Question: I’ve gotten pretty confused about when to talk with new partners or boyfriends about STDs and HIV status. Some of my friends say that as long as you’re having safer sex, there’s no need to have “the talk.” Others say—vehemently, I might add—that I must have that conversation. What do you think? By the way I’m HIV-positive.
Answer: First of all, I can’t help but note that this week marks the 30 year since the Centers for Disease Control and Prevention first identified the disease now known as AIDS.
With more than 60 million infected worldwide and nearly half that number dead, it’s important for us to remember that this epidemic continues, both here and overseas. It’s also key that the changes in sexual behavior initiated by the gay community back in the ’80s are largely responsible for curbing the spread of HIV/AIDS in the U.S.
I asked a number of experts in the HIV/AIDS field about your question, because there hasn’t always been a consensus on the finer points of disclosure. After talking to them and weighing all the information, here’s my take:
All of us who are sexually active need to be responsible for considering the risks of spreading STDs and for taking steps to protect ourselves and our partners.
Whether positive or negative (or, god forbid, unknowing), we owe it to everyone involved to talk about our sexual health before having sex. I’ve long said that if you’re intimate enough to have sex with someone, you’re intimate enough to talk about HIV status.
Still, it’s usually easier to do this before you find yourself in the heat of the moment, where folks sometimes get carried away by the throes of passion and take risks they might not otherwise. “The talk” needn’t be involved or lengthy—although, admittedly, it can be hard to make this particular topic romantic—but this isn’t a time to be reticent.
Be truthful and direct, saying, for instance: “I just want you to know that as far as I know, I’m [fill in the blank]. What about you?” Sometimes it’s easier if you volunteer your health status first, as a way to open the door. If humor comes to you naturally, by all means try that; but remember, you’re not giving a public health lecture.
Since you mentioned that you’re HIV-positive, let me give you some more advice to chew on.
Even if you’ve hinted at your seropositive status, don’t assume your partner knows. The subtle signals of human interaction—especially sex-charged interaction—are easily misinterpreted. The words you’ll choose will depend both on your personality and on the kind of connection you have with this person, but you should be clear no matter what. Some come right out and say, “I’m HIV-positive.” Others get there sideways, by asking, for example: “Have you ever dated someone who is HIV-positive?” and then steering the talk toward their own health status.
Similarly, it’s smart for HIV-negative people to tell their partners that information, too. This may well help a poz partner disclose his status or help both of you gauge where you’ll play on the safer-sex spectrum.
All that said, there are some caveats. (Nothing is simple these days.) If you’re planning to have anonymous sex, say at a club or bathhouse, it’s hard to imagine having much of a conversation about anything, much less about HIV status. In this case, I’d say that you, as an HIV-positive man, must assume there are HIV-negative guys present and that you should therefore practice safer sex all the time. Of course, everyone may define “safer sex” differently; for instance, where does fellatio without a condom fall on your personal spectrum? An HIV-negative person who finds himself at a similar venue should assume that HIV-positive guys will be among his partners and should protect himself accordingly.
Readers, tell me what you think. And what “rules” you play by.