How we have failed gay men
The 2001 Gay Men's Sex Survey, Know the Score,
has been published. "No evidence of an increase in 'HIV complacency'
among gay men," says an accompanying press release from the Terrence
Higgins Trust. This is because 97 per cent of gay men, when asked, agreed
that "HIV is still a serious condition".
We think the press release is a tad complacent. Gay men may think HIV
is serious, but that hasn't much impact on what some do.
Last year, twice as many gay men caught gonorrhoea than in 1998; three
times as many, chlamydia; fifteen times as many, syphilis. As for HIV,
1,400 UK gay men, give or take a hundred either way, have become HIV positive
every single year since 1988.
That's nearly 20,000 too many. A 'successful' HIV prevention campaign
would at least bring the HIV rate down; at best, to zero. Why, despite
squillions spent on safer-sex campaigns, are they not working better?
We think gay men's HIV prevention has made three mistakes.
One: it's tried to reduce HIV transmission by changing gay men's behaviour
rather than directly cutting infection risk. Imagination and dosh have
gone to waste on persuading gay men to 'love and respect' each other,
to quote GMFA's campaign. A worthy aim. But behaviour change is too slow.
Such campaigns might eventually produce some very loving, sorted...HIV
positive gay men. In the same way, if you tried to cut HIV by weaning
heroin users off needles, instead of providing clean ones, you'd end up
with some sober, strong...HIV positive ex-junkies.
Two: it's targeted wastefully. The journal Nature recently said that there's
no such thing as a 'medium' number of sex partners, even among gay men.
Most have a few; a few have a lot. Target the few with intensive medical
interventions specifically. Know the Score reveals that just one-eighth
of HIV negative gay men are the 'busy boys' who have sex with more than
30 partners a year. They're also more likely to have unprotected sex.
This makes them 20-50 times more vulnerable to HIV.
page 1 of 2
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These guys are identifiable - they show up at GUM clinics. You don't lecture them. You don't send them to counselling, or not anyway with the sole aim of making them use
