BISEXUALITY AND AIDS
'Thinking about AIDS has made me realise how important each minute of life is – much too important to waste with regrets about past troubles and future fears.'
Research and understanding about the HIV virus and AIDS itself are changing so fast that anything we might summarise here could soon be out of date.* But there are aspects of the epidemic and people's responses which are specific to us bisexuals. So we will concentrate on these aspects and accounts of personal experiences and feelings.
By now we should all know the enormity of the threat of the HIV virus, the personal difficulties and challenge of becoming a carrier and the trauma of developing AIDS itself. It should be reiterated that AIDS is not a gay disease and in some places the virus and AIDS have always affected heterosexuals as much as any other group. However, in the UK as elsewhere, the spreading of the virus into the general heterosexual population has brought alarm about 'bridging groups' in contact with the concentration of the virus in the gay community.
These groups are identified as bisexuals, intravenous drug users, prostitutes, and people from highly infected areas such as parts of Africa and the USA. Intravenous drug users have rapidly spread the virus amongst themselves by sharing needles (particularly in prison where shared needles are the only ones available). In a similar way this has happened apparently in some African countries with the medical re-use of unsterilised needles. Prostitutes are considered a high risk, especially as research suggests that the virus is more likely to pass from an infected woman to a man than vice versa,** though with both women and men prostitutes, as with anyone else, the use of condoms for intercourse reduces the risk. Bisexuals, especially men, have been seen as a primary bridging group bringing the virus into the population at large. This has focused people's attention as never before on the extent of bisexual behaviour.***
Up until now the fact that maybe over a third of the population has strong attractions to or sexual activities with both sexes has generally been ignored. Sexual self-identities have been seen as either heterosexual, or gay or lesbian. But in reality people are not in distinct groups. As far as disease transmission is concerned, it is actual behaviour rather than self-identity that counts and many self-identified heterosexuals and gay men and lesbians behave bisexually. Contrary to a frequent association of bisexuality with promiscuity, it is our experience that many self-identified bisexuals are recurrently celibate, and increasingly so as part of a safer sex life.
The spread of the virus initially among gay men in the USA happened before AIDS was clearly identified and transmission associated with sexual activity. Once this was established the gay communities worked to inform people of the need for 'safer sex' as certain types of sexual activity and the number of partners greatly increase the chance of spreading the virus. As a result of these warnings very many people, both virus carriers and non-carriers, now take much greater care about their own and their partners' sexual lives and general health. But it is only after years of delay and with lobbying by the medical profession that governments have begun to inform people more widely. There are many reasons for this delay, but undoubtedly one is that governments endorse heterosexual monogamy and ignore or negate homosexuality.
The result of this attitude and the widespread fear of homosexual feelings and activity, is that bisexuals, gay man and lesbians grow up with virtually no positive images of their sexuality. It is absent from or negated in every day life, education, literature and the media As a consequence, many of us cannot but bring some of the received negative self-images to our gay relationships, thus putting then, under more stress. Whilst promiscuity is often seen as a political choice which challenges limitations on personal freedom, it is also, together with covertness, partly the outcome of this overall negation of homosexual life.
From this perspective the rapidness of the spread of the HlV virus is as much the result of the homophobia in society as anything else. Yet, all too often homosexual people have been used as scapegoats by the manipulative, the frustrated and the ill-informed As for life-long monogamy, the tensions within so many marriages in past generations and the present high divorce-rate show that this is a cultural ideal so often at odds with the changing lives of the people involved.
The personal responses of bisexuals to AIDS has been varied Some retreat into the closet, experiencing increased tension and the fear of becoming infected and infecting others. Here, the particular challenge is to inform and support those bisexuals, particularly men who are not 'out' and continue to live 'double lives'. These men could infect their women partners who may become pregnant and thus be more likely to develop AIDS themselves, because of the hormone and immunity changes during pregnancy, as well as passing the virus to the child.
