As we approach the new year and I’m still in blog-lite mode, I though you might be interested in some of the stats we’ve compiled to date.

First, let’s look at those polls that are at the foot of each page, right next to the strippers. 

Q: Did you discuss HIV status during your last sexual encounter (566 votes)

Answers      Percent     Number

Yes         48.2%            273

No          48.8%            276

Unsure     3.0%              17

(To me the 48% who answered “yes” seems surprisingly high, given that we’ve learned here that guys think disclosure isn’t all that common. I’m wondering if guys are including the kind of “implied disclosure” we’ve talked about here, i.e. signalling etc., rather that the big chat. Or perhaps sex in the context of a relationship, where status is old news, has skewed the “yes” numbers. Any ideas? Or do you think these resultslook totally screwed?)

Q: Have you ever had sex with a guy whose HIV status was different than yours (854 votes)

Answers        Percent       Number

Yes                65.5%            559

No                 13.3%            114

Don’t know    21.2%            181

(I would have expected a higher answer for “yes” than 65%. After all , black T-shirt guy says that, if you’re living in Toronto (where HIV prevalence in gay guys is around 25%), chances are you are having sex with poz guys. On the other hand, the question could be interpreted a number of ways, particularly the “don’t know” category. Any takes on these numbers?)

Other campaign stats: to date we’ve had 22,263, visits from a total of 16,229 unique visitors. The blogs have attracted 17,119 page views (that’s a hell of a lot of lurking, guys! Next time, why not leave a comment? ) The average visit here has lasted site 5 min, 54 seconds.

Of the visitors to the site 4,759 have come from the US but many other countries are represented in the list of visitors.

There have been campaign billboards up in Toronto, Hamilton, Ottawa, Ajax, Thunder Bay, Orillia, Barrie, London, Kitchener, Windsor and Kinsgton.

The campaign ads have been appearing in XTRA Fab, Capital, XTRA, Eye, Now and twenty ethnic newspapers. Also on the TTC . though not on GO Transit, who rejected us, likely because we didn’t disclose (just kidding! Well kidding about the disclosure bit; they did reject us though.)

Happy new year, guys.  See you in 2009.

I suspect it’s possible, if you work at it, for some of us poz guys to ignore the impact of HIV on our lives. That’s particularly so if the incessant pill-taking becomes routine and we’re not plagued with side effects. Yesterday’s clinic day was not one of those days.

I was in Toronto for my quarterly appointment at St Mikes. Where I got the good news that my CD4 is the highest in fifteen years (681) and my viral load remains undetectable.

But I wasn’t a particularly happy camper. Grouchy even, not feeling christmassy at all. My encounters with the medical establishment are often smooth and efficient, sometimes less so. Yesterday was less so. A two and a half hour round of waiting (lots of it), form filling, doctors, nurses, blood work, consulting with the pharmacist - it went on and on - saw to that.

So I come home to relax, to forget all that. But I’m my own worst enemy. Rather than leading a “normal” life, I choose to immerse myself in a lot of HIV-related work. Which work, like participating in this campaign, I enjoy, but it subverts attempts to establish an identity free of HIV, which would be kind of nice, albeit somewhat unrealistic.

In any event, ’tis the holiday season, definitely a time when for me at least my thoughts are elsewhere, as I celebrate with my chosen families. The guys at www.HIVStigma.com - evil taskmasters that they are (LOL)  - want us to keep blogging over the holidays. No fun. Holidays are for getting presents you never knew you wanted, overeating and trying to keep the dogs from tearing up the christmas tree. Not yacking about stigma. Not yacking about HIV.

But I’m happy to keep blogging about less serious topics for a change. And none more important than sending out a few seasonal shouts.

Greetings to James, Steve, Jason  - the behind-the-scenes peeps at www.HIVStigma.com who have been a joy to work with these last few months. And greetings too to Michele, the lovely and talented creative person behind all this.

