HIV-NEGATIVE GAY MEN UNCOMFORTABLE RELYING ON AN UNDETECTABLE VIRAL LOAD TO PREVENT HIV

Much more confidence in PrEP

Australian HIV-negative gay men express far more confidence in pre-exposure prophylaxis (PrEP) than an undetectable viral load in preventing HIV, with only 18% agreeing that “a person with an undetectable viral load cannot pass on HIV” and 6% feeling comfortable having condomless sex with an HIV-positive partner who had an undetectable viral load, according to a pair of articles recently published in Sexually Transmitted Infections and AIDS & Behavior.

Confidence in the efficacy of PrEP was much higher.

Researchers from the Burnet Institute conducted an online survey with gay and bisexual men living in Melbourne and other parts of the state of Victoria. It included a series of questions to gauge men’s knowledge of and attitudes towards condoms, an undetectable viral load and PrEP.

Australia has a long history of promoting condom use and regular HIV testing in gay men. More recently, there has also been high-profile support for treatment as prevention and PrEP. Around the time the survey was conducted in August and September 2016, a PrEP demonstration project was scaling up in Victoria. Several Australian campaigns promoting the benefits of HIV treatment had already been run, but the international “Undetectable = Untransmittable” campaign had not yet taken off.

Half the survey participants were between the ages of 25 and 40; most identified as gay; and 20% were born outside Australia. A third reported condomless sex with a casual partner in the past six months, and half with a regular partner.

The survey was completed by 844 people, but men with diagnosed HIV were excluded from the following analyses. The data on comfort having condomless sex come from 771 HIV-negative or untested men, including 83 PrEP users (12% of the men). The data on perceptions of effectiveness come from a smaller group of 462 survey respondents who answered all relevant questions and were not using PrEP. (The researchers did not report on responses from PrEP users for these questions.)

Perceptions of effectiveness

Although this analysis excluded current PrEP users, the majority of respondents expressed confidence in PrEP’s effectiveness: 78% agreed that “PrEP is effective in preventing HIV infection” and 65% agreed that “An HIV-negative person who is on PrEP is unlikely to get HIV”. Respondents also agreed that PrEP users were “being responsible” (74%) and were “protecting themselves” (84%).

In contrast, 18% agreed that “A person with an undetectable viral load cannot pass on HIV”. A similar statement, with less definitive language was not much more popular – 20% agreed that “An HIV-positive person on treatment is unlikely to transmit the virus”.

Despite this scepticism, other findings showed that respondents were aware that HIV treatment has a prevention impact – 37% agreed that “If more HIV-positive men have an undetectable viral load, then I’m less likely to get HIV” and 82% agreed that “HIV-positive people should go on treatment to protect their partners”.

Moreover, taking treatment soon after diagnosis appears to have become a community norm – 84% agreed that “People should start treatment as soon as they are diagnosed”, while statements suggesting that people should delay until they are completely ready or until treatment is absolutely necessary were supported by fewer than 10%.

This cohort of HIV-negative men generally rejected relying on their partners using antiretrovirals in order to be protected from HIV. They suggested that their personal sexual strategies would not change in response – 16% agreed that “If more men are on PrEP, I would feel like I don’t need to use condoms to avoid getting HIV”. Similarly, 12% agreed that “Because of PrEP and HIV treatments, I’m less likely to ask my partners about their HIV status”.

Comfort having condomless sex

Men were asked, “How comfortable would you be having anal sex without a condom with casual partners in the following scenarios?” and were asked to respond for a number of partner types. There were important differences between the responses of PrEP users and non-users.

The 668 men who were not taking PrEP were generally uncomfortable with the idea of having condomless sex – only 7% said they would be comfortable doing so with ‘any casual partner’, 5% with a casual partner of unknown HIV status and 3% with an casual partner who was HIV positive.

It made little difference if the HIV-positive partner had an undetectable viral load – 6% would feel comfortable having sex with him.

Men appeared to be more comfortable serosorting, although this can be a risky strategy for HIV-negative men as there is always the possibility that a partner has recently acquired HIV but has not yet been diagnosed. Among men not using PrEP, 31% said they would be comfortable having condomless sex with a casual partner described as HIV negative. If the same man was taking PrEP, fewer men (23%) would be comfortable having condomless sex with him, perhaps reflecting a perception of PrEP users as risk takers.

