A Quarter Century With HIV and Thriving Sexually

One of my greatest fears after testing HIV-positive was that I would never have sex again. Fear had been a constant presence in my sex life even when I was HIV-negative, and now that I was positive that fear transformed into something else. Then it unexpectedly dissipated. Living with HIV allowed me to explore and deepen my sexuality in a way I had never anticipated. For many of us, the 40-year pandemic has affected all facets of our sex lives, but we can continue to prioritize the pursuit of pleasure and intimacy.

After 25 years of living with HIV, I felt it was time to reflect on the impact it's had on my sex life. HIV was always incidental to my life. I was scared of getting HIV even before I first had sex. For me, like many gay and bi men (and trans women) of my generation, HIV was not a matter of if. It was simply a matter of when.

Soon after my diagnosis, I experienced a surprising sense of liberation when I realized I never had to worry about getting HIV again. Of course, having HIV came with a set of fears, but they were tangible, not some ominous specter haunting all facets of my sex life. I was 23 and my sexuality was still evolving, so a new sense of liberation allowed me to embrace it in a way I never thought possible when I was consumed with fear of HIV.

The absence of fear finally allowed me to concentrate on pleasure and understanding my relationship with sex. I could experiment and explore in all sorts of ways. I had the opportunity to meet other guys living with HIV who were on a similar journey.

We fostered a sense of community from our shared experiences. We were gay and bi men living with HIV who dared to cultivate a satisfying sexuality amid that pandemic. This led to the creation of social groups, sex parties, and bareback hookup sites, all catering to those living with HIV. And that was all before the advent of U=U (the knowledge that those who are on treatment and undetectable are unable to transmit HIV). Our mutual positive diagnoses countered any concerns of transmission.

My new sexual frontier was teeming with opportunities, but it also meant navigating stigma and fear within our community. There are persistent and insidious beliefs that people living with HIV are "stupid," "reckless," or "whores." (Studies show none of that is true.) The advent of gay dating apps made it easier to find other poz guys, but it also meant dealing with explicit HIV-phobia in men's profiles with requests like, "Clean, UB2." Having to regularly confront stigma can have a profound impact on one's mental health and sex life.

There is also the structural stigma that still needs to be dealt with, such as HIV criminalization. In the U.S., over 30 states still criminalize HIV in some way. It's difficult to overstate the detrimental impact of such policies. For many, fear of arrest and prosecution infects all parts of their sex lives.

Gay men living with HIV have had to cultivate a sexuality while encountering stigma, rejection, and criminalization. We've also had to navigate feelings of guilt and shame around our status. Yet through it all, we persist. We pursue a fulfilling sex life and explore meaningful connections between HIV-positive men, and in doing so, create a sense of community.

Gay men must be reminded that being HIV-positive does not mean giving up one's sexuality. We can value, invest in, and cultivate a pleasurable and satisfying sexuality. Our sex has meaning and value, and it's one of the reasons we've been able to endure four decades of a global pandemic.

ALEX GARNER is the director of community engagement at MPact Global. MPact is a catalyst for creating change among global gay, bisexual, and genderdiverse communities. He was most recently the senior health innovation strategist at Hornet, the gay social networking app. He crafted sexual health messaging, developed social marketing campaigns, created digital content for a global audience, and led Hornet's research efforts. Alex has over 25 years of experience working as a community organizer. He has been a freelance writer for over two decades, capturing the experiences and perspectives of the queer community. As a writer and an artist, he has utilized the cultural arts to advance the narratives of LGBTQ+ communities.