Public speaking isn't for everyone. It used to scared the shit out of me. 

By getting involved in public speaking I’ve seen many people struggle with it just like I did. We all have a story, and you would think that telling our story would be easy but it really isn’t. It’s our story; how could we get it wrong? I’ve learned there is a right way and a not so effective way to do it. You can ramble on and on and bore the hell out of the audience or you can leave the audience with some information they can relate to and leave them with a message they can take away with them. 

I belive that we need to put faces and stories to HIV and show the world that it can happen to anyone, it can happen to them. We have to stop this belief that it is just a gay disease and or something you just don’t admit to or talk about. I also believe the more people that can find the courage to speak up, it will help those of us who are living with HIV and feeling the stigma. I would never insist that anyone do what I do but if it helped them live a fuller life, not having to hide it from family and friends, it might serve a purpose. 

I haven’t had all the opportunities to speak that I had hoped for. Someday I hope I do. One of my pet projects is the healthcare business. I have worked in healthcare and I have seen people show their fear of gay people and HIV. At one place I did my practical in, there was a gentleman in the facility with AIDS. My fellow students all voiced their opinions that they wouldn’t work with that person. We were taught that the only thing we needed to do was to use universal precautions like any other resident but they still had their reservations. 

I have sat on two panels for my ASO, at our annual symposium on HIV and aging. I feel the healthcare system needs to hear that they don’t have to be afraid of me. At the second symposium I was asked to give my opinion on what I would like to see happen. I forget my exact words but this is what I tried to convey: 

Back in the 80’s, doctors, scientists and the people living with this new disease worked together, they were leaders that brought us to this point, where today I can live with HIV, I don’t have to develop AIDS, I don’t have to die of AIDS. Many humans endured the first trials of medications, many died from them but these leaders learned and they kept fighting for more. Now - we are the new leaders to take us to the next step, to grow old and be treated with dignity. By 2015, half of the people who live with HIV now will be over 50 years of age, many of us may need to go into the healthcare system and they just aren’t ready for us. Sure there are some places operating solely for HIV patients in some bigger cities but what about me? I live in a smaller community and will have to go into a local place. Soon it won’t be one or two people every ten or so years but it could be ten people every few months. We need to educate the facilities and their employees. 

Some other messages I try to leave people with are below. I don't use them all in one speak; in most cases you are only allowed a short period of time. (The most time I've been allowed so far is twenty minutes.) 

1.   Everyone is at risk now. Don’t think for a minute it can’t happen to you. You need to know what your risks are. If you can’t remember what you did the night before, ask yourself, “did I take a risk?” If you can’t answer that question, go get tested. 

2.   If you are re-entering the dating scene…..well, it’s changed. Don’t take someone's word that they are negative, ask them and find out. Insist on using a condom. A person who cares about you and about themselves will not have a problem with using one. HIV is still here, it didn’t go away and STIs are out there as well. If you contract an STI first, your body is busy fighting it and HIV can find its way into your system a little easier and in most cases your body will continue to fight the STI first. 

3.   If you know someone, such as a friend or family member, who you believe may be putting themselves at risk, talk to them, support them to go and get tested and go with them if you have to. 

4.   HIV is not a death sentence anymore but it is a LIFE sentence. You can live to be a much older person with the medications we have today but it won't always be easy. Some of the medications come with side effects. 

5.   If you do test HIV positive you will have to tell every potential partner you have throughout the rest of your life. If you are 20 years old today, you can live to 70, maybe 80 years old, do you want to have that responsibility for that long?  Sex doesn’t end at 50. Failing to disclose your status could lead to some very serious legal circumstances and you could go to jail. The law hasn't caught up to the current information and facts. There are people fighting to have them changed but it seems to be one step forward, two steps back right now. 

6.   They say that every twelve seconds, someone in the world will become infected with HIV. One of those people may be in your neighbourhood and if they were, would you support them? It's believed and statistics are available that show approximately 26% of men who have sex with men don't know they are infected or haven't been tested. They are now trying to compile statistics on women who don't know their status. 

