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Tuesday, November 23, 2010

World AIDS Day Thoughts

So World AIDS Day is coming up again, and we'll get a little flurry of articles and some notice in the mainstream media: Not much, but some. In the latest UNAIDS Report there is a bit of good news: the global infection rate has begun to fall - a little - and let's wait a few years to see how solid this trend is - but it's good news.

New Zealand barely rates a mention: we get bundled into Oceania. We have one of the lowest infection rates anywhere, and as they note, as is typical in a high-income country, the majority of our new infections still involve men having sex with men, and most of those are men who report getting infected here in NZ.

We are a small country, with a small population, and what is by most countries' standards a tiny population of HIV+ people. Even when you include those who have died we have only had about 3,000 people infected - and roughly have 2,000 living with it now.

We don't get a hell of a lot of attention from the government, which also reflects the tiny HIV+ population I guess. The recent much-anticipated Miller Report basically said everyone working in the field is doing a good job but they need more money. Well, that's no surprise. Fat chance we'll see any extra cash though. And I'm a bit disappointed it didn't take a more critical view of some aspects, I have to say.

I'm one of those men who got infected with it overseas - probably in the USA when I fucked my way from San Francisco to New York in 1984. Hey, I was 23 and out for a good time. One of the first pieces of safe sex advice I got in NY was to give anyone I wanted to go home with a hug, and try and slip my hands in his armpits to see if his glands were up, and if they were, to make my excuses. No condoms and lube on the bars in those days.

It's hard to remember just how bad it was back then, the level of fear and hysteria that surrounded it all was intense. There was a lot of bigotry, a lot of ignorance, a lot of nastiness. Generally things are better than back then, but you still find the bigotry and ignorance - even in the gay community.

But for most HIV+ people - and I stress the "most", I know there are exceptions - life today is far better than anything we could have hoped for. Most HIV+ people in NZ are doing ok. Some are doing excellently. But some never really recover from the shock of their diagnosis. Some simply can't tolerate the side-effects of the medications.

I look at my own life with HIV, and see how much of an impact it has had. I've been working on my CV, and there is this big gap, from 1994, just when I was moving into a good place career wise, getting into management, and 2003, when I next have real work. I was simply too sick and weak through that time to work. It hasn't done my job prospects much good.

And like many guys who have had it for a long time, I still have that sense that it is all going to come tumbling down around me. I find  personal long-term planning difficult, and at times I still can't quite believe that I have a future, that I'm not an invalid, that I won't be back in hospital in a few weeks. It's weird, because I actually do have a very good life, I feel loved and cared for, I have wonderful friends, I do pretty much what I want, though I'd like more financial security - but who wouldn't?

So my feelings are mixed around World AIDS Day. It's good we get a little attention. Basically, in NZ, if you have HIV you can do pretty well: you will get access to good medication, if you're near a big city you'll get excellent medical care.

But having HIV still sucks. Keep yourselves safe, don't get it. It is really not something you want in your life.

Tuesday, November 9, 2010

Who's to Blame?

I saw this piece in Poz saying that 65% of US gay men think anyone HIV+ who barebacks (has unsafe sex in other words) without disclosing their status should face criminal prosecution. In other words, if two or more guys decide to go without condoms, and one is Positive and hasn't told the other(s), he has committed a criminal act.


Now in NZ, if you know you're Poz, you don't have to disclose your HIV status to sexual partners, so long as you take every reasonable precaution to protect them. That means use condoms. But we should all use condoms.

I'm just a little bit torn on this. On the one hand, yeah, if you know you have HIV, (and remember, about 30% of HIV + people DON'T know they have it )  you do, I believe, have a greater moral responsibility to protect the people you have sex with. So, in the first place, if you're poz you shouldn't be barebacking anyhow, unless maybe it's with someone else who is poz too, but even then, it's not recommended. And most HIV+ guys are very careful and concerned about protecting their partners.

But it takes two to tango, and if you believe you are HIV Neg, what the hell are you doing having unsafe sex anyhow? It's not all our fault or responsibility. HIV Neg guys have a duty to look after themselves - if you take the risk and get infected, I think you have to accept some of the responsibility here. It's as if they think they should be able to fuck without rubbers because they are HIV Neg, like it's some sort of a right, and HIV+ guys should exclude themselves from the sexual scene.

And here's the trouble with this approach. It breaks our world in two. There are those of us on the one side who know we have the virus, and we are supposed to act in one way, according to this logic, and those on the other side, who are allowed to act in another. This weakens the whole idea of safe-sex, that it's not just about protecting yourself, it's about protecting the community, and not picking on people with HIV to carry the whole burden. The original safe sex message was for everyone to use condoms, HIV+, HIV Neg, no matter what your status. That way everyone can have fun, and people with the virus aren't singled out. I still think it's the best approach.

Turning one part of the population into criminals for doing what the others do just leads to stigma and injustice.

But what about when someone knows you are HIV+ and has unsafe sex with you anyhow? That's happened to me, I've been fucking with guys who know I have HIV and then realised that he's no longer wearing a rubber. It pisses me off when that happens, immensely. But it has happened, and more than once. Usually they justify it with things like "Your viral load is low and I've read..." or "You look so well..." . It feels like a violation to me.

Am I too blame if he gets infected? And how would we prove it any how?

If someone knowingly sets out to infect others, lies about it, and persuades them into unsafe sex, that's a different story, and thankfully it's a very rare story too. But even then I think that if you are HIV Neg and take that risk, no matter how charming and persuasive he is, you have to take some level of responsibility.

The simplest and best answer: Use a condom.

Wednesday, November 3, 2010

It Gets Better - Even With HIV

I have really loved the whole It Gets Better project - I think it's so important to reach young gay/queer people and let them know that in fact the terrible shit we often have to deal with as teens doesn't last and life can in fact be pretty damn good even if you don't fit the normal patterns.

Some people have criticised it for being too simplistic, for not acknowledging the crap and bullying that can happen all through our lives, or for being too white and middle-class, and while I get that point, I think it ignores the fact that for most of us life does get better.

I've wondered if there would be any point to doing something similar but about living with HIV. Because, as shitty as it is to have this virus in us - and it is - it does get better over time. And again, there are exceptions to be kept in mind - it's not a bed of roses, but it's not as bad as it was in the old days.

Now I don't know how I'd cope if I were living in a small town and had HIV. I imagine it would be very lonely and difficult without good friends and other HIV+ people to share stuff with. Having a network of HIV+ mates and knowing how to use the services around, and just being in a gay community that is supportive of me and looks past my HIV makes a massive difference. I know I'm lucky. And some poz people have very limited choices about where they can live for all sorts of reasons, so they can't just up sticks and move to a bigger city with better access to support. I'd love to see something effective done to give those poz people better support somehow.

There is something lacking in support for HIV+ people in NZ, and to be frank none of the groups or organisations around are doing that good a job at meeting those needs right now, with the exception of Positive Women, and even they have their critics.

But, after that initial shock of diagnosis, which  can often take a couple of years to get over, or for some even longer, life with HIV does get better for most of us. You can travel. You can work. You can have a sex life.You can fall in love. You can lead a good life. Maybe it won't be the life you would have had without HIV, but you can still have a very good life.

It's important to hold onto hope, especially in the bad times. When I was diagnosed in 1988 I was told I had about 2 years to live - but I'm still alive, working, loving, playing, and enjoying my life mostly. I've had times of being incredibly sick, and for a long time I never imagined that it could or would get better - but it has.


Hold on through the bad times, ask for help and support. It does get better.