‘It’s a bit like a never-ending tsunami,’ prof says of HIV

Beyond Behaviours gay men's HIV conference held in Vancouver


Poor body image is affecting the happiness of gay men, according to results of the 2011 Sex Now Survey, presented at a recent gay men’s health conference in Vancouver.

“It’s one of those issues which comes out very prominently in gay men — particularly with reference to bisexual men and straight men in this survey — that gay men are much more conscious of these things and much less satisfied with their own bodies,” says Terry Trussler, of Vancouver’s Community Based Research Centre (CBRC), who presented these findings at the Beyond Behaviours conference at SFU Harbour Centre on April 15.

“They aren’t happy with their body, and so we see this in wanting to lose weight, wanting to feel more muscular, wanting to present better to their guys; that’s the best way to put it,” Trussler says.

“So this comes in a lot of different ways. It comes in gay men’s eating habits, it comes in exercise, and so there’s a lot of gay men who are members of gyms because they are trying to muscle up and lose weight and so on.”

Beyond Behaviours: Uncovering the Social Production of HIV Epidemics Among Gay Men was hosted by the CBRC in collaboration with Universities Without Walls and followed the Canadian Association for HIV Research (CAHR) conference, which took place in Vancouver from April 11 to 14.

“Over the years [CAHR] has not made as much room for gay men’s research, particularly the research that is trying to challenge the dominant biomedical model,” says CBRC research director Olivier Ferlatte.

“There are always a lot of people travelling to the CAHR conference,” Ferlatte adds, so CBRC conference organizers hoped to engage people nationally, who were already coming to town for the larger HIV conference.

The participants of the CBRC conference, which attracted 90 attendees, attempted to move the discussion of HIV beyond condoms and risk to address some of the social factors that come into play with respect to gay men and HIV.

“There’s a lot of us that have been pushing for this agenda to stop looking at HIV risk and try to go beyond behaviour, which was the theme of the conference,” Ferlatte says. “We have been having this conversation for such a long time, but I don’t think we’ve had it in such an organized way. So hopefully, that will help us because we all feel challenges to go beyond this and do the research in our practice.”

The CBRC conference opened with a talk by Adam Isaiah Green, an associate professor of sociology at the University of Toronto who provided an overview of the history of the HIV epidemic and the various approaches to the epidemic.

 

“The point is that unprotected intercourse is determined by so many different factors that one might rightly ask if the very question that you’ve been asking for 30 years — ‘Why do gay and bisexual men have unsafe sex?’ — is not the right question at all,” he says.

“Ironically, the very question ‘Why do gay men have unsafe sex?’ seems to rest upon the assumptions and roles we are trying to fight against, which is the assumption of the rational actor whose practices will respond appropriately to protect his health, putting his safety before pleasure.”

Scott Harrison, a nurse for Providence Health and president of the Canadian Association of Nurses in AIDS Care, suggested the prognosis was not looking good for young gay men who, he says, are not getting an adequate sex education.

“We still see, unfortunately, lots of very young gay men, 17 and 18, seroconverting or coming to us with sexually transmitted infections after their first sexual debut, and they really know very, very little about their own bodies: how it functions or what gay sex even looks like,” Harrison says. “They learn what it looks like when they got a dick in their hand and it’s a bit late.

“Their heterosexual counterparts have much more input in the schooling system regarding safe-sex practices, and a lot of young gay men are learning about sex by watching porn, and they wonder when you stick a dick in without lube they go ‘ow’ and not ‘yeah.’”

Green says that studies regarding HIV transmission among men who have sex with men in North America, Western Europe, Scandinavia and Australia suggest that prevention work has not abated HIV transmission.

“It’s a bit like a never-ending tsunami,” he says. “HIV continues with wave after wave of new infection, so just when we think we may have the upper hand on the virus it seems to elude our prevention campaigns, or it calls for a continuous reinvention of those campaigns and adaptation of those campaigns to ever-changing target populations.

“Indeed, with respect to ending the HIV epidemic once and for all, we may indeed need to move beyond behaviours in some sense.”


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