I’d like to take the opportunity to thank you for your articles. They helped me A LOT when I was depressed about my diagnosis and made me feel much better.
That’s very kind of you to say. Your question illustrates a big problem with the condom doctrine. Various figures fighting AIDS — including the bombastic Michael Weinstein, president of the AIDS Healthcare Foundation — have outright smeared HIV prevention methods that don’t promote condoms as a primary preventative (and has supported his arguments with unfounded, anti-scientific rhetoric).
He mostly takes aim at PrEP, the once-daily pill for HIV-negative people that prevents HIV. Like other anti-science scaremongerers, Weinstein has touted a disaster scenario that PrEP (currently the drug Truvada) will eventually fail and that other organizations including the Centers for Disease Control are actively pushing PrEP as a replacement for condoms in some kind of anti-condom conspiracy.
Although this is patently false (the CDC clearly states on its official website that PrEP should be used in conjunction with condoms to be most effective), PrEP doesn’t mean much for us, people living with HIV. Luckily, PrEP is not the only HIV preventative. Being HIV-positive and undetectable — achieved by diligently taking your ART (HIV meds) every day — makes you undetectable and therefore unable to transmit HIV.
But HIV isn’t the only sexually transmitted infection you’re trying to protect yourself and your sex partners from, right? PrEP and TasP (treatment as prevention — taking your meds and being undetectable) don’t protect you or others from gonorrhea, chlamydia, syphilis, and the rest of the motley crew.
My friend, this is one place in your life where you have to weigh the risks. No, condoms are mandated for you. There is no condom police. I choose to forego condoms. I know many, many HIV-positive tops who refuse to use them. If asked, I imagine many of them would site the same problems with them that you’re experiencing as their reasons for not using them: they suck.
They don’t feel great. Many men can’t stay hard when using them. And if statistic data tells us anything, sexually active men who have sex men aren’t going to use an HIV prevention method that doesn’t feel good — regardless of the risks.
So let’s talk reality. You’re not going to want to continue using condoms if you can’t stay hard. Your meds can prevent HIV, but what do you do about other STIs? Well, nothing, except get tested very frequently. Like, once a month. Get tested for everything, including Hep-C if you’re into fisting. Tell your doctor to be thorough.
Very frequent testing is what barebackers (guys who don’t use condoms) do to minimize the spread of STIs like gonorrhea and syphilis in our midst. If you catch something, get treated for it and don’t fuck anyone for at least two weeks. It’s true that this isn’t a preventive methodology — it’s a reactive one, so it’s automatically more taxing on the body and higher-risk. Frequent antibiotics and other medicines used to treat common STIs are hard on the immune system (as well as your gut and colon health). But these are the risks we choose to take. A realistic public health approach must involve practices that people will actually adhere to — and available data shows that men who can’t get hard wearing rubbers will not use them.
So Michael Weinstein — and whoever is telling you that you have to use condoms — is wrong. There are effective safer sex methods, and HIV prevention methods, that don’t involve them. As long as you take your meds as directed and get tested frequently, go ahead, get hard, and fuck raw (as long as your partners are aware of your HIV status and also want to fuck raw).
An HIV diagnosis is hard, but I hope someone has told you by now that you’re going to be fine. Your sex life will continue, and it may be even better than it was before. It does not have to be a sterilized sex life filled with a thin latex membrane wrapped around your dick.
Above Image: Photograph by Ruben Chamorro