Neg Guys Barebacking With Poz Guys = Safe Sex

30 January 2008 | 14 Comments

Last night I wrote a post saying I think most “neg” bareback bottoms are actually poz. Now today the big news is that poz bottoms are now neg… At least in Switzerland…

OK, not exactly, but… This one is big, so pay attention…

[See the update at the end of this post…]

The Swiss Federal Commission for HIV / AIDS has put out their first ever consensus statement saying they all agree that HIV-positive individuals on effective antiretroviral therapy and without sexually transmitted infections (STIs) are sexually non-infectious.

That’s right – you can’t get HIV from a poz guy if all of the following are true:

  • the person adheres to antiretroviral therapy, the effects of which must be evaluated regularly by the treating physician
  • the viral load has been suppressed (<>
  • there are no other sexually transmitted infections

That’s huge… They’re comparing this pronouncement to the statement many years ago that you can’t get HIV by kissing someone. It’s impossible to prove it for certain, but they’re unable to find any evidence that it’s wrong.

This has a lot of implications. In yesterday’s post I was saying that I didn’t think barebacking with poz bottoms was all that much more risky than barebacking with neg bottoms since the neg bottoms could have just converted and be highly infectious – looks like I was right on target – at least for guys who have been poz for a while and are on meds.

It also has implications for serodiscordant (poz/neg) relationships… Those couples can now breathe a sigh of relief – and even “safely” bareback each other. They just have to keep on top of those viral loads and avoid STDs for both partners.

But curiously it puts the burden for protecting the community onto the poz guys. I worry a little bit that there will be a pressure for poz guys to take meds earlier and earlier to get viral loads down to absolute zero and stay there. I’m not sure that’s completely fair, but the flip side is that I expect this will have poz guys feeling a bit better about the social implications of being poz.

And I’m guessing you’ll start seeing “undetectable for X months” in profiles to signal to neg guys that the poz guy is “safe”. In a way, this almost makes the poz guy safer than some neg guys to have sex with since the risk is more controlled and predictable. Wouldn’t it be weird if neg guys started preferring poz guys ’cause it was safer than it is with neg guys…

This does change the whole landscape of “safe sex”. Any guesses how long it will take the “condom nazis” to pick up on this news?


The news is now out a day later that the Swiss researchers only looked at studies with heterosexuals in drawing their conclusions. So presumably most of the sex behind the studies was vag sex, not anal. [What were they thinking?]

So what does this mean for us gay guys giving and getting cum up the ass? I think the straight studies are parallels. In other words, if you can say conclusively that straight bareback sex with a poz partner is “safe” then you can say that gay sex with a poz partner is “relatively low risk”. In other words what they’ve shown is that the viral load of the poz partner makes a difference. That’s not going to change for gay guys, but it may not reduce the risk down to, or close to, zero in our case.

For me, it’s about relative risk and I still feel comfortable in hooking up with poz guys with undetectable viral loads. It may not be zero risk, but it’s relatively low risk and consistent. You’ll each need to make your own decisions. Hopefully they’ll look at the data for anal sex and give us a statement on that as well…

UPDATE 2: Please see my post on the video one of the authors of the statement gave