4 min

Kick-starting the discussion

Time to re-invigorate HIV prevention

Credit: Robin Perelle

If the recent screening of The Gift was anything, it was an opportunity to begin talking again.

It brought out the curious and the concerned and what ensued was the most important community dialogue about HIV in the gay community that I’ve witnessed since the mid-’90s.

The documentary from San Francisco was shown recently during the Out On Screen festival to a sold-out crowd. The screening generated so much interest that people were turned away after waiting for hours in the hope line. Folks came as much to see this disturbing and provocative documentary as to hear Dan Savage and the other panelists make sense of the phenomenon of gift-giving and bug-chasing (willingly offering HIV to someone seeking infection, and intentionally seeking HIV infection).

As the moderator of the panel discussion that followed the screening, my role was to stimulate discussion and keep things on track. My job that day was an easy one. Xtra West editor Gareth Kirkby, Carl Bognar, Michael Botnick, Dan Savage and the audience members did a fabulous job of keeping things flowing. The documentary incensed the crowd sufficiently and people didn’t want to hear excuses or complicated explanations. They had questions and they wanted clear, simple answers.

I think some may have wanted blood.

The debate that occurred is not unlike many a debate occurring right now in gay men’s communities across the globe. Sexual behaviour norms within the gay community that were adopted in the ’80s, and maintained through the early ’90s, have changed.

HIV infection rates are rising once again and there seems to be a complacency regarding the impact of living with this terminal illness. Guys with HIV are living longer than before which, to put it crudely, means there is more HIV in circulation.

The question on everyone’s mind is : What’s being done about it?

I first heard about bug-chasing and gift-giving about five years ago. I saw it on the Internet where it was being eroticized as the ultimate in sexual intimacy. I also saw sites where folks were sticking their heads up horse butts. I found the former slightly less repulsive but at the time I thought they were probably practiced to the same degree.

Seven years ago I heard about barebacking. It was around the time of the International Conference on AIDS that took place here in Vancouver.

HIV-positive guys were talking quite openly and comfortably about a choice they were making about condom use with other HIV-positive partners. What I was hearing was “if I’m already positive what’s it going to hurt to get HIV again-if that’s even possible.”

At the time there was no definitive position regarding the existence or impact of infection with multiple strains of HIV, and we knew way less about drug resistant viruses than we do now.

After years of using condoms and not really feeling entirely satisfied, some HIV-positive guys were willing to take a risk.

It was the same way with HIV-negative guys. At the time, HIV-negative guys were starting to talk openly about not using condoms when they fucked other HIV-negative guys. It was a controversial idea, perhaps, but not one completely without merit.

It was about this time that the last large-scale community mobilization occurred to pressure policy makers and funders to keep up the fight against HIV. Vancouver’s Downtown Eastside was also being identified as the Western Hemisphere’s hotbed for HIV and Hepatitis C infections among injection drug users.

And it was about this time that a concerted response to HIV prevention for gay men really started to flounder.

From there it was all downhill, really.

Little by little it became more and more difficult to do HIV prevention in the same old ways. In some cases that was a good thing. For instance, fear-based HIV prevention was believed by many to be outdated.

Not only did gay men have no stomach for it, it was clear that there were negative impacts on the very guys they were trying to reach.

It was hard enough for many gay men to deal with the shame of being gay and the fear of AIDS as an inevitable outcome of their dirty desire. Using shame and fear as tools to try to save their lives only served to alienate them from HIV prevention efforts.

But there was no money for HIV prevention campaigns targeting gay men anymore, anyway. Not from the government and not from the community.

This is some of the context for HIV prevention over the last seven years. And it’s in this context where discussions to illuminate the meaning and impact of barebacking, gift-giving and bug-chasing, among the plethora of issues swirling about, failed to really get started.

So, with all this going on, what’s been happening to ensure that gay men’s HIV prevention needs aren’t completely forgotten?

Well, there has been a handful of men and women working behind the scenes trying to re-invigorate HIV prevention for gay men. Not in ways that are ineffective throwbacks to the early days. Rather, they have been working to address issues at a social and cultural level that contribute to a gay man’s vulnerability to HIV infection.

Homophobia, for instance. This same homophobia that led to the de-gaying of AIDS to such a degree that a paltry one percent of provincial dollars spent on AIDS went to gay men’s HIV prevention.

HIV prevention campaigns were once the vehicles for sustaining community-wide discussions about this horrible and fucked-up disease. These take money, creativity and a broad perspective. Believe me when I tell you we have the creativity and the perspective.

And I’m happy to say that, finally, we also have a little bit of money. It’s not enough, but it’ll get us started again. And we won’t, won’t, won’t be going down the road of shame and fear.

We’ll tell the story straight but we won’t crush people’s spirit in an attempt to save their lives. Not HIV-positive guys and not HIV-negative guys.

I think Out On Screen and the panelists in the discussion provided us with an invitation. It doesn’t matter what your position is on The Gift-just have one. And be willing to stand up and state it.

HIV is not going to be solved by HIV prevention organizations. It’s going to be solved by the community. That’s you.

* Phillip Banks is the coordinator of Gayway, Vancouver’s new holistic gay men’s health program. Gayway will host an open discussion called Negotiating Safer Sex-Is Barebacking a Problem? Sep 24, from 6:30-8:30 pm, at 913 Davie St. Register in advance by calling 604.682.3900.