.

are evidence of that. Now, stigma seems like - well, jelly on a plate. It’s still a bit hard to contain, to come to grips with, but we know better now the nature of it and what it looks and tastes like. Quite well, in fact, I’d say.

Too well, I wonder?  Have some of us become so sensitive to stigma that we see it lurking behind every bush? Here’s an experience that just happened to me this week that caused me to ask that question.

I’m a researcher (believe it or not, because that is soooo not my background) working on a trial intervention with poz guys. The objective is to see if a group of guys’ approach to risky behaviour can be changed by a series of group sessions which stress a holistic approach to sexual health. It’s largely untried, anywhere, and potentially very worthwhile. The normal way to fund research like this is to approach various bodies for grant money. One such body, an incredibly esteemed one here in our province, turned down our application. That’s OK, we can likely resubmit. But in declining us, the reviewer - a behavioural scientist (I imagine) experienced in HIV research who remains anonymous - made what I thought were some startling observations.

 “Despite continued unprotected anal intercourse among HIV+ people, an overwhelming majority of HIV prevention efforts continue to focus their efforts on HIV-individuals. This is problematic because working with men who are already HIV+ has a greater impact on the epidemic than focusing on those who have not yet acquired the virus“ he said.

Now this struck me as stigmatizing us poz guys - and I said so. It seems to be fingering positive gay men as drivers of the epidemic, when we know - or at least we should know - that they are not. Here are the facts one last time. the majority of new infections come from so called “neg guys” who aren’t aware of their positive status. Talk that suggests otherwise, I think, is stigmatizng, and I’m finding it increasingly annoying.

But in raising the issue of stigma lurking in the response to our grant application, I also raised the question of whether I’m being a little bit too sensitive. Has participating in this campaign led to me seeing stigma where it’s either not there, or perhaps more likely, not intended?

I honestly don’t know.

What I do know is that I’ve learned a lot. We all have here, I think. We’ve learned about how we think about stigma, about sex and about life. We’ve learned about strength, and about frailty. We’ve learned about our community too - about some of its very real strengths and some of our collective weaknesses we need to work on. We’ve learned to listen. We’ve learned to be respectful but we’ve also learned to be opinionated when we need to be (We’ve seldom minced words here.) We’ve learned about technology too and new ways to play with it, to exploit it and to explore it in future. And we’ve gained new friends. (If we’ve gained some enemies in the process too, they’ve been well-behaved ones.)

There are people who’ve left comments here - lots of them - that I only know by their first names, I’d love to meet them in real life and carry on these conversations over coffee. Perhaps one day I will. But to everybody who has dropped by and who has contributed to the discussions - or not (we have had lots of lurkers, and we love them) a big THANK YOU from me.

Now we go in to evaluation mode. We may be taking the show on the road too; it looks like I’ll be speaking about this campaign in both Toronto and in London shortly. And then, for me, it will be back to blogging about more everyday topics - the ebb and flow of my life in the country in particular. Follow me there, if you want, at http://ruralrob.livejournal.com/

Here’s looking at you, kids . .

The HIVstigma.com team was front and centre for a large chunk of the program. James spoke, Steve spoke, Jason spoke and five of our eight bloggers - Gaston, Murray, myself, David and Nik - each gave short presentations on what messages we’ve taken away from the blogs. I mostly talked about the links I’d seen here between stigma and what guys have told us about how it impacts the kind of sex they have, who they have it with and how they discuss it.  Murray’s presentation was funny in parts - he read out some of the abuse his blogs received in the early days, which now seem to cause me much less offence than they did at the time.   We’ve all grown from this.  All in all, the gathered prevention types liked us, they really liked us, I’m convinced.

I also got a chance to chat with another presenter, Nico from Ottawa, who I’d never met but who has been good to us here in numerous ways, not least of which was linking us to his own blog http://ickaprick.blogspot.com/ . Nice guy he is, with lots of good ideas on blogging about HIV-related issues. It made me think lots about how we can best use the medium in future initiatives.

Also launched were two amazingly good guides for positive gay men, produced by - who else - GMSH. Both pocket-sized, one is a legal guide to help poz guys understand HIV and the laws on disclosure, etc. The second is a poz guide to sexual health. Want to know what significant risk means? How about viral load and how it impacts the risk of transmission?  How about re-infection? Are STI’s bad news for poz guys?   It’s all here, probably for the frist time in one place.  Count me impresssed.