In contrast to this many other bisexual women and men have responded to AIDS by becoming more open about their lives and more responsible about their sexual activities. Here the personal issues are often about past sexual behaviour when unaware of AIDS and safer sex practices, and about having a medical test for the virus. The essence now is sustaining and creating relationships with partners of either or both sexes where there is a dialogue about enjoying 'safer sex' and exploring more sensual as well as sexual satisfaction. On a wider level there are bisexuals working to inform people about AIDS and safer sex and also who support people with AIDS or with the virus.
Safer Sex, in brief
Each of us has to decide just exactly what we feel is safe enough for ourselves and our partners. In the UK, unless you have been celibate or in a mutually monogamous relationship since before 1978, you cannot be sure you are HIV virus free without having a lest. And an anti-body negative or virus-free result is only meaningful if you have been celibate or had only no-risk sex for at least three months**** before the test and then, of course, continued like that.
The boundary between relatively safe and unsafe practices has been changing as understanding of the virus grows. At the time of going to press, it is generally thought that the principle is not to exchange body fluids because, in an infected person, the virus will he present in blood and semen, as well as being in saliva, vaginal and other body fluids in smaller concentrations. The virus can then find its way into a partner's body and blood through any opening in the skin, internally or externally, such as a cut or sore. For this reason, anal sex is very high risk and vaginal sex high risk, though a condom will reduce the risk provided it does not tear or slip off. Any sex act which may cause a cut or draw blood is also high risk. Oral sex which includes wet kissing is considered low risk, although some people have openings in their gums or digestive tract through which the virus could be transmitted.***** Masturbation, dry kissing and body contact carry no risk.
The following are descriptions by members of our Collective of their responses to AIDS.
AIDS: ONE WOMAN'S THOUGHTS
I've been in close contact with people talking about AIDS for over a year now and it's only recently I've bothered to seriously think about it in relation to me and my body. I've just had treatment for internal warts which means no intercourse for over a month. I've had to consider sex much more thoughtfully (I did, already, a bit) and I've also had to think about my health and not just take my body for granted. I have always thought in the past 'Oh, I'm safe, I know who my lovers have slept with in the last couple of months', but what I don't always know is 'who have they slept with a year ago?'
The more I read about AIDS, the more symptoms I think I have. That seems to be the problem with a lot of people – most are fit and healthy but when they start to believe they have particular symptoms they can become ill and run down. The moment I started worrying I came out in a rash and picked up 'flu!
It's only recently that I've realised the possible consequences of not practising safer sex &emdash; I should have been thinking (and doing, something) about it months ago. I hope I'm not too late.
SAFER SEX: ANOTHER WOMAN'S POINT OF VIEW
For anybody seeking, or open to, a new sex partner I suppose the main issue to think about is safer sex. I've found this topic very difficult and confusing to consider, because although facts about the virus are gradually becoming more available they are still minimal How safe do I need to be? Is a totally safe sexual relationship possible If so, what does it mean? All these are questions my friends and I talk about a lot and different people come up with slightly different solutions for themselves.
I've been to organised discussion groups with and without 'experts' present, had informal chats with each of my close friends and received skilled counselling from people in both high and low risk AIDS groups. Oh yes, and I've sent off for and read all the literature I can get my hands on about the subject.
Watching myself and all the others I notice that it seems very important to just talk and talk and think. Find someone else who's interested – maybe because they want to think themselves, or maybe because they are your friend and want to help YOU think. Another thing I've noticed is that attitudes and behaviour seem to change in stages rather than all at once, and there seem to be different solutions for different people. There have been people who think I am much more careful than necessary and those (my mother included) who think I take ridiculous risks.
I find the idea of being passed or passing on something that could cause AIDS so frightening that it has totally altered my own range of possibilities with ANYONE since I became AIDS conscious. Until the medical world knows more and can vaccinate against/cure HIV-related diseases I am behaving very differently.
