By: Marcus J. Hopkins, Blogger
I tested HIV-Positive on April 12th, 2005, while living in Atlanta, GA, and after a six-month self-destructive phase of methamphetamine and alcohol abuse, I entered into a year of self-enforced sexual sobriety. I escaped Atlanta, and fled north, to the cooler climes of Kingsport, TN and Morgantown, WV – two places where I felt certain I would never run the risk of having sex with anyone, both because of the dearth of attractive men (by my own standards) and my innate ability to be “refreshingly” candid about my HIV status. I put that word in quotation marks because, what I consider to be brutal honesty, many people perceive as inappropriate oversharing.
I grew up with the threat of HIV throughout my entire life, so for me, testing Positive never really existed in the context of “Clean vs. Dirty;” you either had it, or you didn’t, and being a gay teen living in the 90s, one grew up learning that it was always best to assume that everyone had HIV, and if they didn’t have that, they probably had something else. While many in the gay male community now view that type of thinking as “sex negative” or “slut shaming” – it isn’t – for many of us, it erased the line between “Clean” and “Dirty.”
From the day I tested Positive, I have never been ashamed of that fact. Shame is for the weak-minded, to my way of the thinking, and allowing oneself to feel ashamed about something that’s not going to change is an act of self-loathing that shouldn’t be tolerated. I also recognize that, thanks to my outright refusal to be indoctrinated into any sort of religious mythology, my concepts of “shame” and “guilt” don’t necessarily align with others’. As such, I have never had a problem with telling someone that I have AIDS, whether or not I’m interested in a sexual encounter with them, because I feel that it’s an opportunity to educate others.
For many others, though, shame, guilt, and self-loathing are behaviors that have been beaten into them (both literally and figuratively) over the course of their lives. Much of this relates to the role that religion has played not only in their own lives, but in the lives of the parents, grandparents, and ancestors in shaping the way we think about sex, our bodies, our sexual predilections – the most basic blocks that help to shape who we are, as human beings. We are taught that our bodies are temples; that sex is shameful and should be hidden; that the types of sex we enjoy are outside the norm if they aren’t engaged in solely for procreative purposes.
Disease has always been associated with cleanliness – that of mind, body, and soul – and despite the light years of advancement made from the days when leprosy’s necrotic physical manifestations defined the “unwashed masses,” we still hold on to the belief that, if someone has contracted a disease, they must be “unclean;” that they are in some way inferior to the “clean” people around them who manage to keep their actions, thought, and spirits “pure.”
Since the sexual revolutions of the 1960s and ‘70s, increased attention has been paid to venereal disease (VD) than ever before in human history. “The diseases of Venus,” – the diseases of love – blood borne sexually transmitted diseases (STDs) and sexually transmitted infections (STIs) have taken the health and medicine communities by storm, since the early ‘80s, when medical science had finally advanced enough to the point where we could properly attribute their spread to certain behaviors and methods of transmission. The AIDS crisis played a particularly important role in helping us to better understand how VDs worked, and how best to treat them.
But, as with anything related to sex, the tyranny of Puritanism still plays an outsized role in how we view human sexuality. Now that leprosy is largely contained to certain parts of the world, largely thanks to penicillin and better sanitation, the new “filth” is that of STDs. Because most transmission of STDs/STIs is related to specific behaviors – sex, sex with multiple partners, injection drug use, et cetera – it is easy to draw a line between those who are “clean” and those who are “dirty.” If someone has managed to contract an STD, regardless of how they’ve done so, it is immediately assumed by some that the person must be behaving in a “dirty” manner.
The truth of the matter is this – the relationship between “cleanliness” and “diseased” is always going to exist; people who believe otherwise are deluding themselves. Truth be told, there is some merit to the argument made by the “sex negative” crowd: if you don’t engage in behaviors that are consistently shown to result in negative health consequences, you generally don’t have to worry about getting an STD.
That said, there are those who argue that, if proper precautions are taken, you can still engage in those types of activities with a far lesser likelihood of contracting an STD:
If you’re HIV-Negative and PrEP is properly utilized, you can avoid contracting HIV; the caveat to that is the fact that Truvada (Gilead) does not prevent the transmission of any other STD (save, pending further research, Hepatitis B), and if used without additional prophylaxis (i.e. – barrier devices such as condoms), there is still the risk on contracting another STD/STI, such as Syphilis, Gonorrhea, or Chlamydia.
If you’re HIV-Positive, recent studies have shown that consistent use of Anti-Retroviral Treatment (ART) to suppress the HIV viral load (the number of actively replicating HIV cells in one’s system) greatly reduces the risk of transmission to a sero-discordant partner.
If you’re an injection drug user (IDU), don’t share needles with other people…ever. Use “clean” needles to inject your drugs. Sterilize the needles and the injection sites to reduce the risk of infection.
There is a “cleanliness” component to reduction of disease transmission, and to pretend that that component will not be applied to people is simply ridiculous. The purging of toxins and infective agents from the body has always been referred to as “cleansing.” If you’re drug and alcohol free, you’re “clean;” when you’re eating all the “right” foods, you’re leading a “clean” lifestyle. These are standards of living by which we all live our lives, to one degree or another, and so long as “cleanliness” is measured, this will literally always be the case. When the scientific reality is that better standards of cleanliness, sanitation, and application are used, the risk of disease transmission is greatly reduced in virtually every case, to expect that standard not to be applied to an individual’s behaviors and habits is unrealistic.
More importantly, there is a contingent within the gay male community who gladly adopt the “clean” and “dirty” labels for themselves, and apply them, also, to others. If you don’t believe me, take a trip to the dark side and read some of the “Bug Chasing” fiction – stories whose topics include the purposeful infecting of someone with HIV – to learn how many people fetishize the taboo of “dirtiness.” While those examples are not reflective of everyone within the gay male community, so long as the fetishizing and glorification of the “taboo” of being “dirty” exists and is popularized, the stigma of HIV infection as “dirty” will remain.
So, how do we address these stigmata? Honestly, I don’t know. Personally, I don’t ever feel “dirty” because I have AIDS; but, again, I didn’t really have the same indoctrination that others had as a child. Perhaps the best way for people to address the “Clean vs. Dirty” stigma is to be open and honest about their status, regardless of the social norm. The saying that “sunlight is the best disinfectant” (notice, again, the reference to cleanliness) doesn’t just apply to dirty political structures; when people have greater exposure to people living with HIV who attempt to live “clean” lifestyles, they are less likely to conflate “HIV-Positive” with “dirty.”
Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates. Please note that the content of some of the HEAL Blogs might be graphic due to the nature of the issues being addressed in it.