When I tested positive for HIV in 1990, AIDS was considered a death sentence, and my first concern was for my health. Early on, my gut told me that AIDS was not going to kill me. That may have been what is often called “healthy denial,” a kind of lie we tell ourselves so we can get on with our lives in desperate circumstances. As it turned out, my gut was right: AIDS did not kill me, and HIV became a condition you can live with if you take your medication as prescribed, presumably (as we are still awaiting a cure) for the rest of your life. At that point, the issues that came to the forefront of my life again were those that occupy the attention of most people who believe they have their whole life ahead of them—love, commitment, family, and, of course, sex. There’s so much to say about these issues from my perspective as a 60-year-old gay man who has been living with HIV for over 30 years; but for now, I will focus on how PrEP and U=U have affected my sex and dating life.
Once upon a time, social networking apps gave users the option of indicating whether they were HIV-negative or HIV-positive. That raised a lot of moral, ethical, and practical issues, and allowed both deception and stigma to have free reign. Today, things are different. Social networking apps now allow users to indicate in their profiles not only whether they are HIV-negative or HIV-positive, but also whether they are HIV-negative and on PrEP, or whether they are HIV-positive, on ART, and undetectable. This way of doing things provides a lot more incentive for users to disclose both their HIV status and their HIV prevention method of choice (or lack thereof). Of course, users can always leave any or all relevant information off their profile completely; but even silence can provide useful insight to other users, who have the opportunity to decide how they feel about interacting with people who choose not to share this information.
My experience is that many guys on PrEP are very open to linking up with men who are living with HIV. The app Daddyhunt even gives users an option to indicate that they “live stigma-free,” which means they are open to dating someone of any HIV status. I know that I’m reaching out to people with whom I can feel safe in terms of the whole HIV disclosure issue.
It remains important for me to disclose my own HIV-positive status on my profile, and sometimes even to reiterate it in the course of in-app chat, depending on the sense I get of how carefully someone might or might not be paying attention to issues of HIV status.
Some men on gay social networking apps actually fetishize men who are living with HIV. Some HIV-negative people think that sex with a person living with HIV is “hot,” while others fantasize about actively seeking to become infected by having unprotected sex with a PLWH. This is referred to colloquially as “getting pozzed.” I sympathize with PLWH who find this fetishization of HIV offensive. Personally, while I recognize how potentially “messed up” it is when guys want to “get pozzed,” I tend to shrug it off. For one thing, I’m undetectable, so I’m incapable of “pozzing” anyone.
For the most part, however, I find that my dynamic with guys on PrEP exemplifies the promise of PrEP, which was to make it safe for people to choose their sexual partners without regard to HIV status. (Of course, PrEP does not protect its users from STIs including gonorrhea, chlamydia, or syphilis, but that is a separate issue that merits its own in-depth exploration.)
The advent of U=U (if you’re on HIV treatment and virally suppressed, you can’t pass on HIV to your sexual partners) has the potential to reduce the stigma associated with HIV. Much of that stigma arises from the fear that PLWH pose a danger to people who are HIV-negative, especially when it comes to sexual connections within the most affected communities. As a PLWH who has an active sex life and uses social networking apps, I have seen this new dynamic played out in my own experience. Just as social networking apps give you the option to indicate that you are HIV-negative and on PrEP, the major apps now also let you indicate that you are HIV-positive, on ART, and undetectable. I find that most of the guys who hit me up on the apps are HIV-negative and on PrEP, and our chat often reveals that they noticed the “positive, undetectable” status indicated on my profile—in fact, they often say this is one of the reasons they reached out to me. Whether fantasy or reality, there is a perception among some people—and perhaps especially among some younger people who are HIV-negative—that older PLWH make for “better” sexual partners. Regardless of HIV status, younger men often seem to value the company of older men because they find them to be savvier both about sex and about interpersonal relations compared to their own younger peers. Some younger guys seem to extend this notion to HIV status, believing that older PLWH are more sexually adventurous and are more likely to be able to “show them a thing or two.” Again, I have no evidence for or against this presumption, but as an older PLWH, it certainly rings true to me.
Overall, I believe the greater the awareness of U=U, the greater the likelihood that people who are HIV-negative will feel safe and comfortable connecting sexually with PLWH who are on meds and undetectable. This has certainly been my experience. If anything, I find that some people in my community, especially young gay men, are sometimes not aware of the distinction between PrEP (a prevention strategy) and ART (a treatment strategy). While my HIV status is in all of my profiles on social networking apps, I often make sure to disclose my status in chat as well. When I do so, some guys will ask me if I am on PrEP. I assume they mean to ask whether I am on ART—but I don’t think they really know the difference. When this happens, I will say, “I’m on treatment. PrEP is for people who are negative; treatment is for people who are positive.” In most cases, they will simply reply, “Oh okay,” and we then get back to the matter at hand—by which of course I mean a cup of coffee!