7.   There is so much stigma attached to HIV/ Are you prepared to live with it. There doesn’t have to  be the stigma that there is, only when people get the education and the truth, we might see an end to the stigmatization. 

8.   HIV has been around for over 30 years now, let’s not let it be around another 30 years. 

I was never expected to give a play-by-play of how I became infected; in most cases it isn’t necessary. At most of the speaks I’ve done it was explained there will time to ask questions but I may not want to answer if they were too personal. I don’t have a problem telling that part so I will talk about it. The main thing is to be honest about what you say. 

It looks like this subject is going to be a two parter. So until then…………

Since the last International AIDS Conference in Vienna in 2010, the landscape has changed significantly.  Two years ago, for instance, HPTN 052 was not even in our collective vocabulary.  Now it’s ubiquitous, and the issues it raised – the promise of a 96% reduction in transmission rates for those on treatment (although it’s not quite that simple) are a principal focus of AIDS 2012, as they should be. But where is Canada on this and other recent advances – and are we slipping from our position as once world leaders in the response to HIV?

I think we are. Not that there isn’t some good news, things we can be proud of  - and we’ll get to those in a minute, but in the last year particularly, that has been overshadowed by an overwhelming statis that has set in.  So while other countries have recorded remarkable progress in reducing infection rates, for instance, we now flounder, the product of an unsympathetic government and a community that has grown sluggish, uncoordinated and, dare I say, timid.

So where does Canada stand in 2012?  Let’s get the bad news out of the way first.

On criminalisation, we do in fact lead other countries – but in the worst possible way. The number of prosecutions for non disclosure here surpasses any other country on a per (HIV+) capita basis. Our response to this, while vigorous, has been ineffective.  Praiseworthy  efforts  by community advocates in Ontario to introduce prosecutorial guidelines to limit the number of prosecutions have instead been met by efforts from the Crown Attorney’s Office to make disclosure laws much, much harsher – with, they suggest,  disclosure required for any sexual act regardless of the risk. If successful, this will see prosecutions sky-rocket. It’s a prospect worthy of Iran, and, of course, potentially a major defeat for our community.

Moving to treatment as prevention, ironically a concept fostered in Canada, the world has been taken by its potential as a powerful tool, if not to end the epidemic but perhaps bring it to its knees, along with other prevention technologies. It’s clearly a key focus of IAS 2012, in fact, to see how the world can move towards implementing treatment as prevention, despite huge challenges, not the least of which is a worldwide reduction in the kind of foreign aid needed to make this happen. But where does Canada stand? We are undeniably a divided country, arguing over whether it works or not, and not just in regard to gay/bi men. No one has focussed on those divisions more pointedly than our foremost proponent of treatment as prevention, IAS past-president Dr Julio Montaner of the BC Centre for Excellence in HIV/AIDS. “Unacceptable” and “reprehensible” were the terms he used to describe Canada’s position in an interview with me for PositiveLite.com last year.

Just this week, in a letter to Canada's Minister of Health, Montaner said "You can prevent death, you can prevent morbidity and you can stop transmission. You can deliver on an AIDS-free generation. All you need to do is implement what we already know and we get it done within your political term."

One is not used to thinking of the US as a model, given the huge problems in access to care and treatment that country experiences, but our neighbours to the south have officially embraced treatment as prevention ahead of us.  It will be a challenge for them to make it work. But three other recent innovations have left Canada trailing also. Earlier this year, the US was quick off the mark in introducing revised guidelines which recommend, in many situations, that HIV treatment should start immediately on diagnosis. That, oddly, has left scarcely a ripple in Canada.  True, Canada has no national guidelines – healthcare is a provincial matter and so there is no real equivalent for the US guidelines – but Canada’s collective silence has nevertheless has been deafening.  Given that some of the benefits of starting treatment are better health outcomes, although some would dispute this, I would expect in the interests of newly infected individuals, there would have been a more vigorous debate here.