Unless my partner has had six years of being either celibate of exclusively monogamous with a partner who is also exclusively monogamous, I consider them at risk of carrying HIV. I consider myself a risk, too, because I do not fit either category and there are so many 'unaware' carriers now in Britain. I include even lesbians as risky potential partners for unsafe sex because they may have had male partners at some time in the last six years, or bisexual women partners or untested self-insemination or even sex with another lesbian woman who had a male lover in the last six years. My lesbian friends often react with shock when I tell them this and my usual first reaction is to reassure them that, yes, lesbian sex is still the lowest risk of all the traditional sexual behaviours. But I still want to make the point that safer sex is an issue for everyone who considers having a new sex partner in their life from now on, even if it is a case of minimising the risk of transmission rather than eliminating it altogether.
It seems important to me that everyone talks and thinks and decides what they will do BEFORE they find themselves in a sexual situation. Trying to decide what is safe at that point in time does not work. All the people I have asked are unanimous on that.
For myself I see three choices, none of which felt the least bit attractive at first. I could decide to become celibate which would be totally safe as the only sexual partner would be me. Alternatively, I could choose a partner who mutually agreed that we would be exclusively monogamous and then both of us spend three months without sex during which time we both took two HIV antibody tests. If both proved negative we could go ahead and have an 'unsafe' sexual relationship. The third choice I see open to me is the one I've chosen currently, which is to continue my lifestyle of having several relationships at once, while radically altering what we do together.
I want to eliminate risks altogether, so for a while now I have simply enjoyed sharing a bed and a naked cuddle and intimate conversation with a new lover. Caresses, massage and dry kissing, all away from the genital area, are very pleasurable and I've certainly discovered delicious new levels of sensuality and sexuality.
The difficulty of telling someone new what I want sexually is that I get very embarrassed and beat around the hush looking sheepish and giggling. But I've found a very sensitive and encouraging reaction so far, maybe because we're all used to a bit of embarrassment around sex, and it has been well worth it for each of us. This may take hours, but sometimes one of us gets very turned on and wants to reach orgasm. The answer seems to be to masturbate avoiding blood or semen contact with each other at all and then wash well straight after. So far I haven't really enjoyed this practice very much, it feels too scary. From now on, if my partner is male I will ask him to wear a condom and if I have my period I will either abstain or masturbate myself, followed by a good bath straight away. I would want a woman lover to do the same.
AIDS awareness has caused a huge uncomfortable upheaval in my already complicated life (having several relationships at once is not easy in our society), but the benefits of safer sex and the challenge of having to deal with HIV transmission have widened my experience and even improved my life. I have learned so much about how to talk about sex (brilliant recipe for losing my nervous sexual tension, I've discovered!) The trust I've built up with people when I've discussed safe sex with them has been qualitatively stronger than before and reflected right through the rest of our friendship / relationship. To have talked about something so intimate and sharing such vulnerability together seems to make an extra bond.
Now, with safe sex there is all the time in the world to explore a closeness that I didn't know existed. Somehow, in the past, there was always a goal of intercourse or orgasm to sex. I sometimes miss this, but much more important is the new intimacy that has taken it, place.
SAFER SEX AND TESTING: ANOTHER WOMAN'S EXPERIENCE
In the autumn of 1984, my boyfriend's brother flew in from San Francisco and told us about the impact that AIDS had had within the gay community there. He was part of that community, and through him, we came to realise that it was going to have a great impact in Britain too. At the time it was only getting small paragraphs in the papers.
Examining the nature and history of our past and present relationships which were in both cases bisexual, my boyfriend and I felt that a test for HIV was unnecessary. We reached this decision after seeking out the available information, including a memorable talk given to the London Bisexual Group by Tony Whitehead, chairperson of the Terrence Higgins Trust. We also made an informed choice not to use condoms.
Certainly it was possible that either one of us might have the virus, but it appeared to be so unlikely that we were not prepared to change. I do believe that condoms can be a lot of fun – at least I've never put one on anybody without laughing – but I would feel less amused if I used them more frequently.
Only 18 months later did taking a test become an issue for us Increasingly, I found it unsettling and anxiety-making to discuss plans for having and/or adopting children which would never happen if one of us had the virus. Obviously no plans we make in this life have guarantees, but I needed to know.