The 83 respondents who were using PrEP were more comfortable with the idea of having condomless sex, but comfort levels were not particularly high.

PrEP users were most likely to feel comfortable having condomless sex with other HIV-negative PrEP users (72%) and HIV-negative partners not taking PrEP (64%).

The proportion who would feel comfortable having condomless sex with an HIV-positive partner (29%) was lower than for a partner of unknown HIV status (34%) or ‘any casual partner’ (40%).

And less than half of current PrEP users would be comfortable having condomless sex with an HIV-positive partner with an undetectable viral load (48%), although the respondent would be protected by two extremely effective prevention methods.

Conclusions

“While gay and bisexual men are highly supportive of pre-exposure prophylaxis, there remains some scepticism towards HIV treatment when used for prevention,” sum up the authors. “Increasing community understanding of treatment as prevention is needed to optimise treatment-based HIV prevention strategies.”

“In general, HIV-negative and untested gay and bisexual men indicated that they remained more comfortable negotiating condomless sex based on knowledge of HIV status, rather than PrEP or undetectable viral load.”

Many men continue to rely on serosorting: “HIV-negative men tend to perceive all sex with HIV-positive partners as potentially risky, regardless of condom use, HIV treatment or viral load.”

Some commentators have suggested that PrEP and understanding of undetectable viral loads could help reduce HIV stigma and the fear of partners living with HIV. However, PrEP users’ relatively high levels of discomfort with the idea of condomless sex with HIV-positive partners suggest that these hopes may be over-stated, the authors comment.

By Roger Pebody

References

Wilkinson AL et al. Measuring and understanding the attitudes of Australian gay and bisexual men towards biomedical HIV prevention using cross-sectional data and factor analyses. Sexually Transmitted Infections 94: 309-314, 2018. (Abstract.)

Holt M et al. Comfort Relying on HIV Pre-exposure Prophylaxis and Treatment as Prevention for Condomless Sex: Results of an Online Survey of Australian Gay and Bisexual Men. AIDS & Behavior, online ahead of print, 2018. (Abstract.)

Reprinted from the ETAG article published 6/6/18

Australian law needs a refresher on the science of HIV transmission

This article comes from “The Conversation”; www.theconversation.com/ and is worthy of discussion and consideration. 
Recent improvements in medical management of HIV infection are not well understood in the legal sector. 
Being diagnosed with HIV is a confronting experience.

However the stigma associated with HIV infection – a hangover from its social and medical history – is responsible for an exaggerated perception of transmission risk through sex, and the harms of living with HIV infection.

In our consensus statement published this week in the Medical Journal of Australia, we detail the latest evidence on HIV transmission risk and recent advances in HIV prevention and treatment.

We propose that legal cases relating to HIV transmission should be considered in light of such evidence, and that alternatives to prosecution such as the public health management approach are often appropriate.

HIV infection no longer a death sentence

There have been many advances in HIV diagnosis, prevention and treatment since the identification of the first AIDS cases in the early 1980s.

In the initial days of the AIDS epidemic, patients would, after a number of years, develop serious infections and other illnesses due to their immune deficiency, usually resulting in death. When the first treatments became available, they bought time but often at the cost of serious medication side-effects, and complicated treatment regimens involving many tablets each day.

While it remains a serious infection, HIV is now a disease that can be effectively managed through medical treatment, regular health monitoring and healthy lifestyle. For many people with HIV, treatment involves taking only a single pill each day. Those taking antiviral therapy can expect to live a normal life, in good health, with a life expectancy similar to their HIV-negative counterparts.

These great improvements, familiar to those working in health, are not as well understood in the legal sector.

Prosecutions for HIV infection

Unlike other diseases, HIV has a long and uneasy relationship with criminal law. In the early years of the epidemic, the stigma around HIV, the fact that it was almost always fatal, and unfounded fears about its potential use as a weapon led to the criminalisation of HIV transmission and exposure.

Since 1991, there have been more than 38 criminal prosecutions for HIV transmission or exposure during sex in Australia. Despite the significant improvements in health and longevity of people living with HIV, the rate of criminal prosecutions has not decreased.

