WOK around China Town: September 26, 5:30 - 8:30 Dinner at 6 pm.

This news article by Trenton Straub firrst appeared in POZ on-line August 4, 2011.

It’s not every day that we come across HIV-related research that explores health-promoting sexual behaviors. So when we came across the article “USA Study of Sex Toy Use by HIV-Positive Men Who Have Sex With Other Men: Implications for Sexual Health” in the International Journal of STD & AIDS, we wanted to know more.

Conducted by the Center for Sexual Health Promotion at Indiana University in collaboration with Online Buddies Inc., the survey included 2,275 HIV-positive men who have sex with men (MSM). Participants were recruited from Manhunt.net and spanned the United States; most were white (83 percent), Latino (7 percent) or black (4 percent).

The survey set out to look at sex toy use and its implications for health among positive MSM. It found that 70 percent of participants reported using at least one sex toy in the past year, including dildos (49 percent), butt plugs (31 percent), vibrators (28 percent), masturbation sleeves (17 percent) and anal beads or balls (16 percent). And 31 percent reported using toys in the previous four weeks. White men were more likely to use toys, and men in sexually active relationships were more likely to use toys than those not in such relationships.

Before beginning, the researchers hypothesized that using sex toys not only increased sexual pleasure but also lowered the rates of sexually transmitted infections (STIs) and lead to fewer instances of unprotected anal sex.

To find out the results, we spoke with Joshua G. Rosenberger, PhD, MPH, who’s an assistant professor in the Department of Global and Community Health at George Mason University in Virginia and has a joint research appointment at the Indiana University School of Medicine and the Center for Sexual Health Promotion.

Your survey results found that positive MSM who used sex toys were not statistically more likely to have an STI or to use condoms. How does this bode for your hypotheses going into the research?

Overall we saw relatively low rates of people reporting risk reduction as a primary reason for toy use. What we found with the sex toy use was, not surprisingly, it was more commonplace for sexual pleasure. When we created the survey, we were more interested first in documenting the [sex toy] behaviors—focusing on how much do you enjoy this, how do you incorporate this into your sexual life—because no one had ever done that. [Risk reduction] is important, but that wasn’t our main goal.

Now that you know more data about sex toy use, how would you like to see the data used among advocates and health practitioners?

First and foremost, it’s a way to educate them that MSM sex is not just anal sex and that there is a whole sexual repertoire that exists. There really needs to be more discussion and dialogue about what that looks like. We spend so much time on disease transmission, on labeling gay, bisexual and other MSM as having all this anal sex.

When you’re thinking about HIV, [sex toys are] just one other risk reduction strategy. You can easily recommend toy use as a safe way to engage in fun, healthy sexual activity in which both people can get satisfaction and pleasure without risk—and you can teach them the necessary steps around toy use, which would include making sure the toys are cleaned properly. And really just putting that message out as another alternative. It’s not just abstinence; it’s not just condoms; here’s one other tool that you can use to make sex possible.

You’ve done previous research on sex toy use among the larger U.S. population. How do the MSM results compare?

The numbers, in general, are mostly the same across the board in terms of rates of use and lifetime use, [but] slightly higher among MSM. There’s actually a paper under review right now that’s looking at a final study we just completed with women who have sex with women, and we have questions in there about HIV infection and women who are HIV positive.

Can any of the takeaways from this MSM survey be applied to other groups?

Absolutely. That’s why it’s important. The implication of what can be done [in terms of risk reduction and sexual health and satisfaction] can be extrapolated to any population, regardless of [HIV] status.

The survey did reveal some interesting aspects of the general health and sexual activities of MSM living with HIV. It was great to hear that 91 percent of them described their health as good, or excellent or very good, and then there were the findings that 53 percent were not dating, and yet that 88 percent were sexually active. What do these stats say about this population group?

I think that the overall data is saying that men living with HIV are actually not that much different from those who are negative. And I think that’s an element we’re often forgetting within the public health domain, [which is] always looking to point out all the differences. It’s overall a pretty healthy population. So it really demonstrates that HIV is not the end all be all and all of a sudden you’re doomed, and there’s no more sex, no more relationships. With medical treatment, there’s no reason that [people living with HIV] shouldn’t be engaging in safe and happy and healthy sexual behaviors.