Are you HIV-negative, sexually active, a frequent tester (we hope so), heard  pre-test counselling a thousand times and think access to an at-home oral HIV test would both serve your needs and keep you even safer?  OraQuick has been approved in the States to do just that.  It’s not available in Canada.  OraQuick manufacturers have yet to make application to sell the product in Canada, but the wrangling has already begun, and I’m predicting will sink this product’s chances of increasing our HIV testing platforms here, a necessary step in bringing our new infection rates down. Kudos though to sane voices like that of respected researcher Montreal’s Dr. Mark Weinberg  who are stating quite noisily that Health Canada needs to approve the test.

And just this week, the FDA announced approval of Truvada for PrEPin the States, the first officially approved drug for use in HIV prevention, considered by most observers a major breakthrough in the war against HIV. Again, implementation is problematic. But where is Canada?

All this is well and good, you say, but we are winning the war on new infections in Canada, aren’t we? Or at least they are not spiralling out of control?  New infection rates are, in fact, stable. But people like Dr Montaner call stable “unacceptable“. "To have the knowledge, much of which has been produced here, to know how to treat, control and stop this epidemic and not implement it because of lack of political will is unacceptable and reprehensible” he told me. 

But are new infection rates in Canada stable? We really don’t know. The most recent Health Canada data on hand in the form of PHAC surveillance reports is from 2009. Now we know that our provincial health structure complicates reporting, but the questions remains: how can we track the effectiveness of this nation’s response  to the epidemic on the basis of numbers which reflect the prevention efforts  and behavioural trends of half a decade ago? The answer is, of course, you can’t.

Where else are we trailing? Well, it’s hard not to argue that in 2012 our collective commitment to GIPA (Greater Involvement of People Living with HIV/AIDS) seems lukewarm at best. Just look at the number of persons living with HIV being sent to Washington. Time was when provinces like Ontario fielded community members to attend  in large numbers,  IAS Toronto and Mexico City being prime examples. But these are harder economic times and GIPA is something we do only do if we can afford it. So few will be there.

And, in 2012, we in Canada still don’t have a national organization for people living with HIV, a united voice, like NAPWA in the States, for instance. 

Having said all this, not all is doom and gloom. In some of the most important markers of all – PHA longevity for instance - we are doing better all the time. Our drug regimes  - and more people have access to them here than in most nations - are simpler, easier to take, and have much improved side effect profiles than even five years ago. Standards of HIV care for many remain very high.

Public attitudes to HIV are improving too. Let’s ignore for the moment that an overwhelming majority of the public supports jailing those who don’t disclose their status, In fact the notion is surprisingly popular even amongst the ranks of people living with HIV.  Other attitudinal markers show good progress.  For instance, the CANFAR-commissioned report on public attitudes, knowledge and perceptions of HIV in Canada released this year indicates that HIV stigma may be declining, based on a number of measures.  For example, the report indicates . . .

• Substantial and increasing majorities of Canadians report that they are comfortable interacting with people living with HIV/AIDS in several situations
• Today, more than three quarters of Canadians would be comfortable working in an office where someone had HIV/AIDS (those who report that they would be “very comfortable” is up 7 points from 42% in 2006 to 49% in 2011) .
• Almost three-quarters (72%) would be comfortable shopping at a small neighbourhood grocery store where the owner had HIV/AIDS (those who would be “very comfortable” is up 4 points since 2006 and up 8 points since 2003).
• Six-in-ten (60%) Canadians would be comfortable if their child was attending a school where one of the students was known to have HIV/AIDS. Those who would be “very comfortable” is up 5 points since 2006.

Lower numbers than we would hope perhaps, but it’s the trend that is important. It’s the result of a lot of work, community education efforts that are paying off.

What else is going well?  It’s too early to measure results, but there are exciting things happening on the prevention front as we gain a better understanding of the drivers of behavior, particularly in the gay/bi men’s community, which continues to account for the lion’s share of new infections in Canada. Interventions drawing on gay men’s resilience, for instance, or applying a harm reduction approach to risk behaviour, could produce results that will turn things around.

