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Real Talk Forum: HIV Risk-Reduction for Sex Without Condoms?

, by Reilly O'Neal

Condoms are a tried-and-true HIV prevention tool, but they only work when used correctly and consistently—which for many reasons doesn’t always happen. To address issues around condomless sex in our community, San Francisco AIDS Foundation and STOP AIDS Project hosted a public community forum, titled “F**ck Without Condoms? Ever?”

The forum was the second event in our new Real Talk forum series, the purpose of which is to host timely, interactive dialogs and exchange knowledge and resources around topics at the forefront of discussions in our community. Last night’s event convened a panel of HIV-positive and HIV-negative men with varied perspectives on sexual health and partnering. The discussion was moderated by longtime community advocate Sister Roma. Representatives from the San Francisco Department of Public Health also participated.

Key issues raised by panelists and audience members included HIV stigma and rejection, knowledge about acute HIV infection (and the possibility of having the virus despite a negative HIV test result), and current data on and community experience of serosorting, in which individuals choose how and with whom they have sex based on their own and their partners’ HIV status.

Introducing the evening’s topic, Sister Roma reminded everyone that condom use for HIV prevention is a strategy pioneered by the gay community during the early days of AIDS, when it seemed the only way to stay safe was to not have sex at all. (The community’s response to that prospect was “Oh, hell no!” recalled Sister Roma.)

Data presented at the forum, however, show a decline in condom use in San Francisco in recent years, and audience text polling revealed that 84% consider skipping condoms the norm. Lively and emotional comments posted on the Real Talk event page on Facebook attest to our community’s interest in other ways to manage HIV risk. “In the REAL real world, [condoms] often are NOT used. So…What then?” asked one commenter. “The fact is we wouldn’t be talking about serosorting if people believed in &/or were actually using condoms,” added another.

The need for open discussion about sex without condoms is clear, as another commenter observed on the event page: “If we do not create space for HIV+ and HIV- men to talk about the sex they have without condoms then that sex will continue to happen in secret, which creates shame, fear, self-loathing and a dangerous lack of self-care tools.”

Two of the forum’s goals were to create that space in which to talk about condomless sex and to provide the best information possible so people can make their own decisions about the level of risk they’re comfortable with. As one member of the audience put it, for HIV-positive and HIV-negative men alike, it’s critical to “go into the decisions you make knowing what the consequences of those decisions can be….In a better world, we are making those decisions consciously before sex.”

Reilly O’Neal is a freelance writer and former editor of BETA.

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