For Kevin Bynes, director of Oakland, Calif.’s AIDS Program of the East Bay, it’s essential to understand the nuances of how infection is spread. “Gay sex isn’t itself a higher risk — anal sex is,” Bynes told The Root. He explained that HIV, transmitted through blood and fluid exchange, is “attracted to anal sex” because the rectal mucous membrane is extremely thin and prone to tearing, allowing the virus to pass easily from one partner to another. For that reason, heterosexual couples who engage in this type of intercourse are also at increased risk.
“Sex without a condom is the natural way to have sex. The condom is the extra thing,” Bynes added. “Our job is to convince people to do the extra thing.”
Though sex without a condom can lead to HIV infection, some gay men still take their chances. “A lot of guys have turned me down because I wouldn’t have raw sex with them,” Khalil Hodge, a 26-year-old Brooklyn, N.Y., resident, told The Root.
Then there’s the example of the Bareback Brotherhood, an online community in which men gather to hook up and tell tales of their raw-sex experiences. As McCree explained, the rising infection rates can’t be separated from “the environment and the context in which these behaviors occur.”
Reaching for Solutions
But there is hope. According to studies by Truvada‘s manufacturer, Gilead, the pill — part of a prevention regimen called pre-exposure prophylaxis, or PrEP — when taken daily and combined with condom use and consistent physician care, is highly effective in preventing transmission of the virus. Many in the health care and advocacy communities are celebrating the existence of a new tool in the HIV-prevention toolbox in addition to other PrEP methods, such as microbicides, which are currently in trials.
“As a provider who sees patients, there’s a diversity of those who like this or that delivery device, so I’m glad that I will have multiple contraceptives,” Dr. Damon Francis of the East Bay AIDS Center and Oakland’s Downtown Youth Clinic, told The Root. “It would be great with PrEP to have options that fit different lifestyles.”