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COMMENT: FIGHTING HIV – THE WAY FORWARD

Comment, Health, Highlights by HOMOVISION on October 28, 2009 at 8:02 am

The final part of Gary Leigh’s three-part report on HIV prevention. Here he reveals what he believes is the only logical solution to successfully start reducing HIV infections among gay men…

The Soho Live survey exposes catastrophic failures and appalling degrees of negligence within HIV prevention. Indeed, the problems are so ingrained and endemic that if the suicidal shift the sector has implemented this past decade in softening up and normalising attitudes to HIV is to be reversed and the virus’s unrelenting march stemmed by a ‘tough love’ approach that zooms in on the harsh realities of living with the virus – as favoured by most of the 500 gay men who participated in September’s Soho Live Sex Survey – then HIV prevention must be taken off life-support forthwith and placed in the care and trust of those motivated more by a sense of service to others than a calculated career move; who don’t eye gay men as potential pill dispensers, future support service users or components of a strategic business plan; who don’t speak in the cold, bureaucratic language of “measured outcomes” and “qualitative assessments” but from a place of compassion, feeling and an innate grasp of the enormity of the task they are confronted with; who aren’t immune to criticism and wallow in obfuscation but are fully transparent and accountable; and who have the courage and conviction to say out loud that “a life without HIV is a life best lived”. It isn’t rocket science, just plain common sense.

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  • HEY GUYS

    Thanks for all your comments on this article.

    The discussion now continues over in the MyHOMOVISION forum:

    http://myhomovision.ning.com

    Thanks!
  • OK, Paul, sorry I misunderstood your question. I've done a quick google search and can't seem to find any evidence that harder hitting campaigns DON’T work. And I certainly can't think of any reasonable argument against them, although I suppose the industry might argue hard-hitting campaigns fail to engage those men who are the target of HIV prevention activity, that confronted by campaigns that bluntly label certain sexual behaviours as wrong or irresponsible, gay men are likely to turn off. I can't agree though, living with HIV can be an absolute horror, publicising some of the detail of that would certainly give gay men a reason to put a condom on or, as we often forget...just do something OTHER than anal.

    I suppose the inverse question answers yours. Are the soft sell campaigns making any difference to HIV seroconversion rates? The answer is a very provable 'no.'

    In Sydney, our AIDS Orgs. latest campaign has dolly boiz handing out bananas.

    http://www.starobserver.com.au/news/2009/09/29/...

    Gawd knows what it cost, or what it's supposed to say, but I can't think of anything more useless or ridiculous. As one commentator said, "Gay wallpaper ads trivialising hiv infection and Aids." Someone else makes a good point: "People travelling to a place with an earthquake or tsunami forecast want and deserve to be made aware of what risks their journey presents. Media coverage of these events and forecasts is not accused by the tourism industry of being ‘alarmist’ – it is serving its proper purpose."

    I'm with Swarmite Parker on this one, "I repeat again – the time has come for [our HIV/AIDS orgs] to say sorry, we got it wrong. "
  • Shayne, you misread what I wrote, or I didn't make myself very clear. I was asking for evidence that harder hitting campaigns DON'T work, and that they stigmatize people with HIV.
    This isn't the sense I'm getting from the people I've talked to, so I wondered if the HIV charities had evidence to back this up.
  • @ Mike N. Yes I noticed this too over the past 12 hours, the march of the dastardly Red thumbs - but far from devastated I am amused that my words have hit home and continued to be backed up by others on this thread more academic than I.

    I repeat again - the time has come for THT & GMFA to say sorry, we got it wrong.
  • Paul Burston says: "Perhaps we need to see some evidence to back up this assertion? "

    You'll have read the Soho Live survey. When asked whether AIDS campaigns which normalise HIV’s image had influenced them to be complacent about safe sex, 6% of respondents said they now engage in unsafe sex “every time” and 22% said, “sometimes”. (Among under-25s, 11% said “every time” and 35% “sometimes.”) Asked if HIV campaigns depicting the reality of living with HIV would be more effective in persuading them to engage in safe sex, only 4% said “no” while 36% said “yes.” Only 4% agreed that harder-hitting ads stigmatise HIV-positive people while two-thirds disagreed with the HIV sector’s rhetoric.

