Getting the facts right about PrEP, serosorting and your sexual health

Feelings can easily be misconstrued as fact

My friend Phil openly serosorts.

Serosorting is a practice used by men who have sex with men which relies on choosing a sexual partner who has the same HIV status as you (and is used with the belief that it reduces the risk of contracting or transmitting HIV). When Phil is chatting with someone online who he’s interested in, he’ll ask their HIV status. If they’re positive —even if they’re undetectable — he’ll refuse to meet with them.

His justification is that he’s lived through the worst of the AIDS crisis in the ’80s and ’90s. Phil volunteered with different organizations during that time and was lucky enough not to contract the virus; so, in his mind, things like serosorting kept him alive.

Of course, we’ve had many disagreements about the subject. He even kicked me out of his home once because I adamantly stated that it was wrong to feel threatened by men who are HIV-positive.

When I say “wrong,” I don’t mean that I feel it was wrong on some moral level (even though there’s that too) — I mean that it was factually wrong.

Studies have shown that antiretroviral treatment could prevent the transmission of HIV with consistent use by suppressing viral loads so it cannot be transmitted to others. To label HIV-positive men — who are undetectable — as threats, is inaccurate and only feeds the HIV stigma.

When you take into consideration that in Canada, just over one in five people who are positive are unaware that they are, you realize that those who say they’re negative pose a much greater risk than those who are undetectable. In some cases, guys may think they’re negative, when they don’t actually know what their status is. This is why only sleeping with “negative” guys won’t protect you.

Phil is against PrEP (pre-exposure prophylaxis) too, because he feels that it’s irresponsible yet can’t seem to explain why. It’s just what he feels.

Still, our perceptions (or rather, misperceptions), are a big part of our decision-making process when it comes to sexual health. So when we trust our feelings over facts, what impact does that actually have?

Taking a step back, we can see that people choosing what they feel over what is fact is nothing new, even outside of the sexual health realm. We’ve all been witnessing the train wreck that is the US presidential election. John Oliver, host of HBO’s Last Week Tonight, explained the idea of feeling over fact best in a segment he did about the Republican National Convention (RNC).


Oliver used the example of actor-model Antonio Sabato Jr, who, following his speech at the RNC, told ABC News that he doesn’t believe that Obama is a Christian. He concluded by saying that he believes that Obama is a Muslim, despite there being no evidence to support this. It’s just what he believes in his heart, arguing that he has the right to believe whatever he wants to believe.

“What is truly revealing is his implication that believing something to be true is the same as it being true,” explained Oliver.

He certainly has the right to believe whatever he chooses, but there can be consequences to peddling such lies, especially when you’re doing so on ABC News — and we need to hold these people accountable for it. In this case, this lie about Obama’s religion, when peddled as truth, arguably creates a more divided and hostile America.

But how does this translate to sexual health, specifically relating to HIV stigma and PrEP?

In an interview with Slate, HIV/AIDS and LGBT rights activist Peter Staley explained, “Today’s younger gay men have decided that the way to avoid becoming HIV-positive is to believe that HIV is not their problem.”

He went on to say how some have constructed false beliefs that HIV is an issue that only affects older generations and if they’re looking for HIV-negative partners, as is the case with my friend, Phil, then they’ll be safe.

“As long as I’m only being sexual to find my next boyfriend,” Staley said, hypothetically, “I’m not that guy that’s sleeping around, and I really am not at much of an HIV risk.”

Like Antonio Sabato Jr’s misperception, this also creates divides within our community, and hostility in the form of slut-shaming. And that too has serious consequences.

Staley says these misperceptions pose another danger; when HIV or PrEP become associated with “slutty” behavior, people who are actually at risk and need PrEP the most may not ask their healthcare providers, because they don’t want to be perceived as promiscuous.

“As human beings, we’re designed to believe our own perceptions,” explained Lisa Firestone in an article for Psychology Today titled, “Can You Trust Your Own Perceptions?”

“Some of our emotional reactions are based more on what happened to us than what’s happening to us,” she added, suggesting that our perceptions are influenced early on in life.

It’s important to note that in this article, she’s linking present perceptions with early childhood experiences and adversity, but there are still similarities for events experienced later in life. In Phil’s case, he relates his misperceptions back to the AIDS crisis, a traumatic period for him where he watched people that he knew die. This was during his most formative years as a gay man.

You would imagine that basic introspection would solve such misperceptions, though that requires a willing participant interested in fixing these things. That isn’t Phil. He’s quite content with his opinion, and thinks he’s right, without a doubt.

So should we just accept that some people like Phil will continue to put feelings over facts and potentially perpetuate falsehoods?

Perhaps, but I continue to chip away at his beliefs surrounding HIV or PrEP whenever I can. Sometimes I’m very subtle about it, and he seems to listen, but other times I just directly confront his “beliefs.” Everybody is entitled to their own opinion, but when it’s factually wrong because it’s based on feelings, we should step up and all call out how feelings can deceive.

PrEP School runs every other Monday on Daily Xtra. Columnist Mike Miksche explores and navigates the world of sex and PrEP.

>Read more PrEP School columns here.

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