The survey looked at whether condoms were used during the last 10 times participants engaged in anal intercourse. The HIV-positive MSM who were the insertive partner, or the top, reported using condoms an average of 5.85 times out of 10. Those who were receptive, or bottoms, reported 5.68 times. Can you put these figures in a larger context?

We don’t have partner data for these events. And a lot of research out there talks about, or asks, “Did you or did you not use a condom? Yes or No” without understanding the contextual factors, such as not knowing their status, whether people ejaculated during this event, [whether they were with a long-term partner or was it an anonymous encounter]—all those factors that actually, when you’re thinking about risk, are important.

Having said that, we found that the number of events that were protected [averaged at nearly 6 out of 10]. Some people interpret that as 40 percent of sexual events were condom non-protected. Data from national representative studies [show] that among gay and bisexual men, regardless of HIV status, the rates of condom use are higher than in the heterosexual population in the United States. I think that gives you a nice comparison. Condom use might not be perfect; it may not need to be perfect; if there’s not a risk of disease transmission, then there may not ever need to be a reason to use a condom.

And now the million-dollar question, if the data can answer it: Does using sex toys make you more sexually satisfied and healthier overall?

What we found was yes, individuals who reported more toy use were more likely to report higher rates of satisfaction, pleasure and all of the domains that are associated with sexual happiness. [However, here’s the chicken-or-the-egg conundrum: How do you know whether toy use makes people more sexually satisfied or whether] people who are more sexually satisfied use toys? We don’t have that answer. We can’t really indicate which one leads to which.

Finally, why is it important to study a topic such as sex toy use among HIV-positive MSM?

It’s important to understand how individuals living with HIV construct their sexual lives. Being optimistic, a day will come when we have a cure or vaccine for this disease. It will be a shame [if] we look back at the literature and media [in] 50 years and [will not know] about the sex lives of gay men because all we’ve done is research about this one single disease.

And while [risk reduction] is certainly important, we’re [not] really taking into account that [HIV-positive] individuals are living healthy, sexual lives and have their own sexual health issues just as anyone else. Sex toys are just one way to bridge this gap and still promote both pleasure and risk reduction.

It’s usually the sign that the person who is asking is one of the 76% of Canadian’s who are not tattooed. A cultural tourist. And yet, I’ve started to ask my poz friends with tattoos a similar question. What does it mean that the HIV+ are over represented in tattoo culture?

For many, the tattoo is a metaphor of difference, and history and popular culture have long associated  the tattoo with danger, two concepts familiar to any HIV+ person.  The permanence of tattoos and the permanence of HIV are certainly parallel. Could these shared characteristics be at the core of why HIV+ people are participating in tattoo culture?  My own experiences as an HIV+ person are certainly reflected in the narrative of some of my tattoos, and my first tattoo did come about after having tested positive. Getting tattooed back then was about cementing and broadcasting my own outsider status within my queer community, and less about the art.     

Local business owner Tim Fillion believes that the prevalence of tattoos among his HIV+ peers is about “recognizing that things can change, while tattoos do not” and is directly related to mortality.  My friend Garrett Rubin has a tattoo of the AIDS ribbon on his upper right arm, and has been HIV+ for over 3 years but sees no connection (besides the obvious) between being tattooed and having HIV “unless you’re in jail.”

In Canada, HIV is seven times more common in penitentiaries then in the general population. Despite this alarming statistic, access to clean needles for the purpose of tattooing was removed by the Conservative Government in 2009.  However, the connection between HIV and prison is only a small part of the story.  

I think the real reason HIV+ people are over represented in tattoo culture is connected to one of the major motivations of becoming tattooed in the first place: the commemoration of a life event or journey. HIV is definitely a game changer, and as a result, many of us are seeking help in adjusting to our new realities. While it may have sounded absurd 40 years ago to suggest that getting tattooed was about self help and self care, tattooing today for many people is about working out personal and emotional issues on their bodies.

The scars of HIV can be very deep; why not cover them up with something beautiful?

Tattoo, Ink, Ed Hardy, HIV

Lately, I’ve been feeling more stressed than usual. Life has changed a lot over the past couple of years and the effort and knockbacks involved in getting it back on track are starting to frustrate the hell out of me. In addition to that, I’m dealing with some other problems, including a close relative who is very ill.

I called my dad who responded with, ‘Things could be worse’, which I have since added to my growing list of ‘Most useless things people have ever said to me’. Not that I’m disputing that things could be worse. It’s just that pointing that out doesn’t acknowledge or help me with my problems. It’s a bit like saying, ‘What the fuck are you complaining about?’