Greetings to my fellow facilitators - Gaston, Murray, Brian, David, Nik, Tim, Vijay - well done guys, keep up the good work. It continues to be a great learning experience working with you. Happy holidays! You’ve earned them.

And most importantly, happy holidays to all those who’ve visited this web site, especially those who’ve contributed to the discussions here. Grab yourself a stigma-free holiday season if you possibly can.

I’ll leave you with a holiday photo of our stigma-free basset hound Dudley, who is way more fun-loving than he looks here. Dudley hates me for getting him dressed up, but he nevertheless joins me in wishing all of you the best of the season. Happy holidays, everyone!

I suppose this post is an extension of the “poz pride” discussion happening elsewhere on this site. But this one’s for neg guys too.

Poz guys, would you wear this T-shirt?  It’s about as stigma-busting as you can get, isn’t it?  I mean if you are out about your poz status, why not be OUT. And if there’s poz pride out there, isn’t this the ideal way to show it?

Have to admit I probably wouldn’t. I suppose I have more issues than I thought. And not even including the fact that I don’t look good in T-shirts.

Neg guys, would you wear this T-shirt?  Again, it’s stigma-busting, and it shows solidarity with poz guys for sure. But how comfortable would you be with other guys not getting the political statement behind it, and thinking you are poz. It’s a pretty brave thing to wear to the bar, isn’t it?

Annie Lennox and Nelson Mandela can get away with it. Everybody knows they aren’t positive (at least I don’t think they are) They are celebrities. Am I a cynic to suggest that, for them,  if this isn’t exactly a fashion statement, its a statement of fashionable principles. A bit like wearing a red ribbon, in fact, in the days before Hollywood got bored with that, and dumped us.

But perhaps I shouldn’t knock these two celebs. They seem like they want to be our friends - and I get the warm and fuzzies just looking at these images. I can’t help feeling these people really do address stigma, even while I ask uncharitable questions about the motives of the wearers.

Confused, aren’t I?

It’s always struck me as odd that, despite the fact that we’ve embraced the concept of shared responsibility for years, prevention messaging has largely been aimed at neg guys. The prevailing message has been “use condoms to avoid becoming infected”, or variations thereof. Sometimes we’ve backed that up with dire warnings of the consequences of becoming infected. HIV speakers in fact regularly go to schools and warn kids not to become like them. It’s the “scared straight” school of prevention, one that I dislike, by the way.  (However well intentioned these speakers are, I’d rather my poz life not be painted as anything less than whole and complete, nor a life that nobody else would want in a million years.)

Anyway, no stranger to casual sex, I’ve always felt a bit left out of prevention messaging. If GIPA (the Greater Involvement of People Living with HIV) suggests that we deserve to participate in all decisions affecting our lives, how come nobody talks to us about prevention?  It’s like we’re left on the shelf or something, the perpetual wallflowers at the prevention dance.

Truth be told, the past lack of prevention campaigns aimed at poz guys has in part been a product of the fear of stigmatizing us. And I suppose that’s good. But it’s also a bit insulting, because it suggests we can’t participate in an honest, adult conversation. Folks have been scared that involving us in prevention campaign messaging won’t be well received, that it will stigmatize us more. The concern is that poz guys will be offended, that we’ll think fingers are being pointed at us, think we’re being labelled as “vectors of disease”, drivers of the epidemic, yada-yada-yada.  And to be truthful, I’ve heard some poz guys paint poz prevention in those terms.

I don’t.

What I’ve seen coming down the pipeline here in Ontario - and I have to admit here to being on a GMSH poz prevention working group, so I’m not exactly a bystander - takes a holistic approach to sexual health. The concept is essentially that if you stay healthy, you’ll be more likely to make healthy decisions - healthy for you and healthy for others. Sure, one of its objectives is to reduce new infections, but it’s coming from a place of keeping poz guys healthy physically, mentally and spiritually. Importantly, it’s driven by poz guys, for poz guys.