The courts have shown an understanding of the effectiveness of condoms: no one who has used condoms has been convicted. However, people continue to be prosecuted, including for “exposing” others to the risk of HIV infection, even in the absence of actual transmission. This occurs despite the relatively low per-act risk of HIV transmission and the fact that for most people the harms of HIV infection are far less serious than they once were.

New approaches to limit HIV transmission

HIV is actually difficult to transmit. Sexual transmission occurs during only about 1% (or less) of penetrative sexual encounters, even when a condom is not used and the HIV-positive person is not on treatment.

HIV prevention messaging in the early days of the epidemic focused on sexual abstinence and condom use. However, prevention messaging is now more nuanced and has expanded to include new ways of reducing HIV transmission risk. A not insignificant number of people at risk of HIV infection choose to have sex without using a condom, which is why developing alternative methods of HIV prevention have been prioritised in recent years. Such research has delivered game-changing results: “treatment as prevention” and “pre-exposure prophylaxis”.

Treatment as prevention refers to the greatly reduced risk of HIV transmission as a result of HIV-positive people taking antiviral treatment, which suppresses replication of the virus in the infected person’s body. When a person with HIV has a very low viral load (unmeasurable levels of HIV in the blood), the risk of sexual transmission becomes very low. In fact, there has never been a documented case of HIV transmission from a person with an undetectable viral load.

Pre-exposure prophylaxis describes the use of antiviral medication by an HIV-negative person as a way of preventing HIV infection. Pre-exposure prophylaxis is a very effective means of preventing HIV transmission, with only isolated cases of transmission identified among people applying this approach. This groundbreaking new strategy is available in Australia via limited pilot programs, and is being evaluated for Pharmaceutical Benefits Scheme listing.

How the law treats people with HIV

Criminal laws relating to HIV transmission and exposure vary from state to state, but a common factor is that people with HIV are expected to take “reasonable precautions” to prevent transmission. Condom use has long been accepted as meeting this threshold.

The evidence now supports acceptance of treatment as prevention (for the positive partner) and/or pre-exposure prophylaxis (for the negative partner) as meeting the same standard. And the limited harms of HIV infection as a consequence of acts involving low to negligible risk of transmission mean HIV cases generally do not belong in criminal courts.

There is an alternative. All states and territories have health protocols for managing allegations of risky behaviour. This public health approach – involving education, case management and, where required, behavioural orders and isolation – is a much more effective way of protecting public health.

As researchers and clinicians, we are intimately aware of the impact an HIV diagnosis can have. We have all supported patients coming to terms with an HIV diagnosis; many of us having had the painful task of delivering that devastating news.

The criminal law has a role to play, particularly should there ever be a case where a person deliberately transmits HIV.

However, with the advances of recent years in both prevention and treatment, authorities need to be more familiar with latest scientific and medical evidence, and consider alternatives to prosecution such as the public health management approach.


Elizabeth Crock, Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine, co-authored the consensus statement.

 

Beyond Positive Workshop Series

Beyond Positive is a workshop series for HIV Positive Gay and Homosexually Active Men.

Topics include Sex, Intimacy and Relationships, Stigma & Discrimination, Disclosure & Empowerment, Treatments as Prevention, Living Well and more.

Facilitated by Mark Reid, the Positive Peer Educator. The workshops will run weekly on a Tuesday evening from 6:30pm from November 14th to December 12th.

  • Tuesday November 14th
  • Tuesday November 21st
  • Tuesday November 28th
  • Tuesday December 5th
  • Tuesday December 12th

Evaluation and Debrief on Tuesday December 12th followed by dinner at 7.30pm. If have any special dietary requirements please let Mark know when you RSVP.

If you’re interested in this event, please contact:
Mark Reid on 9482 0000 or email mreid@waaids.com by Tuesday October 31st 2017 to secure a place.

Not linked in with the WA AIDS Council? Not to worry. If you haven’t connected with the WA AIDS Council previously and would like to register for this event, please contact Alli at apaterson@waaids.com or on 9482 0000, who will explain how you can get involved.

