As an HIV negative guy have you ever thought about knowingly dating someone who is HIV positive? Your first reaction could be to head for the hills at the mere possibly! Perhaps you've experienced being on a date or were about to strip off for a steamy sex session when the guy let you know that he's HIV positive. Many of us are likely to feel a sense of panic or even revulsion.
That's credit controller Sean's (29) reaction at the thought of dating an HIV positive guy. "Hell no, I would never do it. The risk is just too high," he says. "I don't know if I'd be able to even get it up because I'd be paranoid about every little thing."
OUT's Health and Well-being Manager Jacques Livingston says that, to some extent, Sean's reaction is normal. "We all have a fear of contagion. It's very primal and we all have this anxiety to some degree or the other." But he is quick to point out that the way that we manage it depends very much on the individual.
Jacques points that another fear that confronts people in these scenarios is that of loss; of losing a partner, the possible loss of your health and the loss of a possible future together. But as HIV becomes better managed, people live longer with the virus, and "servo-discordant" couples (the official term for a couple in which the partners have different HIV statuses) become more open, some don't see the issue as such a big deal anymore.
Journalist Ferdie (35) has no problem dating someone that is HIV positive. In fact he was involved with an HIV positive partner for almost a decade and, while now single, remains HIV negative. ("It wasn't the virus that broke us up," he makes sure to point out.)
"It's just a disease and shouldn't influence your feelings for them. There are ways and means of having sex and being almost 100% sure that you won't get the disease," he says. "Everyone has their problems – they could suffer from depression or diabetes for example – you can't stop that from establishing a connection with someone. It's a set of challenges and circumstances that you need to know if you can or want to deal with."
HIV positive activist Pierre (45), who has been dating HIV negative Francois for six months, insists that HIV should not be a barrier to dating someone. "If you're afraid of falling in love because of possible complications that might arise in the future, them well my goodness. Life is made of complications - and you will never find a scenario or relationship without complications."
For sales manager Andres (30), who is also HIV positive, the dating game is definitely more complicated because of his status. He says that the biggest anxiety for him has been the fear of rejection when someone finds out. "It's my own fear of other people's reactions, especially when I really like someone." It's a fear that led him to date only HIV positive guys for a while because he thought it would simply be easier.
"But I found that at the end of the day they are still people and if they are not the right fit for you they not the right guys, regardless of their status." He explains that he generally doesn't discuss his status on the first date, "unless it ends up in the bedroom" and waits for what he feels is the appropriate time.
Pierre, who has been HIV positive for 28 years, has seen things change dramatically over the years. "When I was first diagnosed, people would literally run away in fear when I told them I was positive. In those days we thought you could get it just by looking at someone." Today he will let a potential partner know no later than two weeks into dating about his status.
Andres says relationships with guys that are HIV negative have been quite challenging. "I was always super conscious of protecting my lover. It actually became exhausting at times. Plus, I was always concerned about what his friends might say." He believes that "it was my fault [that the relationships failed] mostly as I was operating from a place of fear. I was unable to share how I really felt and pushed them away".
Each discordant couple has their own strategy to avoid infecting the negative partner during sex. This can include using condoms every time they have sex, only having oral sex, pulling out before coming or only allowing the positive guy to bottom. There is also research which suggests that risk of HIV transmission could be greatly reduced (possibly by more than 90%) if the HIV positive partner is undergoing ARV therapy that has successfully lowered his viral load (the amount of virus in the blood) to undetectable levels. These all have varying risk levels so every couple should be aware of what these might be and talk about them openly.
When it comes to safe sex, Pierre and Francois are on the cutting-edge of discordant relationships. While Pierre is on ARVs and has an undetectable viral load and they used condoms at the start of their relationship, they have since abandoned condoms in favour of a controversial new strategy: Francois also going on ARV treatment – even though he is HIV negative. Known as PREP (Pre-Exposure Prophylaxis) the idea is to use ARVs to stop someone becoming infected before they are exposed to the virus.
"We don't use condoms now. My viral load is undetectable – and we monitor this every six months – and then with Francois on PREP, the risk of him catching it is almost non-existent. It's not full proof, but nothing is. A condom is also not 100 percent risk free; It can break and it can be old. I think this is better than a condom..."
Pierre admits that the treatment is still experimental; the long terms effects are not known and there is concern that people may think "I'll take PREP and I'll just fuck around", he says, but he's convinced that after much discussion and research this makes sense for them - and that it will become increasingly more common among discordant couples.
The one positive about dating someone that you know is HIV positive is simply that you KNOW they are. At OUT's offices in Pretoria, Jacques points out that a survey conducted by the organisation found that a large percentage of men who have sex with men and who know that they are HIV positive choose not to disclose this to their sex partners. And in turn their partners usually don't ask – perhaps because they don't really want to know.
So it seems that while knowingly dating or loving someone who is HIV positive is no walk in the park, it's also no certain catastrophe for those who are capable of managing the virus in a relationship. It's ultimately an individual choice that if freely taken with knowledge and insight has no right or wrong.
If you have any questions about being in relationship, whether casual or serious, in which one or both of you are HIV positive, then contact one of the OUT or Health4Men offices or clinics. They provide friendly and non-judgemental advice, counselling, testing, free ARVs and other services to men who have sex with men and can be contacted in Pretoria: 012 430 3272, Soweto: 011 989 9756, Green Point Cape Town: 021 421 6127 or Woodstock Cape Town: 021 447 2844.
*Names of some of those interviewed have been changed.
Originally published by Mambaonline.com