CATCHING HIV IN THE NET
With half of all gay men now meeting online, are our sexual health and HIV prevention messages outdated, asks Gus Cairns
HIV prevention for gay men in the UK isn’t working. Diagnoses in this group have risen 40 per cent since 1999. And new infections among gay men in 2003 are expected to top 2,000 for the first time.
Our Government wants to slash new infections in gay men by a quarter by 2007, yet, instead of going down, numbers are rising at a frightening rate.
HIV Hotspot
It is a common assumption that HIV rates among gay men are rising fast everywhere. This is not the case. In the US, new cases among gay men in San Francisco, New York and Seattle increased 12 per cent in the same period - far lower than in the UK - despite moral panic about crystal meth and Viagra fuelling bareback mayhem.
When HIV positive Brits were asked if they had had unprotected sex with a casual partner who was, or might have been, HIV negative, one in three said ‘yes’. In Amsterdam, just one in nine gay men answered ‘yes’ to the same question.
Ford Hickson, of Sigma Research, a partner in The Community HIV and Aids Prevention Strategy (CHAPS), believes HIV prevention campaigns that focus soley on public health risk demonising gay men.
“If you read Health Protection Agency press releases, you’d think the HIV increases were among UK heterosexuals. The DH spent millions on their Sex Lottery campaign that targeted heterosexual teens. Most money is spent on the people least at risk.”
CHAPS counters this by concentrating on people at highest risk: urban gay men with lots of partners. But Ford thinks they can do more.
“We have to press Primary Care Trusts (PCTs) to cater for the gay men in their midst. And then there’s gay marriage. Instead of asking ‘how can we keep him safe when he’s fucking in a backroom’, perhaps we should be thinking ‘why isn’t he tucked up in bed with his husband?’”
Internet interventions are also vital. “The internet has led to increases in the number of men who have sex with men, and the number of partners they have, and the proportion who fuck, protected and unprotected.”
2D prevention, 4D world
But how does campaigning for gay marriage, or producing posters telling gay men to be nice to each other, improve their sexual health?
“I challenge you to go into a UK gay bar, pick up any HIV prevention leaflet, and find a clear statement why you shouldn’t catch HIV,” says Yusef Azad, senior policy officer with the National Aids Trust. And Azad is not the only one who thinks we’ve got it wrong.
“Gay men’s encounters are in real time,” says Mark Watson, managing director of www.uk.gay.com, the UK’s second-largest cruise site after Gaydar.
“The Internet is a 4D area and we have 2D prevention campaigns. Click on the THT’s gay men’s prevention resources links and you’ll get poster pdfs.
“On our message boards people always say, ‘I don’t know how I got HIV? I don’t think I have a very extensive sex life.’ What they mean is they don’t identify with the guys in the safer sex posters.”
Watson reckons the UK does some things well, like Aidsmap. “It’s a smart site for smart people to look up the latest HIV news. But who’s smart with his hand on his dick at 5am?”
He sees no point building separate sexual health sites as prevention messages are needed where guys are cruising. “GMFA and partners spent £10,000 on setting up www.metromate.org.uk. Then they spent zero on making anyone aware of it.”
And he bemoans demonisation of the Internet. “It enables people to meet where they don’t feel they will encounter social disapproval if they talk about fucking without condoms. That discussion is not about ‘deliberate infection.’ It’s about guys discussing condom use - and being poz - in a place where it doesn’t feel unsexy to do so.”
SafeSexCity
Californian, Frank Strona, founder of www.safesexcity.com says research shows guys in cyberland who say they’re always ‘safe’ get fewer hits. “Talking about safe sex is a turn-off. You’re seen as prissy or judgmental.
“This site is for guys who want safer sex but find it difficult to resist at 3am and when they haven’t had a hit for five hours and some hot guy messages asking to do it bareback.
“There is only one membership condition for SafeSexCity; you are a guy who uses condoms, no matter how high or horny you are.”
So far the site has 1,600 members but numbers are expected to grow following a publicity campaign in January.
What works
Deb Levine runs Internet Sexuality Information Services www.isis-inc.org, a not-for-profit organisation with new and effective internet interventions.
She helped devise a syphilis testing campaign (www.stdtest.org) that offered theatre and book coupons in return for getting a test, and banner ads on cruising sites.
The banner ads got 32,000 hits in two months on gay.com and 5,000 redeemed their test coupons.”
Levine says: “Interestingly, it wasn’t the ‘have safer sex’ banner ads that people clicked on; it was the most the scary one; a picture of a syphilis sore.”
Another successful campaign offered anonymous STD on-line partner notification.
Frank Strona says what doesn’t work is local organisations volunteering to do chat room work. “The last thing you want when you’re cruising on the net is to have some health worker message you. Guys get very cross. Message boards, newsgroups and plain old banner ads, especially for testing services, seem to work better.”
Reaching the unreachable
Mike Siever, a poz gay man from San Fransisco runs www.tweaker.org, an award-winning website for gay guys who use crystal meth.
The site offers sex stories, tips on safer injecting and maintaining safety when high and even the beginnings of a gallery.
“We had to fight really hard to keep the feel of the site campy and light,” says Siever. “A lot of guys - especially ex-users - wanted to have a heavy ‘don’t do what I did’ message. But you’re not going to reach a guy who’s actually using and having a lot of drug-assisted, unprotected sex with heavy messages.
“We know we’re succeeding, because we get a lot of guys writing into the forum who are clearly high - we have to correct a lot of typos!”
Tweaker.org links with www.magnetsf.org, the website of a unique gay men’s sexual health centre which runs exhibitions, performances, and a once-weekly meet for men using crystal.
“The whole idea is to use the internet to revive a sense of community, when the conventional wisdom is that it’s destroying it,” adds Siever.
