Sero-shunning

The most important scientific breakthrough of 2011, according to the journal Science, was a study called HPTN 052, which found that having an undetectable viral load reduces the risk of an HIV-positive person transmitting the virus by 96 percent.

Does this mean that gay guys should start having more sex with poz guys with undetectable viral loads because they’ll no longer seem so scary?

Are negative guys actually scarier to play with because 2.5 percent of them may be poz but not know it? A newly poz guy can be 20 to 25 times more likely to pass on HIV.

So who do you choose when you want to get fucked and have two guys in front of you? Both are hot: one is poz with an undetectable viral load, and the other thinks he’s negative but actually just got infected.

If you choose the negative guy and he’s actually positive and fucks you raw, you could have a 1 in 10 chance of getting infected, compared to the 1 in 38,000 chance with the poz guy with the undetectable viral load.

So where does that leave us? Should we, as a community, switch to seeking out poz guys with undetectable viral loads and shun the supposedly “negative” guys?

The science suggests there may be a good case for this. But do we really want to just shift — rather than challenge — the HIV stigma to the guys now considered most likely to infect us?

Many negative guys already fear and stigmatize poz guys. But that fear comes from prejudice, not science. It’s a prejudice that’s unlikely to change easily. It will take more than science and facts to help reduce the stigma against being HIV-positive.

That stigma is even reinforced by a lot of safer-sex campaigns and organizations that tell us we are at higher risk if we have sex with poz guys. Surveys will ask, “Do you have sex with poz guys?” then tell us we’re more at risk if we do.

To me this is a form of institutional stigmatization. It is not true that having sex with poz guys with undetectable viral loads is riskier than having sex with randomly chosen guys who think they are negative. The institutional response should be, “Know your partner’s viral load not his HIV status!”

Granted, the 96 percent reduced transmission figure comes from a study with heterosexuals, but other studies show that the risk of transmitting HIV through anal sex is the same for heterosexuals and gay guys.

It’s also worth noting that viral loads can fluctuate. If a guy gets his viral load tested for five years and it is always undetectable (under 40), then it likely will be undetectable when you have sex with him, too. But even if it, by chance, registers 100 at that moment, or even 500, many experts say he will still not pass on HIV.

Either way, you will likely never find a long-time positive guy with a viral load as high as a newly infected guy whose viral load can be 1 to 10 million.

No matter what you decide to do, and who you choose to have sex with, nothing is ever risk-free.

The question is: do we want to stigmatize and shun anyone based on assumptions?

Is it just a question of stigmatizing the “correct” (ie statistically riskier) guy? Or should we drop the HIV stigma altogether, since science shows we can no longer reliably know who to stigmatize?