HIV: Prosecution or Prevention? HIV Is Not a Crime

A chapter from the book The War on Sex edited by David M. Halperin and Trevor Hoppe. March 27, 2017 By Sean Strub

Iowan Nick Rhoades is HIV-positive and has had an undetectable viral load for many years, making it virtually impossible for him to sexually transmit the virus. When he had sex with a man he met online in 2008, he also used a condom. Despite these protective measures, Rhoades was prosecuted and convicted for not disclosing his HIV status to his partner before they had sex. He was sentenced to 25 years in prison and lifetime sex offender registration.

Willy Campbell is serving 35 years in Texas for spitting at a police officer; David Plunkett served over six years in a New York state prison before an appeals court ruled that saliva could not be considered a “deadly weapon” in New York State. Monique Howell Moree was charged by the U.S. Army for failing to disclosure her HIV-positive status to a partner in South Carolina before having sex with him, even though the partner said he didn’t want her charged and that she told him to use a condom. Kerry Thomas is serving 30 years in Idaho, even though his accuser agrees that he always used a condom.

All over the United States — and in much of the world — people living with HIV/AIDS (PLHIV) are facing criminal penalties for nondisclosure of their HIV status prior to having sex or for perceived or possible exposure to, or transmission of, HIV. About two-thirds of U.S. states have HIV-specific criminal statutes, laws that only apply to PLHIV.

Most people believe the law should apply equally to all and that creating different statutes for different parts of society based on immutable characteristics — whether it is gender, sexual orientation, race, physical ability, or genetic makeup — is a bad idea. Yet here we are doing exactly that, creating a viral underclass in the law with one group singled out for different treatment.

Sero Project, a network of PLHIV combating HIV criminalization, has documented more than 1,300 instances of charges led under HIV-specific statutes. But HIV criminalization isn’t constrained by geography; in every state, regardless of whether there is an HIV-specific statute, PLHIV can and often do face more serious charges or harsher sentencing under regular criminal statutes than do HIV-negative individuals accused of the same crimes. Texas and New York do not have HIV-specific statutes, but as mentioned, have incarcerated PLHIV because they considered their saliva dangerous.

These statutes and prosecutions create an illusion of safety for those who do not have HIV or do not know their HIV status, putting the entire burden of HIV prevention on those who have been tested and know they have HIV. The statutes undercut the fundamental public health message that HIV prevention is a shared responsibility and that everyone should act in such a way as to maintain their own health and protect themselves from contracting HIV or other sexually transmitted infections.

Decades-long sentencing and required sex offender registration are not unusual punishments for HIV-related crimes in the United States, even though actual HIV transmission is seldom (less than 5 percent of cases) a factor in these prosecutions. Many cases boil down to whether the PLHIV can prove they disclosed their status to their partners in advance of intimate physical contact; it doesn’t matter whether there was even a risk of HIV transmission. People living with HIV charged under prostitution or assault statutes frequently face significantly more severe penalties solely because they have HIV. They sometimes face charges for spitting, scratching, or biting that are “pile-on” charges, driven by accusations made by law enforcement, first responders, or prison guards.

The first HIV criminalization laws in the United States were passed in the late 1980s and early ’90s, largely in response to a provision of the Ryan White Care Act that required states, in order to qualify for funding, to demonstrate an ability to prosecute what was then labeled “intentional transmission.” At the time many considered any intimate contact with an HIV-positive person a life-threatening risk; contracting HIV was believed by many to be tantamount to a death sentence.

A second wave of statutes was enacted after the introduction of combination therapy in the mid-1990s, which fundamentally changed what an HIV-positive diagnosis meant. What was once thought a death sentence had become a chronic but manageable long-term health condition.

As it became understood that PLHIV were surviving much longer, the public’s perception of PLHIV also changed. Rather than objects of pity facing a “death sentence,” PLHIV became seen as viral vectors, potential infectors — an inherent threat to society. Living longer meant PLHIV would be around longer to infect others.

The criminal justice and public health systems began to define and treat PLHIV as a dangerous population, one that needed to be sought out, tracked down, tested, reported, listed, tagged, monitored, regulated, and, increasingly, criminalized.

While the statutes were used in the early years disproportionately often against heterosexual African American men (often in conjunction with other criminal charges), today they are used more broadly, typically in circumstances where there was no intent to harm, often when there was no other crime involved, and frequently for behaviors that pose no or little risk of HIV transmission.

