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HIV Victims and Villains: Who Is Really At Fault?

Picture of Tyler Curry (@iamtylercurry) courtesy of  Kevin Chung

 

There is a common assumption among the sexually active homo population that it is the responsibility of HIV-positive men to disclose their status before engaging in bedroom gymnastics. Based on this assumption, a person who doesn’t mention his status before he tries and fails to make a baby with another man silently asserts that he is HIV-negative by default. Even if a person living with HIV is undetectable and protection was used, he would be considered reprehensible, immoral and altogether villainous character if he failed to disclose his scarlet plus sign to his unknowing HIV-negative partner. But when it comes to the laws of responsibility in HIV disclosure, sometimes there is more than one suspect in a crime.  

The Scene of the Crime

The following scenario is based on a true story

Parker is a young, successful and single gay man living with HIV. Nathan is of the same homo vein, but he is HIV-negative. The two met while Parker was at a business conference and Nathan was on vacation with several of his friends. A mojito at the hotel pool quickly led to martinis at the closest gay bar. Dinner was served, flirtation escalated and Nathan ended up back in Parker’s room for a little more than dessert. The fast and frenzied pace of this out-of-town romance caught Parker by surprise and he failed to find the right moment to disclose his HIV status (and Nathan never asked). His viral load was at an undetectable level and they used protection, but his conscience wasn’t satisfied with this threshold of safety. 

The Confession

Parker and Nathan parted ways the next morning with plans to meet up for a drink later in the day.  By six o’clock, the weight of the guilt over not disclosing had Parker in need of more than just a strong pour on his vodka gimlet. He needed to clear the air. 

Parker told Nathan that he was HIV positive. He explained that he was on medication and had an undetectable viral load. He said that since they used a condom, his health was not at risk, but that it was important for Parker to be honest about his status. 

Nathan was visibly shaken and admitted that Parker should have disclosed his status before they had sex. He was concerned because there was a lot of kissing and oral play that took place.  Parker explained the reality of transmission and that Nathan had nothing to worry about, but the damage was done. Nathan felt victimized and he was sitting across from the smoking gun.  Needless to say, the two men didn’t order a second round.

For the jury of public opinion, the judgment of who committed the crime and who was the victim receives a unanimous vote. But before the sentence of shame is handed down to Parker for not disclosing his status, let’s look at who had the motive to commit the crime. 

Parker did want to tell Nathan about his HIV status. As a man who was actively managing his disease with treatment, it was important for him to be up front about being positive, even if there was no health risk involved. However, many people fail to understand that when you become positive, you aren’t handed an operator’s guide on how to handle your new status. The variables of sexual psychology are limitless when concerning dating and HIV. Although he failed to disclose that he was a positive man, he had taken the steps to protect Nathan and himself—both by using a condom and being steadfast in his treatment regime. 

Nathan is a sexually active gay man who, by default, is part of the HIV community. With one out of every five gay males being HIV positive, it is his responsibility to protect his own sexual health.  It’s true—Parker did not disclose that he is HIV positive. But Nathan didn’t disclose that he was HIV negative, nor did he ask to know Parker’s status before the clothes started to come off. In this scenario, Nathan has a motive to stay negative. Therefore, he is also guilty of committing a crime of not disclosing his status and not inquiring about the status of his sexual partner.

This is only one out of many criminal scenarios that many of us find ourselves in when it comes to dating, dirty talk and disclosure. When it comes to sex, there are always two (or more) suspects whose motives should be investigated. And when it comes to protecting each other’s health, the burden is mutually shared and the responsibility is equally divisible, regardless of status.

I always disclose my HIV-positive status because it is in the best interests of my health, not yours.   

Comments

I completely agree with the sentiment in this article.  It falls to each person who is having sex to keep their own safety in mind.  There is no right time to disclose your HIV status, positive or negative.  If you want to know, ask.  If you are concerned (and you should be) use a condom--for anything that worries you.  There's more than just HIV out there.

That said, as a doctor, I want to correct Larry's point: just because one's HIV viral load is undetectable in the blood doesn't mean it's not there, just below an acceptable threshold for treatment response.  Further, HIV is still detected in the semen of men who have undetectable viral loads--it's just not clear if it's as infectious as those not on meds.  Long term studies of this have not been done.  The risk is assumed to be lower, but it's still unclear.

I think medical professionals claim this but there is no scientific proof. I've been undetectable for twenty years. It is not in my body fluids...I cannot pass this disease....others yes, if symptomatic. That is all.

I don't agree with the reasoning here.  If one out of five men who have sex with men is positive, it means that 80% of the members of that group are not.  It seems perfectly reasonable to assume, absent a disclosure to the contrary, that your (potential) partner is negative.  Add race and ethnicity into the mix and the numbers become very different.  A huge portion of new infections come from Black and Latino populations.  Thus, if Parker and Nathan are blonde-haired, blue-eyed dudes, the 1/5 number is likely inaccurate.

I was in a long-term relationship with a guy who cheated and became positive.  After we broke up, he rationalized NEVER disclosing his status to men he hooked up with because he was on meds and they failed to ask.  I like to ask someone's status before clothes come off, but I'll admit that I've missed that opportunity a few times.  However, not disclosing a positive diagnosis is WRONG; it robs another person of the opportunity to make their own decision about their health.

Parker should have figured out how to disclose.  Nathan is guilty of making a stupid mistake.

Assuming someone is Negative despite the numbers is WRONG and STUPID. If you want to know for certain...ASK!!!

The ONLY thing one can know "for certain" is that someone is positive. Positive people have a set of information that the rest of us do not.

I was not suggesting that people who have recently tested antibody negative should rely on "numbers" and act as though everyone they hook up with is negative until told otherwise.  Of course, EVERYONE should be using condoms (and maybe other prophylactics) and should ask every partner's status.  However, if someone KNOWS they are positive, THEY SHOULD DISCLOSE.  In the context of that discussion, they may need to educate their potential partner.  But, they have a unique informational advantage.

If YOU want to know for CERTAIN, stop having sex.  There are no guarantees that ANYONE is negative, especially in a world where positive people don't feel the need to share their statuses.  

Each person is responsible for his own health and his own decisions.  Life would be easier for everyone, neg and poz people, is we all play by the simple rules of safer sex.   But people are more worry about others' HIV status and not about playing safe.  Many neg people assume others are negative or believe what any sexual partner will tell them.  We all have to assume that everybody we have sex with is poz or could be, and it is our responsibility to play safe at all times with everybody.  I do not have any sympathy for those who will discriminate against someone poz but will go to bed for someone who may be lying by saying he is neg.  False sense of security,

Asking someone if his status is fine, but basing behavior on his response is foolhardy. He might be lying or he might not know that he's actually positive.  Better to presume that everyone is poz and to protect yourself accordingly by using a condom each and every time you have penetrative sex. 

I like this article, as it brings up the complicated nature of sex and HIV. In reality, we are all responsible for ourselves. I do think it is the proper thing for anyone to disclose their status, however everyone is responsible for themselves! If a person is neg and wishes to remain that way, they cannot wait around and hope that all poz people let them know. Rather, we should all take active responsibility for ourselves and start that conversation, neg or poz.

Just on a side note, I would be cautious with referencing the 1-in-5 HIV statistic. The study that comes from (which this article fails to cite) has a rather problematic methodology, and the only population it really speaks toward is young, gay, poor, black men.

Very Interesting article!  Thank your a very insightful point view.

Not sure I would agree since the negative man could be positive without knowing it, the positive man is not detectable, he can't pass the disease, it is not in his body fluids. Thus I believe even if the sex was not protected, some discussion of health care is appropriate. I'm not saying anything about hiv status, General health, and lifestyle. I realize my words to be controversial.

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