And while advocacy is a dirty word (funders don’t like) it, activism in Canada is not entirely dead.  In fact a revitalized AIDS ACTION NOW! is more active, at least in Toronto, than in a very long time, and doing sterling work to boot.

All in all, it’s a mixed bag – a good news/bad news report card for Canada - but perhaps it’s always been like that.  What I think has changed in the context of AIDS 2012 is that Canada went to earlier conferences wearing the cloak of world leaders in all things HIV, our mission to teach.  People like our own Stephen Lewis, although representing the UN, were our mouthpiece. World leaders on HIV no longer, we have lots to be proud of, not least in our survival as one of the first nations affected by the epidemic, with thousands still alive and living proud, strong lives.  So Canada goes to Washington this time humbled and not to lecture or berate, but to acknowledge that we, as much as any other nation present, have much to learn.

I ended my ten part series about my life as a refugee claimant in Canada, A New Life in Canada, with me waiting for my hearing before the Immigration and Refugee Board (IRB) to decide whether or not I will be allowed to remain in Canada as a Convention Refugee  i.e. someone who has a well founded fear of persecution based on several factors, for example membership in a particular social group. In my case it's based on my sexual orientation and membership in the LGBT community. From then to now, a lot has happened. Including my refugee hearing. So here's an update of the proceedings.

I received notice of the date of my hearing back in January. It just so happened that the most important day of my life fell smack dab in the middle of Pride week. It was like a double whammy. Two important events in the space of a couple of days. Of course I had to prioritize and focus my energy on the hearing as opposed to Pride. But let me just say that it wasn't as easy as it sounds.  Since experiencing Pride a couple of years ago, I had more or less lived for that week every year since then. But my lawyer made sure that my time was preoccupied with daily prep sessions for the hearing. It was a hectic week!

As the date drew closer, my mind was constantly racing and I was a hot mess. No sleep, nothing but panic and worry about the "what if" outcome of the hearing. And the thought of going before a "judge" (IRB board member) to justify my claim was terrifying. Especially since this person had the power to send me packing. In other words, my life was in the hands of a total stranger. I knew what was involved when I decided to make my claim so I really shouldn't be bitching but it was scary nonetheless.

I had some really great folks in my corner and support network. For example the Newcomer Community Services Coordinator at the 519 Church Street Community Centre who leads the weekly Among Friends Refugee Peer Support group. The group is a great way of feeling like part of the community. As a refugee you don't easily fit into the LGBT community but, thanks to this group, that wasn't much of an issue for me. The coordinator is a former claimant as well so she understands how daunting the process can be.

So with no Pride plans and nothing but worry, I relied heavily on those close to me to keep me from completely losing it. Though hearing the words "don't worry it's going to be fine" didn't reduce my anxiety around the date, it was good to know that they had my best interests at heart. Especially with all the changes around the refugee program and health coverage.

The morning of my hearing was surreal. All that I had done in the last year had now climaxed to this one day. The wait was over. I was accompanied by my lawyer, my partner, and two very close friends. As we all sat in the hearing room, which was located at the end of what seemed like an endless maze at the time, my lawyer went over the setting of the hearing. By this time, my mind was in some faraway land. I had no more concentration left in me.

When the IRB member entered the room, I was just about ready to pass out. He didn't appear as I had imagined. He was actually humane. That eased a bit of tension for me. The hearing lasted about two hours. I was questioned extensively. It was like an inquisition. Nearing the end of the session when my lawyer took over to give his summation/closing arguments, I had left the room mentally.

I was barely hearing what my lawyer and the IRB board member were saying. But as the member began to speak, I tried my best to tune into what he said. I thought I had heard him say that my claim was accepted but I couldn't be sure. By this time I was fully tuned in. He was giving his reasoning for his decision; one that I wasn't clear on since I didn't hear what he said. Then he said something the really shook me. He said that he didn't expect me to live in a cave having to hide my sexuality and live in fear of society etc... And that he accepts my claim. I almost had a heart attack. I was beyond happy.

