Why Gay Men Still Don’t Talk About HIV

Writer Jameson Fitzpatrick opens up about risks, stigma and the unpleasant realities of being a gay man.

When the mainstream media reported on Charlie Sheen’s HIV status, many writers resorted to sex-shaming and fear-mongering that was eerily reminiscent of early responses to the AIDS epidemic.

LGBT media outlets, rightfully, were quick to to call out the outdated and offensive language used to discuss Sheen’s situation.

But, while we may be more informed about HIV than our straight peers, many gay men continue to perpetuate shame and ignorance about the virus.

Handsome gay couple on Campus
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HIV-related stigma in gay communities remains a serious problem, connected to high-risk behavior, sub-par medical treatment, dating rejection and lower rates of testing and counseling.

Young gay men who did not experience the worst of the crisis first-hand have a particularly complicated relationship to HIV: They’re the population with the highest rate of new infections (19%), and the only group that has seen a significant rise in recent years (a 22% increase between 2008 and 2010).

I grew up hyperaware of the legacy of HIV: My uncle—who lived with HIV for many years and died of AIDS-related illness in 2006—was one of the few gay men I knew as a child.

For me and my family, my sexuality has always been associated with the possibility of illness.

Intimate gay couple

Most of the openly positive men I’ve known, like my uncle, have been older. I was curious about the experience of someone from my own generation, so I talked to my friend—and sometimes bedmate—Ben (not his real name).

When we spoke about his HIV-positive status, I was caught off guard by some of Ben’s responses: For one, he’s said he’s never had a guy react poorly.

“I’ve been surprised to find that guys often thank me for being up-front with them.”

Looking back at our own online conversations, I realized this was my response, as well.

Still, he says the social and psychological aspects of his diagnosis were harder to deal with than the health effects. Ideally “all gay men would be knowledgeable about this topic already,” but Ben admits, “you sometimes do have to play the role of educator.”

His viral load is undetectable, but he assumes (“maybe unfairly”) that most gay guys don’t know what that means.

“I feel like I have to give an impromptu information session when disclosing my status, complete with citations in MLA format.”

Gay couple sleeping

What struck me most was when the question of his status comes up: “Only when I bring it up—I’ve never once been asked about my status by a potential sexual partner, whether it’s a guy from Grindr or [someone I met] in real life,” he says.

“I don’t hold this against anyone, because I never used to ask guys when I was negative, either,” Ben admitted. “I understand that it’s not a sexy question. But I do think that, in an ideal world, asking someone about their status would be as normal as asking them ’so what are you into?’.”

Again, I looked back at our early messages—indeed, Ben had been the one to broach the subject, well before we had sex for the first time.

I had to wonder: Would I have asked?

silhouette of man looking out window with flare

As someone who’s negative (and a top, for whom the risk of transmission is lower), the question isn’t built in to my bedroom routine.

I’ve certainly asked, but not always—and more often than not I wait until my partner inquires. Ben’s comment forced me to consider how my own silence makes me complicit in the larger taboo surrounding HIV.

“It’s tragic how many guys are unaware that they have HIV,” he says. “Breaking down the silence around HIV, and holding each other more accountable in terms of getting tested, would make all of us healthier.”

But what’s to account for the enduring stigma among gay men in a time when an HIV diagnosis has never been more manageable?

In some ways we have ourselves to blame.

We can’t acknowledge our inability—as gay men and part of a broader culture—to accept an unpopular reality: Sex is not safe.

This isn’t to say that sex is necessarily unsafe—there are various measures to mitigate the risks—but STIs have been a part of the human experience since the dawn of time and probably always will be.

Gay couple sleeping

Every time two (or more) people become intimate, they accept some degree of risk. Whether you’re bottoming bareback with a trick or in a long-term monogamous relationship, there is no foolproof guarantee of sexual health.

People cheat, people lie, people don’t get tested often enough. And even the tests themselves have margins of error.

And, yes, the risk is statistically greater for gay men than for straight people.

It’s not uniform, of course: It’s higher for men who engage in penetrative anal sex, for bottoms, for men with many partners, etc. But its presence remains a constant.

We hate this fact—that on top of the social stigma we face about our sexuality, our own pleasure can hurt us.

Young male couple looking at smartphone together
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We hate that our desire, so hard-won, can betray us. We hate that we must be vulnerable and take ourselves out of the moment. So we transfer this anger and anxiety onto HIV itself, the most urgent (though not only) reminder of sex’s risk for gay men.

HIV stigmatization then becomes a way for negative people to distance themselves from their own mortality. And to pretend we’re not making a choice to have sex in spite of the danger.

But HIV doesn’t exist in and of itself, so positive people pay an unfair price—summarily (and sometimes cruelly) dismissed on dating apps, demonized in the media, blamed for having engaged in the same behaviors that negative people do.

Before every positive gay man was positive, though, he was negative. The difference, while not inconsequential, is a small one.

Ironically the stigma makes sex more dangerous for everyone: The more afraid we are to to acknowledge the risk, and talk about HIV as something that affects everyone, the harder we make it for positive people.

Harder to disclose, to get treatment, even to get tested and learn their status in the first place.

And harder, as Ben pointed out, for us all to make informed decisions about our sexual health.

A man handing condoms to his partner

We owe it to ourselves and, more importantly, to each other, to have conversations about HIV—however uncomfortable or unsexy it may feel. It’s the only way these conversations will ever become comfortable or sexy.

I’m HIV-negative. I get tested regularly and have not tested positive for any STI. (I did have crabs once—twice, if you count not getting rid of them the first time.)

To my knowledge, Ben is one of the few positive partners I’ve ever had—and the only one with whom I’ve had penetrative sex.

“To my knowledge” is an important caveat, though: I can’t remember every guy I’ve ever had sex with, let alone if I was aware of each one’s status. I’ve barebacked regularly in a committed relationship, but, as a rule, use condoms for “recreational” sex.

I’d be lying if I said I’d never been drunk, or in the heat of the moment, and made an unnecessarily risky choice. I’ve also had bareback sex with guys who are on PrEP and get tested regularly, though it’s not something I do often.

Topping Ben with a condom is, in fact, one of the less risky sex acts I’ve performed. Given that he’s undetectable, and that the chance of my contracting HIV that way is statistically small, my desire to remain negative doesn’t outweigh my desire for him.

For me, the choice wasn’t difficult. Nor did it give me much of a reason—unlike some of my past sexual decisions—to be nervous when I got tested three months, and then six months, later.

More recently, though, I found myself challenged: I was on Grindr, chatting with an older bottom looking for a younger top. He told me he was positive, undetectable and preferred to play raw.

I told him how hot he was, but that I had to play safe. He apologized, politely, and said he’d played safe for years and wanted to live his life.

For a brief moment, I considered his offer—he was hot, and topping an undetectable guy bareback wouldn’t be the biggest risk. But then, just as quickly, I resolved not to.

I didn’t know enough about this guy on the basis of his pictures alone. And I knew myself enough to know that it wouldn’t be a decision I’d feel good about—not for longer than the length of our encounter, at least.

While I can respect his willingness to take that risk and, especially, his open communication, it wasn’t worth it for me.

Gay Dating Apps Get Men's Attention For HIV Message

Some risks are worth it—like bareback sex with a negative boyfriend, or wordlessly fooling around with a guy in the Meat Rack. I don’t deny the danger in such behaviors, but, for me, they are worth the pleasure.

Of course, the risk inherent in any sexual encounter is no reason to become celibate. But it does mean we each have a responsibility to our personal and collective sexual health: To know our boundaries, to get tested regularly, and, whether we’re willing to take a risk with someone or not, to talk about it.

This is most important to do with our partners, of course, but our friends might be a good place to start. The last thing Ben told me was how much he wished that more positive people would disclose their status to their friends.

“HIV is only this dark thing we think no one has because no one says they have it,” he explained.

So let’s keep talking. Let’s accept that safety is never guaranteed in sex, but that it’s up to us to make it safe to talk about HIV.

And, in doing so, to make sex safer for everyone.

Jameson Fitzpatrick is a poet. He lives in New York and believes Susan Sontag's "Notes on Camp" is the greatest listicle ever written.