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To Fuck Or Be Fucked… That Is The Question: Myths About Anal Sex That Help The Spread Of HIV.

sexualityDiscussing unsafe sexual practices and beliefs instead of safe sexual practices may be seen to be controversial. We are also being very explicit with our terminology. We make no excuse for either of these things. We need to be explicit about the sexual practices that spread HIV, unprotected anal intercourse in particular. We are trying to redress the myths, beliefs and emerging cultural norms that have grown over time as a result of the extended impact of HIV/AIDS. HIV is still a real and present danger within our community.

More and more gay men and MSM in Perth are choosing to fuck without condoms. Make no mistake. HIV is continuing to be spread as a result of this risky behaviour.

After more than 20 years of living with the epidemic, we recognise that gay men have considerable knowledge and understanding of HIV. They are creating strategies that enable them to feel safer about not using condoms based on their knowledge of HIV and their beliefs about how HIV is passed on.

But Chinese whispers abound in this environment. People talk about what they believe is safe and pass this on to others – serosorting (fucking with only other neg guys when you’re neg), topping instead of bottoming, fucking with guys who have an undetectable viral load. Some of these strategies are effective in reducing risk, but the belief that these strategies eliminate risk of virus transmission is a dangerous untruth.

There are some commonly held ideas surrounding anal sex without condoms and HIV transmission that are fuelling disturbing risk-taking behaviours among gay men and MSM. Here are just a few.

Myth: I’m neg. So, if I top and don’t use condoms, I’m still safe.

Truth: Topping, or being the insertive partner, is statistically safer than bottoming. But a lower risk doesn’t mean ‘no risk’! Other factors can confound this and increase risk. If you or your sexual partner has another STI, risk of HIV transmission is increased up to 10-fold. Recently seroconverted bottoms have astronomically high viral loads and are considered the most infectious during the window period and early on in the progression of the virus. ‘Seroconvesion’ is the term used to describe a person converting from HIV negative to HIV positive.

Myth: I’m poz. So, if I bottom and don’t use condoms I won’t pass on the virus.

Truth: This is a similar argument to the one above, so the issues with recent seroconversion and STIs make this unpredictable and unknowable.

Myth: If I only fuck bare with other neg guys, I’m still safe.

Truth: Neg guys fucking with other guys who say they are neg is extremely problematic. At the end of the day, there is no way of really knowing the truth of his sero-status (‘sero-status’ is the term used to describe whether a person is HIV positive or HIV negative). There are a few scenarios to consider:

  1. Is he telling the truth? Due to stigma, discrimination and basic fear of rejection some guys are not prepared to front up about their sero-status when asked.
  2. He truly believes his sero-status is negative. Unfortunately, that thinking is only as good as his most recent HIV testing, if he has had a test at all! If he is prepared to fuck bare with you, he will probably be doing it with others. Remember, if you fuck bare with that guy, you are fucking bare with all of his sexual partners.
  3. He may be within the window period, so his HIV tests will show up negative, but he may be positive and not know.

Fucking with guys who have the same sero-status as you only works for guys who know they are definitely positive. Even then, issues with other STIs complicate matters.

Myth: If the bottom has an undetectable viral load, I am safe to fuck him bare (viral load is how much HIV is in a 1 millilitre of blood).

Truth: Recent studies point to this as a possible strategy for reduced risk. Again, that does not mean ‘no risk’. The studies that were conducted followed only 100 heterosexual couples in a poz-neg relationship where the poz partner was adhering to treatments 100%, there were no complicating STIs and there were no sexual partners outside of the relationship. There has been no such study done on male-male sex, nor on the unprotected anal intercourse.

Myth: If he pulls out before he cums up my arse, I’ll be safe.

Truth: Early withdrawal does not account for HIV in pre-cum when we are discussing unprotected anal sex. It is not an effective way of preventing HIV transmission. HIV can be present in pre-cum and the anal canal can be easily damaged in the normal course of barebacking. Guys have become positive even with no cum inside them.

Myth: I’ll be safe if I only have sex with young guys because HIV is an older gay man’s disease.

Truth: HIV can’t tell the difference between people – younger or older, male or female, straight or gay, married or not. You can never really tell by looking, and you can never know the whole truth about someone’s sexual history.

These myths, and the trend towards unprotected anal intercourse, have been identified through community consultation, outreach data, internet observations and surveys in Perth.

Our surveys tell us that gay men are modifying their sexual practices to include one or more risk-reducing strategies to lessen the risk of HIV transmission based on their knowledge of HIV. We see no point in denying that many of these strategies do, in fact, work in regard to reducing risk infection and that many of these community beliefs are founded. But they only reduce the risk, they do not take the risk away. Gay men and MSM need to become much more aware of the true risk factors and then make choices about how to have anal sex.

Becoming well-informed and communicating is the best way to change mistaken beliefs. Speak up when negotiating your sexual practices – not just “what are you into?” but also ask questions like “what do you do to stop the risk of HIV?” If the question is out there, it will soon become the norm; an accepted prelude to sex between men and an important tool in limiting the spread of HIV.

Let’s reinvent the joy of male to male sex, but let’s do it safely! We have enough knowledge and understanding out there to be able to make informed choices about what we need to do to ensure our safety and the safety of our sex partners. We need to expand our discourse about sex to dispel misconceptions and false beliefs about HIV.

The Project X Team invites you to discuss this hot topic with your friends and lovers. We invite you to discuss them with us at Project X. Take a good look at your own strategies: do they ‘lessen’ the risk or do they ‘stop’ the risk of HIV?

 
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    Want to find out what it is like for other guys? Want to get support and information from guys who understand where you are coming from? The Project X Team from the Gay/MSM Program at the WA AIDS Council adopts a peer education model in our health promotion, outreach and education. All our programs are run by Gay/MSM guys and one to one peer support is also available.