Tag Archive: HIV

How HIV agencies marginalize HIV+ guys

 

 

Many HIV organizations will tell people to “know the HIV status of your sex partners”, I think this is bad advice.   There is now at study that shows it is bad advice.

 

It seems that anyone who tells you to know the status of your sex partner is setting you up for risk for becoming  HIV+.   The first question is why do you want to know the HIV status of your sex partner?  If you are fucking with condoms, then their HIV status does not matter.  If you are not fucking then HIV status will not matter.

 

When you compare the amount of HIV virus a person has, the guy on effective treatment likely has an undetectable load, (meaning <40), the guy who is most likely to have 200,000 time more HIV virus in them is the guy who thinks he is negative, not the poz guy.  He may have 200,000 times more virus than the poz guy on treatment for 4-26 weeks.  This makes the guy who thinks he is negative much more likely to pass on HIV.

 

Well lots of us guys fuck without condoms at times.  We know this happens, a lot.  By playing with the stats, we are trying to find ways to make fucking without condoms ok.   Well it is not easy to do.  Monogamy is one possibility, but I have talked to too many guys who say “my boyfriend thinks we are in a monogamous relationship.”  Only fucking with negative guys is another but we cannot know if they are truly negative.

 

Why would anyone tell you to know the HIV status of your partner, it seems beyond reason to me.  A person can only know their HIV status if they are HIV+, or not having anal sex and had a negative test.   Someone you meet for sex will almost for sure not be able to know they are negative.  They can say they had a negative test last month, last week or yesterday, but that does not mean they are truly HIV negative. (Positive results do not show for 10 – 90 days depending on the test.)

 

Talking about HIV status as a screening device to decide who you will have sex with goes a long way to marginalize and stigmatize HIV+ guys.   Do we really want to isolate and discriminate against 20-25% of our own population?  A study in the last year, explored anal sex contacts of 2623 gay guyswho do not always use condoms. The results showed that serosorting , that is: assuming, knowing,  or being by a sex partner that they are HIV-  -only gave a person a “small decrease in risk of getting HIV”.

 

How do we make the decision to fuck without condoms?  We know it is a risk to become HIV+.  So, some of us will drink too much to really think about it.  Some of us will do other drugs to “not care” at the time they are fucking.  Some will tell themselves he is so nice, so hot, in such good shape he cannot be HIV+.  I often think if someone wants to fuck with me without a condom, do I think I am special and the only one he does this with?  If there are other guys he fucks with then there is a bigger chance he may be positive without knowing it.  Some guys will ask if he is negative and then feel the chance is lower.

 

So we have a widely accepted practice of telling guys to “know the status of their partners, we now know this is bad advice.  This advice will further divide our community into HIV+ and HIV- guys.   We need to support each other, have sex together, and accept our differences.

More on genetic immunity to HIV

 

UPDATE!!!

http://www.delta-32.com/  This website will now give  you the test for HIV immunity.

The map below show where people are most likely to be immune to HIV.

Picture

 

Some people are immune to HIV (well, almost totally immune).  There are thousands of organizations giving public messages about HIV, but very few will talk about genetic immunity to HIV.  The general understanding of immunity to HIV is that some 1% to 3 % of the population is immune to HIV because of the genes they carry. People fromSwedenorNorthern Europeseem to be more likely to have this genetic immunity.

However, there are a few people who have become HIV+ even though they were supposed to be immune. This is an extremely small number, but the immunity is not 100%.  When I talk about immunity in this article,  I, am therefore referring to almost total immunity.

I first heard about HIV immunity back in the mid/late 90s.  At that time, a gay guy who I knew socially told me he was a researcher who was doing research into genetic immunity to HIV.  He told me that he felt that the only way someone who had the CCR5 gene (the name of the gene linked to immunity) from both parents was for them to have the virus in the anus from someone who had fairly advanced stage of HIV.  I have lost track of this guy, but the last I heard he was still working on this research in theUSon the East Coast.

To be immune to HIV both of your parents must have the CCR5 gene.  IF only one of your parents have this gene, then you will be less likely to become HIV+, and if you do become HIV+ then you are more likely to be a non-progresser, which means that HIV will not have as severe effect on your body.   About 10%-15% of the population fall in this group of being less likely to become infected.   One study from 2001 in Science Daily reported that persons with the CCR5 gene from one parent “had a 70% reduced risk of HIV infection”. I have talked to lots of guys who say: “I have had lots of unsafe sex and I am still negative so I must be immune”.  Well it may be, or it may also be that instead of 50 time of unsafe sex it may take 400 times before this person becomes infected.

