An Early Diagnosis: Part Two
Jacob* discovered he was HIV positive while living in Australia in 2013 and, through medication, quickly got an undetectable viral load. He has since met a long-term partner and moved back to New Zealand. He describes how they decided whether or not to use a condom in their monogamous relationship and why that decision changed when they decided to have a more open relationship.
Shortly after I was diagnosed as HIV positive, I met my partner – who is negative – and we began a relationship. Then after around six months we decided we would have more of an open relationship and we’d hook up with other guys while we were overseas. We travelled together through Asia, and then when we returned we had another conversation about really wanting to have a monogamous relationship for now and not hook up with other people.
Now that we have a monogamous relationship and I'm maintaining an undetectable viral load, we don’t use condoms with each other - but when we were hooking up with other guys the importance of condoms was more on the surface. Obviously the PARTNER study shows no transmissions of HIV from the undetectable positive partner to the negative partner, but I still had some concern about the potential of that. So in order to protect my partner and any other guys we were hooking up with, then we did use condoms.
It was not really about the fear that I could transmit HIV to my partner or whoever I was hooking up with, it was really around safeguarding the possibility. I do understand that “undetectable” practically speaking means “untransmissable” - and I guess risk is something that we all might understand intellectually, but we also have an emotional experience of that too. My emotional understanding and my emotional space was of really needing to feel like I was protecting my partner in particular, as well as the guys we’d hook up with.
Within my relationship with my partner we had a conversation about whether we’d use condoms with each other. He knew I was positive and I was open about that from the first day I met him. He was negative and his own history was that he’d never had sex with a guy without a condom, so the conversation then did come up between us about whether we’d carry on using condoms between us when we committed to an ongoing relationship and we both felt comfortable with not using condoms together.
In saying that, when I am the insertive partner I don’t cum inside him and, again, it’s not that I don’t believe the PARTNER study or the outcomes of that, it’s just what I feel comfortable about in terms of managing risk - even when all the evidence suggests I might not need to in that way.
So we had made the decision not to use condoms with each other, but then we decided we’d hook up with some guys while we were overseas travelling in India and Thailand, which changed that. It didn’t make a difference to us where we were travelling and being in Asia wasn’t the reason we made the decision, but it can make a difference for others that there are areas where HIV is more prevalent than others.
Therefore, if there are people having conversations about whether they will or won’t use condoms and there is any form of flexibility for those individuals, then where they are in the world would factor in their conversations – but, for us, we just made the decision that we wouldn’t use condoms when we were with each other, but we would use them when we hooked up with other people. It didn’t matter what country we were in, it was just a standard we kept to.
In terms of other STIs and condom use, I think when I was in Australia and not long after I was diagnosed, they were looking at PrEP studies and having an undetectable viral load as being something that was quite strongly promoted as an acceptable form of safer sex. When me and my partner were hooking up with other people, condoms featured largely because of other STIs, not because of HIV transmission. It was more that if either of us got an STI, then it would make our lives a lot trickier!
We didn’t need to have a conversation with hook-ups about using condoms most of the time, because we simply made it clear we were using condoms. If the conversation was needed, then it would be myself or my partner who would bring up using a condom and at that point it was done confidently and in such a way enough that there wasn’t any doubt or alternative about it – you’d just put it on and be assertive about it.
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*Jacob's name has been changed for the purposes of this article.