Q: What is Positively Negative?
A: Positively Negative is a novella-length nonfiction book that follows two couples from falling in love to the birth of their first children, conceived naturally despite the man's HIV-positive status. Along the way, you meet the Hartmanns, the Morgans, and researchers including University of North Carolina's Myron Cohen, the Swiss Commission on AIDS-Related Issue's Pietro Vernazza, and UC San Francisco's Deb Cohen.
Q: Aren't you promoting unsafe sex in Positively Negative? Isn't this irresponsible?
A: No on both counts. While the public's understanding of HIV hasn't progressed much past the trauma of the early loss of hundreds of thousands of American lives to this cunning virus, the science has experienced no such stagnation. Rather, advances in antiretroviral therapy and more sophisticated care have transformed HIV into a manageable chronic condition.
Let me drop two new HIV prevention methods on you, used separately by the Hartmanns and the Morgans: First, the science now shows that if a man (in this case) sticks to his drug regimen, doctors can't even detect the virus in his system. Thus he has no virus to pass on to his partner. This is called "treatment as prevention."
Second, the Food and Drug Administration in 2012 approved one HIV medicine, Gilead's Truvada, for a HIV-negative people to reduce their chance of contracting the virus. This is called pre-exposure prophylaxis, and it has been found to be up to 85 percent effective in blocking transmission.
Finally, Positively Negative takes a distinctly human approach to this issue. This is not a virus having contact with a host. This is the story of two couples, deeply in love, with a natural urge to create a family. The story lays out in detail how hard a decision it was for each couple to go against decades of conventional wisdom. And it lays out the careful way the research has been done. This is a story of love, not risk.
Q: Why are you talking about straight people? Why don't you talk about all the work that's been done in the gay community to raise HIV awareness and reduce transmission?
A: This story focuses on HIV-positive men and their HIV-negative wives. There are HIV-positive women married to HIV-negative men, of course, and a world of research on transmission rates between gay men. Those stories are worth telling, too, but they aren't this story.
Q: Why the emphasis on conception? HIV-affected couples have been adopting and using sperm donors for years.
A: HIV-discordant couples adopt every year. That's a great story, and this article does address the question of adoption. But ultimately, the Hartmanns and the Morgans decided they wanted to conceive naturally. The fact that it's now possible gives us a window into how the since and lived experience of those affected by HIV have changed.