The fifth workshop in the current series of free open discussion forums for people living with HIV hosted by the AIDS Committee of Toronto (ACT) will be held on Wednesday, January 9, 2013 at 7:00 pm at the Ramada Plaza Hotel, 300 Jarvis Street in Toronto. 

This month, the forum will focus on the challenges faced and successes experienced by HIV-positive newcomers to Canada. Topics to be discussed will include: 

• Ethnoracial diversity
• Getting into health care
• Navigating the system

The guest speakers are: 

• Dr Alan Li, primary care physician, Regent Park Community Health Centre, Toronto, and founding co-chair of the Committee for Accessible AIDS Treatment 
• Maureen Owino, Program Coordinator, Committee for Accessible AIDS Treatment 
• Sue Hranlovic, primary nurse practitioner and AIDS certified RN 

The forum will be webcast live so those who cannot attend in person can participate in the event online. The forum and the webcast will begin promptly at 7:00 pm and last two hours. 

To join the live webinar: login at 7:00 pm EST on January 9 (00:00 UTC, January 10) at www.actoronto.org/forum   

The forum will also be recorded and should be available for viewing on the day following the event at the same website: www.actoronto.org/forum   

This forum and webinar are free and no registration is required. For those attending in person, a light buffet will be available from 6:30 pm. 

For more information, see the flyer below or contact Robin Rhodes at This email address is being protected from spambots. You need JavaScript enabled to view it. or 416 340 8484 ext. 219.

Clinicians, researchers and representatives from Montreal’s gay community are joining forces to launch a major study, the IPERGAY trial (CTN 268), to evaluate the effectiveness of the drug Truvada in preventing HIV acquisition among individuals who are uninfected but at high risk. If it proves effective, this approach could contribute to eliminating the transmission of the virus that causes AIDS.

In a context in which gay and bisexual men are disproportionately affected by the epidemic (in Montreal, HIV prevalence within this population is estimated to be 13%), community members are mobilizing to assess how new prevention strategies can be added to existing approaches such as condom use.

The IPERGAY study involves comparing the drug Truvada to a placebo (a pill with no active ingredients). Participants will also receive prevention counselling, condoms, and other support, and their well-being will be closely monitored throughout the study. In addition, all participants will be tested for HIV at regular intervals and comprehensive medical care will be provided if an infection is detected.  Part of an international study, the trial aims to include approximately 500 men who have sex with men in Quebec, who will be enrolled for 4 years.  The Montreal study site will be based at CHUM-Hotel-Dieu in collaboration with clinics specializing in HIV treatment and community groups who do outreach to men who are potential candidates for the study.

The concept of daily pre-exposure prophylaxis (taking the medication every day on an ongoing basis) has shown some efficacy in previous studies. However, the success of this approach is dependent on the drug being taken very consistently each day, which can be difficult to maintain over a long period especially among individuals who are not sick. Daily pre-exposure prophylaxis is already starting to be used, but only on a very limited basis. For this reason, we want to rigorously evaluate a different concept, “on-demand” prophylaxis (taken when needed based on the frequency of sexual relations) that has not yet been scientifically validated. Our goal is to learn whether this approach is effective in preventing HIV infection, how easy it is to maintain over the long-term, and how it can be integrated into overall HIV prevention efforts in Montreal.

In the fight against HIV/AIDS, we are living in a period of renewal that has given new hope that an AIDS-free generation may one day be possible. Since the beginning of the epidemic, concerted efforts within the communities hardest hit by the virus as well as by clinicians and researchers have succeeded in transforming a fatal disease into a manageable chronic illness and have inspired belief in the possibility of its eventual eradication.  We are now, once again, gathering our forces to advance the fight one step further.

For more information about the IPERGAY study, please contact:  Ms. Pascale Arlotto, 514-890-8000 ext 15195; This email address is being protected from spambots. You need JavaScript enabled to view it.  