I found a story by the Australian Federation of AIDS Organisations Inc. (2007) describing an Australian company, delta32.com.au, who advertised on Gaydar.com.au to offer CCR5 gene testing.  Two organizations complained that the company should not test gay guys for the CCR5 gene, and the website was soon closed.  Many other websites I found were closed down, or did not reply to my emails.  There appears to have been pressure to make sure people (gay men) are not allowed or encouraged to find out if they are immune from getting HIV.

Despite this, it is possible to get tested for the gene that causes HIV immunity (CCR5).  But before we go there, there are a few important questions to consider.  These questions are:  Would you want to know if you were immune to HIV?   What would you do with that knowledge?  Would you stop using condoms?  Would you believe someone who told you they were immune to HIV so they do not have to use a condom to fuck you? What about STIs?  How much would it be worth for you to find out if you were immune to HIV?  These are all interesting and difficult questions to sort through.  But the real question, I believe is: should you have the right to know that you might be immune to HIV?  Is it better that we do not know that HIV immunity exists?  Does this make a better and safer society?  I have no clear answers to these thought provoking questions.  But I tend to believe that honesty and transparency makes for a better society.  I do not think there are many times that hiding information from the public is a good idea.

So, I did a great deal of searching online to find someplace  you might find out if you had the CCR5 gene and if from one parent (partial immunity) or both parents (almost complete immunity).

IF you are an HIV+ guy, would you want to know if you had one of the genes meaning that you are less likely to have complications from HIV?  I am sure there are some people that think that people should not be allowed to know if they have the CCR5 gene.  But if you are not one of those and are interested, here is how you can find out if you have the CCR5 gene from one or both parents.

There is a company in the UScalled “32andme” that does a broad range of genetic tests, including testing for the CCR5 gene. To order the kit, and instructions on how to send a saliva sample to the company in the US, go to  https://www.23andme.com/store. The test costs $209 US (so that is about 50 cents Canadian LOL).  To see an example of the report you will receive, look at:  https://www.23andme.com/health/Resistance-to-HIV-AIDS/ .  I assume there are other places that test for HIV immunity, but I did not find them.  I hope that readers will post addresses of other places to get tested for CCR5 at xtra.ca as a comment to this column.

I wonder if the reason people do not hear much about HIV immunity is that some will worry that it will perhaps give people a licence to not practice safe sex.  If there is more condomless sex, then there is the chance of spread of STIs.  However, it is important to remember that we are only talking about a small number of guys who will be immune to HIV.  Although we should find in the gay community that older negative  guys who have frequent condomless sex are much more likely to have the CCR5 gene because many of those without it protection will have become positive or will have already died.

 

 

 

 

http://www.wired.com/medtech/health/news/2005/01/66198?currentPage=1

http://www.afao.org.au/library_docs/policy/Delta_32.pdf

 

 

The failure of medical community in delivering HIV messages

 

 

It has been more than 25 years that gay guys have been told to use condoms for sex.  Yet many of us still sometime do not do what we are told.  Almost no sexually active gay guys will say “I did not know I should use condoms”.  So why do we still get the same message, for 25 years, that clearly is not working?

Sex is complex and there are a lot of emotions that are part of our sex lives.  But the emotional part of who we are and the importance that sex plays in our lives, is not addressed.  Our originations around the world still shout at us to “USE CONDOMS”.  This message gets old and tiresome, yes we know that.   Where are the messages that help us to understand why we are not using condoms?

HIV has for over 25 years been dominated by the medical profession.  Medicine has done wonders at helping those of us who may be infected to have a healthier and better life.   But medicine tends to take a scientific and logical approach to problems.  Hence the simple message of “use condoms”.  Medicine is not as good at dealing with complex emotional aspects of human behaviour.

I think it is time for medicine to step aside in addressing HIV prevention and give way to the social scientists to explore more effective messaging.  It is also time for our organizations to focus more on messages other than “use condoms”.

If you ask gay guys why they sometimes do not use condoms they often have no more understanding than “I do not like condoms.”  There was an effort to tell us that condoms were fun and sexy but that message did not go very far.  So we may know that sex is better, more fun, easier, and more intimate without condoms.  But we are not assisted much in understanding how we sometimes allow ourselves to not use condoms.

