Research shows that if they're getting treated, I'm not at risk of contracting it from them—even without a condom.
Image courtesy of Cole Grissom
"I'm HIV positive."
These were the last words uttered by a man during my first sexual encounter after a seven-year hiatus from homosexuality. Immediately I burst into tears—onto his dick. I was single for the first time since my early twenties and I was terrified. The little I knew about HIV came from watching Philadelphia—which, to be fair, was really about AIDS—so my knowledge base was hovering somewhere below ignorant. I quietly cried as I pulled my pants back on and hoofed it to my car where I sat contemplating the new reality of HIV in my dating life.
After coming out at 16, before the dawn of the apps, I fumbled around high school and college attempting to date, which ended up largely unsuccessful. And then, surprisingly, at the end of undergrad, I stumbled into a relationship—with a woman. I think I just genuinely fell in love with her, as a person. And, yes, our sex was amazing, but let's be clear, I'm gay. As in, never-ate-her-out, firmly-on-this-end-of-the-Kinsey-spectrum gay.
After this stint, I flailed my way back into the testosterone-laden waters of man-dating, ill-equipped to deal with things like HIV. And the more I attempted to discover about the virus, the more I realized that I wasn't alone. My friends would often give vague non-answers to my questions, or avoid the topic completely. They seemed to know just as little about HIV as I did. Since they couldn't help—and in an effort to avoid crying on any more dicks—I decided to do some digging. After some research, and speaking with several professionals, I surprised myself with what I concluded: I'd rather have a partner who is living with HIV than someone who isn't.
I was surprised myself, but hear me out. Some of what I discovered contradicts everything we've been taught.
On my journey to deeper understanding, my first point of entry was the PARTNER study that came out in 2016. It looked at 900 HIV-discordant couples—meaning one partner was living with HIV (undetectable and on antiretroviral therapy [ART]) and the other was negative.
From September of 2010 to May of 2014, these participating couples provided detailed sexual diaries, accompanied by routine examinations, which produced a wealth of data that was analyzed, synthesized and then published. Jens Lundgren, director of CHIP, Centre for Health and Infectious Disease Research based at the Copenhagen University Hospital, and also the principal investigator on the study, tells me, "we found that despite studying more than 50,000 [condomless sexual encounters], none of the partners contracted from each other—there was no risk."
50,000? Sign. Me. Up.
"There were 11 instances where someone did contract HIV—but all 11 acknowledged that they had sex outside their relationship, and, using phylogenetic analysis [comparing different DNA or RNA sequences], it was proven that all transmissions did in fact come from outside the relationship," Lundgren adds.
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This was wild to me—from what I've been told, these findings (albeit from a single study) weren't consistent with mainstream messaging surrounding HIV. These results were saying that the risk of transmitting HIV from someone who was living with the virus and on treatment to a negative partner was negligible to non-existent. I had to dig deeper.
"We had information coming [into the PARTNER study] that there was no risk, but the data was weak," Lundgren says. "The impetus for the study was the Swiss statement." In the statement, the Swiss National AIDS Commission asserted that someone living with HIV and on effective treatment (ART) cannot transmit HIV through sexual contact. It provided the caveat that those living with the virus must be undergoing and adhering to treatment, have an undetectable viral load for six months or longer, and have no other STIs. The statement, released in 2008 for doctors in Switzerland, has since seen several important studies produce evidence in support of its claims—the PARTNER study being one of them, and, most recently, the CDC's letter published this past September.
The more I discovered, the more confident I became in my preference. "One of the main things driving stigmatization is fear—the fear of [someone living with HIV] being 'contagious,'" Lundgren says. The risk of contracting isn't from those who are living with the virus and taking their medication as prescribed, it's from those who are unsure of their status. HIV can take weeks or months to test positive. Not knowing your status can, in theory, be no fault of your own, but attributed to the length of time it takes to test positive. And I don't know about you, but even that syphilis test came back negative three times before they were able to definitively tell me what I had. So, when can one ever be 100 percent certain of their status? Unless…they're already positive.
But because decisions surrounding my sexual health have potential long-term, irrevocable impacts, I had to know more. So I went to the source of the Swiss statement—Pietro Vernazza, chief of Infectious Disease Division, Cantonal Hospital in St. Gallen, Switzerland.
His work in the late 90s and early 2000s centered around HIV-discordant couples and their attempts to conceive. During this time, he was one of the first physicians to look at the viral load found in the semen of patients on effective ART treatment.
Spoiler alert: He never found any.
Of all the couples he treated, none of those living with HIV and on standard ART treatment had a discernible viral load in their semen. And yet the couples were under high stress about HIV transmission. He decided to say something—doctors needed to talk to their patients about the realities of the risks involved.
"[Having sex with someone who is living with the virus] is not as dangerous as you think," he says. "I believe it's an ethical requirement to tell your patients this. The risk is so low that to tell patients they must use a condom [to prevent the contraction of HIV] without telling them that there is virtually no evidence to support this statement is unethical."
He tells me that there has not been one case of someone living with HIV, on suppressive ART therapy with an undetectable viral load, passing on the virus. "Everyone wants to be the one to publish that case—but it doesn't exist," he says.
With my understanding of HIV deepening, I took these discoveries and bounded back into the dating scene with new found enthusiasm. Enthusiastic because I now respected the seriousness of the virus without living in irrational fear of it. I figured, I cried on the last dick I had in front of me, it could only get better from there, right? After a lot of swiping, the basic bitch inside me was thrilled when I landed a date with a model.
Everything was going off without a hitch: We were drinking, having a great time, and then we started making out. It was hot. Until he began crying into my mouth. Into. My. Mouth. I pulled away to investigate what the hell was happening. That's when he told me he was living with HIV and was scared that, despite the fun we were having, once he told me, I would get up and leave—because that's what so many others had done. While the HIV didn't put me off, the mouth crying effectively ended any sexual tension that had been building, quickly bringing our evening to an end.
In the car home, as I was trying to process the mouth crying, I stumbled onto a Queerty article featuring the newest dating app to hit the scene (sweet Jesus, just what we need). The app connects wealthy older men with those looking for a sugar daddy. Never one to rule out a daddy, I kept reading. The app, DaddyBear, was specifically not looking for customers who were living with HIV. Finding this jarring, I reached out to DaddyBear for further clarification. A spokesperson for the app solidified their stance:
"We believe that most gay men care more about health than sex when seeking gay arrangement, which is the main reason why we [created] this gay dating app."
In another article, their CEO further confirmed this statement by saying, "No one would like to date people living with HIV unless he is living with it…many rich and successful gay sugar daddies do not want to date gay men living with HIV, which is the reason why we launched this app to meet their needs." (Their asshat of a CEO has since issued an "apology.")
Welp—at that point, I'd officially had it with the tomfoolery of it all. These assertions, and the assertions of others who are ill-informed, are an impediment to understanding and practicing safe sex. I think I just came up with my new app idea—it's for negative men looking specifically to date those living with the virus. Hit me up, developers.
I was eager to give it another shot with the model, but it didn't work out. It had nothing to do with his HIV. He hated my wink—bitch. So, here I am, single again, hopefully armed with enough knowledge to keep me from crying on any more dicks—fingers crossed.
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