    And in January 2008, 82% of the UK Pink Paper’s readers voted in an online survey for harder-hitting HIV campaigns.

    http://www.pinknews.co.uk/2009/11/02...hiv-prev...

    What evidence would you like to see?
  • Mike N.
    It appears we should at least credit Mark/aidos/Andre for demonstrating how easily the new thumbs rating is open to abuse, and perhaps homo.tv would consider abandoning it from this thread to avoid manipulation of consensus? I am sure the Swarmite is devastated to find that overnight he has gone from being one of the most agreed with postees to one of the most unpopular. I wonder what other desperate tricks Mark and his scheming HIV sector kin have up their sleeves to try and stifle debate and save what face they can? With Attitude now joining the collective voice of reason, seems like they are running out if places to hide!
  • I spent today with two very good friends, both of whom are positive. One used to work in the HIV sector. They asked about me about this debate (they'd heard about it, but weren't following it online). We got talking about the wider issues, the main one being (at least to my mind) the resistance to harder-hitting safer sex messages, on the basis that they 'demonize' people with HIV.
    'How wrong!' said my friend. 'And how patronizing!'
    I'm sure he's not the only one. Perhaps we need to see some evidence to back up this assertion? It's not what I'm hearing from the people I know.
  • I was invited to write an article for the gay rags in Australia on this topic:

    http://qlp.e-p.net.au/feature/the-truth-about-h...

    which I understand this site will also be publishing shortly. For the piece, I received the usual flak and abuse, and an invitation from the CEO of my local AIDS Council that I might like to pop in for a chat. I graciously accepted his invite, but said that first, I would require his response to the Soho Live survey and to the issues raised in the article, IN WRITING.

    I've had no further response.
  • David
    In answer to William's question, I must give complete credit and enormous thanks to the previously mentioned Paul Steinberg who with great skill and enormous courage communicated many of my (and his) concerns about recent HIV prevention campaigns within the pages of Boyz in 2007 and famously at that CHAPS conference where he was treated with outright antagonism, despite being invited by CHAPS. The lion's den or what.....?

    Prior to Paul, it's true to say that I hadn't found a journalist interested enough, passionate enough or ballsy enough to say what I thought needed saying - or who even believed what I kinda believed.

    And yes, of course, I was worried that if I went public with my views the HIV organisations would pull their advertising from our magazine - much of which helps to pay for Boyz to be there for our readers every week.

    But personally, it's true, I had been worried for five or six years prior to 2007 of a major movement away from clear, "hard-hitting" condom campaigns by the HIV organisations. I believe this is not conspiracy though - I think it was a genuine attempt by those organisations not to "demonise" HIV positive people and I think in many ways, they were simply following the pattern of America, Australia etc. But it's all got very twisted.

    I would like to see the UK now, be the first gay community in the world to go the other way - back to really trying to prevent infections (and we can argue till the cows come home the best way) but broadly, as my colleague Karl Riley says so eloquently, "gay men need to know 'why' they should avoid HIV". That ain't clear and hasn't been for years!

    I had a meeting at the Boyz office with GMFA and the publishers of QX about four years ago, 2005 I think, to discuss my personal concerns about bareback porn - especially UK productions. I believe Millivres and Clone Zone were also communicated with about the issue at the time. Sadly, none of the people involved in those discussions were to support my view or were to take any action. We don't advertise bareback porn and most of the houses that produce it wouldn't go in Boyz anyway.

    But none of the HIV charities have really said a thing substantial about the dangers of bareback porn even after our own Boyz news reporter Karl Riley and BBC2 Newsnight's reports on the infections of teenage young gay guys in British bareback porn shoots. One of the lads involved, now in his twenties, is now on combo drug therapy.

    The silence that followed those high profile stories about bareback porn convinced me that the HIV sector was dangerously committed to "the right to fuck for positive guys" above and before "the right to be protected from HIV for negative guys".

    The rest, as they say, is history, and has been covered in this thread one way or another. I do believe there are people in the HIV sector who do not share this "right to fuck" approach and I urge them to act and speak out within their organisations.

