FS magazine surveyed over 3,100 gay and bisexual men. We found:

  • 44% of HIV-negative men would not have sex with an openly HIV-positive man.
  • Up to 49% did not know what HIV-undetectable means.
  • 31% did not know what PrEP is.
  • When we explained what PrEP is, 71% of gay men said they would use it.
  • 51% were worried about becoming HIV-positive.

with Matthew Hodson @Matthew_Hodson

Making the decision to come out as a gay man living with HIV wasn’t easy for me. I felt like I was leaping off a diving board, unsure of whether the waters would be welcoming or shark-infested. But I knew that once I’d taken that leap, there was no going back. 

I’m aware that the decision to be open about my status was easier for me than it may be for many others. I’m employed and (for obvious reasons) all of my colleagues are well informed about HIV. I live in a city with high numbers of other people who are also living with HIV so I’m hardly isolated. And I’m not looking for a boyfriend, or even a shag, so I don’t suffer the dreary drip-feed of sexual rejection that so many others do when they choose to be open about their status. 

Maybe it’s just the view from where I’m standing, maybe it’s because I’m in this somewhat privileged position, but right now it feels that there is change in the air. Once it seemed inconceivable that someone would choose to be open about their HIV status, but now more and more people are refusing to conceal it. Social media, in particular platforms like Twitter where people can maintain partial anonymity, seem to be filling with more openly HIV-positive commentators. Gradually the avatars are shifting from the artfully concealed faces to full on ‘stare me in the eye and know me’ pictures. 

And the talk is no longer just about coming out as a person living with HIV. Increasingly we are talking about embracing an identity where we are openly living, without shame, not just as people with HIV but, crucially, as people with an undetectable virus. 

For those who aren’t sure what undetectable means (many of those who responded to the FS big gay sex survey in this issue), it’s when the level of HIV in your blood drops below the point at which it can be detected by a standard HIV viral load test. When you achieve undetectable status you’re very unlikely to pass the virus on to your sexual partners. About 90% of people living with HIV in the UK who are on treatment are now undetectable. 

When we are undetectable, pretty much all the fear that HIV-negative guys have of those of us living with HIV is just wasted energy. In the first two years of an Australian study, which looked at gay and straight relationships, nobody with an undetectable viral load passed the virus to their partner. An undetectable viral load is a better prevention method against HIV than using a condom (and yes, combining an undetectable viral load with condom use is a doubly-safe approach, making the odds of transmission so low they’re not really worthy of consideration). 

We’ve a long way yet to go before everyone hears this message. What’s exciting though is that we are making progress. More and more people living with HIV are choosing to break out of the viral closet. More and more people are talking about not just HIV status but also about viral load and being undetectable when they negotiate sex. More and more we are dispelling the ignorance and fear around HIV and challenging stigma. 

So if you have never tested for HIV, even if your only sexual risk has been small, stop delaying and get tested now. If you find that you are living with HIV you will be able to access treatment which will extend your life and make you extremely unlikely to pass on the virus. If you are absolutely certain that you are not living with HIV, recognise that you will meet men who are, and that they are not to be feared. And if you are living with HIV please consider the positive impact you could have by talking with your friends and partners about what it means to have HIV and be undetectable. 

I took the leap. The water was fine. 

Matthew Hodson is the Executive Director of NAM


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