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Dec20

The case for condoms, part one

Thursday, 20 December 2012 Categories // Gay Men, Sexual Health, Health, Living with HIV, Opinion Pieces, Population Specific , Sex and Sexuality

Christopher Banks wrote “Mike is not a clever dick” in response to an HIV prevention campaign Top2Bottom from the Victorian AIDS Council/Gay Men's Health Centre in Australia. He calls for clear, simple messages about using condoms to prevent HIV

The case for condoms, part one

Mike’s a clever dick.  And he knows about undetectable viral load.  Do you?

As a matter of fact I do, I thought, as the ad appeared before me on Facebook.  But I’ve worked for AIDS organisations and in the gay media for a decade. So I guess other guys might not. I clicked on the ad to see where it’d take me.

The result is www.top2bottom.org.au, click here, a Victorian AIDS Council website designed to provide information about HIV and safe sex.  From the way the site is structured, it appears that its purpose is to counter common misconceptions about HIV transmission, but in actual fact it needlessly complicates matters and – concerningly in some cases – reinforces them.

Let’s start with viral load.  If someone came up to you at a party and told you they knew about undetectable viral load, would you give a shit? Chances are the answer is no. Because the simple fact is this: unless you are HIV-positive, viral load is of no concern to you.

It would be like having a depression campaign that tried to hook you with “Mark’s a brain box.  He knows about serotonin levels.  Do you?”

The thought transaction in the heads of most men is as simple as this:

  •  Do I have HIV? Yes/No
  • Does he have HIV? Yes/No

The answer to the first question is often based on a lot of presumption. The answer to the second question, if answered as “yes” by the other potential partner, will sadly often lead to the person refusing to have sex with them.  If the answer to the second question is “no”, then we’re back to presumption again.

The site reinforces the message on every page that condoms and lube are still the best way to prevent HIV and other STIs, but it is not the primary message.  It is the BUT message – literally.

And if you’re looking to change attitudes and behaviour, men entering the site with a false belief about safe sex will switch off once they get to the BUT, particularly when before the BUT you get sentences like this:

“Akil’s a smart arse… he doesn’t use condoms with his regular partner…”

“Steven’s a smart arse… he knows that always bottoming and his undetectable viral load means he’s less likely to pass HIV onto his boyfriend…”

“Con’s a smart arse… he knows he’s less likely to get HIV if his partner pulls out before cumming…”

“David’s a clever dick… he knows that having an undetectable viral load means he’s less likely to pass on HIV…

Akil is not smart.  By only using condoms outside his relationship, he’s assuming that his partner is doing the same thing.

The world of “less likely” that Steven, Con and David live in is just as illusory.  I’m less likely to get hit by a car if I cross the road outside of peak traffic, but does that mean I shouldn’t look both ways before I do it?

The compromise is in this messaging is deadly.  It simply accepts that some men do not use condoms (not all – according to the latest figures, nearly half of all gay men in Melbourne always use condoms for anal sex with a casual partner, and close to a third with regular partners) and tiptoes gently around the likelihood that this behaviour is going to eventually infect them with HIV if they continue to do it.

Imagine a drink driving campaign worded like this:

Mark’s a champion behind the wheel.  He knows that having a soft drink between rounds means he’s less likely to be over the limit, but it’s safer to drive if you don’t drink at all.”

In fact, here are the opening paragraphs of VicRoads page on alcohol and road safety:

Alcohol is a major factor in road deaths in Victoria. Each year about one quarter of drivers killed in road crashes had a blood alcohol concentration (BAC) of .05 or greater.

At a BAC of .05, your risk of being involved in a road crash is about double compared with a BAC of zero.

Imagine an information page about HIV and gay men that started like this:

  • Non-condom use is the major factor affecting HIV transmission among gay men in Victoria.  Almost 95% of gay men diagnosed with HIV over the past five years said that they had fucked or been fucked without condoms in the six months prior to their diagnosis.
  • If you’re being fucked without a condom, your risk of becoming infected with HIV is 20 times greater than being fucked with one.

Those are facts, and we are not short of them.

The Kirby Institute’s Seroconversion Study in particular contains a wealth of information about the beliefs of gay men up to and including the event where they became infected.

I doubt any of these men consider themselves to be “clever dicks” or “smart arses” now.  Congratulating gay men for their false beliefs about HIV is offensive and patronising.  We have seen an 8% rise in new HIV diagnoses in Australia over the past 12 months, three-quarters of which affect gay men.

How much of this sits on the shoulders of campaign designers who have falsely assumed that there is an immoveable category of gay men who don’t use condoms?  Is there a failure of imagination to design creative, challenging and compelling arguments to men who currently don’t use condoms, and then to deliver these in a consistent and continual way with reach and frequency (in the same way that advertisers that sell us shit we don’t need behave every day?)

Or is there a fear of challenging gay men who disagree with condom use?

The life-changing mistakes and misconceptions have been identified for us.  Let’s use them, unashamedly and directly, to create clear, simple, sex-positive messages about using condoms to prevent HIV.

This article originally appeared on Christopher Banks own blog BiPolar Bear here. 

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