I’m a PhD student in virology at the University of Pennsylvania, and while I certainly don’t intend to (or need to) lecture you about HIV, your post contained a subtle inaccuracy of great importance. You wrote that “middle-class gay men can suppress the virus indefinitely with the cocktail.” It’s true of course that viral load can be suppressed and that life expectancies of HIV+ individuals on strict HAART regimens are close to, if not completely, normal, but that’s not the same as saying that anti-viral therapy will keep you healthy. HIV-associated neurological disorders (HANDs) are a significant problem among HIV+ individuals (up to 50% of cases in the US) and are only partially preventable and treatable by HAART. I’m sure you know people who suffer or have suffered from HAND, and I don’t want your blog to become a place where people go to learn that just because anti-retroviral therapy is highly effective, that there are no consequences of HIV infection as long as you have money and/or insurance. (I’m including links to some more papers on this topic: here, here, and here.)

Another asks:

Isn’t there a possibility that a HIV positive man might be reinfected with a new strain of virus and cause his current HIV drug regimen to fail? I thought there was always that risk.

Nope. Another quotes me:

“Bareback sex feels better for both partners.”

You’ve made similar statements before, in even less compromising terms. (“Infinitely better” I think?) And, well, you’re wrong. Maybe for some people, maybe even for most, but not all. I honestly have no preference either way, not even in terms of convenience. A condom adds a bit of hassle up front, but it saves my partner a whole lot of cleanup, so it seems like a draw there. Certainly no difference in sensation. I understand why barebacking would be fetishized – the subject is so wrapped in danger and mystery and taboo thoughts that of course some people will turn it into a kink. Humans are really good at turning things into kinks! But that doesn’t mean they can’t be used very happily by lots of people.

Another reader:

In addressing whether condom use should continue to be encouraged, you wrote, “The more important goal is for HIV-positive men to have sex mainly with other HIV-positive men, restricting the virus to a pool of the already infected.” When I met my husband in 2005 years ago, he had already been HIV positive for many years. I was (and still am) HIV negative. Sero-sorting is all very well and good in theory, and I’m sure that many people – like yourself – have successfully worked out their lives that way. In my case, I wasn’t going to let a virus cheat me out of an intelligent, funny, caring man.