One thing l like about these little guides, available from your local AIDS Service Organization any day now, is that they are VERY sex positive, perhaps in ways we haven’t seen before. I like the way they also contextualize risk. It’s always stuck me as ironic that we poz guys are portrayed as mountain climbers by big pharma, as if mountain climbing is the activity we should all aspire to.  But surely mountain climbing is a high risk activity if ever there was one.  It raises the question for me why are some high risk activities seen as good (mountain climbing) and others (anything associated with sex) usually seen as bad, and to be avoided?  Clearly it’s not about the consequences, but something else.

The answer I think would take more space than I have here to unpeel.  But think about it.  And have a cigarette while you’re doing that.  Maybe a donut even.  Or live a risk-free life.  Your choice.

Anyway, what does all this sex positive talk have to do with combating HIV stigma? I’d argue “quite a bit”. I’ve always thought our societal hang-ups towards sex have loaded the shame factor on to HIV, which in turn leads to the stigmatization of poz guys. So adopting an entirely sex-positive approach to prevention issues and by extension, to the lives of people living with the disease, can only help, I think.

To give you an idea of the realistic approach to sexual health you’ll find in these guides, here’s an excerpt from the training material that I really, really liked. The concept discussed isn’t new of course, but I can’t help feeling we’ve been reluctant to express it. Until now. Again, it’s about putting risk in perspective.

“Sexual health choices should be understood in the context of other risks we face in our lives. We negotiate risk in our lives every day and make decisions, both consciously and unconsciously, about the levels of risk we are willing to accept. Every time we ride a bicycle, walk on a city sidewalk, eat foods capable of harbouring bacteria, drive a car or take an air plane, we are taking a risk with our health. We hear a great deal about the health risks of smoking cigarettes, drinking alcohol and eating fast food - risks that may eventually shorten our lives. Yet a great many of us continue to smoke, drink and eat fast food*.

One more thing. I’ll likely be posting only one more entry after this. ***sigh*** But it’s almost time to go into evaluation mode. Feel free, though, to comment to the very end. Parting shots are welcome. Say what you think about this site - good and bad. Either way, we’d still love to hear from you.

*Source:poz prevention; knowledge and practice guidance for providing sexual health services to gay men living with HIV in Ontario c 2008 People with AIDS Foundation.

http://www.youtube.com/watch?v=7fEdyBdx_Ls

I should own up to the fact that this video is here mostly for its entertainment value - it strikes me as very, very funny. It has only a rather remote connection to HIV stigma, although it’s there if you look for it. (It’s about turning homophobia upside-down - and homophobia is often a contributing factor to HIV stigma, right?) Anyway, what’s more to the point is that it’s an attention-grabber, something that in the world of blogging is deemed a very, very good thing. It lures people in, one of the challenges that HIV-related blogs invariably face. Which is why we’ve been discussing here  - see my last post - techniques that make blogs that address ***shudder*** HIV issues  more attractive to gay men in general and neg guys in particular.

Here’s one tried and true way to catch the eye of the average gay guy. Liberal use of pics like this . . .

Yet another way to attract readership is the judicious use of tags and keywords - we’re talking filthy, raunchy pig sex talk here. Just ask Nico.

Turning to more - ermmm - serious matters, and on the eve of the Gay Men’s Sexual Health Summit in Toronto, I wanted to say a few thank you’s. In particular, I want to acknowledge some of our fine allies who’ve included promoting this campaign in their outreach work. I hope to hell I’m not missing any, but here’s a list of those who I know have gone the extra mile.

AIDS Committee of Cambridge, Kitchener & Waterloo (ACCKWA)

Africans in Partnership Against AIDS

AIDS Committee of Durham

AIDS Committee of London

AIDS Committee of North Bay & Area

AIDS Committee of Ottawa

AIDS Committee of Simcoe County

AIDS Committee of Toronto (ACT)

AIDS Committee of York Region

AIDS Niagara

AIDS Thunder Bay

Access AIDS Network

Africans in Partnership Against AIDS

Asian Community AIDS Services

Black Coalition for AIDS Prevention

Centre Francophone de Toronto

HIV/AIDS Regional Services (Kingston)

Ottawa Public Health Department

Peel HIV/AIDS Network

Peterborough AIDS Resource Network (PARN)

Prisoners HIV/AIDS Support Action Network (PASAN)

Honestly, this has been a great group effort. Thanks guys and gals.

