Friday, July 16, 2010

What does “clean” mean?

“Clean”, when used in an online profile, can have two meanings.  Neither of them is “freshly showered”.

(Former) Drug Use

“Clean” is often used as part of the phrase “clean and sober”, referencing being in recovery from drug and alcohol abuse.  Used by itself, it will typically only be in reference to drug abuse (meth, heroin, cocaine, etc.), not alcohol use.  It typically is not used in regard to tobacco and marijuana (although there will be exceptions).

Of course, the only people who use the term in this way are those who are actively in recovery (or those whose lives have been so touched by drug abuse that they are part of that community by proxy, and use the terminology).  Which means that someone using “clean” in their profile this way has had a past issue with drug use; those who have no had an issue generally see no need to use the term.

(Drug and alcohol abuse and recovery are a much deeper subject than I’m covering here.  Please excuse glossing over of the details in this post.  I don’t intend to shortchange the struggles involved, but neither is it appropriate to hijack this post to delve into those details.)

(Lack of) Sexually Transmitted Diseases

The other use of “clean” is with regard to STDs, as in “clean bill of health”.  The implication here is that the individual has had a recent health screening and no STDs were found, including not just HIV but also hepatitis, HPV (venereal/anal warts), gonorrhea, and so forth.

Truth and Accuracy

As ever, what people say in their profiles and what is actually true are different things:
  • Profiles may get out of date, so what was true may be months old
  • Guys may have had an HIV test but not a screening for other STDs
  • Some guys will list what they believe to be true, with no actual knowledge
  • Some guys will lie, especially if they think they will get laid
  • Recovery is a long (perhaps never ending) process, so “clean” is really “clean since date X”
  • Some guys relapse, going in and out of recovery
How can you tell which usage is in effect?  You’ll have to read between the lines and perhaps engage the person in direct conversation.  Look for references to drug and alcohol use, to sexual preferences, and to the person’s involvement in the community.  (Or just come out and ask.)

As always, without assuming that anyone is actively lying, always assume the minimum: that what is in someone’s profile is what they believed was correct when they wrote it, but may not be correct now.  Use the presence of the codeword to start a conversation, not to avoid one.

Thursday, July 8, 2010

What does “undetectable” mean?


In technical terms, “undetectable” (with regard to HIV infection) means that the level of HIV in the blood is below the threshhold for detection, typically below 50 parts per milliliter.  During early stages of infection and before treatment, these levels can soar into the hundreds of thousands and even millions.  With aggressive treatment, levels will settle down to the thousands, the hundreds, and below.  There is a direct connection between this level and how infectious a person is apt to be; a major goal of treatment is to keep these levels suppressed, both to reduce risks of infection and simply to keep HIV from progressing into AIDS and further compromising the individual’s immune system.

Here are two web pages for some more info:

Please note that I’m not a doctor nor an expert on HIV therapy, so I can’t evaluate the details of those pages.  I’m just someone who (a) pays attention and (b) wants to help decode some of the codewords people use online.


“Undetectable” often gets used in online profiles to indicate a person who is in a healthy, monitored state regarding his HIV infection, someone who participates in treatment.  It is intended to defuse HIV-phobia, where guys are scared to have sex with HIV-positive guys.

Risky Behaviors

As with any of the phrases I’ve been writing about, though, “undetectable” is sometimes used as a codeword, something either used or interpreted to mean something other than the technical meaning.

In this case, there is an obvious connection that gets made between “undetectable” and “not infectious”.  This is an incorrect connection, of course, because the person is not cured; he is still infectious, albeit believed to be far less so.  This incorrect connection can lead sex partners to assume that unprotected sex with such a person is “safe”.

(Of course, some people are going to read this and be all offended because they think I’ve just accused them of trying to lure HIV-negative guys into having unprotected sex with them, when they are really just trying to put their health status out there.  Calm down, boys: I’m saying that some men use “undetectable” as a codeword for that result, and that some men read that as a coded invite for unprotected sex.  If you don’t use it or read it that way, super, but don’t lie to yourself: you know some guys do.)

Of note as well is the monitoring schedule.  Just as with HIV tests, which are only accurate at the time of testing, “undetectable” was the state at testing time.  Viral load testing is done every 2–3 months, so if the person has had an immune system change, including a change of therapy, a “drug holiday”, been sick, or gone on a bender — and heck, just day-to-day shifts can occur — what was “undeteactable” then may not be now.  (Add to this that some guys rarely or never update their profile text, especially not portions which would change their chances of getting laid.)  And thus coded use or reading of the term has an added risk attached.