Targeting positive men won’t end HIV

Some very interesting and not surprising observations that I thought were worth reminding and sharing with people.
Words by Ian Howley | @IanHowley 

Photo: © Shutterstock.com


I’ve been working in sexual health since 2010 and I’ve seen it all.

I’ve seen how the lack of basic sex education can affect people. I’ve seen how low poor self-esteem can impact someone’s judgement to look after their sexual health. But of all I’ve seen, it’s fear that is having the biggest impact on HIV prevention by creating stigma associated with HIV.

Fear is the worst emotion of them all. Fear makes us afraid of things we shouldn’t find scary. When people are afraid they tend to back off, put up walls, criticise or lash out. Some won’t even believe the facts that are put in front of them. Fear in our community is stopping people from opening up and preventing communication with gay men living with HIV. Fear is leading to a battle within our community on apps and in social settings.

People with HIV are called ‘dirty’, ‘sluts’, ‘bad people’ because luck went against them and they caught the virus. Fear creates a space for targeted hate. Many times HIV-negative people hit out at people living with HIV because they are scared of the virus. But this can have severe health problems for people living with HIV. It’s been found that men living with HIV are likely to have mental health issues because of their status, with some dying by suicide. Four in ten suicides occurred in the first year after diagnosis. During this time, men’s suicide rate was five times that of the general population. This is totally unacceptable.

Over the last several years, GMFA and other sexual health organisations have worked really hard to make sure we reached out to people and help break down the fear associated with the virus. But unfortunately, fear also sells. And in a world where clicks are more important than improving society we are seeing how years of hard work can be destroyed with just one headline. And it’s so frustrating. I know what some of you are already thinking: “Isn’t fear a good thing sometimes, as it keeps us in check?” or thinking that stigma or having a fear of HIV-positive people will stop people from becoming positive.

Well I’m here today to tell you that you are wrong. Recently, Public Health England released statistics that show that about 13% of people who are living with HIV don’t know they have the virus. Those 13% think they are HIV-negative. They are also accounting for around 80% of new HIV infections. So it’s mainly people who don’t know they have HIV, who will tell you they are HIV-negative, who are spreading the virus. If you’re being treated successfully, you cannot pass on HIV.

Here’s something you need to know. People living with HIV and on successful treatment cannot pass on the virus. When someone is diagnosed as HIV-positive, their viral load (that’s the amount of HIV in their system) tends to be very high. Once they are put on HIV medication, the medication works to decrease the amount of HIV in their body and very soon their viral load will become so low that they will become HIV-undetectable, meaning there is so little HIV in their system they cannot pass on the virus. In the last year or so you may have seen this message being pushed quite a bit by sexual health organisations. It’s been proven by science.

The PARTNER study recorded sexual acts between mixed HIV status people and found that no-one passed on the virus. But yet, because of the fear people have we still have people not believing science. I’ve heard many times: “It’s not worth the risk”. But we must continue moving forward with this message. Fear can hold us back but education and awareness will move us forward. We must continue to work to dispel the ignorance that ‘s surrounding HIV, increase people’s knowledge of testing, treatment as prevention, PrEP and condoms, while breaking down the social barriers that are caused by fear and HIV stigma. Only by increasing our knowledge of HIV and how it’s transmitted, can we really make an effort to stop HIV stigma in our community.

Someone’s unfounded fear might just be stopping them from being with someone truly amazing.


This article was originally published in the i Newspaper.

Study suggests many gay and bisexual men are skeptical, but attitudes are on the rise about U=U

First published on January 11, 2018, The City University of New York

Dr. Jonathon Rendina, an Assistant Professor at Hunter College and Director of Quantitative Methods at Hunter’s Center for HIV Educational Studies & Training, and Dr. Jeffrey Parsons, Distinguished Professor at Hunter and Director of CHEST, have published a new paper in the Journal of the International AIDS Society focused on gay and bisexual men’s perceptions of the HIV treatment-as-prevention message, “Undetectable = Untransmittable.” Numerous well-controlled trials have recently demonstrated that there is effectively no risk of HIV transmission during sex with a partner who has a sustained, undetectable viral load. This notion, that HIV treatment can lead to HIV prevention, has been captured with the #UequalsU slogan popularized by Bruce Richman and the Prevention Access Campaign, of which he is Executive Director, and has gained growing popularity and endorsements, including the U.S. Centers for Disease Control and Prevention (CDC). The Hunter CHEST study sought to examine how accurate gay and bisexual men perceive this message to be by surveying more than 12,000 men across the United States in the summer of 2017.