It seems that there has been an underling message of: “be afraid of HIV”, and then by extension that leads to  fear  HIV poz guys.  Many gay guys have become so scared of HIV that they reject HIV poz guys.  Messages of fear are not effective.   Messages of fear have had the effect of marginalizing members of our community, not building a stronger community.  We know too much about stigma in our community; we do not need any messages that promote stigma amongst members of our own community.  We need messages of understanding, acceptance and support.  Where are the messages that a poz guys with undetectable viral load is not going to transmit HIV?  Where are the messages of support and understanding?

I have spent almost 20 years talking to guys about their sex lives and HIV.  I have noticed a few trends in HIV infections.   For over 10 years I would say “Guys are most vulnerable to get infected when a relationship ends.”  In the last few years I have seen that perhaps this message is too narrow.  It seems to me that guys are most vulnerable to get HIV when they are feeling their life is falling apart.  That can be death of a parent or a loved one, job loss, depression,  loss of home and loss of relationship, etc.

I do not pretend to have “the answer” to why we do not always use condoms but I feel I have some understanding of how bare sex happens.  But let’s focus more on why we take risks, when we will take risks and how to support all of us to take better care of ourselves.

Help for gay guys to decide when to have bareback sex

 

 

Sex between guys can be very complex.  Often when guys begin a sexual encounter they do not know how it will unfold, will it include: sucking, ropes, handcuffs, fucking, rimming, piss, electricity, alcohol, drugs, lots of alcohol, sounds, scat, tit play, other guys, fisting and many others.  The creative play between two guys exploring where their sex will go it part of the fun.

 

Reducing safe sex messaging to a simple prescription of “use condoms” is not very helpful, because we already know that message but who helps us to make the decisions in a complex playful experience of having sex.  The medicalization of safe sex messaging has not served us well.  Almost all new HIV infections now have emotional and psychological reasons as a main cause for lack of condom use.  The medical professional is not trained to integrate the emotional and psychological causes of problems, they are trained to look for medical causes.  Where is the messaging that helps us make the decisions we are comfortable with?

 

Let me give an example of how a psychosocial messaging may be more helpful for guys

 

A while ago a guy asked me, if he as poz bottom with long standing undetectable viral load could be fucked without condoms by his boyfriend who was negative.

 

I, as a person trained in psychology, made a few suggestions as follows:

 

1.         Consider how upset would your boyfriend be if he became poz.

 

2.         Also consider how upset you would be if your boyfriend became poz.

 

3.         Some people think that if either you or he have an STI that HIV transmission is more likely, so you could decide to not have unprotected sex outside the relationship.

 

4.         Some people think that if he cums and/or pees after fucking it will clean out the urethra and reduce the chances of getting HIV.

 

5.         If you (the poz guy) get a cold or some other infection your viral load MAY go up; you may wish to be more careful at these times.

 

6.         The spectrum Health website (the largest group of doctors treating gay men and HIV poz guys in BC, suggests that without an undetectable viral load there is 1 in 1,666 chance of getting infected as a top for each fuck.  (6.5/10,000) We can assume that with an undetectable viral load these odds are much less.  The exact chance of getting infected is not known but it may be 1 in 10,000 or maybe 1 in 100,000.  (BC is spending $50 million to reduce HIV poz guys viral load in an effort to reduce transmission; so they must believe that this will have a big effect in reducing the number of new infections.)  (The cynic in me thinks that it is not $50 million being spent because they care about the welfare of poz gay guys, or other poz persons.)

 

So by using the complex information above they can make decisions about the kind of sex they choose to have.

 

Notice that none of the above are “shoulds” but only things to consider when making decisions.  Medicine is good at “shoulds” and “musts” – at prescribing – a behaviour.  He did not want a prescription, but he really wanted to know was “what do I need to consider if we proceed with not using condoms” (if that is our choice).  He knows the normal message of use a condom, that is not what he is looking for and if no one helps him to know what to consider and give him an understanding of what are the risks and  how to reduce those risks of transmission he/they will be “fucking in the dark” – so to speak

 

What is interesting about this question is why he did not go to a medically trained person to ask this question.  I believe that he would have gotten a medical response that is prescriptive and not really useful for their decision making.  The medical profession has done wonders at supporting, treating and educating all of us on HIV.   But, the medicalization of HIV safe sex messaging has run it course.

