In part I of this article, I described some of the very practical HIV transmission risk management issues involved in sex between HIV negative and positive guys. Other issues that often confront “magnetic” or “serodiscordant” couples include not fully understanding the burden that HIV is to your partner, and being only partially able to sympathize and “relate” with his various fears, frustrations, and symptoms. The regimen of regular blood tests, doctor visits, counting pills, and taking pills consistently 1-3 times a day can be a lot to witness in your partner, let alone what he’s going through doing it. There might be other issues like physical symptoms like fatigue or changes like lipodystrophy/lipoatrophy, which are changes in the body such as loss of fat in the face or accumulation of fat in the belly or neck, requiring treatment to restore a normal appearance. What helps a lot is to talk to your partner about these things, ask his feelings, as well as sharing your own. Ask him questions. That will show him you care about him, and it will de-mystify the process for you and make it less scary.
Avoiding running away from your poz Mr. Right is also important from a political and social justice standpoint. Too often, poz guys face a very unfair social stigma like they “did something wrong” by having gay sex, which is way too much like the homophobic harassment that gay men grow up with from parents, peers, teachers, and clergy. Our community doesn’t need any more negative energy. Neg guys sometimes are referred to as “clean,” which implies that poz guys are somehow “dirty” – another very unfair term. Some personal ads inappropriately equate HIV status with addiction to illicit drugs when they say “Drug and Disease-Free”, or state that they are negative and to all potential partners, “UB2.” Racist White people used to embrace “separate but unequal” segregation and would avoid swimming in the same pool with African-Americans in the 1950’s, too, but we’ve come a long way since then in more progressive thinking. Don’t buy into stigmatizing terms or segregation – evaluate partners on a case-by-case basis.
A couple I see for counseling in my practice, “Jerry” and “Don”, certainly overcame a number of obstacles. Jerry is neg and Don is poz. Jerry says, “It was more of an issue at first, but we learned about the mechanics of safer sex and now after 5 years together it’s a no-brainer. I wish we had the freedom to have unprotected sex, but I’m not going to give up Don in order to get it.” Another couple, Jack and Kerry, had similar challenges. “I wanted Kerry to take better care of himself when I noticed he was losing too much weight from some mild wasting syndrome. It wasn’t attractive, and I told him so. We talked it out and he got additional treatment and now he looks better than I do. I hate him,” he laughs. Terry and Morgan had only been together a few months when Morgan learned he was positive. Other obstacles in their relationship were taking up their attention, like Terry’s problems at work, but Morgan needed support for a new diagnosis. Terry did the best he could, but Morgan also needed his own counseling and a support group for newly-diagnosed gay men to get support from others who could fully relate.
Sometimes, negative men can face frustration in being rejected by positive men who also excessively worry about fear of transmission, or by positive men who reject using condoms and want to only have bareback sex with all partners. This sort of “reverse discrimination” is more rare, but it does occur. In these cases, poz guys also need reminding that their ideal partner might just be someone of a different serostatus, and the more limitations one puts on potential partners up-front, the less likely it will be to find a truly satisfying relationship – especially when only approximately 10 percent of men are gay to begin, and plenty of other issues of compatibility come into play.
Another challenge that poz-neg couples sometimes face is the opinions of very conservative doctors, friends, and even therapists who encourage strict sero-sorting and the rejection of anyone of different serostatus in well-meaning but intrusive and perhaps under-informed advice. Taking this advice in and pondering its merits without taking it as gospel requires some mature critical thinking to evaluate it. Ultimately, the partners in the relationship must decide what is right for them, and if they can’t arrive at comfortable agreements on their own, couples counseling and/or their own individual therapy can help. Education, communication, and compromise are the keys to overcoming the challenges of the magnetic relationship – and to enjoying its many rewards.
The ideas and suggestions here are general. For more specific help with your particular relationship, please email me at Ken@GayTherapyLA.com, or text/call 310-339-5778. I would be glad to see you individually, or as a couple, for a session to discuss how all of this relates to your relationship. You can either visit my office in West Hollywood, California, or call for a phone coaching consultation outside of Southern California. I look forward to meeting you.