The 'dreaded' email

[Strafe13]

I think you're exasperated because you can't convince Juan that you're right, or force him to accept the premise of your question, so that he'll give an answer you want. Ironically, you've both expressed yourselves well as to your points of view, and you don't actually disagree on much.

 

I think the escort's responsibility is exactly what Juan has articulated, and is no more than that of anyone else who's sexually active. We should all educate ourselves as to all pregnancy and STI risks inherent in the practice, get tested on a regular basis, make a decision as to the types of risks we can accept and the practices in which we'll engage, and then take the appropriate steps to protect ourselves and potential partners in accordance with those risks and safer sex practices. Except for cases of sexual assault, no one, be they escorts, dates, spouses, or just quick lays, can expose you to STIs on their own, and you always possess the power to protect yourself by either saying "no," or engaging in the safer sex practices with which you're comfortable, upon saying "yes".

 

No matter how blind, ignorant or irresponsible this particular escort was with his clients, he can't be held responsible for their own irresponsibility. If, God forbid, one of his clients became infected due to a tryst with him, they are both equally responsible for what took place in that moment (or moments). Absent an allegation that the escort purposely intended to infect others by lying to them to lead them into sex that he knew was beyond their accepted practice, or by stealthily barebacking them when they had agreed on condom usage (this all presumes that he knew he had a communicable STI in the first place), I fail to see why he should have any special responsibility. It seems that you're implying this when you pose a separate question just asking about what escorts are responsible for.

 

So, that escort's failure to get regularly tested and to regularly practice safer sex was wrong. I don't think anyone disagrees with that. I just personally think it was wrong on a basic level applicable to everyone, not just because he was an escort. I guess Juan's point, echoed so often by many of us on this site's barebacking threads is that so long as you take care of yourself, while accepting that at least some risk (even if minuscule) is inherent in all things in life, you should just go on about your business and not freak out about what an escort does, or may have done, with other people.

 

Your question also seems to presuppose that the clients are saints, who themselves are always responsible (except apparently when they were with this dreaded escort), and that they posed no risk to the escort. Of course, the very reason escorts are at high risk for STIs is because they might contract them from any of their clients. A number of people on this board have expressed an assumption that escorts who bareback on film or in their private lives are more likely to do so in other instances, therefore putting them, as prospective clients, at increased risk. Doesn't this assumption also hold true in reverse -- that clients willing to engage in riskier sex practices with an escort are more likely to do so with untold others, thereby putting the escorts at increased risk? All the more reason, IMHO, that all parties involved have a responsibility to educate and protect themselves, and to also protect their prospective sex partners, whoever they are.

 

This is exasperating...let me try it this way:

 

1. If I'm married and cheat on my wife with another person and subsequently bringing some kind. Of disease or infection into my home, I alone am responsible for it - regardless of whether I'm told that the escort is free of disease. Period.

2. I also agree that one can only have control over their own actions. And destiny. Period.

3. But now we get to the OTHER question, which is: "What is the escort's personal responsibility in regard to testing and revelation?

 

Other than Dave, all anybody wants to talk about is "personal responsibility" as though all these interactions are taking place in a vacuum and everybody has clear insight into all that's taking place. I am responsible as a client - agreed. Now tell me what the escort is responsible for, and please don't fall back on the fact that it shouldn't matter, because that's either purposefully naive or ignorant. What does it mean to be a professional? Coming on time? Being in shape? Giving good head? Telling clients their status?

[Amoco]

Actually, Juan, you're answer was helpful and finally did respond to the question when you indicated that you supported testing and reporting, but acknowledge it's limitations - Now we all agree. And of course there are limitations with any regulation, but as a licensed professional myself, I'm pretty confident that a system could be put in place that does a credible job in minimizing client's lack of information. In regard to the risk of providing a false sense of security, the same can be said about Prep, which is why personal responsibility has to trump all else - seeking perfection, however, can not be the enemy of the good.

 

In regard to the epidemiological data that you refer to, ('huge number of incidents of HIV stem from people supposedly in a monogamous relationship having unprotected sex because they believed it to be safe" - I was unable to find that data anywhere and would appreciate knowing where you read it.

