdened from the fear of super infection, many HIV+ gay men quickly began to have sex without condoms exclusively, and they intentionally sought out other HIV+ men because it eliminated the risk of HIV exposure to someone who was HIV- but also because it simplified the entire experience. For more than a decade, HIV+ gay men were having better, hotter, more sensual sex than HIV- gay men, and absolutely everyone knew it especially HIV- gay men. Sure, they could have the same sexual experiences, and many of them did, but there was no way for them to eliminate the risk of exposure. Then, along came Truvada, and the gay sexual landscape fundamentally changed once again. When Truvada hit the market in 2012, it ushered in a new era in the fight against HIV/AIDS. This HIV medication is used by HIV+ gay men to treat the viurs and also by HIV- gay men to prevent being infected with the virus. Suddendly, HIV- gay men could bareback without the stigma they themselves had placed on the practice and without worrying about becoming infected. This put everybody on an equal playing field again. Exactly as expected, no sooner did this happen that HIV- gay men attempted to revive the status quo. Today, HIV- gay men everywhere desparately try to put themselves on a pedestal above HIV+ gay men, but instead of asking "are you positive or negative", they ask questions like "are you undetectable"? Most of them don't have a clear understanding of what the question means, but the moment I tell them that I am not undetectable, they can't reject me fast enough. But the joke's on them. I wouldn't have sex with them if my life depended on it.

Works Cited

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