Beyond the blatant injustice, HIV criminalization is also horrible public health policy, because it discourages people at risk from getting tested for HIV and makes those who do test positive less trustful of public health authorities.

To be liable for prosecution, one must get tested for HIV and know one’s HIV status. Current HIV criminalization punishes this responsible behavior — getting tested — and privileges the ignorance of not knowing one’s HIV status. Yet new cases of HIV are transmitted in disproportionate numbers by those who have not been tested and do not know they have it; those who do get tested and know they have HIV are far less likely to transmit HIV than those with HIV who do not know it.

Although the HIV-specific statutes were passed by state legislatures with the intent to reduce HIV transmission, the evidence increasingly shows that the statutes may be having the reverse effect.

The Sero Project’s 2012 survey of more than 2,000 PLHIV in the United States revealed that at least 25 percent of the respondents knew one or more individuals who were afraid to get tested for fear of facing criminalization. Research has shown that HIV criminalization makes those who do test positive for HIV less likely to cooperate with traditional disease prevention measures, like partner notification programs, or with treatment adherence programs. Most recently, a study found that HIV-negative gay men who knew they lived in a state with an HIV criminalization statute were more likely to engage in unprotected intercourse.

Repeal of HIV criminalization statutes is necessary both to protect the rights of people with HIV and to reduce the transmission of HIV.

An individual who demonstrates a premeditated malicious intent to harm another person can be prosecuted under existing assault statutes, whether they use a gun, a baseball bat, their fists, or a virus. The HIV-specific statutes are unnecessary and, worse yet, they stigmatize people with HIV/AIDS, discourage people at risk from accessing testing and treatment services, and feed a public bloodlust for punishment. In short, they are worsening the epidemic.

The prevention of HIV — or preventing any sexually transmitted infection — is a shared responsibility, but that does not mean there is not harm inflicted when someone misleads another person and transmits an infectious disease. In those circumstances, the injured party may seek recourse in the civil courts or possibly through a restorative justice process.

In any case, incarceration of PLHIV does not necessarily prevent further HIV transmission, as there is significant HIV transmission within penal environments, where condoms are seldom available.

Advocacy to repeal HIV-specific statutes, modernize public health statutes concerning perceived or possible exposure to, or transmission of, HIV and other infectious diseases, and educate law enforcement, prosecutors, and other actors in the criminal justice system has been under way for several years.

A network of survivors of HIV criminalization prosecutions, launched in 2010, has helped to educate and mobilize affected communities. This HIV criminalization reform advocacy has received support from public health professionals and policy leaders, including the Presidential Advisory Council on HIV/AIDS, the National Alliance of State and Territorial AIDS Directors, UNAIDS, and the American Medical Association.

The first national conference on HIV criminalization in the United States was held in June 2014 at Grinnell College in Grinnell, Iowa. Organized primarily by PLHIV — including participation by a dozen PLHIV who had been prosecuted for “HIV crimes” — the conference included participants from 28 states. It focused on how HIV criminalization affects communities of color, transgender women, sex workers, and gay men. It also showed the impact of HIV criminalization on how members of those communities (and others) access HIV prevention, testing, and treatment and whether they decide to disclose their HIV status. Finally, the conference highlighted effective strategies for reform.

The only state, so far, to modernize their statute substantively in recent years has been Iowa, where the conference was held. After a four-year education and lobbying effort led by Nick Rhoades and other PLHIV in the state, the Iowa legislature repealed its HIV-specific statute in 2014. The legislature replaced it with a new statute that addressed several infectious diseases, required a higher standard of intent to harm, and established tiered punishments. Similar efforts are under way in about a dozen states. A few weeks later, the Iowa Supreme Court overturned Rhoades’s conviction and removed the sex offender registration requirement for all others previously convicted under the Iowa statute.

HIV criminalization is an extreme manifestation of stigma. That is particularly true of HIV-specific statutes that create a viral underclass in the law, establishing a different criminal law for one segment of society based on an immutable characteristic. Despite the biomedical advances in the treatment of HIV, HIV-related stigma remains stubborn, driven in significant part by HIV criminalization.

It is time we learned a basic lesson: HIV can be prevented or it can be prosecuted, but not both.


