A few months before I started taking Truvada for PrEP, I got hit up on Manhunt by a gorgeous HIV-positive guy who wanted to fuck me bare. He was frank about it, telling me that his viral load was undetectable and had been for years and that he wouldn’t cum inside me. In all honesty, I blanched at his frankness.
For years, I had been telling friends (and anyone else who would listen) that choosing to only have sex with guys who think they’re HIV-negative wasn’t really an effective prevention strategy for guys in areas of the country like mine. Where I live, there are plenty of guys who think they’re negative who are actually positive because they haven’t been tested in eons. Transmission is mostly likely going to occur with these guys – not with guys who know they’re HIV-positive.
That may seem confusing at first, but the science behind it is straightforward. When you’re diagnosed as HIV-positive today, most doctors immediately recommend you start taking medication to treat the virus. HIV treatment can fight the virus so effectively that it makes the virus “undetectable” in your system. If the virus is undetectable in your body (and you don't have any other STIs), it’s virtually impossible for you to transmit the virus. Guys who don’t yet know they’re infected aren’t taking these drugs. Without treatment, there could be tens of thousands or even millions of those tiny little critters in just one milliliter of blood. Having that much virus in your system dramatically increases the odds that the virus will be transmitted during sex.
This isn’t just my “opinion”: a recent study estimated that the majority of new HIV-infections in the US are the result of having sex with someone who didn’t yet know that they were poz. The CDC estimates 20% of HIV-positive people in the US don’t know they’re infected – yet it’s this 20% that researchers estimate account for between 54% and 71% of new infections.
The hard-to-swallow truth is that, for guys with a lot of partners (like me), fucking poz guys with undetectable viral loads is actually safer than fucking raw with guys who think they’re negative.
All right, so I’ve known these numbers for years – and yet I was still having trouble wrapping my head around the idea of condomless sex with an HIV-positive guy. I had been trained my entire life to think of that as anathema, akin to reckless self-endangerment. The kind of thing only a crazy person would do. I knew the science had totally debunked that kind of stigmatizing fear-mongering, and yet here I was, faced with an enticing proposition from an HIV-positive guy and feeling downright anxious. It was then and there I decided that it was time I put my money where my mouth was; it was time for the rubber to hit the road.
Unfortunately, the guy ended up being a creep, so I didn’t get to test my metal. It wasn’t until I started taking PrEP (about two months ago) that I started to seriously think about what it would mean to fuck with poz guys. Because I liked to fuck raw, I had pretty much organized my sex life around the rubric of “serosorting” (or, only fucking other guys with the same HIV-status) – but I knew that this system was flawed and bound to fail. With PrEP at my side, I started to incorporate poz guys into my sexual community. I started messaging them online. I joined BarebackRT, where the bulk of guys are poz. I began to open myself up to the possibility of sex across the sero-divide.
As it turns out, seeking out sex with poz guys raised a new set of issues that I didn’t anticipate. First, just as I had spent years telling myself that I wasn’t supposed to be fucking poz guys, many poz guys are simply not interested or willing to have sex with HIV-negative guys. Why concern themselves with my limits, when they can find sex with poz guys who don’t have to worry about transmission?
But more importantly for me, I had to learn exactly what my limits were. This is more of an ad hoc process than I anticipated. Do I let poz guys cum inside me? And what about poz guys whose viral loads aren’t detectable? I learned my answer to both of these questions recently, but not until my legs were already in the air. Before having sex with the first poz guy I let fuck me raw, I had a lengthy discussion about viral loads and safety. He reassured me that his partner of eight years was negative, and that “I know how to keep my bottoms safe.” It was, in fact, reassuring. As he was about to cum, though, I was faced with a dilemma. I love for guys to cum in my ass, but I could feel the nerves running through me that told me I wasn’t so sure I was up to it. He asked where I wanted him to cum, and I told him to cum on my back. You gotta take your harm reduction where you can find it, I suppose.
More recently, I was having sex with a poz guy and he started rubbing his dick against my hole. It felt fantastic, and I wanted him inside me. But we hadn’t discussed viral load and I knew that he had only been diagnosed two or three months before. I asked him, dick-pressing-against-my-hole, “So what’s your viral load?” He looked conflicted, shyly confessing that he couldn’t remember. I kissed him. “But I guess it was something, then, and not undetectable?” “I guess so,” he replied. I told him I would be down to fuck, but only with condoms.
I couldn’t believe the words were escaping my mouth. Condoms!? I was suggesting condoms? But as I came to realize later that day, our encounter may well have been his first time with a negative guy since he was diagnosed. We were both learning, it turned out.
I’ve heard from guys who’ve emailed me to say that PrEP has helped give them a certain peace of mind, but what has been remarkable is the variety of ways that guys report PrEP pushing their boundaries. Let’s face it: PrEP won’t magically turn a guy who’s deathly afraid of swallowing cum into a barebacking, cumguzzling trick-turner. Wherever your boundaries are now in regards to HIV, PrEP is likely to push at them – but how far, and to what end, is entirely dependent on where you begin your journey.
For me, PrEP allowed me to start incorporating poz guys into my sex life, when they had for so long been absent. I am deeply grateful for that. I have long believed that excluding them was wrong and more likely to be informed by stigma than science, but I didn’t have the guts to change my ways. PrEP changed that.
Of course, some guys out there may think PrEP and undetectable viral loads are redundant – that PrEP is really there to protect you with guys whose viral loads aren’t undetectable. Scientifically, that’s almost certainly a sound statement. But our sex lives aren’t a perfect science. They’re driven by gut, emotion, and pleasure – the kinds of things for which science can’t account.
Learning sex takes practice. There’s no manual. There’s no “right” way. We figure it out as we fuck.
So here’s to practicing! As always, send a note with your thoughts. I’d love to hear from you! firstname.lastname@example.org.
Jake Sobo is a pen name used for anonymity. Jake has worked in the world of HIV prevention for nearly a decade, and is eager to share his experiences taking PrEP. Having closely followed the development of PrEP from early trials to FDA approval, he was excited to give it a shot when it was approved for use among MSM for preventing HIV.He has spent the better part of his adult life having as much sex as possible while trying to avoid contracting HIV, and started taking PrEP as a way to help him stay negative. He is well aware that the drug is not 100% effective and that he could test positive; while he hopes that does not happen, he knows that he can rely on his numerous HIV-positive friends to deal with that situation should he seroconvert.