Question Submitted by Reader:

Hi Nathan---

I'm a 50 year old gay man that has been HIV+ for over 22 years and I'm alarmed at the news reports that I read about the rises in new HIV infection rates/diagnoses around the world. I know these stories are not fabrications to scare people as I have worked within the HIV/AIDS Service sector as a gay men's health advisor and I know these statistics to be a reality.

There are lot of reports recently about rises in new HIV infections especially in young gay men; what ,if anything, do you think it will take to get this whole new generation of young vibrant gay men to listen to these reports and as a result of that listening getting them to:

1) focusing a little more on their well being by having regular sexual health check-ups (at least once a year) which will include testing for all STI's (Sexually Transmitted Infections) not just HIV

2) start wearing condoms and learning how to make using condoms sexy and fun even if they feel that using them lessens the pleasure of intimacy or that they ruin the heat of the moment and

3) learn how to negotiate the disclosure of their sero-status with their sexual partners and hopefully at the same time also find out the sero-status of their partners so as to negotiate safer sex practices. Hopefully by addressing these few points we just might be able to make a small dent in this growing rise in new HIV infections?

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Nathan's Response:

Thank you very much for bringing this important topic up for discussion. I agree, the increasing rates of new infection are alarming. You would expect the rates to be dropping, not rising.

I think the first step is simply this: talking about it. A conversation must be present in order to initiate change.

1. How can we encourage regular check-ups?

There's no doubt that the cost of healthcare has something to do with men not going to the doctors more frequently. But I think a lot of people are unaware that they can be tested for HIV and other STD's at local clinics. In most areas the tests are free. All metropolitan areas have clinics that offer this, and most small towns have them too. It is completely anonymous. You are assigned a unique number, and that's how you are identified for your results.

It's very easy and very discreet. Again, I want to mention that it's usually FREE. You can't complain about the price or the distance. So no excuses guys! You should be tested regularly for HIV and other STD's. Go to http://www.hivtest.org/ to locate free screening clinics near you.

2. How do we promote safe sex and make it seem fun?

I think it all starts when people learn about sex, and that's usually during puberty. As soon as a young man or young woman is old enough to learn about sex, he or she also needs to learn about condoms. At this age, young adults are very curious to learn. It's the perfect time to start teaching them the importance of safe sex, and continue discussing it with them as they mature. By the time they are adults, it will be a natural part of their thought process.

This is something that conservative groups have tried to block in recent years, and as a result, they've actually caused damage. They take the approach of pushing for abstinence instead of providing answers. I think that abstinence is a good idea in theory, but not realistic. You have to look at the cold hard facts: The median age that young adults lose their virginity is between 16 and 17 years old. Clearly abstinence is not working.

As a result of narrow minded adults pushing to ban sex education in schools, they teach their children that sex is shameful and not something to be discussed. That causes teens to sneak around and engage in risky behavior, often including unprotected sex. It would just be so much easier to have a healthy, honest discussion about safe sex and making condoms available.

So my advice is to start with education in schools. It's an important time in a person's life and can teach them valuable lessons to carry throughout their adult life.

As for how to change the thinking of young adults, past high school age, I think that's a lengthy discussion that needs to be addressed at a different time because it's so complex and has many angles. As a starting point, I'd recommend improving the way youth learn about sex, and I think we'd see some incredible drops in the infection rates.

3. How do we encourage people to discuss their status?

Many people are under the false impression that wearing a condom protects partners from all STD's. That's simply not true. Many STD's can be transmitted regardless of condoms, and even wearing a condom does not guarantee you will not be infected.

Condoms are designed to decrease risks. They are the symbolic equivalent of air bags in a car. Just because you have an air bag does not mean you will be fully protected from something bad happening. The only way to fully protect yourself is to not drive a car at all. Anything other than that, you're taking a risk.

That is why I recommend using a condom AND being tested regularly AND discussing your status with your partner. Never assume that the person will automatically tell you their status. Also, never be shy to bring it up yourself. If you're old enough to have sex, you're old enough to ask when they were last tested and what the results were.

Everybody deserves the opportunity to make a choice about their health. If you both know each other's status and history, you and your partner can both make more informed decisions.

In addition, just because a person says they are negative, I still feel it's very important to use a condom. HIV and other STD's don't always show up immediately. As the saying goes... better safe than sorry.

I hope that this information is helpful and I know it will be the first of many discussions I plan to have on HIV. I think that this is a good starting point.

Feel free to share your feedback, and please send your questions to editor@outvoices.us. Your identity and privacy are protected.

Thank you, and take care!

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