Tag: HIV prevention

  • Why Not Have Sex With Someone Living With HIV?

    Why Not Have Sex With Someone Living With HIV?

     “Positive Sex ideally would involve disclosure being met with acceptance and understanding, not rejection and stigma. Positive Sex would involve the elimination of terminology that is discriminatory on the dating scene and a shift within the public whereby people would consider dating a person living with HIV, without fear or stigma.”- Gail from the HIV Disclosure Project.

    The HIV/AIDS pandemic of the 1980s led to a surge of condom campaigns. Now when we hear the term “safe sex” we immediately associate it with male condoms, the Pill, unwanted pregnancy, STIs. HIV transmission is discussed in sex education, but what’s neglected are the specifics about HIV as it is today: how it is manageable, what “undetectable” means, why terms like “clean” are harmful, what the hell is PReP (Pre Exposure) and PEP (Post Exposure Prophylaxis). And we certainly never discuss the possibility of having a healthy sexual relationship with a person living with HIV.

    The reason is because, frankly, there is still fear associated with the virus. People like Gail, Jessica and Jolene, founders of the HIV Disclosure Project, know that HIV stigma persists just as it did 30 years ago. It permeates our fears of “death, dying, contracting the virus through protected sex, casual contact, fear of dating a person who is living with HIV as others may think they are positive as well (guilty by association). Fear that people living with HIV are highly contagious”, Gail describes in our interview. “Many people know the facts about transmission and yet are afraid that there might be some “unusual” accident which will lead to infection.”

    The Stigma Cycle

    Image from the HIV Disclosure Project Facebook Page
    Image from the HIV Disclosure Project Facebook Page

    Safe sex messages have traditionally been built on fear and as a result, the campaigns have failed miserably; from that fear is born stigmatization and prejudice against people who are HIV-positive. People who choose to disclose their status risk being verbally and physically abused, risk rejection and isolation, risk discrimination by being “outed” (loss of control over who knows their status), risk discrimination in the workplace, schools, with housing, health care and violations of basic human rights. People are deterred from getting tested and treated regularly; it results in silence about one’s status; thus the virus continues to be transmitted. “It’s what we refer to as the Stigma Cycle,” Gail explains.

    To fight the stigma born out of fear, the HIV Disclosure Project facilitates open discussions about how to make the dating scene more inclusive of people living with HIV. “We provide a safe, non-judgmental space for people living with HIV to role play, practice a variety of techniques for disclosing if they choose to, while aiming to empower individuals to have options, externalize stigma and challenge public perception of people living with HIV. We want to have PSAs (public service announcements) that ask the question – Why not have sex with someone who is living with HIV?”

    HIV DisclosureThe HIV Disclosure Project

    The idea for the Project started with three colleagues- Gail, Jessica and Jolene -who saw a need for a supportive workshop where people living with HIV could “discuss, disclose, practice disclosure, find comfortable and timely ways to gauge when to disclose or not, and to process feelings that derived from stigma and rejection,” Gail says.

    “People living with HIV also needed a space where they could challenge and change dating terminology which perpetuated stigma and fear of HIV, including terms such as “clean”, “disease free” and “dirty”. New terminology was needed to describe one’s status that excluded negative connotations and included acceptance, tolerance, and a willingness to consider dating a person who is living with HIV.”

    At the time, there were no written manuals on disclosing HIV to sex partners. Granted funding from ACCM (AIDS Community Care Montreal), the three colleagues wrote a manual titled “Positive Sex” and designed a pilot workshop that resulted in much success. The Disclosure Project received further funding from the CIHR (Canadian Institute on Health Research) through CTAC (Canadian Treatment Access Council) where Jolene works as Program Manager. Workshops are now being implemented across Canada in collaboration with ACCM. Jessica facilitates these workshops.

    I asked Gail how we might de-stigmatize sexual relationships for people living with HIV. The answer might seem controversial but it reflects upon the fear tactics that are often utilized in government supported sex ed programs and why we need to adopt Positive Sex frameworks in public health.

    “What needs to be reinforced in the mainstream are the basic facts about HIV transmission and repeated public service announcements and education which tells the public that it is socially acceptable to have safe sex with a person living with HIV, that having sex with a person living with HIV does not mean they are going to contract HIV. There are many sero- discordant couples who have been in long term relationships where the HIV negative person remained negative.”

    “Positive Sex” is the new “Safe Sex”

    Image from http://www.ctac.ca/positive-sex
    Image from http://www.ctac.ca/positive-sex

    Gail, Jessica and Jolene bring up an important point about the meaning of “safety” that is taught in sex education. What’s often overlooked are issues of emotional safety, such as consent and self-esteem, that are both cause and effect of sex. Few curricula teach consent or communication in a way that is relevant to sexual diversity. Instead, outdated sex education shames discussions of sexual pleasure and desire, and the different types of relationships humans are a part. The Disclosure Project views this type of shaming in opposition to what is positive sex.

    As Gail explains, “Positive sex to us means finding ways to successfully disclose one’s HIV status while not feeling threatened, stigmatized or experiencing any negative reactions while disclosing. Positive Sex also involves challenging and changing public perceptions of people living with HIV. In the past, safe sex campaigns were based on fear and as a result, thirty years into the pandemic, there are many misconceptions that perpetuate fear and stigma which need to be challenged.”

    “Positive Sex ideally would involve disclosure being met with acceptance and understanding, not rejection and stigma. Positive Sex would involve the elimination of terminology that is discriminatory on the dating scene and a shift within the public whereby people would consider dating a person living with HIV, without fear or stigma.”

