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It's Long, But Is This True Or Utter Bull?


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If HIV is really so difficult to transmit, then how on earth is there an HIV/AIDS epidemic and what was all that going on in the 80s when thousands upon thousands of gay men (and straight people, but mostly gays) were dropping down dead?

 

Hello there. Fortunately, HIV is indeed a very difficult virus to transmit. If that’s the case, then why were gay men falling ill with opportunistic infections and dropping dead like flies, you ask.

 

The answer to your question is actually a very simple one. It’s all to do with three things and three things only. Testing, Drugs and Behavior.

When a person (let’s take “Bob” for example) who has been unfortunate enough to become infected with HIV is newly infected, his viral load is soaring high in the sky, so-to-speak. Bob is highly infectious.

 

 If you were to have only one exposure to Bob’s infected fluids, it isn’t likely to result in transmission (that is not to say that it cannot and does not happen)…mostly though it will happen after a small number of sexual exposures with him. Yes, all it will take is a very few exposures.

 

Hold on, I thought HIV was difficult to catch? Yes indeed that’s true, but we’re now assuming that Bob, a person who is very sexually active, has NOT tested for HIV since he himself was infected with the virus.

 

The longer time goes by that he continues to not get tested (and remains to be promiscuous, which lets face facts, a great number of gay/bi men are) the more likely it is he will infect others. In fact, Bob is very likely to pass the virus on to a great many people, I’m afraid.

 

Bob is not testing, and so therefore, he does not know that he himself has the virus. He’s not a murderer or a vile, evil man who is intentionally spreading a potentially fatal virus; he’s just very foolish and perhaps even frightened of testing. Bob knows that his sexual behavior (“barebacking”) is as far as HIV infection is concerned, high risk.

 

Now, when HIV was a newly discovered disease and we didn’t even know why all these gay men were becoming sick and dying, there was obviously no testing. So you see, everyone with HIV was in Bob’s situation.

 

They were not testing (because of course, there was no test for a virus we did not even know existed) so you see, the virus was able to spread very easily and also very rapidly due to the promiscuous nature of a great many gay/bi men.

 

When the scientists discovered that it was a virus that was causing these “opportunistic infections”, they were then able to develop a test for it. However, even for many years after the test was developed, right up until the mid-late 90s, having the virus was still for most people diagnosed with it, a death sentence. It was also still up to this time VERY easily transmittable among gay/bi men in particular.

 

Why? I thought that I said no testing was the reason HIV was being transmitted from one person to another easily and spreading like wild fire, so when testing came along why was it still happening?

 

Easy answer; There were no drugs (other than a drug called AZT which for most people made them worse, even if not straight away). So despite testing having been introduced, HIV was still easily transmittable (even among those tested and who knew they had the virus…well, if they continued to bareback with other people, that is) because there was nothing to suppress the virus and lower its quantity in the blood and in bodily fluids in people like our poor Bob.

 

Assuming Bob remains untested, or even tested, diagnosed but not on treatment, and assuming he continues to be the horny devil that he is and carries on having bareback sex with lots and lots of other men, he will (yes, will not might) pass HIV on to at least a few other people (though likely quite a good number to be brutally honest) and guess what? Bob will eventually fall very sick and die from a nasty infection which has taken advantage of his extremely weak (or even non-existent, in the end) immune system.

 

So before testing became an option for responsible people, before the advent of treatment and because of the continuation of infected peoples’ behavior in the 80s, that’s why HIV was so easily transmitted. It is and always has been hard to transmit. Even in people like Bob who are untested, not on drugs and not changing their sexual behavior…hold on, haven’t I just contradicted everything I’ve said?

 

No. HIV is difficult to pass on, even in the most ideal of circumstances (an undiagnosed HIV positive “top” with a high viral load like our Bob, passing the virus on to a HIV negative bottom without a condom or lube being used). One such incident is not likely to be cause for concern (though I do acknowledge it’s like a game of Russian Roulette and that it can and does happen, though it is extremely rare) however if people like Bob have sex with lots of people, some of whom could likely be regular “fuck buddies”, it’s the number of times that hence makes it more likely to pass the virus on (and with people like Bob, it wouldn’t need that many tries to get another person infected, until he’s been positive for a reasonable amount of time and his viral load is no longer sky-high but has settled down a bit, then it will take a bit longer for Bob to transmit the virus…..then if he decides he wants to be responsible and get on treatment, he is very likely to never pass the virus on ever, if he can get a low or even undetectable Viral Load…which is very possible, even likely, thank goodness).

 

Now because most gay/bi men do test today, and those who are diagnosed usually get on to drugs, this means that whether they bareback or use condoms, they are unlikely to pass the virus on. Henceforth the rates of HIV infection in the Western world remains steady as opposed to increasing and in many places have even started to decrease. It’s not really down to a change in behaviour/gay men being less slutty than they were in the 80s, it’s more down to the fact that people are testing and are able to get on to drugs.

 

All this said, in today’s world, it should be (indeed is) very difficult indeed to become infected with HIV. Many people have said that they have had bareback sex for a very long time and never become infected, this sounds entirely plausible taking into account and given everything I’ve said.

 

Throw both PrEP and PEP into the equation, and the possibility of HIV diagnoses becoming extremely rare and very much a thing of the past, is a very real possibility we now face. On the HIV frontier, things are looking very, very good indeed.

 

You are very unlucky to get HIV these days (ok, not as unlucky as those in the 80s and early 90s were) but what I mean is that it should be extremely difficult to get it in the first place, unlike in the 80s.

Just for example, the CDC states that the risk is 1 in 161 for a man who “tops” bareback another bottom man who is HIV positive (and assuming he is untested, undiagnosed and on a high viral load, of course)…however the more times a guy does this, the more exposures to the virus he is likely to have and therefore increases his risk. And in all probability, it'd take a lot less than 161 times for infection to take place. With regards to this figure, of course we are talking about 161 exposures and NOT 161 bareback encounters.

 

In conclusion, if you have started barebacking on a regular basis relatively recently, and have had a number of unprotected sexual encounters with people you aren’t sure are infected or not, whether you’ve been top or bottom or both…chances are I’d say your not yet positive (though it will, yes, will happen to you eventually if you keep on going with it). Do the responsible thing and use condoms. If you don’t want to, then by all means carry on as you are, but please for goodness sake TEST , if you get diagnosed, get on DRUGS and protect others with your better behavior.

 

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Yeah, very truthful. The writer basically explains how small chances become almost an inevitability once the exposure is repeated several times.
The only thing that's wrong here is that he presumes that once a person becomes infected, he/she get responsible and start treatment and condom-use. In the majority of cases, patients think that once they're on medication, they won't need condoms, because they heard that antirretrovirals zero your viral load. In reality, only 44% of patients with HIV get an undetectable viral load.

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