NZAF Research Director Tony Hughes has seen the worst of the HIV/AIDS epidemic, and even he's worried about the latest sharp increase in infections. But is anyone listening? The invisibility of the safe sex message, the eroticisation of barebacking culture, and the rise and rise of internet shagging are just some of the factors believed to be contributing to our country's burgeoning second wave of the HIV epidemic. Yet despite new infection rates heading to top the numbers during the dark days of the 1980s, among your average 'men who have sex with men' (MSM) it's simply not a topic worthy of discussion – at least not in person. One story heard recently involved a man being texted by a casual sex partner to let him know he'd just tested HIV-positive. How that text might have read? Perhaps it went something like this: "I've just become infected with the virus that leads to the disease that's killed more than 20 million people worldwide – and seeing as we've been having unprotected sex, you might have it too! Love and hugs, see you next Tuesday." The news that there have been 44 new HIV infections among MSM in the first six months of this year (well over half of last year's total figures) has got the AIDS Foundation's Research Director, Tony Hughes, very worried. Having been with the Foundation since its earliest days, and an eye-witness to the death and destruction caused by the first wave of HIV/AIDS, Hughes is not someone whom you want to see worried. "The reality of the post-treatments situation is that people no longer see individuals dying of HIV," he says. "So it shouldn't come as any surprise that progressively since 1996 [when anti-retroviral drug combinations were introduced] the context in which people view the AIDS epidemic has progressively changed." Some things, however, haven't changed. Hughes sees many parallels between the social and political climate of the 1980s and the present with regards to HIV. “Judging by some of the discussion in the media, we seem to be seeing a return of some of the old 1985-style stigmas. However, they're now impacting for the first time on people in the heterosexual community who've been able to avoid HIV for the last 20 years, unlike the gay community.” But back in 1985, the nature of HIV and its transmission was an unknown quantity. "That's really important to understand," Hughes stresses. "We didn't know what caused AIDS, we didn't know it was a virus, we didn't know for sure if we would be able to find a way to stop it from being spread. That was the context at the start." Now of course, with the efficacy of condoms in preventing the virus well and truly established, Hughes finds it difficult to comprehend why condom use is being abandoned. "It's a sexually transmitted infection which is entirely avoidable by using a relatively simple single precaution," he says. "We're saying, use condoms for anal sex. We're not saying, change every aspect of your life." A bit like wearing a seat belt every time you get in the car? "I think it's very much akin to that, and you know that most people when they get in a car do that now," he agrees. "Remember, for four years we had just 21 new HIV infections amongst MSM in New Zealand, from 1997 – 2000. 21 per annum in a country of four million people. So we know that a programme based on condom promotion for anal sex will work to virtually completely close down the epidemic." Is the safe sex message just being tuned out by men who can hear the AIDS Foundation, but aren't listening any longer? The Foundation banging on about safe sex and condoms – that's their job. If no-one else is talking about it, then it can indeed begin to seem irrelevant to your life. To an extent, this message fatigue is something that gay media suffers from as well. It's a safe bet that the people in our communities who most need to be reading these words right now won't be. Outside of AIDS Foundation promotional material, where is the condom message being pushed? Certainly not through mainstream (ie, mostly-straight) internet dating sites, where there has been a sharp increase in MSM hookups in recent years. Hundreds of men can be online at any one time, advertising their explicit desires to the hook-up world with only the occasional intrusion of a banner ad targeting their mythical pink dollar. But even in environments like sex-on-site venues, which the Foundation says have been very supportive in keeping the message on display, some men are abandoning condoms for bareback sex. National Manager of Health Promotion Te Herekiekie Herewini says the Foundation's health promoters are going to be spending a lot of time in clubs and bars this summer putting a human face to the safe sex message. "If people have a complacent attitude around using condoms with anal sex, then we have to highlight to them why they have to get back into using condoms," he says. "There's so many more opportunities for men to have casual pick ups now through the internet. We have to find ways of having one to one conversations with people who go onto the internet, talk to them about safe sex and HIV issues." In the Foundation's press release concerning the latest shocking figures, Hughes said it was time for the entire community to make a collective decision to use condoms for anal sex, with no excpetions, and that this decision must be supported by "by communities of gay men, by HIV prevention services and by businesses that serve homosexual men." Does he think businesses aren't pulling their weight in looking after the health and safety of their clientele? "That wasn't a comment about businesses – it's a comment about every single individual and organisation in the gay male community, irrespective of ethnicity, age or anything else," he says. "We are in a position in terms of health promotion management in which we don't have to guess whether we have a formula that will work. And this epidemic would not be happening if there was not a higher rate of unprotected anal sex happening." Chris Banks - 12th October 2005