I take issue with a recent comment made by “Savage Love” sex guru and advice columnist Dan Savage about HIV prevention.

The comment was made to the New York Times but also included in the Blade’s “On The Record” column this week. Savage said, in part: “But so long as gay health educators refuse to level with gay men — there’s no ‘moderating’ your meth use; you can suck too much cock; anal sex isn’t a first-date activity and having anal sex with hordes of anonymous partners, even with condoms, is a surefire way of contracting HIV — these campaigns won’t have much of an impact.”

I agree with most of that, but there’s a subtle distinction that I think needs to be made, but first a caveat: I’m not an HIV expert. I have no formal training in HIV prevention, but I have worked in gay media for several years and have interviewed, both formally and informally, many doctors and HIV prevention experts, both for stories and for my own information as I believe all humans have a responsibility to be knowledgeable about HIV and to make informed sexual choices for themselves and their partners.

So I do feel qualified, to a degree, to take public issue with Dan’s comment. It was a refreshing comment to hear, admittedly. And I feel if there’s any error to be made, it’s best to err on the side of caution when it comes to HIV and sex.

But what HIV experts have often told me is that gay men who contract HIV in the ’00s almost always have done so by taking needless sexual risks. My friend Dane, who’s also well read on the topic, has even said that any gay man who contracts HIV these days is pretty much always making irresponsible sexual decisions.

I agree with Dan’s meth comment, but the comments about sucking too much cock and anal sex on a first date, are iffy. So, Dan, how much is too much cock to suck? If a gay man swallows 50 loads and doesn’t contract HIV it wasn’t too much but if he swallows 51 and contracts HIV on the 51st load, then that was too much? Same line of reasoning for when is an appropriate time to have anal sex? The problem with logic is there is no point at which you can quantify what “too much” is. I do agree, however, with the spirit of his remarks if only because HIV is still a major problem for sexually active gay men. Condom fatigue, reduced sensation from condoms, dubiously placed trust — whatever the reason, AIDS is still a chronic, life-threatening condition for gay men and though it can be managed, HIV treatment is expensive and can wreak havoc on your dating and sex life.

I especially take issue with the part about having sex with hordes of anonymous partners even with condoms is a surefire way to contract HIV. I’m not advocating anyone whoring around and having protected sex with hundreds of anonymous partners, but I think this is simply an untrue statement.

I know of only one person who claims to have followed the “condom rule” without fail (i.e. 100 percent usage of condoms for all anal sex between gay men) and still contracted HIV. And even in that instance, I’m not sure I believe him. It’s a well-known gay man, in fact: Andrew Sullivan. If I understand his columns about contracting HIV correctly, Sullivan chalks his positive status to one of those one-in-god-knows-how-many fluke incidents where a properly used condom breaks or fails AND one of the partners was positive AND the other person, heretofore negative, contracted the virus.

I won’t go out on a limb and say that’s 100 percent unfathomable, but it sounds suspect to me for two reasons: properly used condoms are pretty darn reliable and everyone aside from Sullivan I’ve ever talked to or read about in regard to how he (ordinarily I’d add “or she” but we’re talking about men only for now) contracted HIV has admitted to me that, for whatever reason, there was at least one incident of unprotected anal intercourse in his past. Perhaps Sullivan, undeniably brilliant, is too embarrassed to admit he made some unwise sexual decisions.

I’ve also discussed this theory with my friend, Eric, who’s tested literally thousands of men for HIV in Pittsburgh over the last 15-or-so years. He, too, has often said that upon questioning every guy he’s ever had to deliver the devastating “You’re positive” news to, all have confessed to at least one incident of unprotected anal intercourse, almost always as the receptive partner, though that’s not 100 percent the case (or “tops” would never get infected).

I’ve also made it a personal practice of cautiously and politely asking every gay man with whom I happen to cross paths and learn that he’s positive, if he knows how he contracted the virus. I haven’t talked to nearly as many as Eric, but my experience is in line with his. Naturally, they could tell me it’s none of my goddamn business (and that would be fine), but most, I’ve found, are perfectly willing to discuss the specifics, if not necessarily go into graphic detail.

It happened as recently as two weeks ago. I was catching up with an acquaintance I’ve known in Washington for about a year over cocktails at a Christmas party and he told me he’d tested positive just a month or two before. I asked him as diplomatically as possible if he knew how it happened and he admitted, “I trusted somebody and shouldn’t have.”

I realize anecdotal evidence is not empirical, but this is typical of the stories I’ve heard. Even a San Francisco friend who claimed he’d always practiced safe sex, when pressed, admitted it was more “on the safe side” (his words). He admitted letting a pick-up penetrate him sans condom. Naturally, my heart goes out to these guys — you hate to hear of anybody testing positive — and yet part of me also wants to shake them in frustration and say, “Have you not absorbed any of the safe sex information of the last 25 years?”

I interviewed Dan Bruner at Whitman-Walker for a story a couple weeks ago on this very topic and he said (as I’ve heard before) that HIV is, in fact, quite difficult to contract and that only about three out of 100 cases of unprotected anal intercourse will result in a transfer of the virus. Although I only have anecdotal evidence to go on, that sounds a bit suspect to me. I know of several guys who claim one or two slip-ups (of course they could be fudging the truth to save face) so I don’t quite buy that, but it’s interesting to hear prevention experts share such opinions.

The other big factor is how easily is HIV passed through oral sex alone? Eric has told me he’d rather swallow 50 anonymous loads than have unprotected anal sex with one stranger, but he acknowledges there are cases where HIV appears to have been passed through receptive oral sex without condoms (anecdotally, condom use among gay men for oral sex seems rare). Experts also shy away from language such as “this could never happen” because HIV transmission flukes have been reported.

I’d be curious to know what the experiences of other gay men have been. Are there some of you who are HIV-positive who practiced the “condom rule” 100 percent of the time?

And how common is it for the virus to be passed in serodiscordant (one partner positive, the other negative) monogamous relationships where condoms are always used for anal sex?

Drop me an e-mail and let me know if you have experience in these areas.

I’m a Savage Love fan, I’ve read a couple of Dan’s books and I think he’s generally a wise, no-bullshit advice giver.

But I think he went too far in saying that having tons of partners but using condoms is still a “sure-fire” way of contracting HIV. It’s not the wisest thing to do, but the bigger risk is other STDs, not HIV.



Posted by Joey DiGuglielmo, Washington Blade News Editor | Jan. 4 at 3:47 PM | JDiGuglielmo@washblade.com



From: www.washblade.com/blog/index.cfm