If you’ve been following the discussions on this site, I think the links between criminalization and stigma must be pretty clear by now. But we haven’t really looked at who, besides Margaret Wente, actually supports criminalization.  Now we can.  And it’s kind of worrisome.

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?

The comments on the XTRA website in response to their front page story on criminalization (see my last post) are all over the map, and sometimes heated.  But they’re worth reading by all those interested in stigma and how it pans out - or not - in the real world.. You can find them here: http://www.xtra.ca/public/National/HIV_stigma_radiates_from_behind_the_bench-6193.aspx

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.

XTRA’s cover story yesterday was about criminalization, a treatment sympathetic to our cause by Sky Gilbert, which (mostly) hits all the right notes, even though he couldn’t resist criticizing at some length some of our community’s most vocal supporters. You can read the article here: http://www.xtra.ca/public/Toronto/HIV_stigma_radiates_from_behind_the_bench-6193.aspx

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.

This campaign isn’t being wound up yet by any means, but nevertheless some of us are in contemplative mood, trying to summarize for ourselves and others what major themes have emerged. In fact I have to talk about some of these at a Gay Mens’ Health Promotion summit coming up next month in Toronto. The intent is to share with prevention workers from across Ontario some of the things we’ve learned. Some of that material will be derived from the discussion that’s happened on this blog, and on those of the other seven facilitators.

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?

 **************************

 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?

Some folks write to the site, instead of leaving comments here. Their emails are an interesting read; they often voice opinions which wouldn’t otherwise have been heard.

Most people are pretty complimentary;  honestly, the word “amazing” appears quite often. One person used the words “disturbing, blunt and effective” - I liked that too. But there are also some criticisms and I wanted to deal with three of  those today.  These all incidentally revolve around disclosure. I’ll paraphrase them for you.

Accusation  # 1 : Disclosing is not a choice, poz guys have to disclose their status when having sex. You are nasty, irresponsible people for suggesting otherwise!

My reaction?  Clearly there is a bit of work to be done here, involving both poz and beg guys, in helping folks understand exactly what the law says. There seems to be a common perception that the law says disclosure is alwasy necessary  BUT a) that’s not true, and b) if neg guys think poz guys will disclose always, they are unnecessarily putting themselves at risk and c) we need to repeat that the greatest danger of infection comes from newly infected/infectious guys who don’t know they are poz, so disclosure isn’t the magic bullet that keeps everyone safe. In short, the law, and folks shaky understanding of it, have created a minefield of dangerous misconceptions.  In fact those who say the law results in more new infections, not less, are probably right. How we dig ourselves out of this mess I’m not sure, but more education on it will help.

Your reacton ?????????

Accusation # 2: Stigma makes poz guys lie about their status, therefore all sex is dangerous and scary. You are nasty irresponsible people for spoiling sex for me.

My reaction? Stigma certainly isn’t a helpful factor in having people talk openly about their status, but accusations of lying about it aren’t helpful either. I don’t really know whether many people lie; if they do I understand, but don’t approve. I suspect a much more common way of dealing with being poz though is just not talking about it. And that’s OK, in my book, if you’re not exposing your partner to risk, or not considering a relationship. But if some neg guys are relying on partner disclosure as their safer sex strategy, that’s just naive. Why not revert to the strategy of treating all partners as if they are potentially positive?  So that lying, if it occurs, is hardly an issue.

Your reaction: ?????????

Accusation # 3: You’re excusing poz guys who don’t tell their partners their status. You are nasty irresponsible people for encouraging dishonesty.

My reaction? This all seems to stem from that slogan “If you were rejected every time you disclosed, would you?” which has been much discussed here. Some folks whose opinions I respect have questioned the wisdom of choosing this slogan for this same reason - that it appears to condone,. perhaps even encourage, nondisclosure. Regardless of the fact that disclosure isn’t always required by law (see above), I must admit it does concern me that folks have interpreted the campaign that way. So was that slogan a wise choice? Can we afford to have negative interpretations of it out there? Honestly, I’m not sure.

Your reaction:????????

Let’s hear from ya!

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.

So I’m off to Toronto this evening for the big public meeting about criminalization that Tim mentioned in his latest blog entry. I could instead have gone to Peterborough where, by chance, there is also a public meeting on criminalization today.  Criminalization is clearly a hot topic these days,

I don’t know why I’m kind of taking this personally. The law isn’t likely to affect me directly; I’ve said before I’ve been in the habit of disclosing, because it feels better than not disclosing. But I still see this as a personal attack. An attempt, and a successful one at that, to paint folks not really very different from me as criminals requiring punishment, public humiliation and imprisonment. And I hate that.

(For those new to this, the law is a bit complex, but the simplified version is that there is a duty for poz guys to disclose their status where there is a “significant risk” of transmitting HIV. Don’t do that and you risk prosecution. You only have to read the papers to know that’s not an idle threat.)

Now it’s being suggested that we not only need to disclose, but that we need to have some record of that conversation. In writing perhaps, or as observed by a friend. So if you thought verbal disclosure was hard enough, strikes me it just got one step harder.

Harder or not, that getting-things-in-writing thing may fit poz guys going in to a relationship, but it certainly doesn’t seem a good fit with how we relate to each other in baths, back rooms and other places where sex is a pretty anonymous affair.