To top this off, I’ve been feeling like an emotional sponge of sorts. I’ve had at least three people rant at me this week with various problems, in one case for thirty minutes in connection with the devastating occurrence of a broken hairdryer and related life-changing consequences.   In each instance, I’ve had around two minutes of input in the conversation.

I read some time ago of studies demonstrating the negative effect of stress upon the immune system. I don’t fancy ending up like the unfortunate rodents, who after prolonged exposure to stress, developed ulceration of the stomach and a shrunken thymus.

Also, apparently wounds take longer to heal when stressed. In one study, participants were wounded using a punch biopsy. Those who reported more stress took longer to heal than those who reported less stress. This might explain why I have been experiencing a recurring anal fissure which has this week again decided to show face, culminating in the lowest point of my week – walking like a penguin in the rain for 20 minutes feeling like my behind had busted open.

My stress management techniques pre-HIV diagnosis mainly usually involved guzzling a bottle or two of wine and/or heading out and getting completely twatted out of my mind. Not very helpful, as you can imagine...

Lately, I’ve been trying out some progressive muscle relaxation. This involves tensing and relaxing various muscles in the body, with a view to promoting relaxation. I’m having some success with it, indicated by the fact that I usually fall asleep whilst doing it due to the cosy feeling it gives me.

The next step is to get my dusty running shoes out, and run the stress out of my body. That will have to wait though, as running with an anal fissure is probably ill-advised.

If anyone has tips on how they manage stress, it’d be great to hear them!

Bob Leahy: You've written a play - a musical  - called Living with Henry. I know it's about living with HIV today.  I don't think many people are telling that story. Tell me why you wanted to tackle that subject in 2011?

Christopher Wilson: This piece importantly frames HIV as a chronic illness, rather than a death sentence - following the AIDS epidemic in the 80's and 90's.  It however explores the very real challenges inherent in living with HIV - including disclosure issues, fear, family dynamics, medication management and interpersonal relationships, as affected by the virus.  These very important and hard-hitting issues continue to confront both our gay community and the community at large.

BL: I agree. So give our readers an outline of the story you're telling.

CW: The story revolves around it's central character, Michael - a gay man working hard to figure his shit out! The plot includes disclosure challenges with a BF, intense family dynamics, fear with a lesbian best friend, a near-death experience - and a marriage that ultimately breaks down and dissolves.

BL: I like it. How would you describe the tone of the piece?  Sad, funny, reflective, optimistic?

CW: All of the above! The piece is quite an intense emotional ride - but it's filled with honesty, authenticity, humour, sexuality - and introspective reflection.  I won't give away all the juicy details, but when you're talking about HIV/AIDS as it affects the human condition - it's all gotta be there, baby!

BL:  True. Now you've said your main character Michael comes to realize "the pain of the dis-ease".  What do you mean by that?

CW: "Dis-ease: refers to a state of imbalance, a lack of grounded-ness and a potential spiraling out of control. The principal character Michael, lives with HIV - but his life choices and resulting emotional state contribute adversely to his personal health and well being, in context of the story.

BL: I see.  And the music?  Where does that fit in?  Is it easy to take a serious subject like HIV/AIDS and write songs around it?

CW: I 'm a professional musician - so music is my soul language.  Though I have never formally composed prior to this venture, the piece is in many ways autobiographical - so the music evolved and developed very organically.  It's further been workshopped and shifted in the rehearsal hall - but the music serves the piece as a dramatic device and comes out of the intention of the scenes.  When it can't be simply said - it has to be sung!

BL: Talking of singers, you've assembled a great cast.  Tell me about them.

CW: Man, they fucking rock... all of them!  People often ask me if they have to audition to be my friend (LOL).  My nearest and dearest are some of the most extraordinary musical theatre artists in Toronto!  Instead of paying a hundred bucks to see them at a theatre, I have them over for a dinner party.  I want to particularly mention our lead - Ryan Kelly.  He's an incredible queer artist that has contributed significantly to the queer theatre scene here in the city.  And he's kicking ass with "Living With Henry"!

BL: I think I can count on the fingers of one hand musicals that have tackled AIDS.  I can think of Rent and I can think of Zero Patience.  Have you seen those and how do you think they fared?

CW: I've seen both pieces on stage and in film - and I think both works gave an incredibly beautiful, heartfelt and authentic account of the epidemic at the time they were written and presented. These works have unquestionably inspired my work!