Needless to say it was a very special Pride and Canada Day for me. I'm still in shock but I wanted to share this in hopes that it can help anyone in a similar position. Keep pushing through... It pays off!

Several months ago, PositiveLite.com posted an article about Positively Connected,  a social and support group for gay/bi men living with HIV in Victoria BC. The concept of this project is to provide safe spaces where guys can meet and talk about their experiences with HIV as well as connect as people with people. 

We work closely with the Vancouver Island Persons Living With HIV/AIDS Society and provide a coffee or pub night, a walking group a facilitated men’s support group and other activities. For support we also offer one-to-one connection, hospital visiting, email exchanges and check-ins, phone check-ins and more.

We have a presence on Facebook (Positively Connected Victoria BC) and are currently exploring how we can enlarge the mandate of the group to include all people living with HIV. However, the main focus will always be on the health and well-being of gay/bi men. 

This project is not funded through the local health authority. To that end, we’ve launched a fundraising campaign on Indiegogo.com. While we realize that not everyone can contribute to this campaign, we are grateful for people to forward the link to friends, family and colleagues to help keep a worthwhile project going. 

Please also consider donating by going here. 

Read about Positively Connected in the media here.

Editor Bob Leahy says: As someone who appreciates the value of support groups, particularly for those unconnected, I’ve donated to Positively Connected's fundraising campaign.  It's important to keep groups like this, by and for people living with HIV, alive. It's even more so when, like PositiveLite.com, they receive no financial support from any level of government.  I challenge you, if you are able, to make a donation also.

“Unexpressed emotions will never die. They are buried alive and will come forth later in uglier ways.” -Sigmund Freud

I hear many people in my social circles toss around the words ‘male privilege’ when talking about gender. I hear the contempt in their voices and the judgment in their pronunciations. Male privilege is bad, unqualifiedly bad.

 I’m not here to debate that point. I’ll leave that to everyone else.

What I’m here to talk about is the shadow side of that. It’s been said by advertisers that ‘Membership has its privileges’ however it also has its costs.

The costs, sadly, can be staggeringly high.

I found out this past weekend that someone I greatly respected and admired committed suicide. I am shocked, angry and afraid.

I realize that it could all too well have been me. 

It could be me simply because I am (now) male and in our society, men don’t talk about their feelings.

As I write this, I think about my friend who committed suicide recently. I found out that he died on Sunday over social media. While I’m glad that I know, I’m left wondering if the cost he paid for being male was worth it.

He paid for the privilege with his life.  Whatever was going on in his head that became so overwhelming that death felt like his only option, I wonder if the pressure would have been eased if men were well and truly encouraged to talk about how they feel?

I realize that society has moved forward and, in some spaces, given men the chance to explore those emotions; to talk about them and deal with them. I’m conscious of the fact that those spaces are often few and far between, commonly found only among counsellors and therapists.

I’ve even noticed it in my own life; a deep unwillingness to want to talk about how I am feeling. Observant readers will have noted that even in this post, I’ve not really done anything deeper than mention some feelings in passing and then moved on.

You see, men don’t talk about their feelings

It’s not hyperbole to say that my heart longs to let my friend know that he is loved, and missed. I wonder if the outcome would have been different if our society truly encouraged men to bring their full, emotive selves to the table.

I am a huge mix of emotions right now and, despite being socialized as female, I’m slowly losing the ability to tease out the nuances, to give voice to those shadows. Strong is the urge to just go and loose myself in some type of physical labour, to go to the gym or putter around the house and let my emotions settle on their own.

I know I shouldn’t do that, it’s not healthy.

I’m starting to realize that the cost to being male may be higher than I judged it when I began my journey.

I sure hope I have enough cash to get through because it’s going to be a very hard road otherwise.