Rethinking Unprotected Sex for HIV-Positive Men

By Mina Kim

Deon Brimmer, 32, is HIV positive and expecting a daughter.  He’s being treated by a new San Francisco program that helps men with HIV safely realize their dreams of being dads. (Photo: Ryan Anson)

Deon, 32, is HIV positive and expecting a daughter. He’s being treated at a new San Francisco program that helps men with HIV safely realize their dreams of being dads. (Photo: Ryan Anson)

The public health message around unprotected sex for those with HIV has always been the same: Don’t do it. Even with huge strides in medical science that’s changed HIV from a death sentence to a chronic but manageable disease, that directive has not changed.

Now, a new program based in San Francisco is challenging this long-held campaign, and helping HIV-positive men have babies — the conventional way. The program run by San Francisco General Hospital, called PRO Men, teaches men about a range of reproductive options, from adoption to in vitro fertilization — where an egg is fertilized in a lab dish — to carefully timed intercourse.

“I would say as an HIV provider community, we have really failed these men,” says UCSF professor Deborah Cohan, who runs the hospital’s Bay Area Perinatal AIDS Center or BAPAC. “We really have not created programs to help them realize those goals and do so safely.”

“It is one of the last big remaining hurdles that I think many heterosexual men and women have to what they would consider living a normal, ordinary life.”

With the discovery of drugs to treat the virus, Cohan said people with HIV are living long, healthy lives. And for those who want to start families, having “safe” sex, Cohan said, can mean foregoing condoms when a female partner is ovulating. Women can also take HIV drugs, which some studies show can protect against the virus. (BAPAC has helped HIV-positive women who adhere to their medications have healthy babies for years.)

“We know that if the person who is positive takes antiretrovirals and their viral load is suppressed, meaning the medication is working at killing all the HIV in the blood, that the likelihood of them passing HIV to a sexual partner is essentially zero,” Cohan said.

“Essentially zero” but not absolutely zero, Cohan says, because there’s some concern the virus can be in genital fluid even when it’s not detected in blood.

Despite this concern, couples are forging ahead with their family plans. Deon, 32, who thought his life was over when he tested HIV positive when he was in jail four years ago. Now he is about to welcome a baby girl with his fiancée Caroline. (Both Deon and Caroline preferred to go by their first names only.)

The couple became pregnant through unprotected sexual intercourse. Caroline does not have HIV, so the baby does not either. And she said she’s really not too concerned about getting HIV from her partner.

“He’s on his meds, and it’s a really, really, really low chance of me getting it,” she said. “And I just, like I love him, it’s not a big issue.”

BREAKING STIGMA

Though it may not be a big issue for Caroline, being HIV positive and having unprotected sex runs counter to just about every public health message that’s been put out for decades. Both state public health officials and officials with the Centers for Disease Control declined to comment for this story. The latest ethics report from the research and advocacy group American Society for Reproductive Medicine called the practice, “unsafe” and “not recommended.”

The San Francisco program is thought to be the first of its kind, and David Evans with the AIDS activist group Project Inform said it may stay that way for a while.

“I think stigma is still very, very strong in society about HIV in general.”

Evans, who has been following HIV medical science for decades and pushes for policy changes, said that in some states, doctors have refused to help those with HIV have kids altogether. Until about two years ago, health officials in Mississippi required people who tested positive for the virus to sign a form saying they would never have children. Evans said a program that affirms the right of people with HIV to have kids, and let go of condoms, could be revolutionary.

“I think this really changes things in a quite dramatic way,” Evan said. “And it is one of the last big remaining hurdles that I think many heterosexual men and women have to what they would consider living a normal, ordinary life.”

Case in point, as a typical father-to-be, Deon worries more about raising a daughter than he does about his HIV.

“It’s like ‘Oh my god,’” he said. “I definitely want her to know all kinds of self-defense. I envision her to be a black belt in karate.”

Caroline said she’s confident they’ll be good parents.

“We just have a really good relationship, like we really talk about everything,” she said. “He says I can make the decisions, but we make decisions together really, and things are just better when we’re together.”

The hospital treats about 500 straight men with HIV. The PRO Men program plans to launch a monthly support group in March that will also be open to men living outside San Francisco.

Listen to Mina Kim’s story:

Related
  • disqus_ppVsVDERwJ

    This is very irresponsible reporting. HIV WILL turn into AIDS eventually, and you will die from this. It is not simply “chronic”, but a fatal illness. I am very alarmed and disappointed that this article made it into print. It is fatal and while treatable it is incurable.

    • Liam

      HIV will NOT turn into AIDS eventually if individuals remain on effective antiviral treatment. Many individuals have been on treatment for 20 years or more and had no damage to their immune system or progression to AIDS. As a health care professional working in the HIV field for nearly 30 years, it concerns me that people still view this as a fatal illness.

  • Diana from San Francisco

    This is so completely irresponsible! I am shaking my head. I wonder what the women have to say, if they actually know and understand. I am just shaking my head. I have lost too many friends to think this is a good idea.

  • apostleshadamishe

    AMBUSH CURES HIV/AIDS

    Apostle Mishe

    apostleshadamishe@gmail.com

    Sir / Madam,
    For the past 10 years of study of Ambush . a Palm plant extract that if effective in curing HIV.

    Name of Plant; Palm

    Name of ingredient: Ambush

    Molecular weight 640
    (similar to the sequisulfides)

    Where found: In and around the areas of South Florida where uranium waste was dumped in the 1920’s from the nuclear programme that has now leaked out into the water system. A specie of the PALM plant has picked up this waste to be the valuable AMBUSH.

    Chemical compd; Uranium isotope (cus.n) Grayish white soft metallic compound NOT found in chemistry books.

    Uses: Antiviral DRUG..Ambush

    Found to “KILL” the HIV virus when given in a dose of 60 ml three times daily for 21 days at a known concentration.

    Mode of action.. Ambush kills the HIV virus by causing the viral shell to rupture . In the lymph system Ambush produces “natural radioactivity” that “kills” the virus that ‘hides’ in the lymph system . This crosses the blood-brain barrier since the ‘patients’ claim that they are able to see,hear and think more clearly after taking Ambush.

    Viral Loads…This decreases from 100,000 to ‘undetectable’ in 21 days….. but I have had patients VL go to ‘undetectable ‘ in 5 days.

    SIDE EFFECTS / EFFECTS
    1. After 5 to 7 days of treatment, patients MAY complain of HEADACHES.
    2. After 5 to 7 days male patients experience an increase in erection.
    3. Stool becomes soft and REGULAR
    4. Patients c/o being WARM in the trunk area mainly at night when lying down.

    Toxicology……Before administering to any person a complete toxicological analysis was done to include, arsenic, barbiturates and NO KNOWN poisons or harmful substances to mankind were found.

    Systems/Organs

    Skin…becomes clean, smooth and free of eczema or other say they have small eczema patches in the first week that go away by the third week.

    Excretion
    Since this is a very LARGE molecule it is excreted relatively unchanged via urine and feces.

    SEROREVERSION
    After 149 days the patents revert to being HIV NEGATIVE after finishing a course in Ambush hence no one goes public to say they WERE HIV positive.

    Pharmacology of Ambush on the GUT of an end stage AIDS person.

    It is known that late stage AIDS patients posses a high level of the virus in the GUT which should include the entire GI tract from stomach to rectum. Here the virus is found in the lining and this is difficult for ARV’s because these are the areas needed by the ARV’s to enter the blood supply. There is not a high enough blood level returning back to the stomach lining hence the virus remains in high concentration.

    This causes the person’s appetite to decrease which causes a spiraling downhill of the body.

    When Ambush is taken in the liquid form, it is slightly basic and forms a stable compound in the acidic stomach.The Ambush compound is close to the stomach lining to exert the “natural radioactivity” effect which kills the virus in the stomach. Here the entire mid section feels very warm and sometimes feverish. The infected stomach lining with the dead areas is then passed out as a black slime in the stool. This usually happens about day 4 while on an Ambush regime of 60 ml three times daily for 21 days, wherein the person has a large bowel movement.

    After the bowel movement, the person becomes extremely hungry and eats TWO to THREE times a normal serving. Here I usually recommend cornmeal porridge with butter or cooking oil as a prevention against malnutrition and add a daily multivitamin. By day 10 the stomach has recovered and the person eats normally.

    THE CHALLENGE

    The challenge is to find a Virologist, or Biologist of HIV Researcher who is willing to put some Ambush in a Human culture medium infected with the HIV virus, incubate with proper controls and report their findings to the world.

    More info is at http://www.ambushcuresaidsfree.com or
    http://www.youtube.com/user/apostlemishe?feature=mhee

    Thank you for your interest and we will be happy to send you samples and answer any and all questions.

    Apostle Shada Mishe
    apostleshadamishe@gmail.com
    Dallas Texas,
    1-972 294 5161

  • Shannon Weber

    HIV-affected couples and their providers seeking information on safer conception options or the support group for HIV+ men who have sex with women can find info on the BAPAC website: http://hiv {dot} ucsf {dot} edu/care/perinatal/pro_men {dot} html

  • Minh Tuấn Trần