It’s also quite new, and it’s possible guys won’t get it, or treat it with a little mistrust at first. I’d write more about the specific programming that’s involved, if folks are interested, but right now, I just wanted to open up the concept of poz prevention for discussion.

On this note, Nicholas Little, who writes for XTRA in Ottawa, has an interesting and provocative blog post this week which bravely tackles the role of poz guys (or not) in HIV transmission. I urge you to read it here: http://ickaprick.blogspot.com/2008/12/how-many-people-will-you-infect-with.html Nico goes behind the myths to quantify as best we can how much of that type of transmission is actual occurring. Not much, it seems. The problem really does seem to lie largely elsewhere. But that doesn’t mean that for the small number of new infections arising from guys who know their status, poz prevention isn’t worth pursing. In fact I’m mad keen on it.

I’m tired of being a wallflower.

But can we discuss poz prevention without stigmatizing poz guys further? Is there a danger that, like criminalization, we’ll water down the message that neg guys are part of the equation too - the shared responsibility issue we’ve talked about here before?

Waddya think?

Stigma. Some poz guys here have said they don’t experience much of it. Other have said “are you crazy? It’s everywhere!” My response is somewhere in the middle; I’m fortunate not to have to bear the brunt of it - much - in my daily life. Being out about being poz helps see to that. But I see it around me, impacting on others all the time, and I certainly see it directed at us poz guys collectively, all the time.

Often it’s because we are portrayed in the media (like in that Globe and Mail article) or even in our own community (like some of the remarks provoked by that gay.com feature) as being complacent about the risk of HIV transmission, or worse, acting “irresponsibly”.  Vectors of disease, in fact, only interested in our own gratification, with no concern about infecting others.

That’s highly stigmatizing language of course. But if we argue that kind of talk is an unfair and erroneous characterization, we’re accused of “pussyfooting.”   (I hate that term. by the way.)

Here are the three main arguments I and others make against charges of “irresponsibility”:

• most poz guys play safe
• the evidence suggests that its neg guys who don’t know they are poz, with resultant high viral loads, who are the source of most new infections
• where “irresponsibility” exists, it does so in both poz and neg guys, so concentrating on the problem in just one of those communities is unfair and unproductive.

All of these facts are true.

What we don’t deal with so well, perhaps, are the exceptions. We know some poz guys out there struggle, have slip-ups, have self-respect problems and are saddled with a host of factors which make their sexual health, and even that of others they have sex with, not a top priority in their lives. Not unlike some neg guys, in fact. For poz guys, the added impact of stigma doesn’t help, in fact it’s at the root of many of the problems poz guys face. But it strikes me that we poz guys are slightly reluctant to acknowledge that those problems do exist in the poz community and that they sometimes manifest themselves in risky behaviours, like fucking without condoms. It happens. It’s better, I think, to acknowledge that than to sweep it under the carpet.

It’s also helpful, and perhaps even essential, to acknowledge that we can do something about it.  In my next post, I’ll talk about what I see as some of those ways. But in the meantime, I’d be interested in what others think. Do we poz guys hurt ourselves by suggesting we all practice safer sex, all the time, that the problem is solely in the neg community, not ours, that it’s all about testing, or in the other ways we routinely deflect criticism?

And if there is a problem out there, how do we deal with it?

Having dabbled with the condition myself, I was curious about the links between depression and stigma.  So I poked around on the net looking for research on it. There is in fact quite a bit there. But as someone who didn’t even know that the word “construct” was also a noun until my forays in to research, it’s hard going for this wannabe social scientist.  With apologies to the Barry Adams of this world, I’m not good at gobbledegook

Anyway, my brush with clinical depression a few years back is far from unique. Apparently 55% of us people living with HIV have had - or are having - depression. Reminds me of my first time in a psychiatrist’s waiting room. It’s a weird place to be for first-timers, not a bit like that one in the Bob Newhart show.  And so this newbie to the wonderful world of mental health issues had a bad case of not feeling like I belonged there. Frankly I thought everyone else in the waiting room was a nut job - except for me, the normal one, sent here by mistake by my regular doctor. Proving, of course, that the popular perception of people with mental health issues is not kind. They have their own brand of stigma to deal with, in fact.