Sean Strub is executive director of the Sero Project and the founder of POZ. He is the author of Body Counts: A Memoir of Politics, Sex, AIDS, and Survival.

The War on Sex contains two additional pieces on HIV criminalization: Gregory Tomso’s chapter, “HIV Monsters: Gay Men, Criminal Law, and the New Political Economy of HIV,” and Hans Tao-Ming Huang’s essay, “HIV Care as Social Rehabilitation: Medical Governance, the AIDS Surveillance Industry, and Therapeutic Citizenship in Neoliberal Taiwan.”

Straight With HIV: An Interview With Joshua Middleton

I found this article an interesting read and sometimes it is nice to share stories from a different perspective. This interview is shared from The Body and comes from amfAR, the Foundation for AIDS Research.

March 17, 2017

Joshua Middleton

Joshua Middleton (Credit: Vincent Carrella)

Joshua Middleton was 22 when he was diagnosed with HIV on June 5, 2012, during what he refers to as the prime of his life. As a non-injection drug user, non-promiscuous heterosexual, contracting HIV was the least of his worries. “After all, ‘HIV wasn’t something that happened to someone like me but to someone else,’ I told myself, right?” he says.

In 2014, 13-24-year-olds accounted for about 22% of new HIV diagnoses in the United States, according to the Centers for Disease Control and Prevention. Most occurred among young gay and bisexual males. Middleton, however, believes he contracted HIV through heterosexual sex.

In observance of National Youth HIV & AIDS Awareness Day on April 10, we spoke to Middleton, now 27, of Murrieta, Calif., about coping in the aftermath of diagnosis, combating HIV stereotypes, and raising awareness among youth.

You describe the moment you learned you had HIV like getting hit by “a ton of bricks.” What helped you cope in the immediate aftermath?

I was in a state of shock. It didn’t really hit me until a couple of minutes after the doctor told me. I had enough information on HIV to know I wasn’t going to die from it. The doctor reiterated that. I was more concerned with stigma. I thought about my life and some of the things I had been through. I had survived necrotizing fasciitis (a flesh-eating disease), septic shock, and multiple hospitalizations. I was in the ICU for three weeks. Being so close to death it really made me think to myself, “Hey, you have been through something way worse. You can get through this too.” I began by building a support network, which included joining an online support group and speaking with HIV advocates. I also educated myself. I knew a little bit about HIV, but I wanted to know everything about HIV because it was now personally affecting me.

You were also really open about your diagnosis from the beginning. What made you decide to disclose openly and honestly, especially so soon?

I think it was kind of a gunshot reaction. I didn’t really think too much. I am someone who carries my emotions on my shoulders. I was hesitant to tell my parents, but it was too big of a thing. I knew the feelings I was going through, how bad it was hitting me, and this was just the first day. I didn’t understand the exact ramifications of what it was like to live with HIV. I just knew it was pretty heavy, and I didn’t know if I was going to be able to carry that burden alone.

My goal is to raise awareness around HIV and AIDS as a young, heterosexual male, not what would be considered high risk. I want people to open their eyes and realize a small amount of risk doesn’t equal no risk.

What was the reaction from your parents? I know you also contacted your ex-girlfriend.

My parents were devastated. My mom and I cried for a couple of hours. She had a lot of questions. The first thing she asked me was, “Are you gay?” I let her know that I was not gay. She wanted to know how I got it. As for my dad, he’s more introverted, but he gave me a big hug, let me know, “Hey we’re going to get through it together.” When I told my ex-girlfriend — we had been broken up for five months — she let out a blood-wrenching scream. It was as if I had told her the whole world was ending. I said, “Look, I’m not telling you that you have it or that you gave it to me. I’m just saying I am HIV-positive, so you need to get tested.” She thought I was going to die of AIDS. She got so upset she couldn’t talk anymore and dropped her phone. Her aunt picked it up and said, “Hey I’m going to take her to get tested, don’t worry.” She was in a state of sheer terror. (Note: Joshua never heard from her after that.)

You wrote in an essay for POZ that you never thought you were at risk. How do we combat the continuing stereotype that HIV only affects certain people?

