Sat 14 Mar 2015 In: New Zealand Daily News View at Wayback View at NDHA
Shaun Robinson The New Zealand AIDS Foundation has defended this country's long-standing adherence to condom use as the primarily promoted means of avoiding HIV infection, calling those who advocate more reliance on medications to lower HIV transmission risk as a “ militant, noisy minority.” Visiting American porn actor Blue Bailey is amongst those who advocate for more opportunities for at-risk gay and bi men to have anal sex without condoms, based on reducing the infectiveness of those with HIV and pre-priming HIV-negative people with medications to ward off infection. The pre-priming technique is known as pre-exposure prophylaxis, or PrEP. “Blue Bailey seems to be a voice for the strand of American thinking that is militantly anti-condom, as if condoms are some kind of oppression of gay men,” says the NZAF's Executive Director Shaun Robinson. “There are gay guys around the world who buy into this view of the world but they are a noisy minority. In New Zealand we have shown that guys will use condoms on a wide-spread scale and we have seen that this dramatically reduces HIV. Our HIV prevalence in the gay community is 6.5% compared to 25% in Mr Bailey's California. As for Bailey's claim in an interview with GayNZ.com that promoting condom use shames and stigmatises gay men, Robinson says HIV and gay men's sexual health “is not a product of oppression it is about simple biological risks - anal sex is eighteen time riskier than vaginal sex for HIV and has similar risks for syphilis, gonorrhea, etc. So gay men need to protect themselves just as women need to protect themselves from cervical cancer, it's just a fact of life.” “There is also a sense that condoms have failed and everyone hates them, Robinson observes. “Once again we have proved in New Zealand that this is not the case. 80% of gay and bi guys use them most of the time." He says the NZAF is “pleased that new tools like PrEP are now a possibility, but feels that “the whole 'Truvada Whore' thing,” a reference to those who vociferously trumpet the use of the HIV treatment Truvada to ward off HIV infection, “is very unfortunate because it polarizes people instead of getting us to think about the real question, how can new tools like PrEP be used in the NZ context to add to the total prevention affect?” Robinson's view is that there will be a small group of guys who will always resist condom use. “These men are highly at risk of HIV and will also be getting lots of STIs. Mr Bailey is an extreme example. If we can get these guys on PrEP via prescription and clinical support if sexual health services I think we will get an overall benefit. So in a sense I agree with Mr Bailey that as a guy who wouldn't use condoms if he had had access to prep then he might not now have HIV. But he also risked, however, contracting untreatable gonorrhea. The key though is not to let up on condom promotion at the same time as making prep available to those at very high risk.” “Stopping HIV is not about individual choice because it's not just about individuals, according to Robinson. “HIV spreads in a community which is made up of networks of sexual partners - you might have sex with three people in two months who have sexual with three people who have sex with three people and so on. So to stop HIV we have to get prevention behavior to be widespread in the community. In New Zealand we have done that thru condoms and it's pretty much a community wide deal - everyone wears them to protect everyone else.” The NZAF is lobbying for a trial of targeted PrEP use but Robinson says it's important to remember “that PrEP is not as good as condoms because it does not protect from anything other than HIV, it has side effects, long term toxicity risks and actually taking enough pills has been shown to be hard for many guys. So my view is that most guys will stick with condoms for good reasons. But if we can get people who think like Blue Bailey to take PrEP that will be better than nothing."
Credit: GayNZ.com Daily News staff
First published: Saturday, 14th March 2015 - 11:48am