We were still in the process of rebuilding our relationship after a split, and I needed foundations of reality to build on. He was concerned about the devastating effect that a positive result would have and it was mostly for my sake that he had a test with, happily, a negative result. In fact, I had told him that I would 'propose' if he were positive, so all in all he had a narrow escape! To be tested myself seemed unnecessary now I knew that my boyfriend was in the clear. The last male partners I had had were five or six years ago. They were not in high risk groups and have to my knowledge remained in good health, as have I. Of course a small doubt remains (what about my trip to Los Angeles in 1980 which proved to be rather exciting?), but I feel that unless I wished to get pregnant it is not worth worrying about.
I'm determined to tackle what remains of my irrational fears. AIDS has been around quite a while in some parts of the world and I do feel confident that there has been enough knowledge gained to keep me accurately informed of the risks. I support my boyfriend's desire to have 'safer' sex with other men, although admittedly this does require a lot of trust. Generally I believe that men can only gain from trying to have longer-lasting involvements with their partners. We must not let fear swamp us and I hope that I don't lose potential female lovers by not going to extremes of safety. Now I feel very lucky to have had my most sexually active period in the late seventies. It all seemed so carefree at the time.
AIDS: DIFFERENT VIEWS FROM MEN
'I've known gay friends who say that they must have had the virus by now so why stop having sex or change their behaviour. They just go on as if death were not just around the corner. Some people talk about the challenge – but the choice is between no sex life or a greatly curtailed range of activities. I used to be fairly promiscuous but having been tested and knowing I am negative I do not want to take any chances. My gay contacts are now friends. I've given up cruising the bars. There is only one person in my gay sex life now – me!'
'We mustn't be complacent about safer sex, think it is OK to lake risks, to wet kiss, that it's all right if we are with wimmin. Unsafe sex should be monogamous and checked out by blood tests. We are all a danger to each other …. How many people have you slept with in the last six years?'
'I don't believe in the scientific view of health. When I'm loving myself properly, I don't catch anything. But it's difficult to do that all the time and so I play safe …. the tests mean little to me … I took them for my partner's peace of mind.'
'I have become AIDS and safer sex conscious since my marriage ended and since last making love with a woman over a year ago. I still want that intimacy with a woman but I have felt blocked by the prospect of safer sex with condoms or no penetration, neither of which were satisfying in the past. Now I've heard what women in the group have been saying about their safer love lives, and I realise it CAN be satisfying. Also I've learnt from my relationship with my man lover which has not been penetration-orientated and where I have changed from higher risk to other satisfying lower risk sex.
I wonder if male hetero-sex faces even greater changes than gay sex? For is not heterosexual male sex orgasm mostly synonymous with penetration, in contrast to the diversity of gay sex, and is not the 'modern' hetero male used to general freedom and unsheathed sex with the newer woman-based contraceptives?
So it seems to me that the safer sex requirements of condoms or no penetration and avoiding exchange of body fluids will lead many hetero males either to return frustratedly to using condoms or to explore more variety and sensuality – touch, body contact masturbation – in short, more similar to what I have enjoyed of gay sex.'
'From the point of view of safety, the bisexual man has an advantage over the gay, in that he might be able to concentrate more on sex with women and have less dependence on men. We are told that the fewer sexual partners we have, the safer we are likely to be. This is not easy for the man who enjoys the thrill of anonymous casual sex. Yet a case could be made for saying that this form of sex at a controlled low to medium risk level is preferable to involvement with one or two male partners at a deeper, more risky, level.
Not only will safer sex diminish the risk of the HIV virus, but also venereal diseases and hepatitis B (which appears to spread by similar means to AIDS and can be just as insidious). If this is one positive result of the AIDS epidemic, then another must be the encouragement towards being more honest and open about our sexual activities with other people. The situation needs cooperation and trust between us and our partners, male and female. If we are being tempted into risky activities we must not be afraid to admit it because talking to sympathetic ears can sometimes help our self control. This sort of responsible attitude is essential if we are to protect ourselves and others.'
'I would like to be a father one day. If I were HIV positive then I would be putting the mother at risk as well as the baby. Effectively, if I were HIV positive, I would not feel able to father a child. The situation is worse for women. Babies have a 50% chance of being born with HIV if the mother is infected and on top of that, the child would have a further 50% chance of dying in the first three months of life. The thought of playing a game of chance with a woman's (and baby's) life is shocking. I could not take such a chance with anybody.'
SAFER SEX: ONE MAN'S POINT OF VIEW
Until having to practise 'safer sex' my definition of 'sex' would still have been roughly intercourse and orgasm orientated, with other activities such as oral sex and 'foreplay' being treated as adjuncts to screwing.
Lying about cuddling was something I did afterwards and if I skipped anything through lack of time I skipped that and had a quickie, as often as not. I would have said sex wasn't complete without a lot of touching and time to relax, but the emphasis would still have been that they were 'secondary' in some way, although my life never felt complete without a whole morning or afternoon spent in bed touching, at least once a week.
Much to my surprise, when I unwillingly started having to accept the cuddling and touching as being the important part, with intercourse restricted and often cut out altogether, I found it immensely rewarding. It is so much more difficult to relax and to enjoy intercourse when worrying about AIDS and having the use of condoms taking so much pleasure away. I discovered that massage, which I only did for brief periods before, and lost interest in after, screwing, was something I could spent a lot of time doing and which left me and others feeling really good. Without orgasm the enjoyment of sensuality can go on and on and reach heights quite different from those of 'sexual' feeling and at least as important. Altogether it has been an unexpectedly good period in which I have been enjoying myself and other people and discovering new and fun things to do with them.
'COMING OUT' IN MARRIAGE: ANOTHER MAN'S THOUGHTS
The decision to come out to a husband or wife is part of a larger set of decisions and is a very personal one. It is going to depend on many factors, such as how confident the bisexual partner is of their own feelings, and how they feel they can stand up to responses they can only partially predict. It is going to be influenced by the people around the marriage and what is known about their possible reactions, and by what are the bisexual feels they have to gain and to lose by coming out. There is no simple formula to help this decision.
In the sense of a bisexual man who is married, the issues are made slightly different by the fact that there is more HIV among the population of gay men than there is in the lesbian population. For a bisexual wife in the corresponding position, the issue of taking responsibility for health, with outside affairs being a physical threat to the spouse, is just as important, but practically speaking the likelihood of infection by HIV is not quite so immediate at the moment.
In either case, I think the consequences for the bisexual partner are that they must act responsibly with respect to their spouse. It is all very well taking the chance of passing on an unpleasant but temporary and non-life-threatening infection with its consequent embarrassment and treatment with drugs, but HIV is in a different category and requires more serious responses. Either the bisexual partner must give up outside attachments, or practise sex so safely that they can feel quite secure in their own mind that they are not putting their spouse at any risk, or they must be prepared to be open and to discuss the situation. Even if the sex outside the marriage were safe, it is important to consider the feelings of the spouse on subsequently discovering that their health was being decided about without their being consulted. Anyway, perfectly safe sex is not at all easy.
As to what might happen as a result of such disclosures, I am much less certain of where I stand. I can only foresee many problems, conflicts and unhappiness and the need for a great deal of support at the time.
HIV AND TESTING: ANOTHER MAN'S EXPERIENCE
I have always been concerned about my health; I worry about minor ailments. When I first came out I was quite promiscuous. I went along to the Special Clinic every so often for a check up; sometimes I had some infection, but antibiotics or some course of treatment would soon clear me up. On occasion a lover would have some problem which meant I took a quick visit to James Pringle House (a central London sexually transmitted disease clinic), and that's how I got vaccinated against Hepatitis B. There was a game-like quality to popping into the clinic – 'STOP, do not have sex, go straight to the clinic.'
But then AIDS crept into the UK and the incidence of cases rose from 10's to 100's. At first I consoled myself that I stood more chance of dying in a car accident, but that was not true for long. The gay sex I enjoyed the most carried the most risk of catching HIV.
I started being less promiscuous and finally stopped cruising. Then I became aware of the HIV test. After much consideration, I decided that I wanted to know if I carried the virus. If I was positive then I would be able to start coping with that; if I was negative then I could keep myself that way.