And for those attending the summit, I’ll be there on a panel talking about this very campaign. Say a polite hello - or talk filthy raunchy pig sex talk. Your choice.

Think doing forty-three posts about HIV stigma has been hard? Truth be told, it hasn’t. It’s no coincidence that the two of us who’ve been most prolific here - Brian and myself - are no strangers to the blogosphere; we both blog regularly elsewhere, in fact. I also know both of us think like bloggers, always tuned in to something - anything - to write about. It’s a way of life. Have that mindset and writer’s block seldom becomes an issue; things to write about just seems to appear. So it hasn’t been necessary to revert to this book (yet) . . .

Over the long haul, though, daily blogging can get challenging. Now I don’t exactly live in the fast lane, but rather a rural backwater I call Nanookville in my own blog. So that journal, with six-years of entries (2,132 in all) and a cadre of 526 readers, isn’t immune to descriptions of what I’ve had for lunch that day. Or pics of my pets; you do what you have to do. (For the morbidly curious, it’s on LiveJournal, and it’s here:  http://ruralrob.livejournal.com/  ) Of course, I’ve threatened to post pet pics on HIVstigma.com too, as a diversion from more heavy topics, but I’ve only reverted to that tactic once here. So far.  And no descriptions of my lunch here.  Yet!

It’s amazing, though, how many people don’t get blogging, don’t see the allure, don’t understand why anybody would want to share their thoughts, or even their life, in such a very public way. Mostly it’s because we know there are people out there - lots of them - who are curious about how we live our lives, even mine. So our stock in trade is life. We hide what we want to hide. We share what we want to share. Just like real life, really.

I’ll share something with you about the stigma website. You may not realize it, but some posts and responses to comments have been carefully crafted and pored over, sometimes after discussing the content with others working on the campaign. Once we even talked to a lawyer. Personally, I’ve always felt a sense of responsibility to say the right thing here. Having said that, it’s been a great chance for me to soapbox, to share my own take on life, love and HIV, hopefully not too obnoxiously. I’ve pulled relatively few punches, though, because that was our brief - to speak our mind, with few constraints. I hope I haven’t hurt anyone in the process - or lost too many friends.

Were we noticed? Nowadays, HIV-flavoured blogs are, of course, all over the net. Ours have been unique, I think, in their positioning as an integral part of a large-scale prevention campaign. That approach hasn’t been tried before, certainly not in Canada, or perhaps even the world. So that’s exciting. But if there’s a problem with using HIV-flavoured blogs as a prevention tool, it’s that, by and large, we’ve learned they attract mainly poz readers. It’s a generalization, I know, but neg guys aren’t always interested in reading about HIV. (I sure wasn’t when I was neg.). So I’m thinking that to attract a neg audience, or a poz audience that thinks they are neg, and to somehow engage them in talking about HIV, perhaps you have to come to the subject from a different angle. Like sex. Most everybody is interested in reading about sex, arent they? Hot monkey sex, even better. Maybe we need to get dirty.

Still, I think blogging about prevention issues has huge potential, and we’ve made a good start in demonstrating that. Now I can’t deny that I see things here we could have done better, but I’ll save those for the evaluation. Unless you want to give me feedback on that.

Anyway, enough of this blog induced navel-gazing. How about a pet pic instead? (I knew it would come to this.) This, my friends, is my beloved chocolate lab Dougall, and our dumb but much-loved basset hound, Dudley.

What did I have for lunch today, I hear you ask? Well it’s too early for lunch - ask me later. Last night’s dinner?  Roast turkey with mashed potatoes, gravy and broccoli. And chocolate cream pie.  Any more questions?

Nicholas says we need to do an about face; to turn our attention to those guys who assume they are negative but are in fact positive - and highly infectious at that - rather than continually focussing on poz guys as the problem, and by doing so, stigmatizing them.

Interesting.  Even our own community has being doing a lot of work focussing on poz guys lately. I don’t think his line of thought negates the poz prevention work that is being done in this province, and which I strongly believe in.  But it does suggest a new and highly productive avenue for poz prevention to explore further, by expanding its target audience perhaps. Anyway, here’s what Nicholas says . . .

