One of the particular scenarios
that has been much discussed and cited as a potential misuse of home testing is of people asking sexual partners to take HIV tests, perhaps immediately
before intercourse. Apart from the possibility of partners being pressurised to
test against their will, the other fear this plays on is of individuals
using negative results as a license to have unprotected sex, regardless of any
information about the test’s limitations.
“It is interesting to me, and
not a little sad, that so many of us conjure up hypothetical worst-case
scenarios of sexed up gay men behaving recklessly,” commented Jim Pickett, chair of IRMA. He pointed out that testing is a health-seeking
behaviour and something that advocates normally greatly encourage. “Why must
our hypothetical scenarios always bend toward gay men behaving ‘badly?’” he
In fact, the French study
discussed above found that just 4.5% of men interested in home tests said they
wanted to test their partners.
Men could see that taking a test could easily be a mood killer when meeting a sexual partner.
Rather different results have
come from a study in New York, but this may be an artefact of different
recruitment methods and the way in which the American interviewers actively
raised the topic of testing before sex.
Alex Carballo-Diéguez, Timothy
Frasca and colleagues recruited ‘high-risk’ HIV-negative gay or bisexual men
who regularly had unprotected receptive anal intercourse and who were
interested in talking about home testing. Fifty-seven men completed the surveys
and in-depth interviews.
In total, 87% of participants
said that they would use the test. Moreover, 80% would use it with sexual
partners at home.
The interviews explored
how men envisaged using the test, in particular with sexual partners. Men
expressed a variety of opinions about when to bring the issue up, where and
One man said:
“I guess before we leave the bar, like, so, Are you a top? Are you a
bottom? Oh, you’re bottom, great, I’m a top. That’s good. HIV negative?
Positive? . . . Negative? Cool. You’re not going to feel funny about me asking
you to take the test, right? Because you know, I got—I went to [name of
drugstore] last night and I bought a bunch of them so we’ve got to put the
bitches to use. I test everybody…”
But men could see that taking a
test could easily be a mood killer when meeting a sexual partner. In fact, the
same man who was quoted above could also see how badly he might react if
someone asked him to take a test before sex.
“I’d probably freak out… Like,
what, who are you? Are you trained to do this? Like, who are you? Like, I’m
just coming over to fuck you.”
If a casual partner’s result
was reactive (‘positive’), most men didn’t anticipate continuing with sex. Some
said they would show empathy and try to be helpful.
Men noted that the test itself
couldn’t be used in many environments where men meet for sex (such as saunas or
sex clubs) and that use would be tricky if men were high on alcohol or drugs.
Some men thought that raising
the issue of testing would require the intimacy of being at home.
“I will slowly, slowly talk my way into it, or persuade the person to
take an interest in it. I probably would do it first so that somebody could
feel comfortable with it.”
Moreover, some men felt that
the test could be used as a relationship moved from casual to being more
steady. But if either partner’s test was reactive, this was thought to be
extremely problematic. It could signify the breaking of an agreement either to
be monogamous or to always use condoms with other partners. Reactions could be
aggressive or violent.