 

It is time for medicine to step aside with the less than useful messages.  We need a psychosocial approach that will help us makes decisions that fit in our complex lived sexual experiences. What is needed is to understand that only pushing condoms is not effective.  What we need instead is messages to help guys to make informed decisions around their complex sexual decisions.

 

If there was more space I would add the following:

 

We need help to understand when and how we find ourselves vulnerable to take risks that are outside our comfort level.  For some it may be when drinking, for others it may be when depressed, for others it may be when horny, or lonely, or he is hot, or any number of things that we all need to understand more about how we put ourselves in situations where we are not comfortable afterwards.  In my experience the general pattern is when a person feels their life is falling apart, (job loss, boyfriend break up, money problems etc.) then they may do things that later they wish they had not done.

Risks and HIV Transmission for Gay Men

 

 

This one tends to continuation on from my last article in Xtra on 15 Dec 2011, but from a new angle.

 

I recently talked to an MD who works for the government in the field of HIV and s/he said that we need a nuanced message to deal with the new information out there about undetectable viral load reduces the risk of transmitting HIV.  S/he feels we need new messaging because s/he see people every day coping with viral load questions.  My response was that the CDC does not know the meaning of nuance they only know short messages with an all or nothing message, Later I talked with one of those bureaucrats that is part of developing those all or nothing messages. (S/he does not see patients in real life, and I wonder if s/he only knows about sex from journals and books.)  S/he confirmed s/he likes the all or nothing short simple messages.  Short and simple seems to be more important than how accurate the message is.

 

 

 

What if you wanted to go skiing and wanted to make sure you would not get injured in an accident on the dangerous highway 99.  You could decide to drive only between 2AM and 3AM, when there are fewer cars, you can get the best snow/ice tired there are, you can get the safest car with the most air bags, you could decide to only drive on days when there is no snow or rain.  But likely this would not be practical or fun – but safer.  Likely you will just drive to the ski hill when you want to ski and tell yourself to be careful.  After all you did it for two years and had no problems so just tell yourself to be careful.  Well it is a lot like fucking.  There are things you can do to make it safer but they may not all be fun or practical.

 

The Journal Science has declared that the scientific breakthrough of 2011 was a study (HPTN 052), this study found that a person with an undetectable viral load reduces transmission of HIV by 96%.  One article said “Having an undetectable viral was as effective as condoms.

 

That is like going to buy a pair of jeans for $100.00 but finding out they are reduced by 96% so they now cost $4.00.  That is a huge difference.

 

So lets look and what this means for fucking without condoms.  If you are getting fucked raw by a HIV poz guy with and undetectable viral load the chance of getting infected goes from 1 in 200 (no HIV treatment) to 1 in 5,000.  If you are fucking a poz guy raw with undetectable viral load the chances of getting HIV goes from 1 in 1,538 (no treatment) to 1 in 38,461.

 

So if you have sex with a poz guy with an undetectable viral load and if you use a condom that reduces it a further 96%.  So it is like those $100 pair of jeans go to $4.00, and then are deduced again by 96% and now they cost 16 cents.

 

We are told that BC government is spending $50,000,000 to get as many positive persons as possible to have an undetectable viral load.  They call it “Treatment as Prevention”, but that is just the marketing to the government.  It is not preventing HIV transmission but it is reducing the risk of getting HIV by 96%.

 

The risk of fucking without condoms changes dramatically – yea it is reduced by 96%!.  What do us as gay guys do?  Do we take more risks?  Do we decide that maybe we play more in the sandbox with the poz guys with undetectable viral load because they are not so scary now?

 

Do negative guys become scarier to play with because 2.5% of them may be poz and not know it and therefore may be 20 -25 time more likely to pass on HIV. For the guys who think they are negative but are newly positive then getting fucked by them changes the risk from 1 in 200 for a (poz guy with detectable viral load) to 1 in 10 for newly poz guy.

 

You may ask a negative partner if he get tested on a regular basis.  If he does it likely is because he is concerned he is maybe positive.  So why would you think he is negative if he thinks he may be poz and gets tested regularly to find out.

 

So if you decide to have sex only with guys who believe they are negative what is the chance of getting HIV?  We know 2.5% of those guys who think they are negative are really positive.  If we assume that those 2.5% are newly infected and that is why they do not know they are poz then the chance of becoming poz is about 1 in 200 if you choose only guys who think they are negative.   An interesting number – it is the same number as getting fucked by a poz guy with detectable viral load.