A recent UK study shows that over 50% of recently HIV+ gay men leave UK sexual health clinics undiagnosed. FIFTY PERCENT. And of those men who also have another sexually transmitted infection (making them more infectious to others), 80% left the clinics without being tested for HIV. EIGHTY PERCENT.

This blows my mind. We waste outrageous amounts of energy pushing men who know they are HIV+ to the margins of society — straight into prison cells, in fact — while we ignore the real crisis right in front of us. Study after study confirms: too many gay men are not getting tested for HIV - especially those engaging in high risk sex who need to be tested most.

We know who our true target audience is: gay men under the false assumption that they are HIV-, who have recently sero-converted (making them more infectious because their viral load is higher) and who may also have another sexually transmitted infection (make them yet more infectious). This is who HIV prevention campaigns should be focusing on. This is who is most likely to pass on the virus.

Not men who know they are HIV+. Not HIV+ men who self-disclose about their status (the majority). Not HIV+ men who, with their partners, employ harm reduction measures to keep everyone safer (the majority). Not HIV+ men who maintain good general health (by eating well, building strong social support networks with friends, combating HIV stigma, nurturing self-esteem and getting regularly tested for other STIs, among other things).

The UK Study should be sounding alarm bells. The longer we play into the paranoia about people who know they are HIV+ wilfully infecting others, the longer this epidemic will go on. We are wilfully deceiving ourselves and paying a very high cost because of it.

Just this past weekend an Ottawa gay guy told me, I always take my own condom because I am afraid the positive guy might have poked holes in his condoms in advance. I asked him, Do you even know any positive guys? He shook his head no. You do actually. About 11% of your random hook ups are positive. About 11% of guys at the Ottawa gay bars are positive. And seriously, dude, do you honestly think these guys are sitting around in some kind of vengeful stitch n bitch poking holes in big batches of condoms? These guys have way better things to do with their time. Like grocery shopping. Like doing their laundry. Like laying on the couch missing the days when Bob Barker was the host of The Price Is Right. Because they’re fucking human beings, not vindictive aliens. They’re regular, boring, everyday gay guys like you and me. And for all you know, I AM one of those 11% of gay guys. So I’m going to put this condom on that I lovingly perforated for you at home and we’re going to fuck already.

He laughed. And we did.

You can read the full text of Nicholas’s blog post, including recommendations for the way to go forward. It’s good.  It’s here: 

 http://ickaprick.blogspot.com/2009/01/50-of-hiv-gay-men-leave-clinics.html#comments

 Thoughts, anybody?

A new study out of the UK - and it’s a big study, with 8,152 participants - tells us what gay men there are thinking about criminalization.

Here’s the bad news. Most gay men (57%) there support criminalization. Only half of poz guys (49%) opposed it.! Ouch!

Sample quote from one gay man: “to have sex with with someone when you you know you are HIV+ without telling them is is one of the worst things that could ever be done.  These people should be given life sentences.”

Now, understand that the law is slightly different in the UK. and the questions asked reflected that. In particular, the UK researchers questions were soliciting gay guys’ views about punishing folks who transmit HIV; here our roughly equivalent laws seek to punish the act of exposure to HIV. There is a huge difference. Having said that, my impression is that people on both sides of the Atlantic are generally either for prison terms for non disclosure or against them, whether actual transmission occurs or just exposure to the risk of it. Read the internet chat and you’ll quickly learn that folks  typically don’t make any distinction between the two. So I’m thinking that the results of this UK research might be a pretty good indicator of what Canadian gay guys think about criiminalization, no?

If in fact the Canadian gay mindset follows the UK model, this sets me back a little. I said two posts ago that I suspected neg guys, and the population as a whole, are likely not yet convinced that criminalization is anything but entirely warranted. This research kind of backs me up.   But I hadn’t bargained for the high degree of support for criminalization amongst even poz guys.  Only 49% opposed?  Jeez!

But let’s look closer at the profile of those who support criminalization in the UK. Here’s what the research says . . .

