February 22, 2010
Need-to-know info on safer sex
Posted by: Chris
If you are a sexually active gay man, or if you know someone who is, then you need to know about a just released study that raises some findings that challenge the current conventional wisdom about safer sex:
The introduction of effective drugs against HIV, the virus that causes AIDS, has not changed gay men's risk of contracting the virus during a single act of anal sex, new research from Australia shows.
This finding was "unexpected," the study's authors admit, given that treatment with AIDS drugs sharply reduces the concentration of HIV in a person's blood, which would theoretically make it more difficult to transmit the virus.
It's been accepted wisdom among gay men and our doctors ever since the early successes of the "AIDS cocktail" of retroviral drugs that reducing the viral load in the bloodstream and other bodily fluids of those with HIV would also reduce dramatically the risk that they could infect others. At least according to this new study, that assumption was false.
The riskiest type of sexual activity was receptive anal sex with ejaculation into the rectum; each such act carried a 1.43 percent risk of contracting HIV. If a man's partner withdrew before ejaculation, the risk dropped to 0.65 percent. Circumcised men had a 0.11 percent risk of contracting HIV for every insertive sex act, while the risk for circumcised men was 0.62 percent.
The findings are "very similar" to a US study done in the early 1990s, the researchers note, which found an 0.82 percent risk of contracting HIV for every instance of receptive anal sex (whether or not withdrawal occurred).
I tried for years when I edited the Washington Blade and a number of other gay publications to get this kind of straightforward info about the risk associated with various sexual acts, both as the active ("top") or passive ("bottom") partner. We were, for the most part, stonewalled by public health "experts" who were loathe to trust gay men with actual info, favoring instead the tired "AIDS panic" approach of trying to scare men into using condoms by implying that any sort of sex was equally risky.
The results of the Aussie study are surprising because rates of HIV testing among gay men there are high (70%), of the HIV viral load is "undetectable" in three-quarters of those under treatment. And yet the risk of exposure appears not to have changed from the '90s, when almost no HIV-positive men had "undetectable" amounts of HIV in their bodies.
- If you are HIV positive, you owe it to others to always always always wear a condom every time you top, unless you are sure than your partner is also HIV positive. No rationalizations like "he should ask if he wants to know"; no excuses like "I'm undetectable so sex with me is safe."
- If you are HIV negative, you should never never never allow someone to top you without a condom, no matter what you may think about their HIV status or whether they are on the cocktail and seem healthy. There is still no cure for AIDS or reliable information about the long-term harm from HIV meds. It's not worth the risk.
- Finally, it's way past time for the panoply of organizations that make up AIDS, Inc., having received millions in public and private funding to educate gay men and others about the risks of transmission, to disseminate specific information like this so that each of us can make responsible choices about our sexual conduct.
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