Lifestyle

Issue: 140

Charity begins at home?

As World AIDS Day comes round once more, many of us will be asking the question “What’s actually been achieved in combating this epidemic?”. In this edition, Jack Summerside explores whether part of the answer might be closer to home than you might think.

At the end of October I was privileged to be invited to Glasgow to speak at the opening of GayCon, the 2nd National Scottish Conference on Gay men’s Sexual Health and Wellbeing. Speaking at the opening of a conference is a tough gig because you know that the speakers and presenters that will follow you will be armed with all kinds of facts, figures, evidence that you don’t have.

So I chose to speak about ‘connecting with communities’ a theme that seemed general enough to be relevant to the diverse range of people working in health-care, social research and health promotion across different parts of the NHS, charitable organisation, universities and so on.

And, on sitting down to write this feature it occurred to me that what I’d been saying to that audience of people working in the fields of HIV and sexual health was equally relevant to those of us who just “live it”.

In short, what seems to work best in encouraging or supporting people to avoid becoming a sexual health disaster-area is the support, input, advice, or guidance from someone who is genuinely their peer – that is, not a Lord or Lady (that’s a different kind of peer altogether) but someone from the same community, with whom they have some genuine connection or similarity. That could be to do with HIV status, age, sexuality, ethnic background, sex or gender – or a host of other things that create genuine connection. At GayCon, there were lots of good examples given of the ways in which different organisations and agencies were supporting and enabling peer support to develop – from older gay men’s groups in Glasgow and Edinburgh, to newly diagnosed HIV positive people’s support groups, to online sexual health and relationship advice provided on some well known dating sites.

One of the problems with ‘formal’ or organised peer support is that, sometimes people don’t truly see workers (paid or unpaid) from an organisation as being their peer. And many is the time I’ve heard people talk about the “safer-sex police”– or something similarly pejorative but slightly less polite – about community based health promotion workers. I think that’s a shame, when often it’s those of us least likely or willing to engage with those knowledgeable and skilled workers who could actually do with the support and advice they can offer. It makes you think about why some of us are so resistant, or even downright hostile, to people who are there as useful resources – if only we’d get off our high-horses and bother to engage a bit with them.

It reminded me of the song which gave Charlene her biggest hit – revived in Priscilla Queen of the Desert. I mean of course:“I’ve never been to me”. The lyrics have Charlene more or less chasing some poor bored housewife down the street, shouting ‘Hey Lady’ after her. In short, Charlene spent her life putting it about a bit, and now regrets it. The housewife is fed up with dull domesticity, and perhaps rather wishes she’d had the chance to “sip champagne on a yacht/be undressed by kings/been to Monte Carlo.”

Charlene’s attempt at unsolicited peer-to-peer health promotion is pretty much doomed from the start on a few fronts. The first is that her life is so different from her chosen recipient that there isn’t much genuine connection to begin with. Secondly, her approach is all wrong: ‘Hey Lady, You Lady’ hardly seems like a good conversation-opener. Thirdly, Charlene’s motivating factor is “I wish someone had talked to me, like I’m gonna talk to you”. Now that’d have me thinking about calling 999, rather than opening up to a chat about the relative lifestyle merits of ‘moving like Harlow’ against being ‘a regimented wife’. Chances are that the bored housewife is going to leg it back home and end up like the one in The Ballad of Lucy Jordan. She’s the one who realises that at the age of 37 she’s never going to ride in a sports car through Paris with the wind in her hair – then goes off her rocker with boredom and frustration, climbs on the roof of her white suburban house and promptly gets carted off to Bellevue. Some set of life choices to be presented with! In a health promotion intervention in the style of Charlene, the recipient is simply going to feel envious and bitter: it’s a classic “Do as I say, not as I do” kind of situation, and that hardly works satisfactorily for either party involved.

Now I don’t know of any reputable community-based health promotion worker who pursues people to give advice against their will. But I do know a lot of us in our communities who behave as though something unpleasant or unwarranted is being thrust upon us when anyone involved in health promotion or available for sexual health advice comes on the scene. So what I’d like to suggest is that we are all a little bit more open to what’s available to us. The right to have access to accurate, truthful and, where necessary, graphic sexual health information was fought very hard for twenty years ago here in the UK. And in many parts of the world that fight has still got a long way to go before it’s won. So, what’s with the turning-up-of-the nose at it here for? Is it because somehow along the way it became a bit uncool and embarrassing to talk sensibly about looking after your own health, not to mention that of your partners?

The reality seems to be that the only places to go to get that conversation has, over the years, become kind of institutionalised. Right at the beginning of the HIV epidemic, safer sex advice was invented by the community, and spread by word of mouth between friends. There was nothing useful coming from government, nobody in the health services was really geared up for what was going on, and the existence of community organisations working on written information or advertising was a long way off. The early response was truly a community one. The gay community was well and truly up-against-it and we didn’t have anyone to fight our battles for us, so we fought it ourselves. Now it seems that, having founded some of the greatest community organisations ever, as individuals we sit back and want them to do everything. But without us in the community really participating, supporting, engaging, or coming together ourselves.

Margaret Thatcher famously said that there was no such thing as society, only people. And although it pains me to say it, there was a certain amount of truth in that. A community is only a community if individual’s take part in it. Gay community nowadays means either commercial bars and clubs, or one or two internet dating sites. London is one of the few European capital cities without any kind of a Lesbian and Gay (or BTQQ) Community Centre. It’s interesting that such a thing exists in Scotland, and several regional English cities, but not in the UK’s capital – a city with one of the largest gay populations in the world.

If I had a wish or a hope for World AIDS Day, it would be to convert all the hot air from those who like to say that health promotion and HIV prevention isn’t working into each of us taking some real concern in the lives of those close to us. For instance, if you have a mate who you can see is heading for disaster, be a proper mate and sit him or her down and have a good old chat with them. Not Charlene style, but making them feel cared for, concerned about – and knowing that they have someone to turn to for advice and support. That goes for sexual health, substance use, relationship bother, self-esteem – the whole gamut.

We’re very good at encouraging one another with stuff that’s not healthy – another cream-cake, another shag, another drink/cigarette/line of coke. That’s how peer-influencing works. But somehow we’re so much poorer at using that influence for more constructive ends. Partly because we’re afraid of a knock-back, of being perceived as a Charlene or a wet blanket. But that’s how we responded as individuals and as a community when HIV was new. And it’s never been bettered, no matter how organised we’ve become.

So, if you have a problem, speak to a mate. And if you’re a good one, make sure you’re there for them.

Now that’s what I call a community response. PN

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