Cécile Tremblay, MD, FRCPC, Principal Investigator, IPERGAY Study – Quebec; Centre Hospitalier de l'Université de Montréal (CHUM); Institut National de Santé Publique du Québec

Mark Wainberg, PhD, Professor, Lady Davis Institute, McGill University

Robert Rousseau, Executive Director, REZO – Santé et mieux-être des hommes gais et bisexuels

Ken Monteith, Executive Director, COCQ-SIDA

Joanne Otis, Canada Research Chair in Health Education (CReCES), UQAM

Thomas Haig PhD, Coordinator, SPOT Project, CReCES, UQAM

Pascale Arlotto, Research Coordinator, CHUM

Gabriel Girard, PhD, Concordia University

Benoit Trottier, MD, Clinique L’Actuel, CHUM

Jean-Guy Baril, MD, Clinique Quartier latin, CHUM

David Thompson, President, Board of Directors, RÉZO

CTN researcher, Dr. Cécile Tremblay is an infectious disease specialist based at the University of Montreal's Faculty of Medicine. Dr. Tremblay is also the Director of Quebec's public health laboratory and she is the Canadian principal investigator for the CTN 268 ANRS IPERGAY trial

I often use PositiveLite.com as a place where I can let loose with some unabashed rants. But occasionally, I do get the desire to blog about things that I actually like! And today I have a topic in mind that really makes me smile – One brand condoms.

I couldn’t believe my eyes when our Public Health nurse showed up in our agency with bags of the artistic, ironic, and hilariously packaged condoms. Our staff went wild, sorting through the condoms, reading the taglines, and laughing. Each condom has a picture and tagline that is a play off the word “one” – such as, “Enjoy one”, “I O U one”, “Hot one”, “One a day”, “Don’t forget one”, “One likes it hot” – and my favourite, “One time at band camp”).  Each has a picture to accompany the tagline to heighten the joke (such as a picture of a flute with “One time at band camp”, a picture of a chili pepper for “Hot one”, an apple for “One a day” and a picture of Marilyn Monroe for “One likes it hot”).  

I counted 74 unique condoms, although there are many more that I haven’t yet seen. Some of the condoms have been designed through the “Become a Rembrandt of Rubber” contest where people submit their own designs. Brilliant!

There’s been significant discussion in the HIV/AIDS field about how to make safe sex sexy but not so much around making safe sex fun. Well, these condoms are definitely fun. The crazy designs and hilarious taglines make you want to collect them all, like cereal box prizes, only better.

One of their greatest benefits, I believe, is helping to de-stigmatize sex overall. These condoms don’t feel risqué or secretive – they are bold, bright, and playful. If these condoms fell out of my purse (which let me tell you, happens pretty often when you’re a sexual health educator), I wouldn’t feel embarrassed - in fact, you’ll want to display, not hide, these condoms.

A colleague of mine actually put out a great big bowl of these condoms at a party, which served up some great discussion and laughs. She actually worried that the condoms might be too nice – that people might display or collect them instead of actually use them.  But I don’t believe that’s an issue – if you’re in the position where you need a condom, you don’t care how cute that Dalmatian is on the package (One hundred and one!)  

It makes me wonder if maybe making condoms fun is the right approach. After all, as sexy as condom packaging can get, sex is so stigmatized that people can find it difficult to talk openly sexuality and pleasure. Maybe having condoms that look a little bit less sultry and a lot more playful is the key to making them more accessible.

These condoms would make for a great way of flirting (they look almost like calling cards that could be given to someone at a bar) or for easing in to the discussion of safer sex. I can imagine them being displayed in a bedroom in a fishbowl, providing a fun focal point to ease into the discussion around safer sex with a new partner.  

Other benefits to the packaging: they are easy to open, with an existing nick in the packaging to promote easy-tearing. Our only concern is that people need to know to push the condom away from the tear before ripping open the package, so that they don’t accidentally tear the condom itself.  Some of the condoms are also colourful; the colours deviate slightly from the normal primary colours of standard colour condoms – they offer a slightly more “tasteful” palette of shades.

How could these condoms not make safer sex easier to discuss and more fun to have!  I have only one question - why did it take this long for someone to make condoms that are this much fun? 

