Follow by Email

Thursday, March 27, 2008

If Only it Were That Simple...

So I see the idea of “Negotiated Safety” (NS) has been re-appearing, both here on the message boards and in the rag. Actually, that’s unfair, Mark Farnworth in express actually wrote a fairly good, if historically uninformed piece on the topic. And at first glance it is easy to see why people go “Why doesn’t NZAF push this idea…?”

NS was first “named’ by the Australians, Kippax et al, in 1993 if my memory serves me right. They claimed they had ‘identified’ it as a strategy being used by gay men to avoid getting HIV.

I guess Mark was still in primary school when this first surfaced back in the early 90s. Official NS goes something like this: you and the guy you’re with go through a 3 month minimum process of discussing the idea, figuring out how much you trust each other, how easily you can talk about your sex-lives honestly and openly (and that’s never a problem, right?), with a counsellor, then it’s about getting tested, sharing your test results, waiting another month or so, and keeping on talking about it all, getting tested again, and then promising never to fuck around without condoms and put your partner at risk. Whoopee ! No-one has ever lied to their partner about sleeping round, right? And once you get out of the habit of using rubbers, just how many more chances are there for a little slip-up with someone you’re playing with on the side?

Now, that 3 month minimum “talk, test,talk,test,trust” idea was one thing, but what was seen immediately after this was promoted was that guys were meeting in bars and fuck-clubs and “negotiating” their safety over a few beers while feeling horny.

Horny gay men took it as an excuse to throw away condoms.

Well duh!

And HIV infection rates in Sydney went up.

Well, double duh!

Let’s face it. Gay men have been making their own risk assessments around HIV since we first identified the virus back in 1981. Some times guys have decided that the other guy looks “clean” (God I hate that word about being HIV-) and therefore it’s all fine. Sometimes they even ask each other if they have HIV, and trusting the other guy to tell the truth, move on that. The thing is there is nothing new here folks. We’ve been doing it since Year Zero of the epidemic. And yes, HIV+ guys will more often than not throw away the rubbers if they’re with another poz guy.

The trouble with this is that NS is not that effective a strategy for safe sex promotion, for keeping HIV negative men HIV negative, which is what organisations like NZAF are charged with.

Let me give you a comparison. Let me confess, there are times I get into my car and drive when I would be over the limit. I have never once been caught, nor have I ever once caused an accident driving this way. So I must be able to drive anytime I like when I have been drinking, right? Or maybe I’ve just been very, very lucky?

I can’t imagine the LTSA ever saying “Gee, a lot of people seem to be able to drive without killing anyone after a few too many, let’s start a campaign about how to drive a bit more safely when you’re pissed.” That is what NS effectively amounts to.

Does the Cancer Society tell you how to smoke safely? No? Why not I wonder, after all, my grandfather smoked from the age of 12 and died when he was 84. Mean Cancer Society must be hiding something from us, those killjoys.

Of course you can “negotiate”, and guys have been doing it and will continue to do it, no doubt about that. But to claim it is a good idea to promote it in terms of getting an HIV prevention message across, sorry, I can’t agree with that.

Part of my research involves interviewing guys about how they got infected. And I have at least one gay guy who was in what he thought was an honest, loving committed relationship, where they decided not to use condoms, and he got infected by his partner. They “negotiated” their safety, (I don’t have it, do you? No, cool…) except the HIV+ guy was so freaked out about his condition he couldn’t admit he was positive and that every time he put his dick up his boyfriend’s arse he was exposing him to HIV . So much for love and trust protecting you.

Yes, gay men will go on making their own risk assessments, as they have done since the start of the plague. Sometimes they’ll get away with it. But not always.

The idea that NZAF or any other organisation charged with promoting safe sex and with a special responsibility for gay men would push this as a safe strategy is just dumb. If you believe that it is a good thing, you really don’t get what the NZAF is there for. Guys do it, have done it, and will continue to doit, but it’s not a safe-sex strategy.
If you want to make sure you don’t get HIV, but want to enjoy a good sex-life, then use rubbers and lube.

I can guarantee you that every year some guys in New Zealand will practice a form of NS, just as we have since the 80s, and that some of them will get infected by people they thought they loved and could trust and some by total strangers they “negotiated” with in a bar the night before.

No comments: