In 1985, The Sun newspaper printed the following joke: “Mom, I’ve got good news and bad news. The bad news is I’m gay. The good news is I’m dying.” By then, the AIDS (acquired immune deficiency syndrome) epidemic and hysteria was full blown with 20,303 cases globally. The virus, which had claimed a few sporadic cases in the 70s, had aggressively manifested into a worldwide terror, nicknamed by the media as ‘ gay cancer’ and preached as the Lord’s comeuppance on a sinful homosexual community. Thankfully, we have come along way since then.
Why is it that 1 in every 20 gay and bisexual men in the UK is living with HIV and the numbers are increasing?
Medical research into HIV and AIDS is at its most advanced, with continual breakthroughs in prevention and treatment and HIV (human immunodeficiency virus) has become a lifelong illness rather than an immediate death sentence. As yet, there is no cure for HIV or AIDS.The older generation lived through the AIDS epidemic and came out the other side, fully aware of what the virus can do. They survived the despite the lack of information and awareness. We are lucky, now, to have all the information that we need at our fingertips. So why is it that 1 in every 20 gay and bisexual men in the UK is living with HIV and the numbers are increasing? 1 in 5 of this number is currently unaware of his HIV+ status. In London, 1 in every 11 gay and bisexual men is HIV+. Men who have sex with men represent almost 55% of those diagnosed with HIV. Rates continue to rise while behaviours remain unchanged and attitudes seem to show complacency.
In London, mayor Sadiq Khan spoke in early 2016 about the dangers of a relaxed attitude towards HIV after statistics revealed a disproportionate number of Londoners living with the virus. In 2014, London accounted for 45% of the total HIV diagnoses in England, with 30 out of 32 London boroughs showing a higher than average HIV rate. Speaking to gay publication PinkNews, Khan said: “These statistics show a huge rise in the prevalence of HIV+ in London, and behind each of these statistics is a story of human suffering and sadness. While treatment for HIV sufferers has improved rapidly over my lifetime, we can’ t afford to be complacent about HIV prevention.”
Speaking of the rise of diagnosed cases, Dr Chris van Tulleken, a virologist at UCL, who is behind the BBC documentary The Truth About HIV, accredits increased testing and available facilities for the growth in figures but also a “decrease in awareness in many communities. There is now a generation of sexually active men and women who did not grow up with HIV as a death sentence and so they’re less concerned, take fewer precautions and end up more at risk.”
Prevention rather than cure
PrEP (pre-exposure prophylaxis) is a daily pill which greatly reduces the person’ s risk of HIV infection. It contains two medicines that are used in HIV treatment, so if a user is exposed to HIV, these medicines work to combat the virus and prevent infection. PrEP is offered to HIV- people whose behaviour puts them at risk of HIV or someone who is in a relationship with an HIV+ person. PrEP users must commit to seeing their health care provider every three months for a check up. The drug has been shown to reduce the risk of HIV infection in people at high risk by up to 90% and is currently in use in countries such as France, Australia, Canada and the US.
Dr van Tulleken supports the availability of the drug. “PrEP is great. It makes total economic and medical sense. It prevents spread and diminishes the risk of resistant virus emerging. It reeks of homophobia that it is taking so long to make it widely available.”And it is taking far too long. With all the potential offered in PrEP in stamping out HIV, it is wonder that in May 2016, NHS England voted against offering the drug. The decision however has been successfully challenged in court by the National AIDS Trust.
In a bid to further prevent the rate of infection, there are calls for dating apps to provide sexual health advice and offer free condoms to their users. There is no evidence directly linking dating apps to increased HIV rates, however they are a factor which must be considered. The globally popular gay app Grindr is encouraging its one million plus active users across 192 countries to get tested and provides information about local testing centres.
LCF alum Jacob Alexander was diagnosed with HIV on his 22nd birthday. Speaking at a TEDxUAL event in 2016, the creative direction student shared his personal story. Inspired by his own journey with the virus and its stigma, Alexander launched The Positive Project, an app geared to build awareness around the causes and symptoms of HIV. Its users are given HIV facts, health information and directed to local treatment centres, while also building a global community of mutual support.
Though prevention is obviously better than cure, if one is exposed to HIV there is PEP (post-exposure prophylaxis). It is an emergency measure which combines powerful drugs to combat the virus once it is in the body, and must be taken with the first 72 hours after infection. PEP is not a ‘morning after pill’ for HIV – it is a last resort, with unpleasant side effects.
Obstacles to overcome
While the fear of the 80s epidemic has subsided, the stigma surrounding the virus remains strong. In May 2016, Austrian-based magazine Vangardist printed a special edition of its magazine using ink infused with HIV+ blood, with the hopes of raising discussion about the virus and reducing the discrimination. Apps such as Alexander’ s work to reduce stigma as well as do initiatives from organisations such as National AIDS Trust and Terrence Higgins Trust. National HIV Testing Week is an annual campaign which encourages people to get tested. It is free and gives an instant diagnosis. In July 2016, Prince Harry publicly took an HIV test. “Whether you’re a man, woman, gay, straight, black, white, whatever – even gingers! – why wouldn’t you come and have a test?” said the royal.
Although we have access to the internet, where we can find out as much as possible about any subject, it still relies on a person actively seeking out the information. To be informed about something like HIV, you have to search. Section 28 of the Local Government Act 1988 prohibited local authorities, such as schools and councils, from promoting or educating about homosexual lifestyle. Though it was repealed in 2000, sex education in schools remains primarily on heterosexual relationships, ignoring LGBT education. This includes issues such as HIV.
While van Tulleken agrees that education is vital when it comes to HIV, he also appreciates that sexual behaviours are more emotionally charged than intellectually grounded and that is something which must be worked on. “Intellectual knowledge is of less use in decision making about sexual health than more experiential and emotional knowledge. The academic knowledge that it will be more difficult living with HIV than not feels less tangible when at the decision-making moment when possibly drunk and probably horny.”
When it comes to HIV – or any other sexually transmitted infection – van Tulleken suggests that the best view to take is that “anyone with a sex life is at risk. When you have sex, you inherit the sexual history of everyone your partner has slept with too. That casts the net pretty wide and most of us are bad at having the conversation about who our exes have slept with and how.”When it comes to HIV, we live in an age where we have access to all the information we need and access to methods of prevention, and yet the rates of infection continue to rise. We enjoy sexual liberation and open social attitudes, but with that freedom comes responsibility – to others and to ourselves. Education, protection and prevention are the foundations of a future generation that can live without the fear of HIV and AIDS.
We’re not there yet, but if we also support each other, raise awareness and act responsibly, we’ll get there in the end.
Read the full Going Viral article in Issue 9 of Pigeons & Peacocks