 

Where do all these numbers leave us.   Well poz guys with undetectable viral load are a lot less likely to infect someone then if they did not have an undetectable viral load.   Negative guys who will take risks with you will take risks with others also, – did you think you were special – so he may be poz.

 

A number of negative guys have told me that often poz guys are just more fun to have sex with than negative guys.

 

So where does the leave us?  Are poz guys (with undetectable viral load) sought after now, and are the “negative” guys shunned as having the potential for infecting others?  The science may say there is a good case for this.  But after all it is fear and prejudges that made many negative guys shun poz guys in the first place, – it was not science!  Our prejudges against poz guys as sex partners will not change easily.

 

What we do not need is the institutional marginalization of poz guys.  Many organizations will tell us we are at higher risk if we have sex with a poz guy.  Surveys ask “do you have sex with poz guys?”, they then tell you are at more risk if you do have sex with poz guys, this is not true if the viral load is undetectable. The institutional response should be: “ know your partners viral load” not his HIV status!

 

Well this is my last regular column in Xtra,   I plan on doing a retrospective piece next month outlining what I have learned while writing these pieces and bring up a few points to consider.  I may be back with the occasional writing on gay men’s health.

PEP can stop HIV infection

Are we being punished for irresponsible sex?

OPEN WIDE / Why we need access to PEP

Bill Coleman / Vancouver / Thursday, November 18, 2010

 

If 28 days of pills could prevent you from getting HIV after possible exposure, would you take the meds?

The meds exist. They’re called post-exposure prophylaxis (PEP) and they could significantly reduce your risk of contracting HIV. So why isn’t everyone demanding access to this treatment?

The Health Initiative for Men (HIM) has written a position paper on PEP. In it, three cases are briefly described:

Case 1
A gay guy says he went to emergency at St Paul’s Hospital and told them he had relapsed on cocaine after four years of abstinence. He had been in a monogamous relationship with an HIV-negative partner for 18 months — until he went to a bathhouse and had unprotected receptive anal sex with multiple anonymous partners.

Twenty-four hours later he went to the hospital. He was advised not to take PEP, as the risks of taking them outweighed the risk of getting HIV. He was told his chances of getting HIV were less than one in 5,000.

Two months later, he tested positive.

Case 2
A gay guy went to a clinic for HIV testing. He had tested negative six months earlier. He said he was having consensual anal sex with a partner of unknown status when that partner, despite being asked to use a condom for penetrative anal sex, removed the condom during sex and ejaculated.

The guy went to St Paul’s emergency 36 hours later. He was refused a prescription for PEP and told the risk of seroconversion was not high enough.

The guy’s HIV test came back positive three months later.

Case 3
After having unprotected receptive anal sex with a partner he had met online, a guy found HIV meds in the man’s bathroom. He went to emergency at St Paul’s 12 hours later and asked for PEP.

He was told he didn’t meet the criteria.

Like the others, he was not given the option to pay for the meds himself, even though he wanted PEP and could afford to buy it.

He later tested positive for HIV.

The paper’s conclusion: PEP should be available to gay men.

It’s great that HIM has started a push for PEP. Let’s hope they push hard enough to make BC a safer place for gay men.

So why isn’t PEP available?

Simple. I’d say the medical profession is reluctant to give people, and especially gay guys, too many opportunities to behave recklessly. And our community’s silence is letting them get away with it.

I don’t expect a change in policy until someone stands up to demand it. So far, no community group or agency has directly taken on the BC government for its shameful policy on PEP.

How PEP works

If you are exposed to HIV and are concerned about getting infected, you need to start on medication as soon as possible. The treatment has to begin within 72 hours to be effective; some local doctors suggest within 24 hours is best.

How effective is PEP? One study showed that persons who did not take PEP were seven times more likely to get HIV (Roeding et al, 2008).

But accessing PEP is not easy. You need a doctor to prescribe it, which can be tricky at the best of times, and even harder at 6am on a Saturday morning.

One more hurdle: in BC you have to cover the $1,500 price tag yourself, unlike in Quebec and  Australia where the medication is free.

If the BC government can prevent infection in even one person in 20 by providing access to effective medication, the investment is worth it. From a purely financial point of view, paying $1,500 for PEP is much cheaper than providing a lifetime of HIV treatment.

