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Do campaigns appealing to our sense of community work? Or does stigma get in the way?
I’ve always been a Pollyanna kind of guy, simple-minded even, mostly believing in the goodness of human nature. Much of it I blame on Sunday school. The Jesus part didn’t stick, but all that stuff about being kind to each other did. So HIV prevention campaigns that aim to get us to look after ourselves and our community appeal to me. Particularly the bit about community.
It’s a bit like the PRIDE parade. Many people say they get a bit choked up when the PFLAG contingent goes by. I do too. It’s hard to say why; but the sight of all those beaming moms and dad sandwiching their gay offspring touches something very basic in me. One, because it’s just so damned good to see the kind of family ties that I never had. Secondly, it speaks to me about community and how encompassing that concept can be, when we want it to be. For PRIDE, at least, our community includes moms and dads and all those TTC drivers and Mounties and firemen and bankers and rainbow flag-carrying cops. Just for the day, that one day perhaps, but they seem part of our community. And it feels good.
Or at least it feels good to me. We are all different of course. I know for a fact that some folks actually like brussels sprouts! Hard to believe, I know. It’s a strange world indeed!
I know some will say that we gays are not so much one community but rather a community of communities. There are issues of exclusion here too, which can’t be ignored.
But a campaign that focuses on stigma, like this one, tends to spotlight our collective flaws. True, there are messages about community to be had here. The cute guy in the black t-shirt that everyone sees when they first access this site even addresses it. He’s appealing to our basic inner goodness, of course: “Lets learn to keep each other safe” he says. “Help unite our community“. Good stuff. But there’s also the implication that we aren’t in fact keeping each other safe, that we must learn to do so, that our community isn’t yet united on this. Hard to argue with that, I guess. There’s work to be done and tackling stigma - which is, let’s face it, as divisive as hell - is a good start.
I’m curious though. Do you think appeals to us gay guys as a community resonate? Can guys get in to that, or do some of us feel too marginalized for it to work? Or is it all just too damned altruistic for words? Or simplistic, even? If you don’t feel part of a community why would you want to strengthen it? I don’t know. Does it recognize enough that we are all flawed? I don’t know that either.
If you’ve read my blog a few times, you’ll know that there are in fact a lot of things I don’t know. But I do know definitively about brussels sprouts. They are, of course, the devil’s spawn. And that’s a fact!
Tags: brussels sprouts, community, PFLAG, prevention campaigns, PRIDE, stigma
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Nicholas. Those are thoughtful comments indeed. Thank you.
This campaign is primarily aimed at “negative” gay men. As you correctly point out, that group includes a sizeable number who are positive, but don’t know it, and who also may have very high viral loads if they are newly infected. That’s worrying, of course. So yep, there is a powerful case for a stepped-up emphasis on testing - and testing regularly. To some extent, this campaign addresses that by trying to reduce the stigma that affects testing decisions, but clearly more needs to be done in winning folks over.
I agree with you too that health care professionals have a largely untapped role to play in sexual health issues affecting both neg and poz guys. That’s a particularly hard nut to crack though. Doctors will tell you they don’t have the time - mine never brings the subject up at all - but I don’t think we can give up on this.
November 4, 2008 11:39 AM
“Do campaigns appealing to our sense of community work? Or does stigma get in the way?” Great question. I’ll throw my two cents in by way of example…
About 17 percent of gay men in Ontario are HIV-positive. About 30% of them don’t know they are positive. For every 100 gay guys in Ontario who think they’re HIV-negative, five are actually positive. If a sexual partner asked them “Are you positive?” they would probably say “Nope.” If a partner asked them, “Are you negative?” they might say, “I don’t really know” or they might just “I’m negative.”
A study ((http://tinyurl.com/5ltv76) by American CDC researchers and published in AIDS, the Official Journal of the International AIDS Society, found that proportion of new sexually-transmitted HIV infections resulting from individuals unaware of the positive status ranged from 54% (when they had the same number of vaginal and anal sex partners as the control group) to 70% (when they had twice as many vaginal and anal partners). Using the lower bounds, the transmission rate from the group unaware of the HIV+ status was 3.5 times that of the group aware of their HIV+ status after adjusting for population size differences between groups. The CDC researchers concluded that the HIV/AIDS epidemic can be lessened substantially by increasing the number of HIV-positive persons who are aware of their status.
In the Ontario context, that means that 50-70% of new sexually-transmitted HIV infections result from just 30% of HIV+ individuals – those who do NOT know they are positive.
Yet unabated HIV social stigma, increased criminalization of HIV transmission and the amount of backlash garnered by the Swiss statement (http://tinyurl.com/4l7nrn) suggests that we continue to base our HIV prevention efforts on the false assumption that transmission is largely due to status-aware HIV+ individuals’ ignorance, lack of motivation to practice safe sex or even willful intent to do others harm.
The real crisis (http://tinyurl.com/5abecf) is finding innovative ways to get individuals who are engaged in high risk sexual activities to feel adequately safe and motivated to get tested routinely, hopefully in the first stage of infection when their viral loads are highest. If more energy and resources were spent resolving this crisis instead of the stigma-generated faux-controversy of the Swiss statement, I believe we’d see HIV transmission rates fall much faster.
The Kaiser Network reports (http://tinyurl.com/6psjd8):
“In reaction to the survey, health officials called on patients to be more forthcoming, as well as on physicians to inquire about sexual history. “Health care providers should screen patients routinely for HIV,” Begier said, adding, “They should also ask their patients about behavior that may put them at risk. And New Yorkers shouldn’t hesitate to talk openly with their health care providers” (”City Room,” New York Times, 7/24). Sweeney said that as a “group, doctors fail miserably” at asking patients about their sexual histories. “People were not reluctant to talk once you brought it up,” she said, adding, “They’re reluctant to initiate, but once you bring up highly emotional issues, patients will talk about it if you’re not judgmental” (New York Daily News, 7/24). Gay Men’s Health Crisis Executive Director Marjorie Hill said that although she is “distressed” by the survey’s findings, she is not “at all surprised.” She added, “Medical providers are not sufficiently trained in outreach and engagement with gay, lesbian, bisexual and transgendered people” (”City Room,” New York Times, 7/23).”
November 2, 2008 05:06 PM
Roger. That’s good to hear. In my volunteer work, I do get a strong sense of community too. It’s one of things I enjoy about it, in fact.
(And good too that we agree on the brussels sprouts issue. But we are not alone. Google “I hate brussels sprouts” and you get a ton of hits. Time for a new community maybe?)
November 2, 2008 11:11 AM
“Do you think appeals to us gay guys as a community resonate?” I’d say yes. My whole take on life is how can we support one another, in doing so bettering ourselves. We all have different combinations of oppression and privilege (it’s right there in the name, “gay” (oppressed) and “men” (privilege)). How can each of us use what privilege we have to support others seeking fairness and health and happiness and justice?
To totally translates into HIV issues. Poz guys are supporting our community when we take measures to protect other people’s health like safer sex, and when we encourage our fellow poz peers along those lines too. And neg guys support us when they indicate to everyone that they are rational about HIV risks in their own lives, and when they make it clear they don’t tolerate pozphobia among their peers.
You’re right about those sprouts too!