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Something's not working

Thu 4 Jun 2015 In: Health and HIV View at Wayback View at NDHA

The most recently released data on HIV infections shows yet another increase in men-who-have-sex-with men (MSM) becoming HIV positive. This is not good news. It is fair to ask just what the New Zealand AIDS Foundation (NZAF) has been doing over the last few years to counter this trend, because whatever it is they are doing it is clearly not working. The Get It On/Love Your Condom campaign was initiated over five years ago, when Rachael Le Mesurier was Executive Director. It was a good campaign, winning awards and accolades, but it is fair to say it has been pretty to look at but ineffectual when we look at these statistics. It probably had an effective shelf-life of two years, and then they needed something new, but the NZAF seems to have a real blind-spot when it comes to engaging with new ideas and a changed environment. Some of this must come from the strategic direction set by the Board, and some of it is clearly from the operational side. Going back in time, as it was explained to me when I was Chair, NZAF was advised in the 1980s by advertising experts to stick to one simple message as consumers couldn’t deal with more complex messages. That message was, and is, use a condom every time you fuck. No ifs, no buts. I remember when I came back to New Zealand in 1993 telling a guy who was chatting me up that I was positive. He told me I shouldn’t tell him, or anyone. We should all just assume everyone we fuck with might be poz and automatically use condoms every time. Don’t ask, don’t tell, wrap up. That message made sense at the time. But that was a very different time. It means that NZAF has boxed itself in, and still has only one thing to say to people, one message: “Use a condom” . It doesn’t matter that you and your partner have been in a monogamous relationship for 10 years and tested HIV negative every six months, NZAF says you must still use a condom, to maintain condom culture. I know for a fact that people who work for the NZAF do not follow this advice themselves, they know there are situations when it’s fine for them not to wrap up. This is because we live in a very different world when it comes to HIV than we did in 1985. But if their behaviour doesn’t follow their own advice it points to the disconnect that now exists between what the messengers tell us and the real world we live in. We are all much more connected on a global scale, and exposed to thinking and campaigns from around the world that offer more nuanced and accurate pictures of what is and isn’t safe sex than NZAF does. For example, we know that it is true that the chances of getting infected with HIV by someone who has an undetectable viral load are for all intents and purposes zero. One of my medical specialists put it like this to me: “If you could somehow get a whole bucket of your ejaculate (technical word for cum) and pour it over an open wound on my arm, there is a vanishingly small chance I’d get infected, but on the available evidence I don’t believe I would.” This is called TasP (Treatment as Prevention) and it means that HIV positive people who are on effective medical treatment are basically unable to pass on the virus. And of course there is PreP. PreP means Pre-exposure Prophylaxis and involves taking one pill a day to stop you getting HIV, like the birth control pill stops you getting pregnant. You need to take it consistently for it to work, but it does work. Imagine if we’d had a pill that stopped you getting HIV 30 years ago? There are gay men on PreP now in New Zealand, paying for it themselves as it isn’t yet funded. But it is in use here now. NZAF is slowly and it seems begrudgingly acknowledging these changes, but the world isn’t waiting for them, as the fact that guys are finding their own ways to get PreP shows. NZAF is celebrating its 30th anniversary this year. I am a former Trustee and Chair of the organisation and honoured to be a Life Member, and a great believer in our mission, and I say our because I still feel part of NZAF. That’s true for a lot of us who have been involved. But seeing these results, and this upward trend in new infections appearing after all the self-congratulatory back-slapping that went on last year at the International AIDS Conference in Melbourne and more recently here, it seems to me that the organisation needs to take a good hard look at what it’s doing wrong as well as celebrating what it does right. I know that the Board and staff at NZAF will not be happy seeing these results. Nobody will. And you cannot blame every new infection on NZAF failure – but when it is a consistent upward trend then it’s reasonable to ask what’s going wrong. I asked one of the international delegates who attended the Melbourne conference last year what he thought of the NZAF, and he replied that to him ”It seemed like they were in love with the sound of their own voices, echoing out of the canyons of the past.” The world has changed, and it’s time for NZAF to engage with those changes and adapt and engage with them. Otherwise they are failing in their duty, and failing the community of gay men and our allies that set them up in the first place. - Michael Stevens is a contributor, social commentator and HIV positive gay man, who is a New Zealand AIDS Foundation Life Member and former Chair. Michael Stevens - 4th June 2015    

Credit: Michael Stevens

First published: Thursday, 4th June 2015 - 11:35am

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