Tattoos and HIV acceptance

By Elizabeth Landau, CNN

August 10, 2011 -- Updated 1330 GMT (2130 HKT)

Portland, Oregon (CNN) -- As he puts a straw in his fruit smoothie, Michael Lee Howard accidentally knocks over the cup, spilling the seaweed-colored liquid. "Well, it happens," he says. As he collects the smoothie overflow in the plastic lid, he exposes the tattoos on his wrists: a biohazard symbol on the right and a radiation symbol on the left.

Howard might not have come across as such a calm person in late 2005, when he found out he was HIV positive. After his diagnosis, he felt "dirty" in his own skin, and feared infecting others if he so much as cut his hand. Getting the wrist tattoos helped him in his journey toward self-acceptance. Howard is one of many people living with HIV who have chosen to get tattoos to represent living with the disease. They say these tattoos help start conversations, reduce stigma and serve as reminders of how living with HIV has changed their lives.

Tattoos like Howard's biohazard symbol are especially common in men who have sex with men, the subpopulation that bears the highest burden of new HIV infections in the United States. Men who have sex with men accounted for 61%, or 29,300, new HIV infections in 2009, federal health officials said last week. And although the number of new HIV cases has remained stable in the general population, new infections rose among young, black gay and bisexual men from 2006 to 2009. It was also among men having sex with men that U.S. doctors first realized, in 1981, that there was a never-before-seen disease that could destroy the immune system. That disease came to be known as human immunodeficiency virus.

"In the gay male community, we think about it (HIV) a lot more because it attacked our community first. It's wiped out a number of us," said William Conley of Pollock Pines, California. His tattoo, a biohazard symbol with the Celtic motif of a crown of thorns circling around it, means he's winning the fight against this disease.

Identification and awareness

"You're not a victim. You're a champion, you are a survivor, and that's the biggest part of the tattoo," Conley said. The origins of HIV-related tattoos are murky, but the biohazard symbol is recognized in connection with HIV among many gay men, said David Dempsey, clinical director at the Alexian Brothers Bonaventure House in Chicago and The Harbor in Waukegan, Illinois, both transitional living facilities for HIV-positive individuals recovering from alcohol and substance dependence.

"It's to let other men know that they're HIV-positive so that they don't have to come out and say it," he said. In situations of anonymous sex, it can signal status to potential partners and, in that sense, may help with prevention, because unprotected sex with an HIV-infected individual can spread the disease, he said.

For those with HIV, seeing someone else with a biohazard symbol is a sign this is another person living with the disease who might provide support, Conley said, like a "secret identification code."

There are less cryptic HIV tattoos, too. Dempsey has a red AIDS ribbon tattoo on his chest, which he chose even before he became HIV-positive (the organization Visual AIDS created the ribbon symbol in 1991). Dempsey has been a social worker in the HIV community for 11 years, and wanted to show solidarity with people living with the disease, as well as raise awareness.

In 1986, when AIDS was just starting to be recognized as a deadly illness transmitted through sex and intravenous drug use, conservative author William F. Buckley Jr. suggested HIV-positive people get tattoos to protect others. He wrote in The New York Times, "Everyone detected with AIDS should be tattooed in the upper forearm, to protect common-needle users, and on the buttocks, to prevent the victimization of other homosexuals."

Some HIV-positive individuals may have gotten tattoos in resistance to Buckley's article, said Richard Sawdon Smith, professor of photography and AIDS cultures at London South Bank University in the United Kingdom, who has been HIV-positive since 1994. This is not an oft-cited reason among people with tattoos today, although many of the people who got HIV in the '80s and may have gotten tattoos then have since died.

Another theory is that certain ACT UP activists sported biohazard tattoos in their massive demonstrations in the late '80s and early '90s, but founder Larry Kramer said he hasn't heard of these tattoos or of the organization's participation in the practice.