OK, let’s sort something out right now… It isn’t positive guys who bareback with positive guys who are making the HIV problem worse.
1) If people who haven’t been tested for HIV, and suspect that they may have been exposed at some point to the virus and have a duty to disclose their HIV-positive status to new (and indeed former sexual partners), then this will not get people to come forward for testing in the first place, indeed it will be a barrier to choosing to get tested. Instead those who are infected, won’t get tested at all, won’t know they are HIV-positive and will keep having unsafe sex and infecting other people ‘officially unknowingly’ and living in ignorance. If people are known to be HIV-positive then medical intervention can reduce their viral load and infectivity with the use of effective anti-retrovirals. But people need to feel safe enough to come forward for voluntary testing for this to work. If society and the law stigmatizes people with HIV further, the problem becomes an even more invisible one, with people who may suspect they are HIV-positive preferring not to be tested for fear of legal repercussions and criminalization.
2) If a duty is put on an individual who is HIV-positive to disclose their status then it could lead to creating a false sense of security. For example, two people get together for sex. One assumes they are HIV-negative, the other person who knows they are HIV-positive doesn’t disclose, so the HIV-negative person thinks, “Well, they haven’t said anything, so they must be HIV-negative”. As much as the safer sex message is driven home, people do take risks when they make the assumption that it is safe to do so. It is human nature, but assumptions can be dangerous things to make.
3) Safer sex is a dual mutual responsibility. All of us need to take responsibility for safer sex, and for ourselves - as well as anyone else involved in sexual activity - irrespective of HIV status, known or otherwise. One-third of people are estimated to not know they are HIV-positive, a frightening statistic. However, I can speak from personal experience that I have been HIV-positive myself for nearly 21 years. I always disclose my HIV status to someone before engaging in sexual activity – out of choice rather than any sense of duty. My partner of four years was HIV-negative when I met him, and is still HIV-negative now. My ex-partner of five years before him is also remains HIV-negative. Sero-discordant relationships do work and are possible when both parties take responsibility for themselves. Safer sex works, and to create a two-tier system that is discriminatory towards those that are HIV-positive is frankly dangerous.
If society is to follow the course where we perpetuate this kind of discrimination by firmly putting the duty on those who are HIV-positive to disclose their HIV status to new potential sexual partners, then a new argument emerges. What about the one-third of people who don’t know? What about them. Do we move towards a course of mandatory testing for all? Such efforts would have to be an ongoing programme of testing for everyone. There would be nothing to stop someone from becoming infected a day after they had a negative test result, not to mention the cost involved.
By creating an environment that is as comfortable and safe for people to voluntarily be tested for HIV we stand a much better chance of getting people who are infected on treatment and preventing them from infecting anyone else with the virus. We live in a time when things have changed from the mid 1980s to mid 1990s. Today we have treatment that can actually reduce the viral load to undetectable, rendering a person virtually, if not completely non-infectious. No longer are people with HIV (who are on treatment) the ones “spreading the virus”, today it is the “great untested” that are causing new infections. Let’s make it as easy as possible for them to seek testing and treatment, but not though discrimination, stigmatization, or criminalization, but through a safe, non-judgmental and caring environment and society.