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. 

Con – not a smart arse, but a silly bugger.

In my previous article, I asked whether the designers of VAC’s Top2Bottom campaign were guilty of either falsely assuming there’s an immovable category of gay men who don’t use condoms, failing to use their imagination to design creative, challenging and compelling arguments to men who currently don’t use condoms, or afraid of challenging gay men who disagree with condom use.

Based on their response to that blog, which you can read in full here, I am forced to conclude that the answer is all three.

First up, VAC acknowledge that some men are already not using condoms:

“There is growing evidence in social and epidemiological research that indicates that men who do not consistently use condoms and water based lube as a prevention method are adopting different risk reduction strategies to minimise their level of HIV risk in sexual activity with casual and regular partners…

Based upon the research indicating that these risk reduction strategies are already being used by gay and bisexual men in certain settings, it was important that a new campaign be developed that spoke to men for whom condom use was not a regular option, in an effort to generate community discussion about the increasing complexity in HIV prevention, and provide up to date and accurate information about what the evidence says about risk reduction strategies so that people may make informed decisions about what risk they are willing to take when it comes to sex and HIV.” (emphasis mine)

This is akin to a company finding the sales of its product plummeting because of increased options from their competitors and deciding that the best way to get people to buy their product again is to develop a campaign that tells people all about their competitors.

Make sense to you?

The rise of tablets and mobile devices has completely changed the landscape of the computer market.  Microsoft in particular was badly hit, with sales of desktop PCs vanishing quicker than a sausage at a den night.  Their (eventual) response was to adjust their product to make it more appealing to the market, not to spend money on an advertising campaign telling you all about iPads and Galaxy smartphones.

Of course, if Microsoft were to do this, there would only be money at stake, and the survival of the company.  In the case of HIV, there are lives on the line.

If your job is to prevent HIV, and you know that condoms and lube is the best method to do this, then your job is to convince those people who don’t currently do this to change their behaviour, not to provide them with information about “risk reduction” strategies, particularly when – as VAC painstakingly enunciate in their briefing paper – every single one of these strategies is flawed.

The second problem is in targeting: how do you ensure you’re only targeting the men who don’t regularly use condoms currently?  There is certainly nothing in the campaign messaging to indicate this is the intention.

I am a condoms-every-time guy, and yet I see the Top 2 Bottom ads appear on my Facebook every day.  When I visit the site, all I see is a large amount of information about ways I can have unsafe sex, backed up by social proof that everyone else is doing it anyway.

You want to target men who aren’t regularly using condoms?  Then say so.

Lead your campaign with the line: “Not using condoms when you fuck?  Then there’s some stuff you need to know.”

Clearly outline why other methods don’t work, and provide examples of men who have rejected these strategies and remained HIV negative.  Tell people what you want them TO do, not what you want them NOT to do.  Negative campaigning has been proven not to work.

But VAC’s stated objective is not to change behaviour, it’s to create discussion. That strategic choice is fatal in terms of HIV prevention.  They conclude their briefing paper like this:

“We are pleased to see that Top2Bottom has elicited great community discussion and debate around the topic of risk reduction strategies for HIV prevention, and hope that this will continue to foster helpful discussion around what strategies men are using to help minimise their risk of picking up or passing on HIV.”

Anyone feel like we’re going in a circle here?  VAC have already told us they know what strategies men are using.  And they’ve also told us they know that there is only one strategy that works effectively to prevent HIV – condom use for anal sex.

Hiding behind the mantra of “increasing complexity” is not going to stop gay men becoming infected with HIV.  In social marketing and health promotion, your job is to make complicated things easy to understand for a mass audience.

At any rate, “increasing complexity” is a misnomer.  There is one method that works effectively to prevent HIV for sexually active gay men, and loads that don’t.

The question is not what pseudo-scientific methods gay men are choosing to avoid HIV, but WHY they are doing it.  Once you have these answers, you will begin to be able to devise ways of steering gay men back to the one method that works.

Does VAC have the balls to do this?  Or will it continue to concede ground and muddy the waters?

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