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People Living with and at risk of HIV Have Access to Intimacy

October 3rd, 2019

Written by: Kahilb Barton




Intimacy and HIV prevention have rarely accompanied each other. Intimacy can be defined as closeness; it is something that is beyond a surface level familiarity. It allows the spiritual to be connected to the physical. Before HIV was an issue, queer people were in the wake of a sexual revolution. Many of our ancestors were free to engage in condomless sex without fear, innately being able to explore intimacy free of judgement.


Since the advent of HIV, queer people have seemingly lost their access to this intimacy through shame and stigma. Today, anyone can take a visit to a local AIDS Service Organization (ASO) for routine HIV testing. While there you are likely to see signs of queer people connected to offerings of free HIV testing, a basket full of condoms near the registration desk, maybe a water cooler resting under a photo of a group of seemingly happy individuals advertising HIV medication. Whether you are cisgender and straight or queer as they come, your experience in the wait room will likely be the same.


However, depending on whether or not you are gay, queer, Black, trans, or HIV positive, your visit with the community health worker may encompass more conversations about HIV prevention; more presently condoms. Many ASOs still believe in the excessive promotion of condoms as a sole means to protect against HIV. While progress has been made in most urban areas, there are many rural communities particularly in the south that have yet to adopt a more sex positive approach.


Please do not get me wrong, condoms are very effective against preventing HIV transmission but when my cisgender-heterosexual (cis-het) counterparts visit their clinics, condoms primarily serve a different purpose. Additionally, their clinicians often work with them to ensure their sex life is satisfactory for them. As a queer person, I have yet to encounter a community health worker who encourages intimacy while promoting safety. This left me in deep reflection about my life as a HIV positive queer person. In the beginning of my queerhood I would have never openly admitted it but today I can proudly say I do not like condoms. Despite my courageousness, I am still made to feel great shame about this preference, but why? Most of us are here today because of condomless sex. Society has made it clear to me that because I am HIV positive and queer, the standards are different.


Sex without barriers is intimate. It can be one of the most sincere connections you feel with someone else. If open, it can allow for a deeper spiritual connection that condoms tend to interfere with.  This connection has been shared by many cis-het couples without apology forever; usually devoid of the fear of HIV. The ability to be connected to their partners in the metaphysical sense without being told that their love is dangerous.


I can reflect to being a young queer person, watching Noah’s ARC: Jumping the Broom for the first time (probably way prematurely) and hearing the character Alex exclaim that he and his partner Trey were still using condoms after years of monogamy. Even while being young and naiive, that seemed odd to me because I knew that reproduction happened from condomless sex. I felt that as a queer person, I would always be forced to use condoms for the rest of my life; that seemed unfair.


Moving forward to my involvement with ASOs, I always found myself challenging internal and external rhetoric. The thought that it was “nasty” for queer people to have condomless sex was pervasive. People who were very aware that they could no longer rely on condoms who were dehumanized by their peers.


Yes, it is important for us to continue to promote condoms but we can all afford a little realism; sex with condoms is not intimate and it is not fun. When we encounter someone who doesn’t prefer to use them, the community health worker’s role should be to find another mechanism that will work for them.


Routine HIV testing, negotiating condom use with sex partners, limiting sex partners, taking PrEP, understanding undetectable=untransmittable; all of this should be on the table when counseling around HIV and that counseling need not be limiting to people who are considered “at risk” of HIV transmission.


HIV stigma is not limited to overt interactions; it is upheld and supported by the systems we have created to combat the virus.We must be mindful of the policies and practices within HIV services so that they are not further damaging to people living with and affected by HIV.


HIV advocactes need to be reminded of the intimacy behind sex and that everyone has access to it regardless of HIV status. I am grateful to have a partner who is educated enough to understand that I am not a danger to him or anyone else. He has continuously allowed himself to be vulnerable with me despite us being in a sero discordant (one HIV positive and one HIV negative) relationship.


This vulnerability did not come without costs. Many people felt that I was a risk to him, cautioning us against “careless sex” but we could not allow this to be our narrative. We desired a deeper connection that we knew would take time to foster but that we also felt that condoms wouldn’t provide. So we spent time discussing our risk, and making sure both of us feel comfortable and empowered to have an active, normal sex life.


My partner and I are fortunate that we do not allow HIV stigma to permeate our bedroom, however I know that there are people in the world who struggle with this. Allow me to speak directly to them:  You are deserving of love regardless of if you are gay, same gender loving, trans, queer, and/or HIV positive. You do not have to limit your love or your affection for someone else because of their HIV status. Allow yourself to feel and know that your safety is paramount but there are many ways to ensure that fact.


No condoms and intimacy are not mutually exclusive but we have to change the way we approach conversations around queer bodies and intimacy. The desire to have condomless sex will not go away because we make people feel ashamed of their natural instincts. We must continue to educate people about the many different effective prevention tools and allow them to make choices that work for them.