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22 Nov 2012

What's your status? Talk, test, test, trust

Research shows that many of us stop using condoms as soon as we're in relationship or as soon as we think someone might be “boyfriend material,” which can potentially place our health, and the health of our partner at risk. Is there any safe way to have unprotected anal sex?

Whether it's for love, sex, intimacy, commitment or that deep communication, many of us have the desire for a long-term relationship. Some of these factors however can lead us to falsely believe that being in a relationship is an effective way to avoid getting or passing HIV. Research shows that many of us stop using condoms as soon as we're in relationship or as soon as we think someone might be “boyfriend material,” which can potentially place our health, and the health of our partner at risk.

Is there any safe way to have unprotected anal sex?

Safe unprotected sex is possible in long-term relationships, but it takes honest communication and trust.

There is a process called ‘Talk, Test, Test, Trust' after which a long-term couple can safely stop using condoms with each other. This process involves getting tested for HIV together and then, after still using condoms for three months, getting tested for HIV together again. If both partners' test results are still negative the second time, and neither of them has had any risk of exposure to HIV in the period between the two tests, then they can be reasonably sure that they are both HIV negative and stop using condoms with each other.

However, this process also involves the words ‘Talk' and ‘Trust' because the process requires a high level of discussion and trust between the partners about always using condoms if they have sex with anyone else and being honest with each other if one of them breaks this agreement.

Talking the talk

Before just dropping condoms once you've met your man, you both need to have some discussions about where want to take your relationship. There is a diversity of relationship styles in our community beyond stereotypical heterosexual models. Just as it is often difficult to know the point at which a casual encounter becomes a relationship, so is knowing the direction of the relationship – the only way is to talk about it. Will your relationship be monogamous? Open? Or will it be one of the multitude of other arrangements gay and other men who have sex with men make with each other?

It's important to ask yourself what it means when someone you've known for a short time and are about to (or hope to) have a relationship with, tells you he is HIV negative. Here are a few important questions to consider:

• When did he have his last test? It may have been years ago, but then again, it could have been a couple of weeks ago.

• Why did he have the test? Some people get tested after having a scare following unsafe sex. If the window period has not passed he could be positive without knowing it.

• What has he done since then? Just because someone has tested negative a while ago, doesn't mean they still are. It is possible that he may have placed himself at risk for HIV since then (unsafe sex, unclean needle use, etc).

• Is he being honest? Just because your partner says he's been tested, does this mean he's telling you the truth?

When asking these questions, remember that he likely will be asking the same of you.

It's important to always use a condom with new partners. If the relationship gets more serious then you may start to think about not using condoms as long as you can talk the talk. Think about why you want to stop using condoms:

• Is it to show how much you love and trust him?

• Is it to feel closer to him?

• Is it to prove that we're in a relationship?

• Is it because sex with condoms is less spontaneous?

• Is it due to a latex allergy?

• We've already fucked without condoms – so why bother?

The test

The next step in agreeing to no longer use condoms is for both of you to get a sexual health check-up including an HIV antibody test. You'll need to decide whether you'll get tested together or separately, and whether you'll get your results together or separately. The benefit of getting tested and getting your results together is that you'll have each other's support, and you won't have to rely on each other's word about the results.

Even if you've already had unsafe sex in your relationship, don't think it's too late to get tested. It's better to get tested and (hopefully) start with a clean slate than keep having unsafe sex because you think you might have already become infected.

Because of the three month window period, which is the time it takes your body to produce the antibodies that are the indication in the HIV test of whether or not you're carrying the virus, it's important that, even if you both test negative on the first test, you both return to get tested again in three months time. You and your partner need to agree to continue using condoms during this three-month period, so that when the second test results come back you can be sure that they are definitive.

If the tests come back positive, doctors or other support people are available to talk about your health status and about ways to maintain your health. It will also be important to talk to your partner about your result, whether it's negative or positive. You may want to see a counsellor either alone or together. Check out the “contacts” page for counselling services.

Trust

Once you've established that both you and your partner are HIV-negative, you'll need to talk about what type of sex will occur, both inside and outside of your relationship. Some questions to consider are:

 

Once you've had a chance to openly discuss these issues, honesty and ongoing open communication are essential to maintaining a• Will we stop using condoms in our relationship?

• Will we agree to have sex outside the relationship?

• If so, what type of sex is allowed with other people: anal sex with condoms or no anal sex?

• Will we agree to tell each other when we have sex outside the relationship or will it be a “Don't Ask, Don't Tell” policy? condom-less relationship.

Dealing with the bumps along the road

One of the reasons open communication and honesty are fundamental to maintaining any relationship is so that you and your partner can deal with any problems that may arise in it.

For example: what happens when your agreement is broken? There may be occasions when you have unsafe sex with someone else, perhaps because you were out of it, horny, mad at him or because it “just happened.” Whatever the reason, would you be comfortable telling him about what happened? How can you know if he'd feel comfortable telling you?

Remember, if you have stopped using condoms with each other and one of you has unsafe sex, you will need to start using condoms with each other again, so both of you need to feel comfortable about telling the other what's happened. Talking this possibility through beforehand and coming to an agreement about it will make it much easier if the situation arises.

Some things do come to an end

Some relationships work; some don't and come to an end. People often feel vulnerable at the end of a relationship and having to go back to safe sex again after the break-up of a condom-free relationship can increase the sense of loss. You've been used to having sex without a condom, and it might it to be a hassle going back, but it's important to think about the risk of unsafe sex with casual partners.

As one relationship ends, another new one may be just down the road, and it's important to remember that if you are considering not using condoms with a new partner you need to go through the same steps, including waiting three months for the second test.

Going with the ebbs and flows

Relationships change with time and agreements within relationship can change too. For example, one of you may feel differently about the arrangement you have and seek to open it up – or quite the opposite! Once again, dealing with change requires healthy, open and honest communication. While the agreements may change, it is important to ensure that whatever you're doing (especially sex outside the relationship) continues to be safe.

This article was first published on http://www.top2bottom.org.au and is republished with permission from the Victorian AIDS Council Gay Men's Health Centre (VAC/GMHC). Top2bottom is a campaign developed and maintained by the Victorian AIDS Council/Gay Men's Health Centre in Melbourne, Australia; and is funded by the Victorian Department of Health.

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