Sex, lies and HIV 

Should you hold health hostage to a vow of monogamy?

A few years after we broke up in the mid-'80s, my first partner died of AIDS.

In those years, before effective drugs were available, people died in a few months or weeks after receiving a diagnosis. The disease quickly starved the flesh from their bodies. Their eyes became sunken and dark. Curling up in their deathbeds, my friends often took on the appearance of otherworldly beings. Their voices reminded me of high-pitched winds. It wasn't unusual for nurses to refuse to come into their hospital rooms. One doctor even abandoned a good friend and I had to take him home to die. It was terrifying.

Being an intimate witness to so many AIDS deaths made me committed to safe sex. It wasn't easy to get used to and, for a period, I practiced "negotiated safety" with a partner. That means we abandoned condoms because we were supposedly monogamous and negative.

As it turned out, my partner was neither monogamous nor safe with others. Inevitably, he tested HIV-positive. I'd been exposed to the virus, in short, and the next six months were a hellacious waiting game to see if I'd been infected. It was a horrible time. Even though I turned out to be negative, I was devastated by the betrayal and sick that he'd been infected himself. Of course, the relationship did not last, ending with a lot of hostility.

The experience made me so much a safe-sex Nazi that I don't really believe in "negotiated safety" anymore, and I have angered quite a few couples who have come to me for counseling. I always ask if they are having safe sex and if they are not, I suggest they agree to tell one another about any straying, since it only takes one exposure to get infected. Such couples hold their health hostage to a vow of monogamy -- a foolish thing to do, especially when they are already having general problems.

I have twice had the sad experience of seeing my warning come true. After accusing me of being cynical and unsupportive of their romantic values, the couples stormed out of my office. But one member of each couple returned months later to tell me that they and their partners had in fact been infected in just the way I warned them. Something else made their sero-conversion exceptionally surprising, incidentally. In both cases, the strayer, who was always the most adamantly opposed to my position, was a physician.

And now we have the case of Gary Wayne Carriker, a 26-year-old Emory medical student, who is awaiting trial after being arrested for violating Georgia's HIV disclosure law. The 1988 law, which has been rarely enforced, requires anyone with HIV (or hepatitis) to inform his partners before sex, whether protected or unprotected.

Carriker is no sloucher. He is an exceptional student, elected president of the school's Honor Society. Before enrolling at Emory, he attended the Air Force Academy with a full scholarship. He attended Bible study classes at the Church of the Apostles, according to the Atlanta Journal-Constitution, which published an article about his case Sun., Sept. 11, following several articles in Southern Voice, the city's gay newspaper.

Carriker is charged with violating the law with three different men. He was first arrested in Fayette County. Then, after trying to settle the case out of court, he was again arrested for the same behavior with two men in Fulton County. According to the three men, allegedly Carriker initially claimed to be HIV-negative, only revealing the truth after exposing them to infection. (All three men remain negative.)

I certainly empathize with the three men. Their alleged experience is far worse than my own, since they were intentionally exposed to the disease. And I think Carriker's behavior, if true, was reprehensible. But it astounds me that people still engage in high-risk behavior and blame their partners for the consequences, whether physical or psychological. I went through that myself but ultimately had to admit that my decision to practice "negotiated safety" set me up for exactly what happened.

The law Carriker is accused of violating is bad in many ways. It doesn't discriminate between nearly zero-risk oral sex and high-risk anal sex. It makes no exception if the positive person doesn't disclose his status but practices safe sex. Indeed, since the law doesn't apply to a person who doesn't know his status but still infects others, you could even argue that it discourages HIV testing.

The three men who have accused Carriker claim they are acting to protect society, not to exact revenge. (Nonetheless, one of them has filed a civil suit.) But the three must know very well that their own willingness to engage in unprotected sex puts the community at risk, too.

If Carriker had not eventually disclosed his alleged lie, would the men still be having unprotected sex with people claiming to be negative? If they really want to help the community, they should be telling the story of their own naive behavior, not trying to put someone in jail for perversely telling the truth at the wrong time.

Cliff Bostock holds a Ph.D. in depth psychology.

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