"Most men don’t use condoms at one time or another..."

You don't need to be a hot, speedo-clad Aussie to take advantage of these sexual risk reduction strategies - via Australia's very cool "Cruising" site - which offer clear, non-judgmental info for sexually active gay men beyond "use a condom every time." The site also features good, practical stuff about saunas (bathhouses), backrooms, sex clubs and crusing online, netiquette, cyber sex - and more.

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What I do makes a difference

Most men have heard a lot, even from a young age, about HIV and how condoms are the most effective way to stop HIV being passed on. In Australia, HIV remains heavily concentrated amongst men who have sex with men with more than 85% of current HIV infections occurring amongst them. Almost every HIV infection amongst men who have sex with men in Australia has taken place during times when men have had anal sex without condoms.

Most men don’t use condoms at one time or another. Sometimes these decisions are made wisely with an informed sense of the risk being taken and efforts made to reduce the risk of getting or passing on HIV. Other times, these decisions are made in a less-than-informed way, with not a lot of effort being made to reduce risk. Sometimes we’re not really sure how risky or safe what we’re doing really is or we just don’t want to think about HIV at the time. So it’s not until later that we start thinking about the risks we may have exposed ourselves to.

What follows here is not an attempt to advise you to not use condoms. It is given in the knowledge that while condoms and lube are always the easiest and most effective way to stop HIV transmission in casual sex, sometimes men don’t use condoms. At these times, there are other things we can do to reduce the chances of HIV being passed on. Most of these strategies will reduce risk but not eliminate it altogether.


Want to top?

Some men of different HIV statuses fuck without condoms by having the negative guy “top” (that is, be in the dominant or insertive position in anal sex) and the positive guy “bottom” (that is, be in the submissive or receptive position). Sometimes this is called “strategic positioning”. This idea is based on the assumption that the chances of the negative man getting HIV are reduced if he is the one that cums inside the positive man, rather than the positive man cumming in him. It’s also based on the idea that “tops” (men who fuck, rather than get fucked) are less likely to get HIV. While this is true and the chances of getting or passing on HIV are generally greater if a positive man tops a negative man, tops can still get HIV.

Some men have still caught HIV even though they’ve used this strategy. Around 1 in 5 men who recently contracted HIV were tops. This strategy reduces the chances of HIV being passed on, but it does not eliminate the chances altogether. It also means that sometimes men have to take on positions in anal sex that they wouldn’t normally or that they don’t particularly want to do, simply because of the HIV statuses of the two men. It also means that it’s important that both men know what HIV status they are.

I’m pulling out!

Some men reduce the chances of HIV being passed on by pulling out before cumming when they fuck. While this might reduce the chances of HIV being passed on, it doesn’t eliminate the chances altogether. Pre-cum (the clear fluid that comes out of your dick prior to cumming) can contain HIV and little breaks and tears can occur in the lining of the arse when fucking, making HIV more likely to be passed on. HIV can also enter the head of the dick from another man’s arse.

Counting down…

Some men use the results of viral load tests to make decisions about anal sex. Viral load is a test taken by HIV positive men to measure the amount of HIV in their blood. These tests help HIV positive people and their doctors to make decisions about treatment. There van be other factors besides treatments that affect a viral load test result. Other sexually transmitted infections and other infections like the ’flu can increase a person’s viral load.

Commonly, people with HIV who are well check their viral load every three months. It is possible for a person’s viral load to go up and down quickly depending on what else is happening to their health. So, the results of a viral load test taken weeks or even days ago may be very different to what that person’s viral load is now. The lowest viral load results available are called “undetectable”. This doesn’t mean that there is no viral load (only HIV negative people have a zero viral load) – it only means that the viral load is below the level detectable by current tests. Also, viral load tests are measurements of the amount of virus in blood and no test is readily available to measure the viral load in cum. Lots of HIV positive men are interested in knowing whether a low or undetectable viral load result (for their blood) applies to their cum as well. Many experts say that generally, viral load results can be applied to levels in cum, however there is evidence that suggests there can be quite different levels of virus in blood and cum at the same time. Other sexually transmitted infections for example, can rapidly increase the amount of HIV in cum.

Some men make decisions about the chances of HIV being passed on, on the basis of viral load results thinking that an undetectable test means that there is no chance of passing on HIV. This is not true. HIV treatments cannot make an HIV positive man become HIV negative again. Once a man becomes HIV positive it will always be possible for him to pass HIV on to someone else, no matter how effective HIV treatment is for him or how low or undetectable his viral load is. Remember also that a viral load count only indicates what your viral load was at the time of your last test, not what it might be at the moment.


I don’t know anyone with HIV

Some HIV negative men don’t use condoms because they think there aren’t HIV positive men around the places they go to have sex, like beats or sex clubs and saunas. HIV positive people live in all areas of Victoria and Australia – inner city, suburban, regional and rural areas. A lot of people still think that HIV is an inner city problem and that no one in their suburb or town has HIV. Even if we’re travelling and are in a place we aren’t normally, it’s important not to think that there are no HIV positive men around. Wherever you are, it’s important to not guess that a guy you’re cruising or having sex with has the same HIV status as you.

I didn’t think he was positive

Some HIV positive men don’t use condoms in some sex clubs where other HIV positive men tend to gather. If condoms aren’t introduced into the scene it’s easy to think that the other guy is already HIV positive as well. You can never be sure whether another guy has the same HIV status as you.

A lot of the time we think that if a guy has a different HIV status to us, he’ll say so. But a lot of HIV negative men think it’s more important that HIV positive men tell their HIV status. A lot of HIV positive men get rejected by HIV negative men when they say they’re positive. And lots of HIV negative men won’t have sex with a guy they know is positive. You can’t rely on HIV positive men to say they’re positive when they know they’re likely to be rejected. So don’t assume that you’re going to be told when fucking a guy who has a different HIV status to you. Also some men don’t know their HIV status so they couldn’t tell you whether they were HIV positive or negative. A lot of guys who don’t know their own HIV status assume that they’re negative when they might not be.

A lot of men still think they can tell whether a man is HIV positive or negative by looking at him. Men of all ages and all walks of life are getting HIV. There is not one single “type” of man that is HIV positive. HIV positive men look as different from each other as HIV negative men do. And a lot of HIV positive men don’t look “sick”. Sometimes whether a guy introduces a condom or not is what we use the most to indicate his HIV status. But men interpret wanting to use condoms in different ways.

Some men think that wanting to use a condom means a man is HIV negative; others think it means he’s HIV positive. There is evidence that men read condom use in this way differently in different cities and towns across Australia. There’s no way to tell whether a man is HIV positive or negative from the way he looks, how old he is or whether he wants to use a condom or not.

I must be immune

Some HIV negative men have had sex without condoms with men whose HIV status they don’t know and not got HIV. Others have had sex without condoms with men who they’ve even known were HIV positive and still not been infected with HIV. Sometimes HIV negative men and HIV positive men have knowingly fucked together and the HIV negative man has stayed HIV negative. Some of these HIV negative men even think they are immune to HIV. No one is immune to HIV. HIV only needs one opportunity to pass from one person to another, so the more opportunities you give, the more likely it is to happen. In other words, the more chances you take with your HIV status the higher the chances of you getting HIV. Just because something has happened to you once or twice or even many times before, doesn’t mean the same thing will happen each time in the future. So the more you fuck without condoms and the more men you fuck with, the more likely it is you will get and/or pass on HIV.


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