    I am also keen to see HIV prevention campaigns becoming a political issue at the next election and would like to see all the political parties state their position on the issues very clearly. I am hoping our news page in Boyz between now and next May - and the likely election - will be a forum for the political parties to say what they really think about how HIV prevention campaigns should be conducted in future.

    Who are we targetting and who do we want to get the message? Personally, I believe every single new infection is worth trying to stop. The average person with HIV - like myself - will currently cost the UK tax payer £320,000 in his lifetime. I have cost the taxpayer much more because I was hospitalised back in 1996 with PCP pneumonia and have visited my clinic on many occasions deeply sick with lung infections as a result of that initial illness.

    Yes, I take my combo drugs and I am generally OK and I wouldn't pretend otherwise. But, for Christ's sake, who wants to take drugs every day, have clinic appointments every two months and God knows how many ailments treated with antibiotics etc directly cos my immune system will never be as good as someone without HIV.

    My message to every Boyz reader - and everyone else reading this excellent thread on Homovision - is stay negative at all costs. And I won't stop saying that just because I'm HIV positive myself.
  • Mike N.
    I don't need to be in anyone's fan club thanks all the same Mark. I am more hhan capable ofweighing up the available evidence and drawing my own conclusions. Let me see. HIV rates in gay men have doubled in 10 years (tick). The HIV sector had been working to government dictates since 2001 (tick). HIV campaigns of the last few years have abandoned safe sex messages on favour of risk minimization (tick). In 2006 PEP was approved by the Chief Medical Officer for wide use and touted as a morning after pill for unsafe sex in ad campaigns by both THT and GMFA. This new approach enablef the normalization of HIV and the rise of barebacking; a period during which thousands of gay men are known to have become infected (tick). In 2009 the HIV sector is instructed to ramp up campaigns imploring all gay men to be tested (tick). Last week our buffoon of a Prime Minister announces he is committed to gay men being tested but no mention of a return to effective HIV campaigns. Fait accompli. But why would our government be so callous, uncaring and profligate with our money, you cry, enriching it's pharmaceutical industry donors in the process? For the same reason that for the last ten years New Labour has demonstrated that it is corrupt to the core and that is the only way it knows how to be. Having connected the dots I rest my case. The only conspiracy doing the rounds right now is the one that seeks to convince us that we have not been betrayed.
  • William B
    Am I the only person on here to notice, for all it's worth, that Marks' posts have mysteriously gained 10 or so extra thumbs-up signs overnight as if from thin air? For someone who said this system is irrelevant and open to abuse I think he has revealed his true character by indulging in such childish displays at one upmanship. Or is it Mark's "fan club" working overtime? If you don't have the ability to win the argument on even ground then resorting to yet more tricks and tomfoolery only destroys your stand entirely Mark.
  • William B
    "As I’ve said probably too many times on this forum, I have very deep concerns that the “right to fuck for positive men” has been placed above and before the “right to be protected for negative men” by the HIV sector. Again referencing the latest THT Assumptions campaign as clear evidence of this (”No point in using condoms. All the lads here are positive”)."

    That one sentence encapsulates exactly what is going on David, and as an HIV+ individual I applaud your braveness in being able to say something that would be considered politically incorrect by many other poz men. When a good number of influential people in the HIV organisations are themselves regular fixtures in environments where indiscriminate barebacking is rampant you begin to see how self-interest and conflicts of interest have been alllowed to pervert the safe sex message. These individuals who will remain nameless (for now) have bred a fertile climate for such "underground" venues with campaigns that have become ever sleazier; endorsed and legitimised such establishments with a code of good conduct emblem often positioned in plain sight of guys gang banging one another with or without condoms; and have even launched a web site providing a step-by-step guide to the hard sex scene all the while sticking two fingers up at the still negative majority. But negative men won't be the majority for too much longer if the deranged minds sanctioning these dangerously disproportionate projects are allowed to continue the sleazification of our culture. I have even been told by insiders that a running joke in one main HIV charity is that some of today's HIV campaigns are intentionally designed to recruit "fresh young meat" rather than keep them negative.

