A recent study confirms that fear of HIV continues to trump scientific knowledge of the virus.
According to a recent study in the Journal of the International AIDS Society, a disturbingly high amount of HIV-negative gay men doubt the veracity of the statement “Undetectable = Untransmittable.” If you haven’t heard that motto before, it’s pretty simple. People living with HIV who are on medication and whose viral loads have reached undetectable status cannot transmit the virus to their sexual partners. The motto arose after the PARTNER study showed in 2016 that, among over 1100 mixed-status couples who had condomless sex, not one HIV-negative partner acquired HIV from their HIV-positive partner.
The 2018 study on U=U ended up recruiting 12,222 eligible gay and bisexual men to share how they really felt about the slogan, which is gaining consensus among the medical and scientific communities, though that consensus has not extended to the general population. The men recruited were asked to give four possible answers on how accurate they believe the slogan to be: completely accurate, somewhat accurate, somewhat inaccurate and completely inaccurate.
Only one-third of HIV-negative men and men who didn’t know their status believed the statement to be either completely or somewhat accurate, compared to 70% of HIV-positive men. Among HIV-negative men, those who were on PrEP, those who tested for HIV every six months and those who engaged in condomless anal sex with HIV-positive men were more likely to believe that “U=U.”
HIV-negative men need to do better. On a purely human level, the phenomena behind the data is that HIV-negative men refuse to see HIV-positive people as anything other than a virus floating in their blood. When a microscopic virus eclipses someone’s personhood, then something’s gone awry.
As a fellow HIV-negative man, I understand the myriad reasons that you might not yet believe that undetectable = untransmittable. It’s not actually about learning something new, but unlearning lifelong messages that just being gay, and loving other men, would most likely lead to acquiring HIV. And much of that public health messaging often sold HIV-positive gay men up the river. In New York City, one prevention campaign, “It’s Never Just HIV,” reduced life with HIV to a horror movie. One French campaign literally turned HIV-positive people into scorpions.
Aside from public health messaging, so much of gay male culture revolves around the virus as a shared history. Movies and plays about the American queer experience often portray the AIDS epidemic to differing effect. While it can serve as a way to unite the community by exploring our shared history, it can also create trauma. And, of course, it’s imperative to note that every HIV-negative man also has a personal relationship to HIV, unrelated to its public or cultural portrayals. Though I am not HIV-positive, I watched my father, a loving man and a heroin user, die after years of living with HIV, as well as an array of co-infections.
Though it’s easy to see the root of this long-held stigma, that doesn’t excuse its survival. In the era of U=U, believing that HIV-positive people with an undetectable viral load can pass the virus is akin to denying climate change. The scientific consensus is there. It’s you who are choosing to ignore it based on your own firmly-held beliefs.
In the era of U=U, believing that HIV-positive people with an undetectable viral load can pass the virus is akin to denying climate change. The scientific consensus is there.
Yes, as queer men, we have trauma around HIV and that trauma needs to be respected. But, for those HIV-negative men who decide their trauma is more important than an HIV-positive person’s personhood, it’s important that you acknowledge that the problem is your stigma, not a person’s virus.
When I’ve said this online in the past, I’ve gotten pushback from HIV-negative men saying that I’m telling people who they have to sleep with or that I’m saying they’re a bigot for making choices about their own body. That’s not the case. What I am saying is that there are an array of methods in the world to lower your risk of acquiring the virus. There are condoms, PrEP, PEP and HIV treatment. But fear and stigma are not forms of protection. Your fear will not prevent you from acquiring anything. Holding onto it is doing nothing but creating a gap between you and other queer people, and it’s your duty to let go of your fear, not only for yourself, but for the HIV-positive people it harms.
Fear of HIV continues to wreak havoc on the lives of people living with HIV. While advances in medicine have made life with HIV easier in many ways, stigma and fear around the virus have failed to progress at the same rate. Aside from individual interactions with HIV-positive people, the amount of fear in the world continues to make it easy for politicians and people in the criminal justice system to punish those living with HIV just for living. Your fear is not just your own; it perpetuates a societal viral divide that we should be dismantling, not buttressing.
It takes a ton of work to overcome stigma and trauma, but there’s a beautiful phenomena on the other side of stigma. When you do the work to unlearn it, you make room to recognize the humanity of HIV-positive people and you make room for deeper intimacy and connection. For too long, the work of forging this connection has been left to HIV-positive people, who’ve had to deal with HIV medically and socially. But, the fight can’t be theirs alone. If this study highlights anything, it’s that HIV-negative people are refusing to do the work, even when we’re the ones causing the harm.