By Patrick McAleenan, originally published on The Telegraph
The World Health Organisation has recommended that all gay men take antiretroviral drugs to stop the spread of HIV, but surely education – not more drugs – is the answer.
Anything else they’d like us to take responsibility for? Famine in Africa? Unemployment statistics? Binge drinking in Magaluf?
Being gay can often feel like the world is against you, and yet again the planet’s HIV epidemic is being firmly placed on our shoulders. I’m talking about the news that the World Health Organisation has announced for the first time that men who have sex with men should take antiretroviral drugs, in a bid to try and contain the growing rates of HIV in gay communities around the world. That’s all men who have sex with men. No mention of men who have sex with women. Are they all suddenly having safe sex?
In guidelines published last Friday, the WHO said that it “strongly recommends men who have sex with men consider taking antiretroviral medicines as an additional method of preventing HIV infection”. Gottfried Hirnschall, the head of WHO’s HIV department, said that infection rates among homosexual men are increasing again, 33 years after the epidemic first hit. According to the report, men who have sex with men are 19 times more likely to have HIV than the general population.
I’m not arguing with those statistics, but I do believe it’s important to challenge the constant message that binds all gay men to the rising HIV epidemic. Worryingly, this latest recommendation does nothing to dispel the myth that all gay men are promiscuous, irresponsible or ignorant and regularly play Russian roulette with their sexual health.
Hirnschall highlighted the fact that HIV doesn’t hold as much fear to a younger generation because of the availability of effective drugs to live with the condition, but are more drugs really the answer? Doesn’t the fact that people have become complacent about HIV imply that what we really need is to address is the severe lack of education around contracting it and other STDs, rather than funding and promoting yet another expensive treatment?
This education needs to start with young people, both gay and straight. However, we first have to address the fact that many adults believe that it is inappropriate to talk to young people about sex in full and frank detail, out of fear that doing so will encourage them to indulge in risky behaviours. In many situations, these attitudes are based on moral or religious views rather than any real evidence, and as a result have severely limited HIV and AIDS education in the UK. It is simply wrong to assume that talking to young people about safer sex and the importance of using condoms leads to an increase in sexual activity.
Young people, gay and straight, are having sex, and they are experimenting with drugs and alcohol, just as their parents did. It’s a fact that we, and especially parents, shouldn’t ignore. Some experiment more than others, some play it very safe. Some experiment with behaviour that some adults would view as “immoral”. We of course need to protect children from potential harm, but in teaching them about sex we need to ensure we don’t focus on the negatives, the dangers, and reduce it to argument about what’s moral or immoral.
There is still an assumption among many in our society, which is being passed on to the younger generation, that indulging in “immoral” sex and illegal drug use will lead to HIV infection. This simply perpetuates the stigmatization of people who are living with HIV, and risks implying that anyone who has HIV is therefore involved in “immoral” activities, and has got what was coming to them.
The WHO guidelines feel like a step backwards, promoting a negative gay stereotype that I thought we were moving away from. Let’s be clear: a more relaxed attitude to HIV is not exclusive to the gay community. It’s an attitude that’s become prevalent across all communities. The report will encourage straight people to believe that HIV is simply a gay problem, and that they themselves are off the hook.
I am not against antiretroviral drugs where they are needed. The report correctly highlights that antiretroviral drug use can reduce the chance of passing on HIV by up to 92 per cent. However, other studies tell us that, when used correctly, a condom is about 98 per cent effective. Shouldn’t we be focusing our efforts on educating people to use condoms (which are cheaper than drugs and side-effect free) instead?
A fraction of the cost of investing in vast amounts of antiretroviral drugs would go a long way to creating a programme that educates us all – gay and straight – about responsible sexual health.
Instead, the WHO appears to have created a situation with a very clear winner (drugs companies) and a very clear loser (gay men).