Friday, December 28, 2007

Talk Amongst Ourselves



John Peller keeps sex real, only on LifeLube

“You’re negative.”

Right before Christmas, I got my HIV test results back from my doctor. Negative. For the 11th year in a row.

How should I react to the news? Should I run down the hall at the office shouting the news? How would my HIV-positive friends and colleagues react? Would they feel alienated? Judged?

Miss LifeLube in the office next door once commented, “We don’t do enough to celebrate gay men who stay negative.” He’s right. Partly, I think it’s because we sometimes don’t even know if it’s right to share the news.

I’ve never enjoyed taking it up the rear, so right there, the biggest risk factor for HIV is off the plate. No matter how much lube I use or how patient I am, it’s excruciating. Yeah, know I’m missing out, but it just ain’t for me. In the biz, we call this “strategic positioning”, a risk-reduction strategy that gay men can use to reduce the risk of HIV infection (but not STDs).

The fact that I’m white takes another risk factor off the plate. There are a number of individual, interpersonal and social/structural factors that play into risk (as much as whether you use a condom or not) and that disproportionately affect black gay men (check out Greg Millett’s presentation for more on this).

My mental health is under control, and I don’t have a substance abuse problem – two more risk factors that, thankfully, don’t apply to me. And because I have a partner (yes, we play around, with some rules), I don’t mess around with other guys – much.

But the temptation to fuck guys bareback is omnipresent. Neg, poz, didn’t ask/didn’t know… bang bang and four days later, the dripping began.

This year, I walked away with an STD that took two courses of antibiotics to clear up. Oh, and then there was that staph infection. And that other one.

Let’s be honest about this. Yes, I did something I wished I hadn’t done that put me at risk for HIV. There’s lots of things I regret and shouldn’t do. I overeat, despite more junk in my trunk than J-Lo. I ignored that “no right on red” sign yesterday. I jaywalk all the time. Sometimes I don’t recycle. I don’t floss every night. My cholesterol is high, but I still eat cheese. I’m not perfect, and I’m betting you, my dear, aren’t perfect either. Maybe if we talked more openly about those slip-ups and why we have them, we’d be better able to make sure they don’t happen again.

I’m dead set on making sure I never hear the words, “You’re positive” from my doctor. No way, no how. No matter how much I hate using them, this will be my personal Year of The Condom—Every Time, Every Body. More than a quarter-century into the AIDS epidemic, condoms are the only option we gay men have, and Laura Bush and her As and Bs don’t work for me. All I got is the C. Let’s hear it for rectal microbicides!

I want to find a way to talk about being negative and staying negative. Not how I’ve managed to do it, because it’s nothing but my rosebud that just won’t open, the accident of birth as a white man, and the luck of having a job with health insurance that allows me to manage my mental health. Oh, and a partner who I love who keeps me at home cuddling most nights instead of prowling the back alleys for a quickie.

I want to talk about what it means to be HIV-negative and to stay that way. I want to talk about it in a way that doesn’t alienate gay men who are HIV-positive, but includes them in the dialogue. After all, us neg guys have a lot to learn from them, beyond what happened on “that night”. When you strip away the +/- labels, we are all gay men trying to strengthen our community.

So, come on fellas, let’s talk. Leave a comment below, or email me.


10 comments:

  1.   > This year, I walked away with an STD that
      > took two courses of antibiotics to clear up.
      > Oh, and then there was that staph
      > infection. And that other one.

    Another person could have been exposed.

    A thought experiment... about

    the strategy of getting tested TOGETHER BEFORE having sex for A VARIETY of sexually transmitted diseases.

    What's problematical about just getting tested regularly or from time to time is that detecting an infection is after the fact so it can be too late for the other person.

    What's problematical about one person getting tested is that what really are the test results can be ambiguous for the other person not there getting tested too.

    What's problematical is that the other person's test results are unclear.

    Consider the blood supply and other epidemics when we follow protocols that we don't do for these sex partners' epidemics that have been politicized.

    Blood is tested before transfusions.

    Should public health authorities be observing the phenomenon?... that's going on where potential sex partners turn up asking to be tested together to learn more about what might happen before it could be too late to do anything about it.

    In public health all kinds of behaviors have been observed except potential sex partners that do the strategy. There's no harm for potential sex partners knowing each other's test results. There's no evidence of any lack of efficacy for the strategy.

    ReplyDelete
  2. Okay, Zak. We got it. In a perfect world, we would all seek testing for HIV and STDs with our prospective new partners, compare results and hope for the best we do not succumb to the dreaded "window period." You're actually missing the point of this commentary. The world is not perfect: Our desires, circumstances, motivations, and social structures are complex. As much as we try, 100% safety is, for most of us, a life not worth living. We are pulled and pushed in many directions and often against our better judgement. And the temptation to alienate each other--to generalize about HIV+ men if we're negative or negative men if we're positive (or anything remotely "other")--is strong. It's so much easier to believe there are bad or judgmental men out there whose behaviors, values, and actions are far removed from our very own. That some people deserve what they get or don't even understand what we are going through. More difficult is accepting that, despite whatever serostatus or conditions divide us, we have more commonalities than differences. That, in many cases, our behaviors, values, and actions are not all that different from one another. That other forces--including luck--may play a significant role in who stays negative and who does not. And talking about it openly may be the hardest thing of all.

    ReplyDelete
  3. That statement almost makes suicide
    and murder sound nice and respectable.

    ReplyDelete
  4. Murder? Suicicde? Isn't that a bit over the top Mary Anne? What the hell is your problem? You make ZERO sense. I am a regular on this blog, and your one-note contributions are really wearing me out. If your lame idea is so fucking great, why don't you get a grant and do a study to see if it works? Then come back. In the meantime, do you have ANYTHING else to say?

    ReplyDelete
  5. Metalevel, eh?

    Equating consensual unprotected sex with suicide/murder is NOT a form of rhetorical attack? Please. So, by this strained logic, I suppose the overweight diabetic who supersizes his Big Mac meal is automatically suicidal and the 18 year old serving it to him a murderer?

    These histrionicis do nothing to advance our understanding, and may only keep people in the closet about their behaviors.

    Come up with some solutions, please oh wizened Zak. And the "get tested before every sexual encounter" idea has been used many, many times before.

    Any other tricks up your sleeve?

    ReplyDelete
  6. The gay health educator who told me I was HIV poz about 10 years ago, died last month of a heart attack. He was a heavy tobacco user, and I have no idea of anything else about his health history. But I do know that our community lost a good person, an advocate for our health and well being. Not directly because of HIV, but perhaps indirectly because of it.

    How many of us have lost friends because of other illnesses that can be related to nonsexual "lifestyle" choices, habits, addictions? When will we begin addressing ways to thrive and survive given our community's (and society's) unhealthful addictions to tobacco, alcohol, drugs, high calorie/fat/sodium junk food diets, stress, etc.?

    HIV remains only one part of a tiny piece of one's overall well being. As gay health educators and advocates, we must stop looking at HIV by itself. It's not necessarily just the unprotected fucking were doing, although this might contribute to the equation. We have to address the other things that are killing us and learn how to enjoy life without the addictions of our stressful, unhealthy lives.

    What do you think?

    --mark

    ReplyDelete
  7. If you were paying attention to larger, other cultural issues, you would know that considerable attention is being paid to the problem of obesity. There is quite a battle going on now between corporate profit interests and the healthcare community about exactly what to do about obesity. Don't be surprised when the first case of murder by Big Mac hits the courts.

    > Metalevel, eh?
    >
    > Equating consensual unprotected sex with
    > suicide/murder is NOT a form of rhetorical
    > attack? Please. So, by this strained logic, I
    > suppose the overweight diabetic who
    > supersizes his Big Mac meal is automatically
    > suicidal and the 18 year old serving it to
    > him a murderer?
    >
    > These histrionicis do nothing to advance our
    > understanding, and may only keep people in
    > the closet about their behaviors.
    >
    > Come up with some solutions, please oh
    > wizened Zak. And the "get tested before
    > every sexual encounter" idea has been used
    > many, many times before.
    >
    > Any other tricks up your sleeve?

    ReplyDelete
  8. Murder by Big Mac?

    Right. Yep, that makes sense. People are being murdered by the fast food industry. Make some room on death row kids!

    Thanks for keeping us in the loop on larger cultural issues.

    ReplyDelete
  9. John-

    Thanks for this wonderful post-- it's very thoughtful and raises a question that I have often wondered about. How do we effectively conduct the sorts of ethical discussions that you have encouraged in your post?

    Daniel Wolfe and I conducted a workshop on gay men's cultures called "Never Forget"-- and we suggested methods that other cultures (African American and Jewish, for example) had used to encourage ethical debate.

    For example, I like the Talmud, the Jewish texts that, in part, propose ethical questions, to which various rabbis can respond (the responses are called by the latin plural responsa ). The idea is that we can ask a question like, "how do we support HIV negative gay men in remaining negative" and allow various community "rabbis" to weigh in with their answers.

    The goal is not to get to a "right" or "correct" answer, but to collect the wisdom of various "rabbis" (perhaps "queens" would be the gay equivalent) who weigh in on a particular question, and then provide those answers to the community so that individuals can make their own decisions.

    I have often thought that we could benefit from our own set of gay "responsa"--- answers given by gay men and their allies to the weighty ethical questions we face.

    As further examples, we could seek answers to the following ethical questons:

    1. What should our position on smoking be?

    2. What do we think about intergenerational relationships (both sexual and non-sexual).

    3. What steps do we think are necessary to arrive into gay adulthood?

    4. In what ways do we think that sound environmental policies relate to gay health?

    5. What role do we think celebration (dancing, circuit parties, drug/alcohol use) play in healthy gay cultures.


    Note that each question is framed in the third person-- what do we think about the question. And in each case, we would ask community leaders and "regular" folks to weigh in with their opinions.

    The value of this system is that it does not infantalize gay men and assume that there is any one correct answer to these questions for every person. Each person could read the responsa and think, "I agree with Rabbi Pickett", or "I can see where Rabbi Peller is coming from", or "I think that Rabbi Bartlett is crazy."

    What is needed, and I think you say this in your piece, is a healthy and vigorous debate that airs all of the opinions and allows our smart gay community to make its own decisions.

    Perhaps Rabbi, uh, Queen Pickett could host a monthly ethical question and seek answers from all of us-- I think that would be fun.

    Thanks for writing this responsum-- I think it was a valuable contribution and I hope you will write more. Chris

    ReplyDelete
  10. > "You're negative."
    > Right before Christmas, I got my HIV
    > test results back from my doctor. Negative.
    > For the 11th year in a row.

    The only reason you're getting the test is because you're doing things that put you at risk.

    One option is to think about
    why are you getting tested every year?...

    and is it because of behavior that put you or
    put other people at risk?...


    > And because I have a partner
    > (yes, we play around, with some rules),

    What the hell does that mean?... "play around"


    > I don't mess around with other guys - much.

    When you say "- much" if the number is larger than zero then that person could be infected.

    ReplyDelete

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