So, it's really pretty simple to avoid HIV infection.

First, safer sexy, every time. This includes "topping." Giving blow jobs does have a measurable, if small, risk of HIV infection.

Second, managing the number of sexual partners. It's just like lotto. The more tickets you buy, the more likely you are to "win." If you seek out places like sex clubs and hook up a lot on line, you are probably meeting people who do the same....and when you sleep with one person, you are sleeping with their full sexual history.

Third, avoid behaviors that make you take chances: drugs and alcohol.

Those are real steps that will help you.

It's worse than I thought!

I've now reviewed the papers on HIV false negatives in sexually active gay men.

The conclusions are a bit alarming. Sexually active gay men in an STD clinic were tested for HIV RNA, which is a test for the virus itself, as opposed to most tests, which look for antibodies against the virus.

In these sexually active men, 10% of those who tested negative for antibodies against HIV were positive for RNA tests. This means that they were recently infected, highly infectious, but had a recent negative HIV test.

New HIV tests which use both RNA and antibodies are coming, very soon, but for now, if you meet men on line, a negative test could have an error rate of 10%.

For sexually active gay men, false negatives are a real issue.

Positive RNA tests

Almost all laboratory tests used to screen for HIV use antibody tests. These tests are very reliable and affordable for huge numbers of people, and make screening of large numbers of people possible, without eating up a fortune in precious health-care dollars.

There is the famous "Window Period" problem though. When the virus first infects a person, it spreads and replicates throughout the body. It takes a few weeks for most people to have made measureable amounts of antibody, so if someone was infected a week ago, they may have sky-high levels of infectious virus in their blood, but they will test "negative" for HIV antibodies.

At STD clinics in New York and Seattle, investigators have tested HIV tests that don't look for antibodies, but for the virus itself. Tests done on people who had a HIGH risk exposure, i.e. unprotected anal sex were tested. About 2% of gay men who tested negative with antibody tests were positive for RNA tests.

These men were acutely infected, and probably very contagious, but they could put "HIV Negative, as of today" in their on-line profile, in all honesty.

RNA tests are good for picking up acute infection in men with a high risk encounter, but are not good for screening the general population. In this case, though, they show that when someone says they are negative, there is a real chance, albeit small that they are wrong.

Party Invite!?

So, out of the blue, I get an invitation to one of those "special parties." It sounds very hot, so I send in my info.

I get an enthusiastic response, saying there will be around 50 men there for a house party on Miami Beach. The host suggests that all will be seronegative, and all attending should be.

I wrote him back to ask if he really thought he could find a group of genuinely seronegative men in South Beach. He replied that condoms were provided, and encouraged.

If you're going to answer like that, what's the point of asking HIV positive men not to attend?