BL: I'm looking forward to it.  But do you think people want to see a show about HIV in 2011? And has that been a barrier to getting this show staged here in Toronto?

CW: HIV is still such a real issue, though it's face has changed dramatically since it emerged thirty years ago. I feel people have become somewhat complacent about the issue in many ways, and yet - it is still so fucking hard for so many to negotiate!  The Fringe was a lottery so we were fortunate to get the spot to share our work this July.

BL: I see The Normal Heart revival, the AIDS-era show by Larry Kramer, is doing really well on Broadway right now.  I think Buddies also has it in their 2011-12 line-up.  I'm surprised, but as a person living with HIV myself, I'm also kind of delighted.  How do you feel about it?

CW: Very cool, indeed!  A friend of mine recently saw the show in NY and Larry himself was handing out a personal letter to patrons as they exited the theatre. I read this missive - which spoke to the reality of all those men who died of AIDS in the last thirty years.  Each man had a name, a family, dreams and aspirations - and none of us should ever forget how their loss has abundantly informed the medical advancements that now allow individuals such as me - to live long, healthy and abundant lives.

BL: Yes, so why do you think that particular play - it's a period piece specific to the early days of the epidemic -  is clicking with audiences now?

CW: It's a human story about loss and overcoming adversity as best as we all can.  We all deal with this shit, day in and day out.  It's the human condition and it's fucking messy at times - but also beautiful!  As an aside, our very own Ryan Kelly will also be appearing in the fall in the Buddies/Studio 180 production of "The Normal Heart".  Can't wait to see it!

BL:   Me too.  I should add that I'm equally delighted that you're tackling the topic of HIV in 2011.  Good for you!  What emotions do you think this piece will stir up for people living with HIV?

CW: This is a tricky question to field.  I think many positive individuals will feel a deep commonality and resonance with the piece.  I think others will say, "Fuck you! I hate AIDS theatre - and that's not MY story!"  It's true, it's not their story - it's mine for the sharing.  I can't dictate or speculate how others will be affected by the work - it would be presumptuous and inappropriate.  I only hope that myself and my entire ensemble can stay true to telling the most honest and authentic dramatic story that we can together.

BL: You're a gay man, right?  And every gay man relates in some way to the epidemic. But it often depends on how old they are.  Were you around in the early days of the epidemic? (I guess I'm asking how old you are, in a roundabout way, LOL.)  What's your relationship to the virus?  Have you had friends die?

CW: I'm a 37 year old gay man. HIV/AIDS was a hot topic when I became sexually active in the 90's and has been a part of my culture since adolescence. I'm also an HIV positive man, having lived with "Henry" for ten years.  Having lost friends and colleagues to the virus along my journey, their loss has spurred on my passion to express this deeply personal story as best I can.

BL: That's good to hear. I think this is the first show you've written, right?  Tell me what it means to you to have it performed here in Toronto.

CW: This piece began with my personal HIV diagnosis - and grew as a means to cope with something that was initially very frightening - to shift it into something more humanized and emotionally manageable. So many people in my cherished community that have supported me through the toughest times, live here in Toronto.  So it's an honour to pay homage to them through this work.

BL: So what is the take-home message of this show? What do you want to achieve?

CW: Everyone has a potential Henry.  Though Henry is a specific analogy for HIV in this piece  - Henry also represents a seemingly insurmountable challenge in someone's life that is overcome through love, compassion, community and a hell of a lot of hard work! Henry could represent depression, diabetes, mental illness, cancer... anything that gets up in your fucking face, in the way and takes up space!  Our bigger goal is to relate universally - and encourage individuals to find the means to "get good" with their own personal Henry.

BL: Good.  Now how can people find out more about it?

CW: Info on the show is available on our production website: www.livingwithhenry.com .It can also be found through the Toronto Fringe Festival website: www.fringetoronto.com Or by calling the Fringe Box Office at (416) 966-1062 - but do it before our opening on July 7th !!!

 Beyond Boundaries with The Toronto Fringe Festival presents

Living with Henry

Written and composed by Christopher Wilson

Opens July 7 and runs to July 17

At The George Ignatieff Theatre- 15 Devonshire Place, Toronto

Tickets $11 in advance, $10 at the door

Available by phoning the Fringe Box Office at (416) 966 1062 or at www.fringetoronto.com