So if that get-it-in-writing approach to disclosure doesn’t fit, because of the venue - you are in a room at the baths, for instance - all that’s really left is to practice safer sex. Always. No slip ups. Nothing wrong with that, I suppose; it strikes me as the right thing to do. Except I suspect prevention experts - and I’m not one - would tell you that didactic approach doesn’t work very well. We’ve always talked about choices. It’s why you don’t read “Use a Condom Every Time” ads much nowadays. It’s pragmatic rather than practical. and doesn’t recognize the complexities of human behaviour. Just like the law.

Wait. How about poz-on-poz sex? Surely that’s safe, legal-wise?  Well, not so much, say the legal experts. Because of the danger of re-infection or super-infection or whatever the hell it is, the notion of “significant risk” in unprotected sex between two poz guys remains, So there is a theoretical risk of prosecution without disclosure, even in those circumstances, we’re told.

So it seems to me that gay men - or some of us - are being painted in to a corner and running out of options. In short, I’m thinking more and more that criminalization, for any number of reasons, sucks big time.   Look how it even limits what we can say on this site!

Or did I miss something here?.

I can’t lay my hands on Canadian data but I came across UK numbers (Gay Men’s Sex Survey, 2005) which found that 70% of neg guys expect a partner with HIV to disclose their HIV status.  And that the same 70% are using disclosure - or perhaps lack of it - as a basis for safer sex decisions.

Hmmmm

Striks me there are some mighty dangerous assumptions being made there.   But what do you think?

It’s exceedingly weird, in my view, that poz folks are being charged - and convicted - for having what strikes me as consensual sex. Of course the courts have ruled it’s not consensual when there is no disclosure and where there is “significant risk” of transmission. It gets complicated when we look at what constitutes “significant risk” but what’s clear, I think, is that fucking without a condom would qualify. (For more on this go here : http://www.hivstigma.com/law.php )

We get emails here on HIVstigma.com. One reader was horrified that we would bring this legal angle up, and certainly didn’t like the language we’ve used to describe the law. Much too insensitive, was his view. (I don’t agree, but I’m honestly sorry that he was hurt.)

I guess what we didn’t express was that spokespeople for the HIV community don’t like the fact that poz sex is being criminalized.  Not an appropriate intervention, stigmatizes poz people, counterproductive, acts as a deterrent to testing, they say. I happen to agree. And if the courts don’t stigmatize poz folks enough, the press certainly does. ‘There is no excuse for the wanton, reckless, self-indulgent behaviour ” is a typical reaction. It’s worse if you’re a woman.

We can debate this at length - and I will, if you want - but let’s bring this argument to the real world. Sex is fun, but it can be a complicated business, and so can how, when and with whom we disclose. The courts say that criminalization is necessary as a deterrent, in effect a systemic attempt to force us poz folks to disclose. But I want to know whether you think the prospect of going to jail is starting to enter in to the decision-making equation.  Of anyone.

So my question to you - and this is directed at poz guys in particular, is: do you think the law on disclosure - admittedly perhaps not well understood - shapes gay men’s decision making in any way at all?  Is it becoming a factor in whether or not they disclose and/or what kind of sex they have?

Neg Guys? What’s your take on this?

I’d like to think this is a safe space to discuss these issues freely. But I’ve deliberately chosen to raise the question using the third person. So poz guys in particular, please feel free to do the same - and don’t say anything here which might incriminate anyone. OK?

I think one of the problems with safer sex is that it’s become waaaaay to closely connected with condom use. Sometimes the two seem almost inseparable. What’s up with that?

My negative partner was checking out this very web site the other day with his usual eagle eye and stopped at the first question posed by one of the strippers in the Explicit Truth section. (You do know we have strippers, don’t you?) “This answer doesn’t make sense” he said. (He never really did have an eye for strippers. I don’t know what’s wrong with him!)

Here’s the question and response that he’d zeroed in on:

 Q: Gay guys are abandoning condoms, True or False.

A: False; Whether we have HIV or not, most of us play safe most of the time. In a 2005 study, 70% of guys reported sex lives with little or no risk of HIV transmission.

That answer is a bit of a non sequitur, so I’m guessing it won’t be just my partner scratching his head on that one. I’m sort of OK with that, though; thinking is always good in my book. But I’m not so OK with the implication that safer sex equals condoms, as if the two terms are interchangeable. That’s clearly not the intent here, I know. In fact this site has a good little section that explains what safer sex can be. You can see that here: http://www.hivstigma.com/safer_sex.php   It’s a far more inclusive list than just condom use, and rightly so.

It’s my take that condoms are a bit of a dog as a prevention methodology. Attempts to eroticize their use as a prevention strategy work for some, but clearly not for others. Some guys will tell you that sex feels better without them, that they kill the mood, that they turn Mr Big and Tall in to Misterr Softeee. BUT, despite all this, a tribute to our collective good sense I think, they are still a staple of every gays guy’s night-stand . More often than not they’re used when they need to be used.  Or - and I think this is important - many guys find other ways to reduce risk. Collective pats on the backs, folks!

But I do wish we had something better for what some see as our prime defence against HIV. In the mean time, I think it’s productive to question whether condoms are the be all and end all of safer sex.

And while we’re on the subject of finding new prevention technologies, I’ve read a lot about circumcision lately. Don’t get me started about that . . .

By coincidence, I put up a photograph in my office yesterday. (We’re in a new home and still in the decorating phase.) It’s a photo I took at the International AIDS Conference in Toronto of the work of a Brazilian artist who works entirely with condoms. She makes fab dresses out of them, in fact. I like the way how she sees condoms in an entirely different light to the rest of us  . .  .  .  .