• Gay guys who have never been tested were the group most likely to support criminalization. (Hmmm.)
• Gay guys who supported criminalization generally regard the responsibility to prevent HIV infections during sexual encounters as being vested solely with the poz partner (Hmmm).
• Gay guys men who support criminalization tend to have strongly stigmatizing views about HIV and appear to have little appreciation of the effectiveness of HIV treatment, so that infection is seen as a death sentence for anyone infected. (Hmmm).
• Few gay guys thought that prosecutions would help reduce the transmission of HIV, when most prevention experts insist that criminalization leads to more infections. (Whether gay guys buy in to the notion that criminalization increases infection rates isn’t clear. I almost hope they don’t. Otherwise we have to wrap our minds around the prospect of guys supporting criminalization even though they know it leads to more infections. And that sucks big time!)

It’s hard not to think that the research findings paint a rather unflattering portrait of those who oppose criminalization. Indeed, a recent report on this research on the AIDSmap website that I drew on for this post uses the banner headline Ignorance and Stigma Provide Foundation for Gay Mens’ Support of Criminalization of HIV Transmission. It saddens me to say it, but it’s really hard not to agree. Anyway you can read the article here, and in fact I’d encourage you to do so, as it’s an important one : http://www.aidsmap.com/en/news/51C2CFFD-1979-4033-BD9E-38ABC51CDC33.asp

So where do we go from here? There has been some discussion on this site about strategies that might work to bring home both the injustice and ineffectiveness of the current judicial fixation with prosecuting people who are HIV-positive.  It’s been suggested here we need to start that advocacy work first in the gay community, as clearly we are divided on this issue right now.  One positive sign in the UK research is that about a quarter of the gay guys interviewed were “unsure” about criminalization.  We need to build on that.  But surely, efforts to convince the general public and ultimately persuade judges that criminalization is wrong will have one hell of an uphill battle as long as our own community lacks unity on this.

So perhaps it’s back again to the issue of building community, of finding innovative ways to strengthen it, how to listen to and educate each other, how even to work towards common values that have as their foundation a sense of caring about each other.

Meanwhile our foes exploit this divide. Who couldn’t notice, for instance, that Margaret Wente in that infamous Globe and Mail article, quoted only the lame views of a poz guy firmly opposed to criminalization.

And meanwhile, while it’s tempting, I refuse to view gay guys who support criminalization as the enemy. They are our potential allies, and we need them. But we’re not there yet.

What do you think?

So that we’re all on the same page, sero-sorting is the practice of guys seeking to have sex with partners of the same HIV status. We’re talking neg-on-neg sex here, or poz-on-poz.

Sounds like a pretty smart harm reduction strategy? Or not?

Sounds like a way to avoid stigma, or perhaps the reverse - a way to propagate it?

Much of the first debate - that harm reduction one - is complicated.  Sex usually is. But for guys who are interested in how effective sero-sorting is as a prevention methodology, there’s an interesting piece of research out - a large scale study from Seattle - the results of which you can read here: http://www.medscape.com/viewarticle/584616

Wade through the legalese - or research-ese - and you’ll find that sero-sorting seems to be on the rise, certainly in terms of poz-on-poz sex. BUT for negs it’s a strategy only partially effective in limiting HIV transmissions, largely because of those highly infectious “neg” guys who don’t realize they are positive, that we’ve discussed many times here. Assumptions gone wrong, in other words. The bottom line seems to be that sero-sorting is a safer strategy than non-concordant unprotected fucking, less desirable than consistent condom use. In other words, proceed at your own risk.

Without sounding too much like a wet blanket - we need to acknowledge that the research doesn’t entirely dismiss the efficacy of sero-sorting, however limited - risk of HIV infection isn’t of course the only issue. The opprtunity to catch up with other STI’s is problematic for sero-sorting poz and neg guys alike, poz guys even more so, actually. (Aside from the viral implications, what poz guy wants a run-in with Public Health when those folks hear even a hint of unprotected poz sex. That can be nasty, I hear.)

For sero-sorting poz guys, there’s all that talk about super-infection too, getting a different strain of the virus on top of your own. Sounds nasty, but want to know what’s the latest on that? Read about it here:  http://www.poz.com/articles/hiv_superinfection_couples_761_15984.shtml

All this clinical stuff can be quite daunting to wade through, right?  But as they say in the infomercials, “but wait - there’s more“. The other part of the sero-sorting predicament is the stigma angle. By preferring to sero-sort, are you saying something negative about positives?