The heterosexual community needs to speak up and share their stories. I have had people in the poz community say, “You must have slept with someone who is gay. You must have slept with a girl who slept with someone who is bi.” Before I was diagnosed, the only person I had ever met who was HIV-positive was an older gay guy who spoke to my human sexuality class, and I couldn’t relate to his story. If I had a straight guy come into the room that day and say “Hey I’m living with HIV and I’m heterosexual,” it may have opened my eyes much more to say, “Hey this can happen to me.”

Why do you think a disproportionate number of new HIV infections are occurring among youth?

Youth are under the impression that they are invincible — like I was. They need to hear from someone they can relate to. They need to put faces to information. You don’t want to make HIV seem like it’s a death sentence — for the majority of the world it isn’t. But at the same time, you don’t want to promote it like it’s a basket of roses. Living with HIV has emotional, physical, and social ramifications. It’s a delicate balance. There are also problems with our sex education system. In some schools, you can’t even say the word “condom.” In fact, youth don’t have a lot of information just on the basics of HIV at least on a level they can understand. But also, parents aren’t talking to their kids about sex.

You do a lot of online activism through your blog Pozitive Hope, Facebook group, and YouTube channel. Who do you want to reach? And what do you hope to achieve?

I really want to touch people who have been diagnosed with HIV but are not yet at that level of acceptance. They are in the grieving process. Because to me that’s very critical to be able to help someone when they are in the darkest of times. My goal is to raise awareness around HIV and AIDS as a young, heterosexual male, not what would be considered high risk. I want people to open their eyes and realize a small amount of risk doesn’t equal no risk. And people really need to not get so caught up in the numbers but realize that HIV can happen to anyone.

Shedding light on HIV discrimination in Australia

These awesome posters are part of The Stigma Projects campaign to live HIV neutral
These awesome posters are part of The Stigma Projects campaign to live HIV neutral

Discrimination is described as ‘choosing to treat someone badly or unfairly because of a characteristic that is perceived as different or unwanted’. The HIV virus is ‘different and unwanted’ therefore society often discriminates against individuals living with the virus. The public at large still perceives HIV as terrifying and infectious, immediately questioning ‘What is the risk to me?’ Having limited knowledge based around myths and misconceptions, their best strategy is often complete avoidance of individuals living with HIV.

But let’s get the facts straight. Today, HIV is recognised as a chronic illness which can be managed with antiretroviral medication. This medication significantly reduces the risk of HIV transmission to almost zero, by reducing the HIV virus in the body. HIV-positive people who know their HIV status can take steps towards managing their health and prevent onward transmission. They are not a “risk” to others. They are capable of working, having relationships, having sex, having families and have a life expectancy identical to that of the HIV-negative population.

To draw your attention to the issue of HIV related discrimination I want to introduce you to the wonderful work of the HIV/AIDS Legal Centre (HALC). Over the years I have worked with a number of clients who I have referred directly to HALC, other community legal organisations or the Equal Opportunity Commission in WA. Why? Because HIV-positive people often face unfair dismissal at work, unwanted HIV disclosure in a medical setting, domestic violence, marginalisation and migration challenges, just to name a few.

HALC is only 50 per cent funded by the government. The remaining 50 per cent is sourced from the good will of the community. HALC’s current fundraising campaign is ‘45 days, 45 lives’ whereby each day explores the life of a different HIV-positive person in Australia and their challenges tackling discrimination. It’s an enlightening read of the struggles PLHIV face and I would strongly invite you to check it out.

In an ideal world HIV-positive people wouldn’t face discrimination, but we have much work to do and education to get out there into the broader community. Campaigns such as ENUF and the Stigma Project have begun to challenge people’s perspectives, but the reality is we still desperately need the services of organisations such as HALC.

So I encourage you to be understanding of the difficulties HIV-positive people face due to HIV related stigma and discrimination. Do your part and help educate people about the facts on HIV in 2015 with these fun and informative BuzzFeed GIFs. You can also support the HALC campaign here

At the click of a button or get to know me?

Everyone has their own way of disclosing their HIV status and there is no right or wrong. A couple of month back Tyler Curry unashamedly wrote an article regarding how he approaches disclosure.

It drew all sorts of comments. However it did raise an interesting point. In America in gay culture it seems more common for HIV status to be provided on dating app profiles. I haven’t heard of people doing the same thing on RSVP or Tinder.