But maybe it’s not simply about saving money; maybe gay guys are not important enough for the government to prioritize. Or maybe this policy is punishment for irresponsible sexual behaviour. Or maybe it reflects an ongoing squeamishness around gay sex.

Bottom line: our government won’t care about us unless we make them care.

So talk to your community organizations and ask them to take action to make PEP available to everyone in need. Write to the health minister. And find yourself a doctor who knows about HIV and PEP, and talk to them about how you might access it quickly if you need it.

 

How often should you get tested

How often should you get tested?
HIV / The higher the risk, the more frequent the test
Bill Coleman / Vancouver / Thursday, January 13, 2011

Most of us hate tests.Some of us thought the end of school meant the end of tests. But gay guys know better.

Gay guys face the prospect of additional tests for life — or at least until a positive one shows up. Either way, they’re not much fun.

Still, most of us should get tested regularly.

How regularly? Have a look at the matrix I created. It’s not intended to address all aspects of a gay man’s complex sexual life. It is only my suggestion for developing a testing strategy based on individual risk activities, rather than poorly defined window periods.

For more than a decade, there was some unhelpful advice that we should wait six months after a risk to get tested. The theory was it took six months for evidence of the virus to show up, and therefore six months to be sure a negative test was truly negative.

Now we know that testing three months after a risk, using the conventional antibodies test, yields a result that’s more than 99 percent accurate.

And now there’s an even quicker test available in some locations in BC.

No more waiting even three months for an accurate HIV result. The new early-detection test (called the NAAT test) can identify the presence of HIV in the body less than two weeks after possible exposure. The Health Initiative for Men is one of several clinics in Vancouver running a trial on this test.

We, as gay guys, have been the largest group of people testing positive for the last few years, so we need better information and guidelines on when to get tested. The BC Centre for Disease Control and other public health agencies should work harder to inform gay guys about testing.

In the meantime, I have made this general guide for gay guys. My theory: the greater the likelihood of testing positive, the more frequently we should get tested.

Open Wide appears in every other issue of  Xtra.

 


Show us the real HIV transmission risks

Show us the real transmission risks

OPEN WIDE / Stop dumbing down HIV for gay men

Bill Coleman / Vancouver / Thursday, February 10, 2011

 

Gay men need to know the truth about HIV transmission.

I asked staff at a local AIDS agency why they don’t tell people the whole story about the risks of HIV transmission. The reply was something like, “Well, we thought about it but decided not to.”

I tried to get another local organization to provide this information on its website, but they declined.

What is going on here? Do people think we can’t handle the truth? How can we make informed decisions when we aren’t given the information we need to calculate the level of risk we’re each comfortable taking?

Can you answer this question accurately: how likely is it that an HIV-negative guy will get HIV if he is fucked in the ass by an HIV-positive guy not wearing a condom? Most people do not know the answer and will guess wrong. The risk is not as high as you might think.

When I used to lecture groups about HIV, I would ask this question. Many people thought there was a 100 or 90 percent chance that the negative guy would get infected. Some ventured to suggest a 50-50 chance of infection.

The truth is the risk is far lower! If you’re getting fucked in the ass by a positive guy, the chance of transmission is one time in 200, according to the US Centers for Disease Control.

The only local place I know of that will tell us these facts is on the Spectrum Health website. It is not easy to find but it is there (www.spectrum-health.net/index.php?option=com&mdashcontent&view=category&layout=blog&id=83&Itemid=200).

Here is the breakdown of sexual transmission risks for gay men, according to the US Centers for Disease Control:

•    being fucked by an HIV-positive     guy who cums inside you:     1 in 200

•    fucking an HIV-positive guy:     1 in 1,500

•    sucking an HIV-positive guy:     1 in 10,000

•    getting sucked by an HIV-positive         guy: 1 in 20,000

I’m not suggesting we all go out and take risks. I’m just saying we’re all entitled to make our own decisions about how many risks, if any, we want to take.

If you like to fuck and get fucked but do not like condoms much, then you can see it is seven times more risky to get fucked than to fuck without condoms.  Make your own choice about how much risk you are comfortable taking and how important the sex is for you.

I also think there would be less stigma for poz guys if we all knew the real risks of HIV transmission. Maybe then negative guys would find poz guys less scary. Living with constant fear of getting HIV can become a huge burden. Knowing the facts can help all of us to feel more in control and can help in making informed decisions around our sexual activities.

