This is difficult for me to write and maybe for you to read.
I'll start with a story.
I came out 23 years ago. My mother said, softly, "This is the worst day of our lives. The next worst will be the day we bury you from AIDS."
Much has changed since then. We know now, as we knew then, that being gay doesn't foretell an HIV diagnosis. The infection is far from a death sentence, at least for those with access to life-saving medications. And for many people, like my parents, a fear of gay people and HIV has been replaced with love and acceptance.
But as gay men, we're still ashamed of HIV, whether we're positive or negative. Some would rather have cancer than live with the stigma of the infection, where a diagnosis is filled with not only internalized gay shame but a sense of fault: "It could have been prevented if only we had just loved a little less..."
Nationally, 20 percent of gay and bisexual men are estimated to be living with HIV. Some are aware of their status and are being treated; others are not aware at all. Whether they know their status or not, there are hundreds of thousands of gay men living with HIV, hooking up and falling in love.
Many HIV-negative men I know live and love in a seemingly blissful denial, pretending HIV isn't already enmeshed in their dating and sex lives. But the fact is that if you're a sexually active, HIV-negative gay man, chances are you are already sleeping with HIV-positive men. You, and they, just may not know it.
You certainly would not know through a casual read of profiles on many dating sites and apps; you might get the opposite impression and be fooled into thinking the infection has gone on some extended holiday, like an aging Hollywood starlet. But sadly, many positive men are just not made to feel comfortable disclosing their HIV status openly on dating sites and apps. Some leave the question of status blank or even list their status as negative. Others may list their status upfront but refrain from showing their faces. Some brave souls add a discreet "+" sign to their profile name.
The dearth of proud, openly positive gay people online in most cities is a lost opportunity for all of us. More open disclosure can lead toward better, more informed, and safer sex. It would also go far toward removing some of the shame we have toward the disease.
To get there, we need to do more to encourage HIV-positive and HIV-negative gay men to openly discuss their status and risk online and to create a dialogue that supports both HIV-positive and HIV-negative people who are working through the difficult challenge of being in relationships with each other.
For Those Who Are HIV-Negative (or Think They Are)
We need to address our own fears and shame around HIV and do it in concert with other people, both HIV-positive and HIV-negative. Only by being honest with ourselves about our fears and our demons can we begin to overcome our own prejudices. We must ask ourselves how we are perpetuating ignorance and shame in our community, regardless of our HIV status, through the actions we take and the decisions we make around dating and sex.
We need to inform ourselves about the risks of HIV in 2012 and understand what it means to have the infection today. And we need to understand, and incorporate into our sex lives, the fact that a risk of transmission is higher with someone who doesn't know his status and/or is not on medication than with someone who is being treated.
There are tens of thousands of serodiscordant (positive/negative) couples who are in vibrant, healthy relationships that last years or decades without one transmitting the virus to the other. Through drugs that can often (although not always) reduce the virus to undetectable levels, PReP, and basic safer sex practices, it is actually remarkably easy to protect both yourself and your partner.
I understand this because I've been there. My younger self struggled to kiss someone whom I knew to be HIV-positive. I've always known you can't get HIV through kissing (t's a simple, safe activity), but the irrational mind is powerful. Today I have many friends I love who are HIV-positive, and I make a point to kiss each and every one of them.
Treat All Your Sex Partners As If They Were HIV-Positive
Everyone who is HIV-negative needs to develop a sexual health strategy that presumes that everyone we are sleeping with could be HIV-positive. For anyone who is sexually active and regularly dating or sleeping with other men, we need to practice safer sex -- 100 percent of the time.
I know plenty of HIV-negative guys who are comfortable sleeping freely with strangers they believe or assume to be negative, but the moment someone discloses that they are positive, they lock the door, paralyzed by fear and discrimination.
In the gay world, we can be sensitive to straight people criticizing or judging us, but there is an amazing amount of hypocrisy and elitism in our own backyard, much of it a result of fear and misinformation.
Don't Be a Douche Bag
We need to let our HIV-positive friends know we are available to discuss status and safe sex openly. Rather than spending time writing things like "neg for neg" in an online profile, we need to clue people in that we are ready to have a more informed discussion around risk and transmission.
And those of us who are HIV-negative need to stop using words like "clean" in our profiles to describe ourselves. "Clean" implies that people who are HIV-positive are dirty. On the Mister app and on DaddyHunt.com, we discourage users to use the term and ask our users to report people who do. After all, we don't tolerate racist profiles or verbal harassment. I wish other sites and apps would do the same, but until then, we can set an example for others.
For Those Who Are HIV-Positive (With or Without Medications)
If all the HIV-positive people online felt comfortable enough to disclose and discuss their status and what it means to have responsible sex on medication, it would go a long way toward creating a less shameful and hidden online culture. Those of us who live in large cities often forget that, for many, the online world is their first and, in some cases, only connection to gay culture and safer-sex messages.
The people I know who are out as HIV-positive are amazingly free of shame and fear around their diagnosis. They are able to receive support and love from their friends; they are able to change perceptions. On an individual level, if you have shame around your diagnosis, every time you tell someone else about your status, you have the opportunity to have some of this shame lifted. You take away shame's power through sharing. You may also be surprised by how many people are willing to love and date you even after they know. Some people you disclose to might even risk telling you about their own HIV-positive status that they are keeping secret.
When and how to disclose is something that every HIV-positive person must reconcile for himself. I'd like to risk sharing some of my own strategies around sex and dating.
Strive to Be Truthful
We all bend the truth. Online, I have been 10-percent lighter or younger at times. But when it comes to sexual health (and not just HIV), it's important to strive to be truthful. If someone asks me directly or indirectly about anything related to health, even a cold, and I plan to have sex with them, then I give them the opportunity to decide for themselves if they want to have sex. Yes, I risk that they may walk away, but I've found that if I blend the truth in order to have sex or a date, I ultimately cheat myself. Informed sex is better sex.
Don't Do Things You Might Regret the Next Day
I don't do things I will worry about the next day -- even if the other person wants to engage in something unsafe.
Admit Your Fears
Until HIV-negative guys start admitting we're afraid of being HIV-positive, until we admit our investment in being HIV-negative, and until we admit the judgments that often get attached to HIV-positive status, we're never going to get rid of the shaming power of HIV and the negative impact it has on us, on HIV-positive men, and on future generations of gay men. If you are HIV-negative, I urge you to to face your fears, acknowledge your prejudices, and stop the cycle of discrimination within the gay community.
Sex, in this ongoing age of HIV, requires clarity, responsibility, and maturity in our acquaintances and friendships, our romances, and, most importantly, in the heat of the moment.
Carl Sandler is the CEO of MISTER app. His article was originally printed in the HuffPost Gay Voices on September 10, 2012.