How Do We De-stigmatize HIV But Still Persuade Gay Men to Protect Themselves?


UK-based gay men’s health charity GMFA yesterday released statistics regarding condom use and attitudes towards HIV among gay and bisexual men.

To me, the figures – for a country were PrEP treatment is not widely available – were shocking. Four out of ten said that the majority of sex that they had was unprotected.

Some of those who answered said that they had decided to do away with condoms because they were in long-term, monogamous relationships (or presumably what they hoped was monogamous).
Forty-two per cent said they are not worried about HIV

Of the single, HIV-negative men who mostly or only have condomless sex, 42% said they are not worried about HIV and 43% said they are not worried about other STIs.

Just over half said that current HIV campaigns don’t speak to them.

As someone who has worried about HIV ever since I first had sex, I find it hard to understand this cavalier attitude.

‘It’s far from a death sentence,’ said 24-year-old Lorne from Cardiff in the survey. ‘I’d prefer to have HIV than diabetes.’

Lorne is single and says he’s had condomless sex with 30 guys in the past year.

‘I endeavor not to decline someone based on their HIV status.’

Not declining sex with someone for being HIV positive is commendable, but that’s where my agreement with Lorne’s attitude ends. This probably highlights not only a gay generational gap, but also the mixed messages that gay men are being asked to process when it comes to HIV awareness.

I’m older than Lorne. I started having sex in the 80s and remember the UK government’s first, scary, tombstone-heavy adverts around HIV awareness. The blunt message was simple; wear a condom or die.

Thankfully, Lorne’s correct in one aspect; HIV is no longer a death sentence. The earlier you get diagnosed, the better your chances of living a long and healthy life.
‘The paranoia that some people have around sex with guys who are HIV is misinformed and outdated’

The main barrier to getting tested is the stigma that exists around being HIV. Some people would still prefer not to know until something goes wrong. Or they simply don’t understand that they have put themselves at risk.

‘I presume most who have HIV are on treatment so are safe,’ said another of those surveyed.

Because of this, sexual health charities have spent great effort in tackling the stigma around HIV. Again, I applaud this: the paranoia that some people have around sex with guys who are HIV positive is misinformed and deeply outdated.

But has this now left us in a Catch 22 situation?

Have we gone so far in de-stigmatizing HIV that a significant number of younger gay men believe it’s no big deal?

On the one hand, we want gay men to protect themselves when they have sex, but on the other, some sexual health charities have highlighted the fact that those who are diagnosed and on medication may live slightly longer lives.

This is not because of any special health benefits from the antiretroviral medication, but simply because they’re more likely to be having regular check-ups with a doctor every 3-6 months and may quicker find out if there’s anything wrong with their health (men being notoriously slow to contact their GP if they think there’s something amiss).

We’re warned that if you’re on treatment you’ll have to take a daily pill for the rest of your life.

Taking a daily pill is an inconvenience but a relatively minor one. In fact, given that Muscle Marys proudly post photos on social media of all the vitamins and other supplements they take each morning, I can’t imagine the thought of adding another to the mix is a huge dissuasion.

The recent, pan-European PARTNER study examined sero-discordant couples (where one was HIV positive and one was negative). The positive partner was on treatment and had an undetectable viral load. Each couple had abandoned condom use.

Of nearly a 1,000 couples studied over a two-year period there was not one incidence of HIV transmission from one partner to the other.

This is great news. To me, it means it is tantalizingly within our reach to halt the spread of HIV if we can convince everyone to get tested and – if they’re negative – to continue to get tested regularly. But just as we’re frustratingly close, many gay men seem to think it’s OK to abandon safer sexual health practices.
Grindr is still heavily populated with men who only want to have sex with you if you’re ‘disease-free’

Besides encouraging people to test, what exactly is the message we should be sending out to them?

Well, we could start by highlighting the fact that, despite some of those surveyed, Grindr is still heavily populated with men who only want to have sex with you if you’re ‘disease-free’.

We could highlight the side effects of the antiretroviral drugs and the rise of untreatable, so-called super-gonorrhea and hepatitis.

GMFA think that more needs to be done to bolster the self-esteem of gay men; to encourage them want to protect their health. Again, I’m not disagreeing. We need to arm them with a response to have in their mind when that really hot guy they’ve dreamed of shagging says he doesn’t like using condoms.

We need to remind them of the importance of getting tested regularly; to not rely on the results of a test they – or their sexual partners – had seven months ago.

Looking at the weapons we now have to halt the spread of HIV – condoms, antiretroviral medication, PEP and PrEP – I can optimistically imagine a HIV-free future for generations to come; but only if we don’t drop the baton so close to the finish line. – Read more at: