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?