Is sero-sorting just about avoiding transmission? Or is there more to it? Is it stigma to seek out partners of the same status, or is it just being realistic? If poz guys hate being rejected because of their status, or just want to play safe, is it bowing to stigma to seek out only poz guys for sex? Similarly, is it OK for mr. neg to be looking for mr. right (for tonight) solely in the neg pool?. David talked a little about that already a while back, in a dating context, but I wanted to see if we have any kind of consensus on that as applied to fucking around generally

Tricky business, this sero-sorting thing, isn’t it?

Brian has commented on this too today; clearly stories like this tend to hit a lot of nerves. So pardon the duplication between our two blogs.

Anyway, here’s a selection of comments from both sides of the XTRA fence:

Male or female, gay or straight, you deserve to be sentenced for deliberately - or through deliberate negligence - giving your partner a lethal disease.

The very idea of “deliberate” infections should be challenged except in the tiniest number of sociopaths, because it doesn’t really capture what happens when two people of different status have sex.

The vast majority of HIV is spread “non-deliberately” by people who don’t know they have it.

There is a difference between criminal intent and just deplorable action. But I find it hard to sympathize with HIV-positive people who complain that being forced to disclose every time cuts down on the pool of potential sex partners. Too bad! This article talks a lot about the responsibilities of HIV-negative people and virtually ignores the responsibilities of HIV-positive people.

I am so sick of hearing this idea that (being forced to disclose every time cuts down on the pool of potential sex partners). This is not the reason people don’t disclose. The reason we don’t disclose is because you can’t control gossip and everyone around you can treat you differently when they know, from the workplace to the bar to family. It changes your life for the worse and that is not fair. A lot of negative folks say “that’s your opportunity to educate,” but that’s easy for them to say. I know many, many guys who regret how open they have been about their status. It doesn’t make stigma vanish. It makes life harder. Please believe me when I say that the risk of disclosure DOES NOT have to do with being greedy for sex.

I am ashamed that this is what the gay rights movement has degenerated to. Defending a rapist! Stop blaming the victims! It’s not their fault when someone lies to them.

HIV criminalization? That has got to be the stupidest thing I have ever heard. I completely understand that yes this man did and does have a legal obligation to inform his partners about his status. However they knowingly participated in unprotected sex, knowing with all the sexual education in the world and all the advertisements regarding sexual health, that they could have contracted the HIV virus. For them to do so was irresponsible . .”

I’m sure many people would turn down a sexual encounter if they know their potential sex partner has HIV. It should be criminalized - it most definitely is murder. I am truly disgusted that the community is willing to fight this charge.

I’m am a closet HIV-poz guy. It’s the stigma and this kind of stuff (criminalization) that keeps me from coming out. The person who infected me (whom I know) didn’t say anything to me about his status. When I found out I was poz, I didn’t go running to the police. I was an adult who made a bad choice and I accept it.

Note that the comments I’ve selected, and the balance between criminalization supporters and naysayers, pretty well reflects the balance of what’s been posted to the XTRA website. It’s about a 50-50 split, I’d say. I don’t know if that split is representative of the views of the gay community as a whole.  But it strikes me, as an opponent of criminalization (was there ever any doubt?), that a lot of work needs to be done to win the day and persuade the court of public opinion if our own community is so divided on this one.

What’s your take on this?

As a footnote, I remember when this campaign first began, we talked as a group about whether the issue of criminalization was sufficiently relevant to the topic of HIV stigma to devote much attention to it here. Times change and so does our understanding. It’s become readily apparent, in fact, that there are very close links between the two topics, don’t you think? Certainly many of the XTRA commenters readily make the connection.

Predictably the article has already provoked a flurry of comments on the XTRA website, including the usual fodder for campaigns like ours. “Take the disease spreaders and hang them up” is one quote. Nice!

By chance, I had planned to revisit criminalization here today anyway, given its relationship to stigma, and the fact that it doesn’t seem to want to go away. I’d already noticed that some in our community continue to debate what is a suitable response to people being pilloried for having sex without disclosure.

Is a fairly simple issue becoming overly complicated through neo-conservatism and the power of hot air? To people living with HIV, I don’t see much appetite or even need for debate. Most of us recognize criminalization for what it is - an attack, an affront and a useless, counterproductive prevention tactic, always. From too many others - and I’m not talking about the Margaret Wente’s of this world but some of our “supporters” - the view is often heard that, well, maybe we poz folks need to feel the strong arm of the law, some of the time. Because, we’re told, some of us are “irresponsible”. Some of us are “deliberately infecting others”

Even XTRA raises this spectre in a side-bar,  by characterizng some of us this way,  although thankfully it’s challenged by at least one reader.