    To learn more about The HIV Disclosure Project follow them on twitter @sexpartnersHIV. Like their Facebook Page for daily prose, thoughts and poems related to HIV and disclosure.

    For information on HIV transmission, prevention, safety and risks refer to ACCM and CTAC.  There are a lot of them, but other helpful resource are: CareXO.com, the YAHAnet (Youth, the Arts, HIV & AIDS Network) and The Life Foundation. There is also an excellent article by The Body.com with medical information about the risks HIV transmission when having sex with someone who has undetectable viral levels.  Keep yourself informed!

  • #WithoutShame: Storytelling about HIV

    #WithoutShame: Storytelling about HIV

    To combat the spread of HIV and stigma, we need honest discussions that go beyond politically correct ways of representing today’s realities about the virus without oversimplifying and shaming. That is what these two digital stories offer. Watch and listen.

    btp_logo_printReal life storytelling is a powerful way to raise awareness about HIV and stigma. Stories not only convey information but they also communicate values that relate the storyteller and the listener in more nuanced ways. The Banyan Tree Project, run by the folks at The Asian & Pacific Islander Wellness Center, has utilized this human resource and extended it to Twitter chat.

    Viewing Stories on Twitter #BTPChat

    They launched a digital storytelling initiative to combat HIV-related stigma in Asian and Pacific Islander communities. For those of you that don’t know, digital storytelling is a workshop-based practice in which participants write their own first-person scripts, record narration, select and scan images, add music, and make 3-4 minute digital videos- in this case, about one’s experience with HIV. The digital stories are uploaded on the project website and have been shared in panels, conferences, and other community discussions to provoke dialogue and community change.

    This is how I learned about the Banyan Tree Project (BTP) and watched the two digital stories posted below. BTP organized 5 weekly Twitter chats with guest including TheBody.com and the USA Positive Women’s Network, among others, and framed questions based on digital stories they shared.
    You can follow and participate in the chats by following @BTPMay19 and using the hashtag #BTPChat.

    June 6, 2012, there will be a #BTPChat about HIV and Youth with the Youth, the Arts, HIV & AIDS Network (@YAHAnet). It starts at 5pm Eastern /2pm Pacific Time and runs for an hour.

    BMCww-aCMAE5bnA
    Image from @yahanet

    HIV and Gay/Bi Men #BTPChat

    Last week’s topic was about men who have sex with men and HIV with the National Minority AIDS Council (@NMAC AIDS). Tony’s digital story initiated the chat. Sharing his experience of grief and denial, Tony emphasizes the need for community support which includes the important role of family and friends.

    (All videos from the BTP can be watched on their website)

    Following the video, @BTPMay19 tweeted these questions for us all to respond.

    1) Tony says “Know your status, get tested, seek treatment, find support.” What do gay/bi men need in order to do this?

    2) Tony most likely contracted HIV decades ago. How has the gay community’s perception of HIV changed over the last 30 years? #BTPChat

    To-the-point answers (you have to be, it’s twitter!) from various HIV outreach professionals and activists rolled out. I’m REALLY generalizing here but comments ranged from issues of disclosure and stigma, the need for everyone (not just poz folks) to have updated info on the manageability of HIV; and the urgency of different ways to frame HIV facts that resonate with different communities.

    In the second video “Side Effects”, a sexual health educator candidly explains what led to his choice to have sex without a condom. He reveals that he’s secretly on post-exposure prophylaxis (PEP) and works through his guilt.

    The #BTPChat question posed were:

    1) PEP/PReP can protect against HIV exposure. What do you think this means for gay/bi men relationships?

    2) What challenges do gay/bi men still face when getting tested/treated for HIV?  #BTPChat

    Also, one of the guest moderators, @NMAC AIDS, asked if this storyteller is a hypocrite and if outreach professionals would use this video when teaching prevention? Again, I’m writing a very simplified overview but I think it’s fair to say that most twitter participants felt this story was the kind of frank discourse needed to tackle taboo subjects like drugs and unsafe sex. Every participant seemed to express support for PEP/PReP stating that it offers more options for different relationships and circumstances. Comments did touch upon the inaccessibility of PEP/PReP due to high costs. It was also emphasized that such treatment must be coupled with promoting regular testing and condoms use in appropriate circumstances. Other participants mentioned that condom stigma needs to be taken more seriously by activists.

    Post-Thoughts?

    The creation and (careful) distribution of these digital stories have potential to make people rethink assumptions about HIV issues and stereotypes of people living with the virus. These are not HIV experiences typically represented in national public discourse. You will not find them in H&M or state-funded sex ed classes. In some ways, they uphold harmful stereotypes that reduce people with STDs and infections as deviant and careless. The storytellers admit to dissent, recklessness, negligence and guilt. But that is the power of these stories- honest talk that keeps it real.

    They expose the trickiness of discussing HIV-related topics without subconsciously casting moral judgment. People are slutty, people are negligent and irrational, people use drugs and take part in abusive relationships (be it with themselves or another).

    However, these digital stories are not innately effective at combating HIV stigma and posing discussion. They require careful framing.  Dialogue needs to be monitored and kept tailored for particular audiences in order to respect the storyteller and effectively combat myths and stigma that might be decoded by the audience. I think the people at APIWellness who run #BTPChat do a great job at this and I hope they continue to twitter #withoutshame.

    What are your responses to these digital stories and the #BTPChat questions?