 

One last thing...I believe your position on testing and responsibility is legitimate and real - but I do not think that's the case with many escorts. Many who are positive but undetectable, or untested, lie, withold information or sidestep responding directly - and that has absolutely nothing to do with a personal philosophy that encourages people to take rpersonal responsibility. It has to do with business and the fact that if they acknowledged it it would probably effect bookings. I see those people as committing "Involuntary Manslaughter" and believe they should be prosecuted to the fullest extent of the law, regardless of whether a client was complicit - if someone walks up to me and asks me to shoot them, and I do, I'm still guilty of murder.

[caliguy]

Actually, Juan, you're answer was helpful and finally did respond to the question when you indicated that you supported testing and reporting, but acknowledge it's limitations - Now we all agree. And of course there are limitations with any regulation, but as a licensed professional myself, I'm pretty confident that a system could be put in place that does a credible job in minimizing client's lack of information. In regard to the risk of providing a false sense of security, the same can be said about Prep, which is why personal responsibility has to trump all else - seeking perfection, however, can not be the enemy of the good.

 

In regard to the epidemiological data that you refer to, ('huge number of incidents of HIV stem from people supposedly in a monogamous relationship having unprotected sex because they believed it to be safe" - I was unable to find that data anywhere and would appreciate knowing where you read it.

 

One last thing...I believe your position on testing and responsibility is legitimate and real - but I do not think that's the case with many escorts. Many who are positive but undetectable, or untested, lie, withold information or sidestep responding directly - and that has absolutely nothing to do with a personal philosophy that encourages people to take rpersonal responsibility. It has to do with business and the fact that if they acknowledged it it would probably effect bookings. I see those people as committing "Involuntary Manslaughter" and believe they should be prosecuted to the fullest extent of the law, regardless of whether a client was complicit - if someone walks up to me and asks me to shoot them, and I do, I'm still guilty of murder.

Are you going to demand that the police set up stop points outside of bars and clubs too? Think about it. They're drunk or high and aren't in control so we should probably intervene there too.

 

If you become positive it wasn't anyone's fault but your own. Excluding rape or blood transfusion of coarse.

[Steven_Draker]

I am a sexually active man and a prostitute, so what I really have to focus on is not the theoretical, but the absolutely practical.

 

Juan, from a pure practical point of view: When did you last get tested for HIV and for "everything else"?

[caliguy]

Juan, from a pure practical point of view: When did you last get tested for HIV and for "everything else"?[/color]

What was the point of starting this old thread? Just curious.

[Amoco]

Are you going to demand that the police set up stop points outside of bars and clubs too? Think about it. They're drunk or high and aren't in control so we should probably intervene there too.

 

Actually, that would not be my strategy, Cali, but thanks for the oh-so-clever response - it reminds me of some of the brilliant points made by the GOP when talking about the 'absurdity' of regulating the financial markets. In fact, I would suggest legalizing prostitution and then creating a system that requires regular testing that is published and available to potential clients. Then I would tax it so that some of the revenue would go to ongoing public education n the importance of personal responsibility.

[Juan Vancouver]

Actually, Juan, you're answer was helpful and finally did respond to the question when you indicated that you supported testing and reporting, but acknowledge it's limitations -

 

I am thrilled that you finally realized that we do agree on that subject. I have clearly written in many posts my stance on testing and reporting but the mind is fallible when one is emotionally invested so I won't take it personally that just now you actually read it. That's settled.

 

One last thing...I believe your position on testing and responsibility is legitimate and real - but I do not think that's the case with many escorts. Many who are positive but undetectable, or untested, lie, withold information or sidestep responding directly

 

Finally! We actually agree one hundred percent! That is likely the case. Some people lie.

 

That is precisely why my advise to all clients, all escorts, all human beings about to engage in any sort of sexual practice is this: Completely disregard what your partner says about his status. Even if the Pope swears over the Virgin Mary he is negative and a virgin himself. Suit up. That's the only way in which you will hold all the cards in your hand.

 

Juan, from a pure practical point of view: When did you last get tested for HIV and for "everything else"?[/color]

 

Of course it's from a purely practical point of view! And it is my pleasure to share this with you, Steven. I am very touched you are concerned about my well being.

 

I last got a complete screening on Thursday September 4th. In the spirit of full disclosure it should be noted that I say a complete screening but I should not since I didn't get a pap smear nor tested for Lynphogranuloma Venereum. I only do that around every year or so.