I could document where and when I’ve heard this notion of “deliberate infections” countless times, and from whom, but that would win me few friends. But in every discussion I’ve witnessed where criminalization is debated, it always - always - comes up.  Namely, what do we do with “these people” who intentionally infect others, the psychopaths. No matter that this phenomenon is virtually non existent, no matter that the criminal code quite handily deals with intentional harm anyway and doesn’t need laws on disclosure to do that, no matter that the debate on criminalization is not - or should not be - about “deliberate infections” at all, we go down this path ad naseum. It’s depressing.

Sometimes it becomes a stumbling block. I’m saddened that the community doesn’t seem to have a response to criminalization that’s universally accepted. Even the recent Ontario paper that recommended we re-examine the law and identify alternatives - hardly conroversial - gets bogged down in the debate about what to do about those non-existent psychopaths.

To repeat; the law deals with psycopaths already. It worries me that in discussions that should focus on the legal challenges that face normal, sexually active poz guys daily, we end up talking about psychopaths. I think that is very telling about our attitudes to poz folks generally.

It’s also telling that this debate is not usually within the poz community, or hardly involves us at times. We have few forums that would otherwise enable this, we don’t have the equivalent of NAPWA in the States, for instance. So community boards often devoid of poz folks, composed instead of well meaning folks with little knowledge of HIV, talk about us - but don’t get us.   Agency staff, who are better informed but often similarly devoid of poz folks’ involvement, sometimes fall in to the same trap. So perhaps it’s the lapses in implementation of GIPA (greater involvement of people living with HIV) coming home to roost. It’s hard not to notice that decisions about our future and judgements about our conduct sometimes reflect the mainstream views of the general public, which can be less supportive than we would like - rather than being inclusive of a poz view of the world. That’s why talking about the state-sanctioned stigmatization of people like you and me ends up talking about our role as psychopaths.

So I started talking about criminalization and ending up talking about GIPA. But there is a connection, and there is definitely a connection with both to the perpetuation of HIV stigma, don’t you think?

Anyhow, I find the debate on criminalization disheartening and depressing.  One organization is asking me to come and talk to their board, to present a poz guy’s view of criminalization. It’s good that they welcome the dialogue. But honestly, I’m so pissed off with the whole thing, I hardly want to go.  I feel like I’m done with debating it. Some times the weight of oppression - and stigma - does that to you. And that’s not good.

Here’s my attempt to summarize one of the major discussion areas:

Pox and neg guys tend to think differently, particularly on disclosure issues. Many report encountering disclosure very infrequently; it just doesn’t happen a lot in many venues, it seems. But neg guys expect poz guys to disclose. Poz guys don’t have a single approach, but a significant number seem to follow the practice of not disclosing when risk of exposure is not significantly present. Neg guys also aren’t so committed to maintaining the confidentiality that poz guys require about their status, and this bugs poz guys. And poz and neg guys alike are all over the map when it comes to whether not being uncomfortable dating a poz guy constitutes stigma or understandable apprehension. There is a general consensus that more dialogue is required on all of this.

I think there are other things that have emerged - the mainstreaming of the view that poz guys are less responsible for new transmissions than untested “neg.” guys, and that if you’re going to sero-sort, you’re perhaps safer with poz guys than so called “neg” guys. There’s been interesting discussion on the joys of condom-less sex too, and how we deal with those. And on whether rejection is a big deal.  But I’d like to hear from others. What do you think has happened here, if anything, that has advanced our knowledge of how we think and relate to each other?

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 And on an entirely different note . . .

 Obama, the president that’s vowed to take on HIV Stigma (see my previous post), is taking early action on the AIDS front.  Now he’s asked PEPFAR pres Mark Dybul to resign.. That may cause a yawn here in Canada, but for anyone who follows AIDS politics this is big!

Read about it here: http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=56599

The significance is not only that Obama is putting his money where his mouth is on AIDS policy but that this likely marks the end to all that abstinence-based crap we’ve seen emanating from our neighbours to the south for way too long.

Can tackling HIV stigma be far behind?