Comment: HIV charity answers back
In the last month, PinkNews.co.uk has published a number of articles on HIV awareness. One of these, by Gary Leigh, attacked HIV charities, claiming they have not done enough to prevent a rise in infection rates.
Here, Matthew Hodson, head of programmes at gay men’s health charity GMFA, discusses how the organisation works to educate gay men about HIV.
HIV is a serious medical condition. There is no cure for HIV, and no cure is expected in the near future, so once you are infected you will probably be infected for the rest of your life. This means that there will always be the possibility that you will pass on your infection to your sexual partners.
If you are HIV positive you will be more vulnerable to a range of infections. To keep your immune system functioning you will need to take medication and you will probably have to take this medication every day from that point onwards. Most people with HIV suffer considerable levels of emotional distress. If they discuss their status with partners they face rejection, if they don’t discuss their status they are vilified. This is the reality and this is why, at GMFA, we view HIV as serious.
So, equipped with this knowledge, should our HIV prevention campaigns hammer home the message that HIV is serious to scare gay men into using condoms? Is there a need for this? The Gay Men’s Sex Survey shows that there is almost universal agreement amongst gay men, irrespective of their age, that HIV is a serious medical condition (1). Therefore, campaigns that only tell everyone how serious HIV is would only be delivering a message that gay men already know.
Although HIV remains serious, the outlook for people diagnosed with HIV has changed considerably over the last ten years. Mainly due to effective treatments, the numbers of gay men with HIV dying each year is, thankfully, much lower now. In 2007, 159 HIV positive gay men died, not all of them from HIV related illness, compared to well over 1,000 at the peak in 1994 (2). Similarly the number of AIDS cases has also dropped to fewer than 200 in 2007, and the majority of these cases were as a result of late diagnosis of HIV infection.
And it’s not just in terms of illness that the picture for people with HIV is improving. A recent National AIDS Trust report found that less than 10 per cent of HIV positive gay men rated their mental or physical health as poor (3).
Of course HIV can have serious impacts and issues such as HIV stigma must be addressed. Many people’s experiences may contradict the wider picture and I would be the last person to belittle the terrible impact that an HIV diagnosis has on an individual. However, we must be wary of overstating what it now means to be HIV positive. A campaign painting a picture of life with HIV as universally devastating and leading to certain short-term death would quite simply be lying. It would also discourage men from getting tested and accessing the best treatment so that their chances of suffering AIDS are dramatically reduced. Also men who are diagnosed and know that they are HIV positive are better informed so that they are able to take steps to ensure that they do not infect their partners.
Instead, campaigns must focus on tackling the reasons why men have unprotected sex. Research shows that three-quarters of HIV negative men believe that a positive man will always say that they have HIV before sex (4), and this expectation of disclosure is increasing. The reality is that only about one in three HIV positive men always tell their partners that they are positive. For this reason, GMFA’s recent campaigns have encouraged men not to guess the HIV status of their sexual partners, stressed the importance of using condoms, and promoted the benefits of having accurate knowledge about their own HIV status.
If we were to focus on some of the worst impacts of HIV infection or HIV treatment, we might perpetuate the false belief that you can always tell whether or not someone has HIV. Despite the number of gay men living with HIV increasing, about half of HIV negative gay men believe that they don’t know anyone who has HIV (5). By portraying HIV as a devastating, and visible, condition we would only support the belief that the person they are having sex with, or fall in love with could not have HIV – and that, therefore, their sexual activity is safe. To continue reading, click page 2.
It’s not just ignorance about the proximity of HIV that can lead to unprotected sex. Sometimes men become infected not because they think HIV isn’t serious but because they have other difficulties in their life. Depression, low self-esteem and a lack of control can lead to decisions whereby men do not protect themselves every time. A wish for intimacy or just desire in the heat of the moment can also result in men putting themselves at risk. Scaring gay men, by giving them inaccurate messages about HIV, will do nothing to empower them to take control of their lives.
At GMFA we have found that the best way to get men to engage with our messages is to use a variety of techniques. We don’t think that any one campaign or style is going to appeal to all men so we use a mixture of humour (the HIV Detector campaign), sex (the Hot Sex booklet) and medical information (the Know Your Status campaign) to get a range of important HIV prevention information across.
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We believe that we can only produce work that will be credible if we are honest and frank. Preventing new infections is what motivates us – the GMFA staff and the hundreds of GMFA volunteers. We provide accurate information about HIV and safer sex through our websites, our courses, our booklets and postcards, FS magazine and through our advertising campaigns. Hundreds of thousands of gay men across the UK benefit from the detailed HIV information and advice on our websites. Hundreds of gay men across England come to our workshops – and not just the famously sexy ones but also to courses on building confidence and assertiveness skills.
There is absolutely no cause for anyone who cares about HIV prevention to be complacent. The best evidence that we have, generated here in the UK and around the world, is that giving gay men clear, honest and accurate information, equipping gay men with the tools for protected sex, and empowering gay men to control the sex that they have is the most effective way of preventing HIV infections.
However, there is no magic bullet, no formula of fear or entreaty that will be able to prevent all future infections. Even if all gay men were well educated about HIV, well equipped and assertive there would still be some men who sometimes would have unprotected sex. GMFA can provide information and some degree of support, but ultimately the power to stop new infections within our community lies with gay men. I believe that by taking responsibility for our actions, by protecting our own health and by looking after the health of our sexual partners, gay men can prevent new infections and build a stronger and safer community.
For more information, visit gmfa.org.uk
1. 97.8 per cent of gay men agreed with the statement ‘’HIV is still a very serious medical condition’ – Gay Men’s Sex Survey 2006
2. Sexually Transmitted Infections and Men who have sex with men in the UK: 2008 Report, Health Protection Agency.
3. Working with HIV – A summary of NAT’s HIV employment research, 2009.
4. In 2006 74.3 per cent of gay men expected disclosure of HIV status from a sexual partner, up from 64.1 per cent in 2002.
5. 48.5 per cent of total sample of men (incl. men who had tested positive themselves) knew someone who is HIV positive, GMSS 2003, a reduction from 65.9 per cent who knew someone positive in GMSS 2000.