Other factors can affect the odds of getting HIV. High viral loads and sexually transmitted infections make transmission more likely, for example. Whereas an undetectable viral load makes it less likely. (Needless to say, avoiding getting cum in your ass makes transmission even less likely.)

Newly infected guys can have a high viral load for two months or more and be up to 20 times more likely to infect someone. I have concluded that it may be safer to have sex with a poz guy with an undetectable viral load than with someone who mistakenly thinks they are negative but really has a high viral load, which is what happens three to six months after infection.

A final rule of thumb to prevent HIV transmission: don’t get cum in your eyes. Getting blood in your eyes in a hospital setting is considered high risk.

Open Wide appears in every other issue of  Xtra

HIV Immunity – Interesting stuff

What if you’re immune to HIV?
OPEN WIDE
What would you do with that knowledge?
Bill Coleman     Vancouver      Thursday, September 22, 2011
In the last decade, studies have shown that a very small percentage of people seem to be almost totally immune to HIV.In 2005, American journalist Randy Dotinga summarized the early findings like this: “An estimated one percent of people descended from Northern Europeans are virtually immune to AIDS infection… All those with the highest level of HIV immunity share a pair of mutated genes — one in each chromosome — that prevent their immune cells from developing a ‘receptor’ tht lets the AIDS virus break in. If the so-called CCR5 receptor — which scientists say is akin to a lock — isn’t there, the virus can’t break into the cell and take it over.”“To be protected,” Dotinga continues, “people must inherit the genes from both parents; those who inherit a mutated gene from just one parent will end up with greater resistance to HIV than other people, but they won’t be immune.”One study from 2001 in Science Daily reported that persons with the CCR5 gene from only one parent “had a 70 percent reduced risk of HIV infection.”Reports that I have read suggest that between one and three percent of Northern Europeans are “immune” overall, and about 10 to 15 percent have greater resistance to HIV. So it seems as if a few people are genetically predisposed to block the virus from their bodies almost, but not quite, 100 percent of the time. We just don’t hear about them very often.Thousands of organizations around the world broadcast HIV messages on a regular basis, but very few of them talk about immunity, probably because they’re concerned that some people might take the possibility of immunity as a licence to practise unsafe sex.Two organizations were so alarmed they reportedly pressured a genetic testing company to stop offering a CCR5 test to gay men. A 2007 brief from the Australian Federation of AIDS Organisations describes an Australian company, delta32.com.au, that advertised CCR5 testing on gaydar.com.au but closed its website after receiving complaints about the test being offered to gay guys.

I found links to other websites that test for the CCR5 gene, but they too have closed down or did not reply to my emails. Still, the test is available to the public.

But before we discuss where to find it, there are a few important questions to consider: Would you want to know if you are immune to HIV? What would you do with that knowledge?

Would you stop using condoms?

Would you believe someone who tells you they’re immune to HIV so they don’t have to use a condom to fuck you? (What about other STIs?)

If you are an HIV-positive guy, would you want to know if you had one of the genes that make it less likely to have complications from HIV?

How much would it be worth to you to find out if you are immune to HIV?

These are all interesting and difficult questions. But I think the real question is: should you have the right to know that you might be immune to HIV?

Is it better that we not know that HIV immunity exists? Does this make a better and safer society?

I have no clear answers. But I tend to believe that honesty and transparency make for a better society. I do not think there are many times that hiding information from the public is a good idea.

So I did a great deal of searching online to find someplace where you might find out if you have the CCR5 gene and, if you do, whether you have it from one parent (partial immunity) or both (almost complete immunity).

There is a company in the US called 23andme that does a broad range of genetic tests, including testing for the CCR5 gene. To order the kit and for instructions on how to send them a saliva sample, go to  23andme.com/store. The test costs $209 (US). To see an example of the report you will receive, look at: https://www.23andme.com/health/resistance-to-hiv-aids/.

I assume there are other places that test for HIV immunity, too, but I could not find them. I hope that readers will post addresses of other places, if they find them, on xtra.ca as a comment to this column.

Do I think that, armed with the knowledge of immunity, people might practise more unsafe sex? Probably.  Is it their right to make that decision for themselves? Yes, that’s always been our right.

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Bill Coleman PhD

I am an experienced counsellor with over 25 years of experience.  I have taught individual counselling and group counselling.  I have worked as a psychologist in a sexually transmitted disease clinic for over 10 years, and I have also work as a psychologist with criminals in different settings.  

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