Tuesday, October 21, 2008

Email from a young guy with a concern about HIV

When I woke up this morning, I lay in bed for a few minutes cuddling up to boyfriend P, but wondering what I should post on my blog today. So later when I found an email in my inbox from a reader wanting some advice, it seemed like an ideal choice. The email was as follows:

Dear GB,

I can’t quite remember how I stumbled upon your blog, however that is irrelevant, as it has been revolutionary for me. As a 19 year old closeted student I hadn't indulged in any form of intimate contact with men till a few months ago as I wasn’t 100% sure. It was your site that persuaded me to use Gaydar, and it has been so emancipating. Thank you.

After finding several people my age, amongst the waves of old men offering to bottom, I decided to meet with one guy. One thing led to another and, well, I ended up staying at his and we had a fun time. We have since met up several times and engaged in all but full blown sex. However I am fearful he is HIV positive. The reasons are:
  • I have suggested anal sex several times, and he refuses to bottom as "he likes being in control" – ok that’s fair enough;
  • I am happy to try bottoming and he always seems so nervous about doing so, and uses the excuse he is too tired;
  • He's very slim;
  • I nosed around in his medical cabinet nothing there, but he went to his studio to get medication; and was very coy about it;
  • He’s asthmatic.
Since writing the above I feel somewhat pathetic coming to the conclusion I have, but I still have this underlying fear. So should I ask him, if so how? Would you still engage in oral sex if he was positive (very personal don’t worry about answering)?

Many thanks,

Doing anything in life carries some level of risk, from walking down the stairs in the morning, to participation in dangerous sports. Having sex with another guy carries a risk which lies somewhere in between those two extremes, because it's possible to pick up quite a variety of infections and diseases including HIV. These days HIV seems to be a manageable condition, however just because it isn't the assured death sentence that it was twenty five years ago doesn't mean it should be ignored. On the contrary, it's still incurable so it's important to avoid being infected if possible. For this reason, as I said a few months ago, when meeting guys for the first time I always ask about their HIV status.

Reading the reader's email, none of the reasons that he gives indicate that the guy is HIV positive. I reckon the only real suspicion arises from the fact that the guy is on medication for something that he hasn't disclosed, but of course he could be on medication for absolutely anything including his asthma if he gets it badly.

As the reader suggests, since they've now met up several times, if they're going to continue seeing each other I think it's reasonable to ask about HIV status. But the reader shouldn't make a big issue about it. Perhaps asking along the lines "By the way, I know you're taking medication for something, so I've been wondering about your HIV status … ?" would work without seeming unnecessarily intrusive.

Even if the guy thinks that he's HIV negative though, there's a possibility that he's actually HIV positive and doesn't know it. Apparently after being infected it can take up to three months for an HIV test to produce a positive result. So whatever the guy's apparent status, if the two of them start having full anal sex the reader should make sure that they always use condoms.

Regarding oral sex, although HIV transmission in that situation is much less likely than with anal sex, it's still possible especially if the guy doing the sucking has bad oral hygiene or bleeding gums. So I wouldn't advise sucking a guy who's definitely HIV positive, because I think the pre-cum of an infected guy does contain some HIV.

Do any other readers have any thoughts on this subject?


SubtleKnife said...

Someone I admire said there are only two truthful answers to "Are you HIV-positive?". One is "Yes", the other "I don't know." If you look at it like that, it really doesn't matter whether your reader asks or not.

My advice to him would be to always take precautions and then... relax and enjoy it.

If you worry about it too much, you're going to end up with the ultimate prophylactic: abstinence.

As for oral, I enjoy it too much and my gums are usually alright. There are flavoured condoms, but I've never tried one. Any opinions?

Mike said...

Well, being a medical student, I can advise him to be very careful in relation to oral sex.

"Numerous studies have demonstrated that oral sex can result in the
transmission of HIV and other sexually transmitted diseases (STDs)."

To those of you who want to know more, here are the links from CDC:




Kenski said...

HIV to one side, my advice would also be to take this 'concern' as a wake-up call about sexual health. We're not often taught as kids that it's okay for us to be proactive in taking care of ourselves. When single we're often predatorial, sleeping with multiple partners, and that puts us at risk.

