The perils of viral apartheid

What if you could find out whether or not your next sexual partner had tested positive for HIV, at the push of a button on your touchtone phone?

That’s the premise behind the “Safe Sex License” offered by STFree Certifications, which claims 15,000 members internationally. Members can “instantly prove” they’ve been tested and share their most recent test results by showing a photo ID card and sharing their PIN number for STFree’s computerized telephone service.

No one needs a license to have safer sex, a concept that originated in the gay community back when powerful forces were still arguing that people with HIV should be quarantined. Safer sex means making informed choices about the risks we take in our most intimate moments — including the risk that one or both partners might have HIV or other sexually transmitted infections (STIs).

Such a service might seem solely in the interest of HIV-negative people. After all, if you had HIV and told someone, who would ever accuse you of lying? The company’s website admits the service can only provide a member’s most recent test results, acknowledging the “window period” that means a person with a recent HIV infection can have the virus and still test negative.

So in fact, nobody wins. That’s because disclosing one’s HIV status is not as simple as dialing up to order a pizza. And there’s more to safer sex than HIV-negative people knowing who has the virus so they can avoid them in bed and in relationships.

Rare is the person who has never had an STI. They’re a fact of life for most sexually active adults. Sexual health goes far beyond preventing HIV transmission, because people with HIV benefit from making healthy and informed choices too.

There are important differences between STIs — with proper knowledge and treatment, some are easily curable while others can be chronic but manageable lifelong conditions. Some are easy to get but others are pretty difficult to transmit. STIs can affect individuals differently. For instance, some conditions that involve bodily sores can make it easier to give or receive HIV. And people with HIV can have a lot more complications if they get certain other STIs.

A one-size-fits-all approach to managing risk misses this complexity — and that in and of itself can be dangerous. Does a complicated infrastructure of computers and automated phone systems really make it any easier to have deeper discussions about sexual risk?

The issue solved by STFree, according to founder Eli Dancy, is that people lie. So his system follows strict privacy standards to acquire personal health information from certified HIV testing authorities.

But dishonesty isn’t the problem — and knowing the truth isn’t always helpful. Given the lingering stigma surrounding HIV, under many circumstances it’s understandable when people opt not to disclose their status or frankly, even to lie about it. People can be sexually responsible without exposing their entire medical history. And why should we hold people who know they’re positive to a different ethical standard than those who believe themselves to be negative, or who don’t know their current status?

Safer sex is a great way to reduce sexual risks — but it can’t always eliminate them. So we all have an obligation to make sexual choices that increase our safety and that of our partners, and to be aware of the risks that still exist in our intimate encounters.

When it comes to empowering people to protect one another, technology itself is not a problem — but underlying motivations can be an issue. There are positive uses of technology to promote sexual health.

One example is the online inSPOT service, poised to launch in Canada this fall with the support of Toronto Public Health. Using the inSPOT website, people can inform their sexual partners that they may have accidentally exposed them to an STI.

You can choose from several upbeat and shame-free e-cards to send to sexual friends and acquaintances, with the option of specifying the particular STI and including a personal message. E-cards can be sent either from your own email address or anonymously.

The inSPOT program is run by Internet Sexuality Information Services (ISIS), a nonprofit that exists “to prevent disease transmission and enhance sexual well-being of individuals and communities.” ISIS also runs HookingUpOnline.org, a clever and savvy advice website for gay men who meet each other over the internet, and SexInfo, a text-messaging program for youth of colour.

STFree Certifications is a for-profit business. Members pay $19.99 to register and upload one set of verified test results. In order to keep their membership current, they need to continue to pay up every three to six months.

What you actually do with information about someone else’s HIV status is the most important piece of the puzzle. In many people’s minds, a Safe Sex License could ironically translate into a license to forego condoms, if they believe both partners don’t have any STIs. But sometimes this strategy backfires tragically, because people aren’t always aware they’ve been exposed to HIV, and the period before it shows up in standard tests is also the time they are most likely to infect others, because of the high viral load associated with acute infection.

If we want to build healthy communities where people feel they can safely discuss their sexual choices with one another, the focus shouldn’t be on proving who is lying and who is telling the truth — or separating the haves from the have-nots when it comes to HIV status.

So if you’re approached by someone who wants you to call up and verify their Safe Sex License, save your quarters, take a deep breath, and get ready to have a talk about what safer sex really means to each of you. Then have fun — because community is built whenever we come together.