Anatomy of sexual risk

An HIV-negative gay man shares why he sleeps with seropositive men and how he deals with the danger.

By David Tuller

Sep 11, 2000 | So let's say you surprise yourself by falling in love with your closest friend. And let's say his name is Steve, and you're HIV-negative but he's HIV-positive. You're not sure why you've fallen in love with him after all this time. But this tale takes place just before the era of miraculous drug cocktails, and his T-cells are not so great, so you know it's partly because you need to cram the long lovely future of the sweetest friendship you've ever had into the two or three years he probably has left. Plus, he's a wonderful guy, and he loves you, too.

He's terrified that he'll infect you, much more afraid than you are. You want to do as much as possible within the bounds of what you consider safe. But he doesn't want you to suck him even a little; he doesn't want to penetrate you even with a condom. In the last year he won't even let you kiss him, really kiss him, although his doctor has told him that the KS lesion on the roof of his mouth poses absolutely no risk to you.

When his health finally collapses, you clean his diarrhea off the sheets and floor and swaddle him in diapers against his will. When he falls into a coma, you lie next to him every night and jerk off amid the scent of looming death. Your orgasms are great. You hold his hand as his last breath slips away and then his mouth drops open and foam bubbles out. They take him away but you can't let him go yet, so you don't change the sheets for two days, and you masturbate some more.

Let's say all this happens when you're just turning 40, and those last two years have been the happiest and the most miserable of your life. You don't really date or have sex for the next 12 months, but finally you start going out again. You don't know much, but you know two things: You're determined to stay negative. And you won't swear off sex or love with HIV-positive men.

This astounds straight friends. They don't understand it. Your mother doesn't understand it. Aren't you afraid? they ask.

You roll your eyes. Of course you're afraid. But here's what you've learned about being a negative gay man in San Francisco in the year 2000: In your body and your mind, fear and desire will forever be joined. Your challenge is to figure out how they can coexist in relative peace. Straight friends haven't had to learn these things. So they ask you again, wide-eyed as children: How can you have sex with positive men? How can you risk your life like that?

You don't know how exactly to answer. You don't know if they want epidemiological data about infection rates and medical details about modes of transmission, or some grand statement draped in the wisdom of the ages, since maintaining an active romantic life amid an epidemic are far beyond anything they could imagine.

You try to make it clear that you don't think of it as risking your life. You explain that of course you take precautions. They just sigh or shake their heads. Sure, you say, it would be great to meet another negative guy, fall in love, enjoy an unencumbered sex life and live happily ever after -- or at least until you break up. But that's an ideal that isn't happening at the moment.

Your gay friends all face the same dilemma, although some make different choices. You know negative guys who won't go out with positive ones, no matter how appealing. And more than one positive guy has told you that he's uncomfortable going out with you because you're negative. But that solution disturbs you.

It feels like what the gay press dubbed it a few years ago: "viral apartheid." To screen out almost half of your available dating pool -- among them lots of great, sexy guys who may stave off illness for decades with ever-more-powerful generations of drugs -- seems too cold and calculating to you. And it feels like a betrayal of the man you loved, whose presence in your life, despite his early death, was a wondrous gift.

So here you are, almost 20 years into this. You've wrestled all along with the cumbersome precepts of "safe sex" and have somehow established your wobbly place on the continuum of sexual risk -- what you will do sometimes, what you can't live without doing, what you can't believe you did and have vowed never to do again.

Your straight friends are still looking at you. They're still perplexed. They want a tight little formula for avoiding risk completely. But you know you have no wisdom to share, just your fears and how you navigate them. And those fears shift with each new study of transmission, each rumor about forthcoming wonder drugs, each emotional connection you make.

It's a complex tango. This is not the 1980s, when the disease plucked its victims at random. Back then you never knew who would be next, and all the news was bad; if you didn't run into someone for a while, you figured he was dead. You set your limits and lived within them.

But now you don't know what to think. The arrival of powerful pharmaceutical treatments makes being infected seem much less of a death sentence. Then reports of harrowing side effects and drug-resistant viral strains make it seem as bad as ever. The exhaustion from 20 years of maintaining safe-sex standards undermines your resolve. Attending another memorial service strengthens it.

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