The more I thought about the problems an HIV positive test would bring, the worse I felt. I would have to stop most of my favourite sexual practices; no chance of being a father; daily worry about my health; risk of having infected others; risk of some brain damage; risk of dying from AIDS. I knew that I had to find out.
Back I went to James Pringle. I talked to the doctor for a while about my decision. Then I was sent to wait to give the blood sample. I had to hold a form to give the nurse. There were some stickers attached: 'RISK OF HTLV III – CAUTION'. This brought the message home.
By the end of the two weeks, I was almost a wreck. The powerlessness of not knowing was terrible. I felt I could cope if only I knew. Thankfully, I was negative, and the experience redoubled my decision to look after my health by not contracting HIV.
The staff at the clinic respected my confidentiality and were pleasant, which all helped me to cope with the fear of testing. Though the test period was fraught, I felt a great sense of relief at knowing my health status. Thus I had a few weeks' worry and avoided years of stress.
AIDS – NOT IN VAIN: ANOTHER VIEW
My cousin has just died of AIDS in New York and this stirred many feelings and thoughts in me. Searching for deeper meaning I wondered again why AIDS particularly for gay people in North America and Europe, and why now at this time?
What came to me as a wide overview starts with the thought that now, when men may soon destroy the earth through nuclear war or ecological abuse, a prime need is for men to love men and for all people to live together in a just celebration of life. Here, for me, is a potential contribution that liberated gay consciousness can share with all people, the realising of love of self and others in spite of oppression, traditional boundaries and the feelings of separation and fear which, especially between men, are behind our potentially suicidal conflicts and insatiability.
And why AIDS? Well, I share the view which may seem strange to many people that our entire universe is a divine being, and that we humans are unique within creation in having free will and consciousness so that we can independently rediscover our spiritual origins and so become conscious co-creators with the great spirit. However our free will and our western loss of a sense of universal wholeness have lead us to our suicidal cliff edge, where now only nature and spirit forces acting with us, can ensure the survival of earth life. Humankind has needed to experiment to the material limit but time is very short indeed now for radical changes of our way of life.
So I wonder if homosexual love in particular is being 'pushed' by AIDS to move on from the brief recent period of relative 'free love' with often a sexual and material emphasis. Not that this is intrinsically wrong as many would traditionally suggest, but I think we need to explore the wider and deeper purpose of our lives, including the homosexual part of ourselves. The suffering and challenge of AIDS seems to be leading many to do so.
This is perhaps similar to other shifts of awareness through such traumas as the world wars, Vietnam etc. The suffering of each illness, of each death, and the loss of loved ones does not change, but for me, finding this perspective on AIDS leads me to feel that in some ways it is not in vain or meaningless and may indeed eventually serve some greater purpose.
Hospitals and clinics throughout the Country give advice on the HIV test. The following are amongst those which can be contacted in London:
The Middlesex Hospital, James Pringle House, 73/5 Charlotte St.. W.I. (380 9xxx/x/x)
St. Mary's Hospital, Praed St. Paddington, W.2. (927 1xxx)
St. Stephen's Hospital, Fulham Road, S.W.10. (352 8xxx)
Royal Free Hospital, Pond St., N.W.3. (794 0xxx)
Royal Northern Hospital, Holloway Road., N.7. (272 7xxx)
also the Terrence Higgins Trust AIDS Helpline (3-10 p.m.) 242 1xxx
** It turned out to be, by far, the other way around. Men denying they had sex with other men, and so blaming their female partner for them becoming HIV+, rather than accepting they'd infected her?
In the UK at least, very high levels of condom use means that the level of HIV infection amongst female sex workers is very low. The number of HIV+ male and trans sex workers reflects the level of infection in their communities more generally.
*** It still took six years before the commissioning of proper government research into this, and another two years before Behaviourally Bisexual Men was finally published!
**** Modern tests now only need a month before being highly accurate
***** Even the main research which suggests that it could be very low risk acknowledge that their findings are consistent with it being no risk – because oral sex is so common, especially between men, they had to make some guesses about the source of the infections they found.