Suggestions For Discussion In 2014 With Emphasis on Sex, Drugs, Trust and Testing
Thank you for your contribution to HIV disclosure to sex partners.
We do not pretend to have immediate solutions or definitive answers, but are proposing topics, ideas,thoughts, services, programs, productions and messages, to examine rising rates of HIV transmission in more depth, as we move forward. As the epidemic continues, we invite the public to join us in 2014, as “There is an increasing and potentially catastrophic HIV and sexual health epidemic in gay men and men who have sex with men (MSM) in every part of the world, Professor Kevin Fenton, the National Director of Health and Wellbeing at Public Health England, told the BHIVA autumn conference last week.
Despite having an increasing number of tools to prevent HIV, Professor Fenton added, HIV prevalence in MSM is increasing almost everywhere and incidence (the proportion who acquire HIV every year) is stubbornly refusing to change.” (Cairns, 2013)
Given this alarming information the following is an abbreviated version of suggested areas to focus on in changing how we manage HIV. As well there is brief reference to research studies and a program which examine, in more depth, trust in a relationship and while looking for sex partners, use of multiple drugs in relation to HIV transmission, sex and HIV testing frequency. The tension lies in the dynamics with sex, trust and relationships and in turn not testing regularly for HIV. The research is ongoing as the HIV community begins to take alternative approaches to HIV prevention beginning with the fundamental pleasure – sex.
The dynamic tension in sex, is the most obvious, yet least elaborated on – our basic, human, fundamental need for sexual pleasure.Studies are underway where sex is examined, beyond the simple safe sex message -“use a condom” where no doubt, interesting results will derive. Sex is being discussed with people who are HIV- negative. The discussion of HIV has reached a catastrophic level and the general public needs to be involved. There is no point in repeatedly giving safe sex information, for the most part, to people living with HIV. They know the reality and they have the facts. The challenge remains in how to engage the public to collaborate, while giving existing messages and information a much needed dusting off as we take more risks and seek information from the source -sex. Those who are having risky sex are being asked how they make decisions, how they process information, or not, what they see as alternatives to the condom message alone, what they deem as risky behaviour, how do they gauge trust, maintain relationships, partake in multiple drug use, have regular HIV tests and what information would people like to have to keep themselves safe, while seeking pleasure.
The findings of a research study involving gay men in relationships conducted in 2011 reported how:
“The investigators believe that an important overall finding of their study was that men who had greater levels of trust in their partner were more likely to never test for HIV. They write: “Additional research is warranted to further explore how concepts of trust affect partnered men’s and gay couples’ HIV testing behaviours, including their interval or history to test for HIV while in a primary relationship.(Carter 2013)
In a webinar presented by Dr. Barry Adams, Professor of Sociology at the University of Windsor, Ontario, on December 19, 2013, through Gay Men’s Sexual Health (GMSH) he discussed the findings of a brief study he conducted with men who were recently diagnosed with HIV as he attempted to understand what the contributing factors were in the conversion process. Adams identified two themes, trust with sex partners, including a sort of blind trust while determining a partner’s HIV status, and the use of multiple drugs that hinder the ability to make rational decisions while engaging in risky sex. What was interesting and made the webinar more comprehensive was the way in which Adams used quotes by participants to explain their circumstances, while not relying on statistics alone. It emphasized an element of naivety. Adams highlighted the need for further research and investigation in this area.
To address the need, Kontak, an Aids Community Care Montreal Outreach program, delivers supplies to sex parties. They go directly to the source,where the sex is happening. This program to date has been successful in reaching directly, those who are at high risk for contracting HIV. It is a bold initiative.
As investigators continue their research on concepts of trust, HIV testing behaviours and relationships, and as outreach programs continue their work, let us examine in depth, while we risk appearing as dissidents, the need to hold on to outdated ideology which is an intrinsic foundation of institutions and which has proven to be ineffective in lowering rates of HIV transmission.
Let us examine, explore, delve deeper into general resistance to go beyond the comfort zone of the safe sex messages as we examine, dismantle and rebuild comfort zones. In addressing comfort zones more thorough solutions to the complex problem may surface.
Let us examine existing organizations and groups who promote healthy living while omitting HIV as we consider initiatives for a dialogue to make the topic of HIV more inclusive.
Let us continue to change terminology on dating sites by asking individuals to re-word their profiles and offer them alternative language.
Let us seek a more definitive response to the oral sex and HIV transmission debate.
Let us be participants in public service announcements which reflect what is actually taking place and what changes are required.
Let us support the use of mobile testing sites for HIV.
Let us examine further the discomfort in choosing a person living with HIV as a potential sex partner, when in fact this could be the safest option.
Let us discuss options for partners to remain HIV negative in sero- discordant relationships.
Let us admit, that we have failed to date in our approach, but there is still time. We have nothing to lose, as rates of HIV transmission are at a catastrophic rate, as people living with HIV are reduced to criminals, each time they seek basic human fundamental pleasure, as people avoid getting tested for HIV, let us commit to resolve this complex state of affairs, which was predicted in 1998.
Cairns, Gus Cairns, 2013. “Urgent Need to Address Resurgent Gay Global Epidemic” NAM aidsmap. November 23.
Carter, Michael. 2013 “A Fifth of gay men in relationships with an HIV-negative man have not tested for HIV while in their current relationship. Higher levels of trust associated with not testing”. NAM aidsmap. August 26