I just spent three days in Toronto, my old stomping grounds,  at the Gay Mens Sexual Health Summit. It was a well attended affair, perhaps 150 or even more - I’m not good at numbers - of the brightest lights on the prevention scene in this province.  And me.

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.

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?