Zero Feet Away

In my 10 years of working in HIV prevention, education and testing I have come across hundreds of studies and read countless theories on how we can stop the spread of HIV by targeting those groups which are at high risk of infection. Nothing I read is new.

The article on the latest study called “Zero Feet Away: Perspective on HIV/AIDS and Unprotected Sex in Men Who Have Sex with Men Utilizing Location-based Mobile Apps” is the most recent attempt to try and understand why men who have sex with men, commonly referred to throughout these studies as MSM, continue to have unprotected sex while simultaneously holding onto a fear of becoming HIV-positive. The first thought that came to mind while I was writing this article was a conversation I had with a group of 20Somethings which I facilitate at The Center Long Beach. One evening we were discussing gun control. Someone said “guns don’t kill people. People kill people, and sometimes it’s an accident.”

After reading the article on the Huffington Post’s website I thought something similar: Social apps don’t spread HIV. People spread HIV and sometimes they don’t realize they are doing so. Social networking for gay men or men in general for that matter, is nothing new. We (gay men) started using technology with the intention of having sex as soon as we realized our neighbors were online looking for the same thing. ASL (Age Sex Location) was one of the early acronyms I remember people using to filter out men within their community. I’m not saying that everyone online, or on social networking sites/apps, are there strictly for sex. Some may simply feel alone, looking for others like themselves to feel better, to chat and even, dare I say, make friends.

I got the impression from the article and the parts of the study which they chose to publish, that sex without protection was the focus: Why were people (more specifically, men) not using condoms? Afterward, I was left wondering, did the study ask other questions that could help us understand WHY men decided to engage in bareback sex? I have been an HIV counselor for nearly seven years and the answer to that question is never simple. There are issues beyond the statement, “it just feels better.” Another aspect of this survey that they failed to mention was the importance of HIV testing and education. How many of these individuals who participated in the survey actually know their HIV status? And with that, how many of them have an open discussion about HIV with their sexual partners?

We know that HIV is spread through bodily fluids (blood, semen, pre-semen, vaginal fluids and breast milk). We also know that those bodily fluids have to enter the body somehow, either through receptive and/or insertive sex where blood or vaginal fluids are present, through needle sharing or through any membrane that is thin enough to allow the fluid to pass through (eyes, unhealthy gums, etc.). Lastly, and what I consider the most significant factor; the fluid has to come from someone who is already HIV-positive. This is where I think the problem lies: the number of people who DO NOT know their HIV status. According to the Center of Disease Control and local health departments about 50,000 people become HIV-positive in the United States each year. Based on that number, about 20-25% of people may not know they are living with the virus. This is where HIV prevention and education should be focused, not why people are having unprotected sex, but why one in four people do not know their HIV status.

Now, I know that getting tested can stir up fears, and possibly awaken anxiety over a past experience, but if HIV was talked about more frequently and matter-of-factly most people, if not all, would feel more comfortable talking about HIV and getting tested. One statistic by the Center of Disease Control in 2011 claimed “there was a 45 percent increase in HIV in MSM 13-29.” This group includes middle school, high school and college students. I can’t help but wonder; are schools doing their fair share of educating this demographic about sex and HIV? I understand teachers are already spread thin and time is limited on what they can cover in the classroom, but I also know that parents have an issue with sex being discussed in schools. More often than not, I get teenagers and twentysomethings who surprise me with their lack of knowledge on sex. They are unsure of how STIs are transmitted and let’s not even mention the lack of knowing about free screening and testing.

Most people in this age range have no idea what sex involves, they have no clue how to protect themselves and their partners should they contract something. All this is because we are avoiding the taboo topic of sex and HIV.

If we really want to help curb the HIV pandemic, studies need to focus on why people continue to place themselves at risk of contracting HIV, not on how they are doing so. The progression of how people interact with each other sexually with the ever growing use of technology will always be a factor. But we can change what people know by helping them make an informed decision on how and with whom they choose to have sex.

The Center Long Beach has used Grindr as a way to help promote HIV testing within a fifty mile radius as well as within 3 cities local to Long Beach. We have received great feedback not only from the communities that have seen the ads, but also from other agencies that  understand the importance of using the most current, trending modes of communication to increase testing and reduce the stigma of HIV and testing. The focus of the HIV testing program at The Center is to get information about free, rapid HIV testing to anyone and everyone. Grindr seemed like the most appropriate tool because of its popularity and accessibility for those with smart phones.