Chris Sibley has been doing health promotion among men who have sex with men for almost three years. He now says he's contributed all he could, and has recently left the Foundation. We asked him his thoughts on what he's learned about the fight to stop the spread of HIV in Wellington and surrounding areas. What did your role at Wellington's NZ AIDS Foundation Awhina Centre entail? As I was one person in a region of almost a million persons, I used a ‘train the trainers' strategy in the hopes of maximising the number of people I could reach in the community. Following this strategy entailed linking up with Sexual Health Providers, DHB's, GP's, Educators, Queer venues, Queers Events and interested members of the Queer communities of the Wellington region. The difficulty of working with Queer communities on health issues paradoxically is one of its greatest strengths… its tremendous diversity. Urban men who have sex with men (MSM), rural MSM, HIV positive gay men, HIV negative gay men, HIV Positive bi-sexual men, HIV negative bisexual men, closeted men having sex with men, experimental man on man sex, transgendered and transsexuals; all of these different groups fall within the domain of the NZAF's contracts with the Ministry of Health and all these groups have different needs and respond to our promotions and campaigns differently. In a way, they are all in competition with each other for time, resources and the information the Foundation has to disseminate around the spread of the virus and its risk to them. Health Promotion and education, unfortunately, is not as simple as having a few pamphlets and packets of condoms it was still the second highest year after 2005! There are more positive people in New Zealand now than ever before and it is estimated that a third of these do not know they are positive. Additionally, significant changes have been occurring within the Foundation that merit community wide inspection and involvement. I would put it to you that all those who have expressed strong views about the Foundation in the media and on the internet over the last couple of years have an obligation to involve themselves in the system by becoming members of the Foundation and seeing that their ideas and opinions get addressed. What the Foundation does in the next couple of years will lay the ground work for this century and it needs all of us asking questions and coming up with ideas around strategies to reduce the spread of HIV and ensure New Zealand has the best basis for the 21st century on HIV related issues. What is it like to be working with the NZAF away from the main (Auckland) office? The NZAF is like a lot of New Zealand businesses, you have the same Auckland vs. the regions dichotomy that many nation-wide companies have. As far as me personally, there were areas of weakness and areas of strength in my relationship with national office, again… like many private industry corporations problems centred around communication, but in the end I leave the NZAF with a strong commitment to staying involved - that should speak for itself. One thing to remember about the NZAF is that the Foundation is full of people like me that have lost persons to complications from AIDS and full of people passionate about the issues connected to HIV/AIDS. Because of that, you have an organisation that is full of people who are passionate about their work and emotionally connected to that work and their opinions about how that work should be done. This is a great strength and can provide an amazing force for support and societal change. However, it can also be extremely difficult to manage… especially if you come along at a time of change. The current board and national management team have had a lot of difficult situations to come up over the past three and a half years and regardless of any real or imagined mistakes that may have been made, I do not envy their position. You have the different regions, the Ministry of Health, the stakeholders of the organisation, all the different branches of the Queer community, positive people, professionals in the field of HIV, global constituencies, immigrant communities, family members of persons lost to AIDS… all fighting for their agendas/piece of the pie or both. The biggest concern in my departure is the care and support of the NZAF staff. The staff are often caught in the middle between the communities with which the NZAF works, all the other constituencies pushing their agendas with the NMT, as well as being intimately involved with positive persons and all people using our systems and resources…it can be a difficult place to be. In the past 3.5 years, the Foundation has lost 30 staff out of 54… that is just over half our staff and a real cause for concern. What have you learnt about Wellington's gay scene? What makes it unique? Do you think it's very different from Auckland's? Mainly my travels and experiences have shown me how alike queer communities are around the world. I think the similarities vastly out weigh the differences. The uniqueness of Wellington is the acceptance and tolerance conveyed by the heterosexual populations and the fluid interactions between these communities. I feel that speaks to a difference between Wellington and Auckland also. My perception is that Auckland seems to still exists in that 70's/80's idea of ‘ghettoisation' of the community where you have designated “gay” areas that queer people try and live in or hang out in… Wellington is more of a free for all… for example, gays freely and openly mix in gay and straight clubs all around the city with few incidences of intolerance. Such a situation further complicates health promotion in Wellington but the trade off of openness and acceptance is well worth the extra work! Is enough being done to fight the HIV/AIDS epidemic in NZ? Is there anything else we can and should be doing? The epidemic is much more complicated now, not just in New Zealand, but around the world. We all just have to accept that and come together to try and find new strategies that will work for 21st century New Zealand. There is this myth that the new treatments available are a panacea and having HIV is like diabetes just another treatable chronic illness. These treatments do not work for everyone nor do they work at the same level of effectiveness for everyone or forever. Additionally, the side-effects (nausea, diarrhoea, vomiting, cramps, lypodistraphy, headaches, and wasting to name a few) can be debilitating themselves. All of which is completely preventable by not acquiring HIV in the first place… which means always using condoms and lube for anal sex. The most disturbing new factor emerging in our gay male communities is directly related to our internalised homophobia and ageism… both of which are enabling the spread of HIV. Many gay men believe if they contract HIV, the new meds will enable them to live 20 to 30 years and it is felt that is life enough, because who wants to be a 60+ gay man? Obviously a lot of work needs to be done around changing people's beliefs around HIV and the value of our queer aging and elderly. It's not just about getting people to use condoms