Maintaining a Safer Sex Life

Part Two:
The Reality of Slipping

When sociologists and epidemiologists
talk about “risky sexual relapse” among
gay men, they throw around a lot of fig-
ures: 25% of gay men in San Francisco
have had unprotected anal sex in the last
12 months; a 400% increase in cases of
rectal gonorrhea in Seattle in 1989; in-
creasing reports of younger gay men ex-
perimenting with unprotected sex; the list
of statistics goes on.

But what is just a collection of statistics
for them is something far more for us, lit-
erally millions of individual struggles to
adjust to and maintain a safer sexual life.
There is no way statistics can begin to ad-
dress the emotional and social complexity
of what we go through around the issue.

The changes that the gay men’s com-
munity have made have been called by
one researcher, “the most profound be-
havior changes ever observed in the lit-
erature on health behavior.” But changes
that comprehensive did not, and could
not be expected to, happen overnight.
And it remains equally unlikely that they
could be universally maintained, without
any “backsliding.”

It is not uncommon for some to look at
gay men who still have unsafe sex and re-
spond with thoughts like, “I just don’t un-
derstand why they can’t simply decide to
stop,” or “Can’t they keep their gonads
under control and stop letting their dicks
rule everything,” or “They must be trying
to get it.” Such a simplistic viewpoint
fails to take into account the incredible
power of sexuality and the strong pull it
exerts on all of us. Let’s face it: sexual
decision-making is frequently, if not usu-
ally, irrational. Spock may be able to ap-
proach it with pure logic, but the rest of
us mere earthlings do not.

For someone beginning to approach safer
sex (whether having previously practiced
unsafe sex or just beginning sexual activ-
ity), the first steps must involve coming
to the realization that this is something
that applies to them, and then making the
necessary adjustments in their own lives.

Ideally, that would be the end of the story
- everyone would stay safe all of the time,
and new transmission of HIV among gay
men would cease to happen. Un-

8

fortunately, things aren’t that simple in
the real world. We are constantly faced
with relearning the earlier lessons, re-
minding ourselves that this is still rel-
evant to us, and remembering how we are
going to stick with it.

It is entirely natural to be tempted to_ go
back to practices that we once enjoyed
freely, or that we never even had the
chance to try at all.

It happens so easily, we just lose our-
selves “in the heat of the moment” or we
rationalize that,“Just once is okay, he
couldn’t have it” or we get drunk or
someone we really want to have sex with
pressures us, or we actually forget about
AIDS or...or...the list of potential slip-ups
is virtually endless. With all those pos-
sibilities, what’s amazing is that most gay
men do manage to consistently maintain
safer sex practices. As a community, it’s
something to be extremely proud of.

Yet that community sense of accomplish-
ment can be an obstacle to individual ef-
forts to stay safe. If having unsafe sex has
become socially unacceptable for the gay
men’s community, where does someone
who has had unsafe sex turn for non-
judgmental support?

Most gay men who slip (or who are
tempted to) do not tell their friends about
it They know that the reaction is more
likely to be; “How could you do that,
don’t you know any better?” than, “Yeah,
I’ve done the same thing too, and here’s
how I felt about it.” A key step in ad-
dressing continuing unsafe sexual prac-
tices must be the ability to discuss it hon-
estly and openly among ourselves.

One answer may be to develop a “buddy
system” contract, where you and a trusted
friend agree to be available to talk about it.
Agree to be honest about your own slips
and your fears, and understand the other’s
needs. What’s most important is that it be
a safe space to talk about these tough is-
sues, without fear of condemnation for be-
ing merely human. Recognize how dif-
ficult it can be at times, and be up from
about your own struggles around the issue.
Try starting a conversation among your
friends with a line like, “Sometimes I
wonder how long I can keep having safer
sex without blowing it, how about you?”
and you may find you’ve opened up one
of the liveliest discussions your social cir-
cle has had in ages.

When you find yourself rationalizing un-
safe activity, think hard about the mental
calculations you are making. With your
“buddy”, or by yourself, do a reality
check on your own degree of denial.
Make yourself look at the risk you may
be taking based on your actual sexual ac-
tivities, not simply the labels you attach
to yourself or your partners. How high
does the risk have to be before you take
it seriously? Are you willing to risk a
one in a thousand chance of infection?
How about one in a hundred? One in
ten? Even in a lower incidence area like
Vermont, a significant portion of men
who have sex with men are infected with
HIV, and this provides a ready reservoir
for future transmission. There is no geo-
graphic protection.

In rural areas similar to ours, studies
have found HIV seropositivity among
self-identified gay men ranging from 2%
to nearly 20%. At either the high or low
end of that range, the odds are probably a
lot higher than most people would ra-
tionally chose to take, especially for an
avoidable risk. But many of the calcula-
tions we make aren’t mathematical in na-
ture. Sometimes we’ll rationalize that,
“He looks healthy, he must not have it,”
or ”He’s too nice to be infected,” or
“He’s not a slut, he couldn’t be positive.”
While we may make these distinctions,
HIV is not so discriminating. The virus
is no respecter of personality, attractive-
ness, or other social characteristics. The
one question you need to ask yourself is
quite simple: could this guy have ever
(even once) taken part in a sexual act
that might put another man’s semen or
blood inside him ? (Or have engaged in
unprotected heterosexual sex, or used a
needle?) For the overwhelming majority
of men you might have sex with, the an-
swer is obviously, “Yes, he might have.”
Others convince themselves that, “It’s al-
most over; AZT is available; they’ll have
a cure if I get sick; it’s a managable ill-
ness now.” Such wishful thinking flies in
the face of the medical reality: AIDS/
HIV remains a devastating -and life-
threatening illness, and while treatments
are improving, a cure is still many years
away. Still others may think that, “I’ve
gone this long without getting it, and
with all I’ve done, I’d have gotten it by

39

HOW .

Anyone who convinces himself that un-
protected sex (especially fucking) is not
putting him at risk needs to seriously re-
consider the rationalizations the is mak-
ing because, unless he is in a mutually