 

In spite of this, I recommend anyone about to engage in any form of sexual contact with me to carefully adhere to safer sex practices. Science clearly tells us that a negative result just means that up to ten days before your test you were negative. Nothing else, nothing more.

 

It seems to me as if we are finally ready to let this thread rest on the clear understanding that we all agree on most things, even if some of us disagree on the subject of personal responsibility. It seems like a very healthy outcome for such a heated conversation.

 

Big hug to you all! (And suit up!)

[Steven_Draker]

http://www.americanbar.org/content/dam/aba/global/global_nav_logo.png

 

Sex and HIV Disclosure

 

by Aziza Ahmed

Aziza Ahmed is an assistant professor of law at Northeastern University School of Law. Beri Hull is the global advocacy officer with the International Community of Women Living with HIV/AIDS. The author wishes to acknowledge Gavin Logan for assistance with research.

 

 

What do you consent to when you have sex with someone? What if the person is a new sexual partner from a night at a bar? What if the person is your spouse or long-term partner? In these two scenarios, people might understand both HIV risk and HIV disclosure differently. Close reflection demonstrates that a purportedly clear set of criminal laws rarely reflects the complexity of sexual interaction.

 

This article explores how the dynamics of HIV disclosure prior to sex contribute to an ongoing dialogue about disclosure and consent: Does a person have a right to know his or her sex partner’s HIV status? And does an HIV-positive person have the right to not disclose his or her status prior to sex?

 

Public Health Rationales for Disclosure

Many public health rationales are given for the need to disclose one’s HIV status to sexual partners. The first is prevention. Disclosure is understood to be a key part of this public health objective by motivating people to seek testing upon learning a partner’s HIV status and in changing behavior to prevent the further spread of HIV. Disclosure is also seen as a way for individuals to receive support. As articulated by the World Health Organization in 2002, studies have demonstrated that for some individuals, disclosing their HIV status has led to increased opportunities for social support, improved access to necessary medical care, increased opportunities to discuss and implement HIV risk reduction with partners, and increased opportunities to plan for the future.

 

While the public health rationales are strong and often people do benefit from disclosing their HIV status, circumstances vary dramatically for individuals who are considering HIV disclosure. In many cases, people do not disclose their HIV status because of fear of rejection, discrimination, violence, and abandonment. In the case of women, many individuals learn about their HIV status through prenatal care services where they are likely to be tested for HIV. Lack of clarity around disclosure laws or the threat of disclosure may also deter people from getting tested. This is particularly true for those in marginalized communities who may fear further discrimination because of HIV.

 

The U.S. National AIDS Strategy has recognized the emotional challenges that accompany learning one’s HIV status and the social stigmas surrounding disclosure, necessitating both the strengthening of civil rights enforcement for people living with HIV and the need to encourage and promote HIV disclosure. The community from which one comes, the cultural dynamics surrounding disclosure and HIV, and the person’s sex place each HIV-positive person in a unique position—seeing HIV disclosure as either a necessity prior to sexual activity or not.

 

Criminalization of HIV Transmission, Exposure, and Nondisclosure

The stakes of nondisclosure are high. Legal frameworks that govern disclosure vary according to jurisdiction; however, many impose criminal sanctions for having sex without disclosing one’s HIV status.

 

For example, the California Health and Safety Code states that “any person who exposes another to HIV by engaging in unprotected sexual activity (anal or vaginal intercourse without a condom), when the infected person knows at the time of the unprotected sex that he or she is infected with HIV, has not disclosed his or her HIV-positive status, and acts with the specific intent to infect the other person with HIV, is guilty of a felony.” The law clarifies that “a person’s knowledge of his or her HIV-positive status, without additional evidence, is not sufficient to prove specific intent.”

 

Michigan law criminalizes nondisclosure, stating that if a person has been diagnosed with HIV and knows that he or she is infected and “engages in sexual penetration with another person without having first informed the other person that he or she has acquired immunodeficiency syndrome or acquired immunodeficiency syndrome related complex or is HIV infected, is guilty of a felony.”

 

These laws are replicated globally. Kenya’s HIV/AIDS Prevention and Control Act states that “a person who is [HIV positive] and is aware of being infected with HIV or who is carrying and is aware of carrying HIV shall not, knowingly and recklessly, place another person at risk of becoming infected with HIV unless that other person knew that fact and voluntarily accepted the risk of being infected.”