As it happens I had a good psych doctor, and so a combination of pills and cognitive behavioural therapy set me as straight as this gay boy could ever be. Well, actually, I did have a relapse, but now I’m “clean”. I think.

Anyway, here’s what I think the research on all this says. People living with HIV who reported feeling highly stigmatized also experienced significantly more symptoms of depression.  One reports says that the debilitating impact of HIV-stigma needs to be more fully acknowledged. i.e. that it’s bad for your health. (Seems to me there may be a bit of cause vs. effect argument to be made here, though. In other words, is the depression the result of heightened stigma, or is the heightened stigma the result of the one-two punch of HIV AND mental illness?)

There is also some research out there on the impact of depression on risk taking. As a poz guy, though, my experience is that depression - and the pills that go with it - can have a disastrous effect on one’s libido, not to mention erections. So that disclosure and/or risk taking can be a complete non-issue when you’re battling the Big D. On the other hand, one hears that there are in fact some links between depression and risky behaviour. I don’t know.

As I’m sure you can tell, this isn’t really my area of expertise. (Exactly what is, I’m still trying to discover.) But I’m mighty interested in hearing from anyone who knows anything about this, or has had experience with depression, either poz or neg, and is perhaps even comfortable commenting on how it has impacted their sexual health.

Over on gay.com, there’s a nice little write-up about our campaign. That feature, though, has produced a storm of debate amongst gay.com readers; you can follow it here: http://lifestyle.gay.com/2008/12/world-aids-day.html   Be warned though, there is some real vitriol here, amongst the pleasantries and pats on the back.

One thing that the gay.com discussion reinforces is that while most guys seem to get the point of the HIVStigma.com campaign, our message is sometimes interpreted in unintended ways. One gay.com reader, for instance, says he’s looked at our web site and it’s “largely about HIV+ guys complaining that potential sex partners reject their sexual advances.” Another says “Yes, the campaign here in Toronto seems to focus on HIV+ men complaining that HIV- men won’t have sex with them”

Yikes! I hope not! There’s precious little evidence - not from the facilitators here or from those poz guys who’ve dropped by and left comments - that anybody is saying anything like this at all. Those so-called complaints just haven’t come up!  And if they’re talking about our slogan “If you were rejected every time you disclosed would you?” I’d strongly dispute that’s at all what it’s about.

There have been also a few suggestions that our slogan implies we’re condoning the practice of not disclosing, condoning unsafe sex. I suppose people read what they want to read.  And I suppose I should be ignoring these negative spins rather that commenting on them, but I am what I am.

I don’t want to ignore the fact that A LOT of the response to this campaign has been really, really good. That’s what I’m hearing. But the possibility sometimes crosses my mind that our campaign message is too obtuse for some, too subtle, too open to interpretation. So perhaps we need to restate from time to time that we’re talking about stigma here. It’s about stigma’s impact on HIV prevention, and it features and tries to engage both poz and neg guys in that discussion. It’s about the role that stigma has in transmitting the virus - including making it difficult for poz guys to disclose, including deterring others from getting tested, including preventing talking to each other about HIV.

The simpler version is that talking about stigma helps reduce it.

But going back to the gay.com discussion about our site, clearly that discussions highlights divisions within our community, which transcend poz/neg lines. It’s pretty clear from the gay.com discussion there is a fair bit of poz-phobia out there too, which also transcends poz/neg lines, And the disclosure issue in particular seems to be really, really divisive.  (Which suggests to me we should be talking about it more, not less.) But is this just activists arguing heatedly, as activist often do, and that banter isn’t really representative of how Joe the plumber gay guy feels about things? Joe the plumber gay guy may not care much about HIV at all, in fact. I don’t know.

Anyway, read the gay.com discussion and see what you think. And come back here and talk about it.