“There are degrees of safe sex”: Drugs that reduce the risk of HIV transmission
I first met Michael at a party in a tech entrepreneur’s renovated San Francisco Victorian. That was the first sign of the times. The second was when the 42-year-old heard that I was a sex writer and grabbed my arm and said: “You have to write about gay men having sex without condoms.” Michael added something about “pre-exposure prophylaxis” and “antiretrovirals” (forgive me, there was free wine involved). A week later, the Centers for Disease Control and Prevention released a study finding an increase in sex without condoms among gay men — and I immediately arranged to meet with Michael.
Sitting in the back of a coffee shop in the Castro, Michael got right to it. “I don’t like to use condoms,” he said, blinking boldly. He explained that he had decided, based on medical advances, that there were times when unprotected sex was OK. Michael’s personal compromise is this: He has condomless sex with HIV-negative men who are on pre-exposure prophylaxis (PrEP), a daily medication that can reduce a person’s risk of becoming infected with HIV. He also goes without protection with positive partners who are “undetectable” — meaning men who have tested positive for HIV, gone on antiretroviral treatment and reduced their viral count to barely-even-there.
“There could be a new definition of safer sex,” he said. “There are degrees of safe sex.”
Indeed, as a study published in the journal Clinical Infectious Diseases found, antiretrovirals have the potential to reduce the likelihood of HIV transmission by either lowering concentrations of HIV RNA, thereby “decreasing the risk that an infected person will transmit the virus” or by using it as pre-exposure or post-exposure prophylaxis. Studies have found anywhere from a 60 to more than 90 percent reduction in transmission risk when an HIV-positive person becomes “undetectable.”
http://www.salon.com/2013/12/22/there_are_degrees_of_safe_sex/
