COMMENT: FIGHTING HIV

Despite reports of a dip in HIV transmissions between gay men in 2008, rates of infection remain at high levels. An independent sex survey recently questioned current HIV campaigns and if they could leave gay men increasingly ignorant and complacent about the harsh realities of contracting HIV, thereby encouraging sexual risk-taking. In this three-part report for HOMOVISION, Gary Leigh explains why he commissioned the survey, and what he hopes its findings will achieve…

Part one

In 2006 journalist Johann Hari, writing in The Independent about the rampant rise of barebacking and HIV-related health risks, quoted Martin Luther King: ‘Our lives begin to end the day we become silent about the things that matter.’ “For the gay community,” Hari added, “this is no longer just a metaphor.”

In August, Pink News ran my commentary, Killing Us Softly, which openly stated what many believe has gone wrong with gay men’s HIV prevention over the past decade. It provoked major debate and a drumbeat for change has been sounding ever since. Three years on from Hari’s coded call to action, the silence is finally breaking.

To sustain Killing Us Softly’s momentum, I decided to put several straightforward questions to gay men about their attitudes to HIV and safe/safer sex campaigning; of a kind never asked by the official Gay Men’s Sex Survey (GMSS) but relevant in light of increasing social tolerance towards barebacking. The GMSS is conducted annually by Sigma Research, the main research and development partner in the CHAPS partnership of HIV organisations spearheaded by the Terrence Higgins Trust (THT).

At my expense I commissioned an independent market research company with no subjective interest in HIV prevention to target 500 gay men attending last month’s outdoor festival, Soho Live; typically QX/Boyz-reading scene-goers and the main recipients of the London HIV charity sector’s safe/safer campaigns. The multi-question GMSS, by comparison, quizzes upwards of 15,000 gay men of all ages and urban and rural areas across the UK, cumulatively blurring and diminishing the true scale of health threats specific to concentrated populations of gay men in the metropolitan cities.

My agenda, simply, was to cut through the bluster of the multi-question GMSS – whose findings can take up to two years to materialise, by which time it is often too late to act effectively on its findings – and provide the gay press with an instant snapshot of how gay men today are responding to safe/safer sex campaigns appearing within their print and online media. Ultimately, to determine whether the policies of those funded and entrusted to safeguard gay men’s health and wellbeing are aligned with the ‘Old Compton Street consensus’…

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Countering the HIV sector’s insistence that their prevention strategies are properly targeted and effective, the Soho Live survey found that its “safer sex”/risk minimisation adverts – for example for the post-exposure “morning-after pill” PEP and “cumming outside” – have in fact influenced 6 percent of respondents to engage in unsafe sex “every time” and 22 percent “sometimes”. Among under-25s, 11% said “every time” and 35% “sometimes” compared to just 2 percent of 40-59-year-olds who said “every time” and 10 percent “sometimes” – a generational shift that can only be attributed to the 1980/90s style of hard-hitting HIV campaigns, whose sustained impact continues to influence many older gay men into taking precautions.

The HIV sector defiantly maintains that hard-hitting campaigns aren’t effective, that they stigmatise those with HIV and deter others from coming forward to be tested, and have long used these arguments to soften and normalise HIV’s image. But when asked if harder-hitting HIV campaigns – specifically depicting the downsides of living with HIV – would be more effective in persuading them to engage in safe sex than today’s campaigns, only 4 percent of respondents said “no” while nine times as many (36 percent) said “yes”, 32 percent said “possibly” and 28 percent were “undecided”. Only 4 percent agreed that harder-hitting ads stigmatise HIV-positive people and almost two-thirds disagreed with the HIV sector’s rhetoric that such campaigns would deter gay men from being tested (again, only 4 percent agreed).

“I think the advert is incredibly stigmatising to people living with HIV who already face much stigma and discrimination,” a spokeswoman for the National Aids Trust (NAT) said of Germany’s new graphic “Hitler”/HIV campaign, “and may deter people to come forward for testing.” Such routinely parroted song-sheet theories originated amid the “gay plague” hysteria of the 1980s, when Aids stigma was rife and gay men were genuinely scared of seeking testing. To still be using them in 2009 as excuses not to run influential HIV campaigns is, frankly, grossly irresponsible and dishonest. Indeed, many survey participants expressed amazement that such PC myths still prevail when the objective, supposedly, is to minimise HIV infections.

To determine the extent to which the cotton-wooling of HIV prevention has shifted general perceptions of the virus from a terminal to a manageable condition, the survey then asked respondents which of three statements best described their awareness of HIV. “With today’s medications, HIV is a manageable illness and infected people can expect to live a normal, healthy lifespan” is a statement popularised by the HIV sector despite having little or no foundation in fact. Nevertheless, 27 percent of respondents agreed with it rising to a staggering 41 percent of under-25s and 44 percent of those aged under 21. Only 16 percent of over-40s agreed.

“HIV is a serious terminal condition and infected people can expect to endure debilitating side effects from the medications and a shortened lifespan of around 20 years” – a statement based on a new 43,000-strong US study which found average lifespans of newly-infected people to be 21 years shorter than their negative peers, and real-life experiences of people who have lived with HIV and antiretrovirals for many years – found favour with 45 percent of all respondents but only 24 percent of under-25s and just 19 percent of under-21s, indicating that the serious downsides of contracting HIV, long since airbrushed from prevention campaigns, are becoming lost among younger gay men. By contrast, two-thirds of over 40s agreed with this statement.

Most shocking of all, “HIV is no more serious than contracting any other STI like herpes, syphilis or gonorrhoea” was agreed by over a quarter (26 percent) of all respondents, soaring to 34 percent of under-25s. Only 14 percent of over-40s agreed.

TOMORROW: How a rigid allegiance to political correctness has paralysed the HIV sector’s prevention efforts…