    David, I also applaud your brave decision to reveal yourself as Boyz' publisher. I have been bowled away by your incredibly astute and wise observations, often pulling this thread back on track when it threatened to run away with itself and descend into endless mud slinging. But I would be very interested to know if your insights came recently or whether you always held them? If the latter, then why did you so willingly provide such an easy platform for the HIV sector's HIV enabling campaigns and printed many of its sometimes crackpot press releases? Afterall, Boyz began in 1993, pre-meds and long before the HIV messages softened in their impact, so you must have been aware of what was happening and perhaps could have spoken out sooner and questioned their content? As a large circulation scene magazine read by many at-risk men the sector has a moral duty to use your platform and they could have been held to task if they threatened to withdraw their advertising for no good reason. Are you speaking out now as a form of redemption? I would really be curious to know. I suspect that this may have been also largely due to Hudson's influence, because like Joseph Galliano he either can't or point blank refuses to see the harm the charities are causing.

    Nevertheless it is great to see how Boyz is now blazing a trail for other responsible print publishers to follow, with Attitude, Pink News, homovision.tv etc also now leading the way on this issue. It is strange to pick up QX these days and see how far it is falling behind in this cultural shift, and how it is still beholdened to the HIV sector above the health and well-being of its readers. Sex club specials and escort erections are still order of the day at that outfit; I just hope they wake up soon and realise how complicit they are in watering the fertile HIV breeding ground their HIV sector chums have created...
  • Mark
    William, it's sad that you've drifted from beginning to make a reasoned and constructive contribution to this debate back to playground insults.

    But I'm going to save you the bother of having to keep saying that your gang is bigger than my gang, and so on, because I'm reassurred and thankful that two of the most important players in moving this debate forward, Paul and David, are neither hysterical nor paranoid, and are capable of critical reasoning.

    I'll leave them and, for what it's worth, the Gary Leigh Fan Club with a thought from Mr Leigh himself that I could not agree with more, and which has motivated my efforts to challenge the dogmatic quality of most of their contributions to this thread.

    "HIV prevention must be placed in the care and trust of those who aren’t immune to criticism."

    Good luck with that.

    Lots of love,

    Mark x
  • For the record, it was Karl Riley's coverage of HIV and the bareback porn industry in Boyz which led to me programming the Bareback Mountain event at the Southbank.
    Karl's incisive reporting on these issues has been second-to-none, which is why I also quoted him in the feature I wrote for Attitude.
    This coming week's Time Out will also be of interest to those following this debate.
  • Mark C
    I will look forward to seeing the boyz world aids day magazine next week. thank you david for keeping on with the message.
    As a newcomer to the page, the thing that strikes me about your point on "the right to fuck" for positive men...isn't that because the hiv sector is made of predominantly positive men, who, in the past, took jobs at tht and gmfa becuase they couldnt face or get them anywehre else? those organisations actively sought out people with hiv to come and work with them. it is therefore a problem that the people who have been infected are the same people coming up with the message about how to stay negative.just a thought.
  • David
    If I can just say, at Boyz we are very proud of what Paul wrote for us in 2007. We are also very proud of what Karl Riley has been writing for us since - eg the bareback porn infection story. Boyz will be publishing a World AIDS Day special next week. I think many of you reading this thread will find its content interesting. I'd like to thank Mark for his honesty. I am not sure whether those of us who are HIV positive (and therefore may have compromised opinions about condom use) are always best placed to determine the importance of condoms in prevention campaigns. As I've said probably too many times on this forum, I have very deep concerns that the "right to fuck for positive men" has been placed above and before the "right to be protected for negative men" by the HIV sector. Again referencing the latest THT Assumptions campaign as clear evidence of this ("No point in using condoms. All the lads here are positive").
  • William B
    "The overwhelming argument here is that we all, positive or negative, have the right to this information. With knowledge, information, and honesty, we all have the tools to make the wisest decisions possible."