GUM clinics are there for our benefit and, whilst daunting to visit the first couple of times, they really aren't that scary. If you have any tangible evidence that something's wrong 'down there', go get it checked. If it turns out you're fine then great, no worries. If not then you can get it sorted there and then before a) it gets much worse and b) you unwittingly pass it along to someone else.

Sir Wobin said...

Act like they are positive until you know otherwise. Use condoms when having penetrative sex. It's the only way to remain safe.

Your man might have concerns about you that he also finds hard to talk about. You could suggest a joint trip to a GUM clinic for testing. That way you can reassure each other and yourselves, bringing you closer together.

Whether you're in a relationship or not, it's sensible to monitor your sexual health with occational visits to a GUM clinic. I do.

Superchilled said...

I wrote an article on the safety of oral sex a while back, posted here at 1234men's health.
It might give some useful tips.

It's always worthwhile communicating and asking sexual health questions - but be aware that your sexual partners may not know all the correct answers.

Bryn said...

Ask and get tested. I think the comment that this is a wake up call about sexual health. It may seem scary to think about it, but hopefully having this one scare will make your reader more aware of their sexual health for the future.

Oh I definetely agree that it is best to use precautions for oral sex but we do think the risk will be low.

yevgeniy said...

if a guy askes me that question (what is your HIV status), it will make me question his IQ level.

ok, i ll tell him i m HIV-. so what? i may be lying. i may have gotten tested 6 months ago and got infected since. one needs to use condoms anyway.

as my ex said (he s HIV+) - it is not the ones about whom you know they are HIV+ that you need to worry, it is the ones you don't know about.

Marc said...

The "lying" around HIV, in my experience, is almost always that of omission. Some men who aren't asked won't tell, but very few will lie when asked directly.
No one should ever feel tense about asking. The biggest spreader of this disease is the taboo and shame around it--discretion can kill.
The important thing is that the asker doesn't react to a "yes" by treating the person like a pariah. This is the fear that keeps the positive from offering it up in the first place.
And the poz (of which I am one) should not only offer it up routinely, but be supportive of HIV- men who choose to try to confine their encounters to other negative men. I won't even have sex with a negative guy, and make sure that info about me is out there at the moment it is clear there's interest.
This disease is taken too damn personally. It's a virus that found an efficient way to spread--most often heterosexually. It's not a referendum on the moral quality of the individual.
Mostly, talk BEFORE sex. There are worse things than deciding not to proceed, say, if you don't like or trust safer sex.

Yevgeniy said...

marc, even if lying is not a factor, HIV- result does not cover last 3 months, so NO ONE can be sure he is HIV- right now. hence the question is stupid and irrelevant in my opinion.

Anonymous said...

I'm 46 years old, have been HIV+ for 16 years with an undetectable viral load, very high cell count and look good enough that lots of men, especially younger ones flirt me me. However, after an unpleasant experience this summer I'm unwillingly abstinent: I met a man I fancied who by the time we got home was only interested in bottoming me, and I just can't do it, even if I did at one point enjoy passive sex with a partner, not a one-night stand. Due to an anal fissure I developed a tumor since removed, it was malignant and I had to go through radiotherapy and my oncologist suggested I no longer try anal sex. Needless to say I explained the situation to him but he kept trying to persuade me. The results: I couldn't perform at all except for attempting oral sex and holding him while we slept. It was a major turn-off. I wonder if younger men expect to be bottomed by an older chap. Being quite a cuddler myself I'd feel much more comfortable in such a role and of course I use protection. Any thoughts?

Kyle said...

Even if the result does not cover last three monts, i think it should be always advisable to ask.
That's because of the reasons Marc stated and because if i know you got tested three months ago, I know that three months ago you were healthy - you may have gotten something lately but since it is clear that you had more intercourses throughout your whole life than in the last period, and since every partner adds up some risk, I know I should worry about a limited span of time. It's maths.

Yevgeniy said...

to kyle. it s not maths. it s a false sense of security. but suit yourself.