 

The law of Uganda states that a person “who is and is aware of being infected with HIV and AIDS shall not, knowingly and recklessly, place another person at risk of becoming infected with HIV and AIDS unless that other person knew that fact.” (While it has not been passed into law, the now-notorious Anti-Homosexuality Bill states that a gay, HIV-positive person can be charged with aggravated homosexuality and be sentenced to death.)

 

These laws have had grave consequences for many people living with HIV, even outside transmission via sex. In fact, many of the prosecutions that occur in the United States on HIV transmission and exposure are based on false information about how HIV is spread, leading to the conviction of people living with HIV for biting and spitting.

 

Sexual Rights, Responsibilities, and HIV

In the context of sexual rights and HIV, a few refrains often emerge: “I have the right not to disclose my HIV status if I take adequate precautions.” Or the other side: “I have the right to know my partner’s HIV status.” Responsibility has also taken on a similar tone for HIV-positive people and HIV-negative people engaged in this conversation: “As an HIV-positive person, you have the responsibility to disclose your HIV status” or “As a person who is not HIV positive, you need to take responsibility over your sexual behavior and ensure condom use.” In reality, all or some of these things may or may not be true at any given moment. A few examples illustrate how this plays out in “real life.”

 

Scenario 1: A woman married at a young age. Her husband has had previous and concurrent relationships, but she has only had sex with him. During labor, she is tested for HIV and found to be HIV positive. Her husband may or may not know his HIV status. A few months later, her husband would like to resume sexual activity with her. She has unprotected sex with her husband, believing that she likely contracted HIV from him. She does not disclose her HIV status.

 

Scenario 2: A male sex worker often has sex with clients without a condom. Since finding out he is HIV positive, he consistently uses condoms (except in violent interactions with clients, in which case he cannot negotiate condom use), and he often steers clients away from penetrative sex that is of higher risk. He does not disclose his HIV status to clients because he is careful. A few clients have asked him his status. When asked, he responds honestly. In these cases, some clients stay and others go.

 

Scenario 3: A woman is living with HIV. Her spouse knows this. They normally engage in protected sex but on occasion have not used condoms. After months of an abusive relationship with her spouse, the woman files for divorce. In retaliation, the man tells the court that she never disclosed her HIV status to him.

 

In each of the scenarios, the person (or people) living with HIV could be subject to prosecution for nondisclosure in jurisdictions that criminalize HIV transmission, exposure, and/or nondisclosure. Yet, it seems that in each situation the ideas of rights, responsibility, and disclosure are no longer an absolute. These scenarios animate the discussions occurring in the HIV activist community about what laws, if any, are appropriate in the case of HIV transmission.

 

Many uncertainties emerge: Does a sex worker have a duty to disclose to clients that they are engaging in high-risk sex because he is HIV positive? Or does the responsibility to ask the sex worker’s status lie with the clients? Does a wife who contracts HIV from her partner have a duty to disclose if she finds out her status first? Or was it her partner’s responsibility to exercise safe sex in the relationship? Was it the wife’s responsibility to demand safe sex? What are the power dynamics that exist in relationships that make HIV disclosure complicated and make one partner fear another? For lawyers, the big question remains: What should the role of the law be in governing and regulating these sexual behaviors?

 

...

 

Conclusion

HIV positive people live and work in a complicated array of circumstances that may or may not dictate that HIV disclosure is always the most appropriate response. People who are HIV negative might engage in a range of behaviors that require heightened responsibility over their own sexual health and life; however, circumstances such as intimate partner violence may dictate that a person cannot make demands for safe sex.

 

Intra-relationship power dynamics alongside social and economic realities may determine who is able to disclose and how they are able to disclose or who may ask a person’s status and who might not. The legal regime currently surrounding disclosure of HIV status is not able to consider the nuance of each circumstance in the manner necessary, and, in fact, the consequences of these laws may be undermining larger public health goals.

 

source: http://www.americanbar.org/publications/human_rights_magazine_home/human_rights_vol38_2011/human_rights_spring2011/sex_and_hiv_disclosure.html

[Juan Vancouver]

Fascinating read, Steven. Thanks for sharing.