If the Australian economy was growing as fast as the rate of new HIV infections then the world’s best Treasurer would have a reason to keep smiling. When considering Blood Borne Virus (BBV) and Sexually Transmitted Iinfections (STI) prevention, it is interesting that in an era when smoking is demonised via graphic campaigns, in the world of HIV education it seems nobody uses the term AIDS anymore!
Australians are increasingly complacent about HIV. The message seems to be: “Medical advances allow infected people to continue working and living a relatively normal life, and soon there will be a pill for prevention”. Reminder messages suggestive of mission accomplished and containing unqualified truths are unhelpful to the long-term health of both people living with HIV/AIDS and the broader community.
There is no cure all pill for HIV, and many positive people who use HIV medications continue to experience chronic ill health and adverse side effects from treatments. The suggestion by some service providers that PLHIV are all well and working may well be a policy strategy to rationalise decisions and hide cuts made to support services for positive people.
Current media campaigns to slow and reverse the spread of HIV and AIDS are clearly not working. The only way to build community behaviours to prevent HIV infections and to stop AIDS in ANY community is to have people on the ground delivering simple safe sex messages via pamphlets and posters at real time events.
Various sub groups respond differently when it comes to addressing sexual health interventions. Language surrounding HIV transmissions in heterosexual populations seems to use words like ‘accident’ and other unperceived risk factors suggesting information shortfalls leading to infection. As STI’s are often a precursor to HIV, it should be alarming that the rate of Gonorrhoea cases in north-west Western Australia is double the number measured for the whole of Metropolitan Perth!
The language about Men who have Sex with Men (MSM) infections sounds culturally different, and includes terms like drugs, bare-backing and ‘don’t ask don’t tell’ practices. There needs to be a serious re-evaluation of the strategies being used here, and a discourse about real risk factors, such as ’Why do HIV negative Gay Men who know about HIV still choose to engage in high risk behaviours, even when they know they shouldn’t?’
For AIDS Organisations an unintended side effect of the push to the online world is that gay men or MSM are no longer an easily accessible hegemonic group. The internet provides MSM and gay men with tools to connect for sex, but unlike Sex on Premises Venues there is no condom handed out at the door and as STD rates suggest, no time for safe sex discussion either! As the Queensland “situation” demonstrates, “the bowl of condoms at a gay party strategy” is not worth funding, so a new approach is needed.
The current “business as usual” model of providing non-judgemental treatment of infections should be questioned. HIV negative gay men regularly presenting for treatment of STIs may have a lifestyle problem or complex psychological issues. Regardless of sexual orientation the most reliable way to influence safe sex behaviours is through face to face contact with a person.
When HIV first appeared it was a combination of the gay community’s swift action to spread the safe sex message, and support given to HIV positive people that were most important in reducing infections. In modern gay culture, we like to appear to be very good at dealing with diversity and discrimination, but the truth is HIV+ gay men regularly experience discrimination within the gay community.
Safe-sex education needs to be made part of mainstream education. Instead of government funding large media campaigns, health promotion professionals need to ensure that basic information and safe sex reminders in the form of pamphlets and posters are produced and distributed for all communities.
It would also be helpful if all school curriculums resulted in students graduating with a skills based approach to sexuality and health education, so that good management is the main determinant of health outcomes, and not good luck.
It is sad that one of the most inadequate websites is the Travelsafe website, produced by the Commonwealth government. This site leaves the impression that preventing you from breaking a nail overseas is more important than telling you how to stop yourself getting infected with AIDS.
Complacency and inaction about STIs and a fear of talking about sex and sexuality seems to permeate Australian society. At a government level there is no single national standard or benchmark in terms of mandated level of support for PLHIV and prevention is funded with few really rigorous and/or results driven measures of accountability.
HIV never goes on holiday. Generally, little thought is given to why the new infection rate among gay men is greater than the mainstream community. It is time to ask why gay men continue to expose themselves to HIV at higher levels than the broader community, and to have known HIV negative risk takers become more accountable for their own health.
The gay community needs to have a real conversation about gay sex practices and risk taking. If websites can be made for people who bareback then why can’t targeted messages also be made to drive behavioural changes and reduce HIV infection amongst risk takers?
Australians are not talking about disease and infections when it comes to HIV and AIDS and you are unlikely to see posters at the airport talking about why it is important to use condoms overseas.
If Australia wants to go back to being the lucky country on all things HIV and AIDS then it’s time to get serious and have new common-sense driven HIV AIDS education and management strategies.
Australian governments have a dubious track record when it comes to supporting people with HIV/AIDS. The current approach of distributing HIV medication through inner city pharmacies during business hours only is at odds with the way people live their lives.
Support for positive people has long been known to be integral to keeping rates of infection lower. Safe, professionally run, non sectarian, drop in centres should be available in each state and territory and if not then government needs to fund peer led groups to help fill the gap.
If the new Queensland ministerial advisory process results in HIV prevention strategies that have vigour in the media and science shows they reduce disease transmission then that must be applauded. If the single biggest problem causing rates of infection of all BBV and STIs is lack of campaigns in the media then Queensland’s decision to stop funding failure has at least got us peanuts in the press gallery chattering.