If you are a trans gay, bi or queer guy into cis guys then you have a big role to play in ending HIV. HIV is on the rise in New Zealand, with 2015 seeing the highest number of new diagnoses on record. Most new HIV diagnoses are among men who have sex with men who are gay or bi identified.
The term trans is used here to refer to people with a gender identity different to what was assigned at birth. It includes trans masc, trans men and guys as well as non-binary people assigned female at birth (including those who don’t identify as trans at all).
Anal fucking with a cis guy with no protection is the highest risk sex there is for the transmission of HIV. The risk of HIV is slightly higher if you are the receptive partner. If you are fucking someone with semen, who identifies as gay or bi in New Zealand, there is about a 1 in 15 chance that they have HIV. Bottom line, if you are a trans guy into cis gay or bi guys, you need to stay safe.
The easiest strategy for staying safe is using a condom during anal sex. Condoms are easy to get your hands on, cheap and very effective at stopping HIV transmission. They also help protect you against a number of other STIs. Find out more about condoms and get freebies here.
While the risk of HIV is lower for vaginal sex, condoms are still important. Not only because of the risk of HIV, but also potentially, pregnancy. Check out our risk continuum for different kinds of sex here.
PrEP is a daily pill taken by HIV negative people that protects against HIV. If you regularly find yourself in situations where a condom is not being used, you may want to explore PrEP as an option.
Learn more about PrEP.
Fucking with someone who is undetectable will reduce your risk of HIV to a negligible level (so small as to not be worth considering), but remember, someone's viral load can go up and down even if they are on treatment. Unless you know a person well, it’s hard to know for sure what their HIV status is, or whether they are undetectable, so it’s safest to use protection when you are having sex.
It's important to remember that neither PrEP or an undetectable viral load will provide any protection from other STIs like syphilis or gonorrhoea - so it's a good idea to keep condoms in the mix.
If you haven’t already, take a look at the recently launched safe sex campaign GRUNT developed by PASH.tm (the Peer Advocacy Network for the Sexual Health of Trans Masculinities). In the words of the campaign:
“GRUNT is about hot, fun and informed sex between trans guys and cis guys. It’s a celebration of who we are and what we are into. A space to get accurate, inclusive and sex positive sexual health information so we can keep it safe, keep it hot and have awesome sex”.
You can also download the classic Issue #1 of Dude Masculinities here.
If you are sexually active you need to test for HIV and other STIs twice a year. Regularly fucking someone with semen without a condom? You need to test once every three months as your risk of HIV is very high.
Don’t want to know if you have HIV? Lots of people don’t test because they are afraid of a positive result. HIV is no longer a death sentence, it is a manageable health condition. It is much better to know your status, both for your own health and that of your partner(s). There is lots of support available if you do test positive for HIV, and you can also access treatment in New Zealand, even if you are not a resident.
Getting tested for HIV is free, quick and confidential at NZAF locations. Find out all about testing here.
TREATMENTS WORK BETTER THAN EVER BEFORE
Many people with HIV are living full and healthy lives. Medications have improved significantly in the last ten years. They are far less toxic, have fewer side effects and are much better at suppressing the virus. Most importantly, they significantly improve life expectancy if you are diagnosed positive.
Getting on treatment early is important. New studies now show that accessing treatment as soon as possible is the best thing for your health. It means your risk of developing HIV related conditions such as renal failure, or cancer is reduced by more than 50%.
Many people who access treatment are able to get their viral load down to undetectable in as little as six months. If someone is able to obtain and sustain an undetectable viral load, then their chances of transmitting HIV through sex is close to zero. If you delay treatment, however, you may restrict your treatment options, and make reaching undetectable more difficult.
GETTING MORE OF US TO TREAT
In New Zealand we estimate there are over 1,000 people living with HIV who aren’t on treatment. This includes people who know they have HIV, and people who are not yet diagnosed.
There is no good reason to put off treatment, and every reason to start. Most importantly, new treatments significantly extend life expectancy for people living with HIV. They are easy to take, and have minimal side effects.
If you are living with HIV and haven’t started treatment, we urge you to rethink this. For many people living with HIV, going on treatment was the most important decision they ever made.
Find out more about treatment here.
We are indebted to PASH.tm (the Peer Advocacy Network for the Sexual Health of Trans Masculinities) and GRUNT for the development of this web content, and much of the language we have used here. Thanks also to everyone else who made it happen – you know who you are!
If you have any feedback about this material, we’d love to hear it.