In addition to promoting HIV knowledge, one goal of the message is to help reduce HIV stigma. Mr. Richman noted, “This study underscores the great need for further targeted educational and dissemination strategies and provides data that will be immensely valuable as we work with our partners to scale up campaigns to prevent new transmissions and reduce HIV stigma.” Among HIV-positive men, reporting a detectable viral load was associated with believing the message was less accurate. Dr. Rendina added, “What we may be seeing is that some guys who aren’t able to maintain a sustained undetectable viral load either have lower levels of knowledge potentially due to being less well-retained in care or that they may feel left out of the message and concerned it will lead to additional stigma placed on them.” He continued, “There is great promise for the message to reduce HIV stigma, but at the same we need to make sure we don’t end up marginalizing or stigmatizing those who struggle with keeping their viral loads undetectable.”

Among men with and without HIV, believing the message was more accurate was associated with having had condomless anal sex with a partner of a different HIV status. Dr. Parsons noted, “This suggests that men who understand the scientific evidence, now endorsed by the CDC, that Undetectable = Untransmittable feel more comfortable having condomless sex when a positive partner is virally suppressed. Because they know that treatment-as prevention is effective—as with other forms of biomedical prevention, like PrEP, it’s giving men more options regarding their sexual health that emphasize autonomy and sexual pleasure. The message of ‘use a condom every time’ is now outdated and limiting.” Strategies such as regular viral load monitoring, efforts to maintain medication adherence, routine screening for sexually transmitted infections, better access to PrEP, and promoting communication about biomedical prevention with sexual partners can be helpful in conjunction with treatment-as- to continue curbing the HIV epidemic and averting new epidemics among other .

Peer Mentor Program set to launch in Perth!

Living with HIV has changed over the past 3 – 4 years.  With modern treatment and support, HIV positive people can lead healthy and active lives.  Learning how to do this does not have to be overwhelming, and no one needs to be isolated or alone.

The WA AIDS Council Peer Mentoring Service can provide the most current HIV information, answer questions, offer support and show how other people deal with HIV.

Peer Mentors are trained and educated on the current health issues surrounding HIV/AIDS, STI’s, self-care, disease progression, co-morbidities, HIV and aging and well-being.  Through a series of supportive discussions, they use everyday language instead of jargon or medical terminology to make topics easier to understand.

The role of a Peer Mentor is to support a person with HIV to gain knowledge and develop HIV self-management strategies, providing the important information need to achieve goals while living with HIV.

Talking with someone who is living with HIV can reduce the stress and anxiety that some people experience and also reduce isolation.  Having good mental health and social supports are important to keep HIV in check, improve emotional health in areas of self-esteem, depression, stigma and discrimination, battling isolation and building support networks.

Here in Western Australia, we are located in the largest state in Australia and the ability to reach out and work with people with HIV who are more rural and isolated is another aim of the Peer Mentors.  Through the use of modern technology such as Skype the ability to keep people connected and supported will help to reduce that sense of isolation that can be detrimental to living positively.

A Peer Mentor  is an HIV positive person who can assist other HIV positive people who are newly diagnosed or who are needing support from someone who is living with HIV to:

  • Improve emotional health
  • Understand current treatments and the role of treatments as prevention in the HIV lived experience
  • Develop disclosure strategies for meeting personal challenges
  • Navigate ‘well-being’.

The program is not limited to those who have been newly diagnosed but is also open to any person living with HIV who might want to address some of their health concerns.  Peer Mentors can assist with support around changing medications, dealing with co-morbidities and the issues of ageing while living with HIV, maximizing quality of life and also to assist in connecting people with appropriate services.

On Tuesday January 23 we will be holding an information night that will tell you more about the project and how you can be involved.

If this sounds like something you might be interested in  then please email me at mreid@waaids.com or call me in the office on (08) 9482 0000.