Michael Weinstein, President of AIDS Healthcare Foundation
These days it seems to be politically incorrect to congratulate gay men for remaining HIV-negative. The theory is that by celebrating someone being negative that you are indirectly stigmatizing people who are HIV-positive. Under the guise of saying there is no shame in being positive, we are supposed to refrain from advocating for the benefits of staying negative. Unfortunately, this form of self-censorship has crippled HIV prevention efforts.
Let’s start with the simple logic that it is better not to have a deadly virus than to have it. It is better not to have to take heavy-duty medication every day for the rest of your life. Can we assume that navigating the ups and downs of a new love relationship are difficult enough without the added factor of dealing with a partner whose status is different than yours?
Sex and love are the most complicated feelings we deal with. In love and sex, we all make mistakes. In many instances the difference between men who are positive or negative is the luck of the draw. Men who are extremely careful in protecting themselves during casual encounters can throw care to the wind when they are in love. One night of drinking too much can lead to a slip that leads to infection.
It is wrong to blame people for having any disease. Catching bugs, sexual or otherwise, is the human condition. A ‘safe’ life lived without sexual gratification is a life less worth living. Being negative does not make you better than someone who is positive. However, if we wish to protect the individual people we love and our community as a whole, we have to take a stand in favor of people remaining negative.
HIV-positive men can make the most effective argument for why their brothers should stay negative. They know better than anyone the changes that have affected their lives, and most would rather be negative.
HIV prevention is ineffective if we don’t place a value on remaining negative. Vague phrases about self-esteem, conscious decision-making and mutual support are too vague. If we want people to stop smoking, we must place a value on quitting. If we want people to lose weight, they must know the health risks of obesity.
Much of the gay community is organized around meeting men for sex. Gay male sexuality is a beautiful, amazing bonanza, but it carries risks. How can we have maximum pleasure with minimum risk? The protection afforded by condoms and limiting the number of sexual partners are the only proven methods of reducing HIV infections and other STDs.
Pre-Exposure Prophylaxis (PrEP, or negative men taking HIV meds) only works when taken religiously every day. Studies have shown that few men have that kind of discipline, even under ideal conditions, which makes it very risky.
Sex with an HIV-positive man on medication who has an undetectable viral load is also touted as ‘safer sex.’ When you put your own life in someone else’s hands, you are taking a chance. People taking HIV meds (like any medication) very often don’t remember to take them regularly. If you are a sexually active gay man and you don’t use condoms for anal sex, over time you have a high likelihood of becoming HIV-positive.
People smoke, take drugs and eat too much because it gives them pleasure. Men have unprotected sex because it feels better in the moment. It is simply a bad long-term investment. The price men pay for raw sex is too high. Add up the financial, health and emotional consequences and it is a no-brainer.
As a community leader, it is my responsibility to tell people the truth: It is better for the individual and society to stay negative. Tough love can make you unpopular in the moment, but it will win in the end. I wish for every HIV-positive man I know to stay healthy and live life to the fullest, and I wish for every HIV-negative man I know to live a lifetime without becoming HIV-positive.