    Of course we do Shayne. Knowledge is power after all. It is ignorance that kills, and for some reason the HIV charities, our government, the pharmaceuticals appear to be colluding to keep us in ignorance, to keep us disempowered and chained to this wretched virus which would be killiing us but for the expensive drugs they dispense which keep us alive, for now anyway. The gruesome long term effects of these toxic potions are only now becoming known, but as Paul Burston astutely observes in his brilliant article in this month's Attitude magazine we fool ourselves if we honestly believe they are going to continue to be liberally supplied on tap free of charge for ever more. When the NHS can refuse vital cancer and Alzheimer's drugs and is proposing making obese people pay for its services you can be sure that a major rethink on Aids drugs is on the agenda for whichever incoming government inherits our virtually bankrupted economy. Have no doubt that the day is coming very soon when only those who can afford to will continue to receive top line AVRs while second-rate generics will de handed to the rest, if we are lucky.

    A few posts ago Mark, now apparently a lone voice in the wilderness, ranted "you will reap what you sew" at those who have expertly and seamlessly torn his crazy theories apart. Mark, I have news for you. It will be you and your HIV sector cohorts who will be sewing for several hundred lifetimes to come for the devastation your actions and insane policies have wrought on us, and for the immense pain and suffering that surely lies ahead.
  • Mark C
    I just found this debate and am fascinated by the ongoing threads.

    It seems as if this has rumbled on for ages, which is good. But I would like to point out that back as far as november 2007, Boyz published an article by their health Editor Paul Stineburg where he was saying all these things about hard hitting campaigns and moving on from a softly softly approach. that guy seemed to write about all sorts of stuff affecting gay men and there health and I liked his column (he wasn't just about hiv either, unlike some people on this page).

    Then, suddeny, he disappeared - what happened to him? Why did Boyz pull his column? Was he sacked for talking the truth because THT/GMFA threatened to pull their adverts from Boyz (which line the owners pockets so nicely)? doesn't that just prove that even the gay journalists and media are in cahoots with the aids charities and pharma companies from which they profit?? they couldnt even stand a visionary in their midst.
    Then I read on here that last year Mr Stineburg took his message to a conference of the hiv sector, only to be shouted down for spreading the message. Two years afterwards, now it seems the message is getting out - see this months' attitude with paul burston repeating what paul stineburg said (is there a rule that journalists who write about hiv have to be called paul????)

    I feel sorry for Paul S for having to take all the blame from the aids sector, when now it seems a critical mass seems to be bulding that is right behind what he wrote in boyz for their world aids day magazine in 2007.

    Where have you gone Mr Stineburg? If you're reading this, don't be scared off by the likes of tht and gmfa - your message has spread far beyond where you began. you should be proud to have kickstarted it. And Boyz should bring back that guy for his articles was the best thing the magazine ever published - some serious stuff amidst the fluff and sex adverts.
  • Mark,

    with respect, I think it's ironic that you display the kind of ignorance about safe sex - including between HIV+ men - and living with HIV that so many argue should and could be ameliorated by accruate education.

    HIV-positive barebackers are at risk for contracting drug-resistant "super strains" of the virus. The virus has ten distinct subgroups and countless strains, HIV+ men who bareback are at risk of giving their partner a strain that resists some of the ARV's, perhaps the ones they are currently using. Many will still debate whether it is even possible to transmit drug-resistant virus, (called primary resistance.) At the 1998 World AIDS Conference in Geneva, scientists from San Francisco presented the first documented case of MDR transmission. More reports followed, and by late 1999, National Institute of Allergy and Infectious Diseases chief Dr. Anthony Fauci was calling primary resistance "unfortunate but inevitable."

    As more poz people are living longer means more people around who can spread the virus. And if HIV prevention is to mean anything in this new era, it needs to move beyond "Always Use a Condom" or "Just Say No" sloganeering and explain the explicit reasons why we need to use a condom...or do something other than anal. The overwhelming argument here is that we all, positive or negative, have the right to this information. With knowledge, information, and honesty, we all have the tools to make the wisest decisions possible.

    Bottom line, Mark, is that gay men are causing harm to themselves and others through a willful lack of basic education, which our AIDS orgs. are chartered and funded to provide. Many lives are being destroyed.The question then remains, why do the AIDS orgs. continue to so obstinately refuse to allow these truths?
  • Mark
    Oh, and please, if anyone is about to go off on one about there being a lack of 'honesty' in HIV prevention campaigns, whilst I wouldn't agree with that, I would refer you to my first post and several since in which I have re-iterated that I'm not saying there is no room for improvement in existing HIV prevention programmes.
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