After the huge impact that HIV had on the gay male community in the eighties and early nineties, anyone in their right mind would think that diagnoses among men who have sex with men (MSM) would decrease.
Disappointingly, this is not the case. MSM diagnoses in the UK have increased since 2000, peaking at 2,811 in 2007. Though this figure decreased to 2,475 in 2011, diagnoses are still 57 per cent above what they were eleven years ago. Although an increase in HIV testing may have contributed to the increase in diagnoses, I doubt that it is solely responsible. There is good reason to believe that the trend must be at least partially attributed to high-risk sexual behaviour. It is shocking that this is true of an informed population, which has access to the real means to reduce HIV infection rates, and that the clearest message of all – that HIV is a devastating virus, which we should aim to eliminate at all costs – may have been lost in the MSM community.
MSM targeted HIV awareness campaigns, which airbrush the reality of the virus, are a cause of this dangerous culture. Whilst it must be acknowledged that life with HIV is different now than it was, this does not justify a misleading portrayal of the virus, which risks affecting attitudes to the point that they pose a risk to those that hold them.
By its nature, HIV will take life unless something else takes it first, and will most likely contribute to whatever that ‘something else’ may be. Moreover, those with HIV may experience life-changing, or even life-ending side effects as a consequence of daily treatment. These include organ decay, cancer, fat wasting, facial wasting, chronic diarrhoea, chronic vomiting, and muscle wasting (muscle wasting can cause heart problems). Opportunistic infections, which highlight the limited efficacy of treatment, are also potentially devastating, as are the psychological effects of living with HIV.
Not only this, the risk of resistance to treatment in the long-term diagnosed (25-29 year olds account for the highest proportion of MSM HIV diagnoses in the UK) is being closely monitored by the World Health Organization.
For some more than others, this is the harsh, wrinkled reality of HIV. So it confuses me why some MSM targeted awareness campaigns treat life with the virus as a walk in the park. I saw one such campaign at a recent sexual health check up. Attached to muscular, tanned men with beaming smiles was a slogan of double entendre – ‘I’m Positive’.
Though I don’t deny that men like these exist, the potential consequences of using them as the face of HIV, and showing them only at their photo shoot best, are deeply unsettling. It terrifies me that someone may be misled by such a campaign, and become careless about his or her sexual health. I myself, when awaiting my results and battling with the irrational but unavoidable question ‘what if I have it?’, had to consciously stop myself from thinking ‘even if I do have it, it doesn’t look that bad. He looks happier and healthier than I do’.
If the connection between the message of some HIV awareness campaigns, and the increase in HIV diagnoses among MSM is as strong as I suggest, then those campaigns must change. But how to change them isn’t so clear. Whilst it is essential that people are made aware of the reality of HIV, and deterred from high-risk sexual behaviour, if a campaign were to show only the ‘ugliest’ faces of the virus, then not only would it be unfair to those who are HIV positive, it would be rather misleading – rather like those which show only the ‘prettiest’.
Ultimately, I feel that the reality of HIV, no matter how ugly, should be featured in any awareness campaign. The aim should not be to incite fear, though fear may be incited in some. Most importantly, the target audience should be made aware of the risks, and given accurate knowledge to increase their self-efficacy in reducing them. Today, there are many faces of HIV; they must all be shown if people are to understand the reality of the virus and make safe, informed decisions as a result.