POSTERS with the slogan “you can fuck raw, PrEP works” emblazoned on them have appeared around Melbourne today, just days after a new report revealed that the number of gay men having condomless casual anal sex is at an all-time high.
The posters, created by a group of activists called SeeItClearly2020, also feature a blue Truvada pill and aim to promote condomless sex as safe sex, granted both sexual partners are on a form of pre-exposure prophylaxis (PrEP).
[showads ad=MREC]Co-founder of HIV-positive peer support and advocacy group The Institute of Many, Nic Holas, said that while the message may seem blunt and “not necessarily helpful for the PrEP cause”, he acknowledged the LGBTI community has a history of activism.
“For me it says that the HIV negative and HIV positive community refuse to live under the dark cloud of HIV any more, we have better alternatives than fear,” he told the Star Observer.
“I am more concerned about the fact that gay men are adjudicating this action far quicker and far more harshly than what we are seeing in the right-wing media. If a shock jock wants to mouth off about this, he will.”
Holas also highlighted how this campaign could have the affect of creating a misinformed debate among gay men.
“As always the gay community has managed to turn on itself a lot faster and we are seeing online gay men absolutely decrying this campaign and people saying absolutely stupid stuff about how this is going to damage marriage equality,” he told the Star Observer.
“This is about the health and well being of our community.”
In a press release circulated this afternoon, members of SeeItClearly2020 said the campaign was designed to shock and start a conversation around making PrEP accessible in Australia.
“Our message is that if you’re going to fuck raw without a condom, you need to be on PrEP — raw sex on PrEP is safe sex,” the statement read.
The group also highlighted what they believe to be a “lack of education and the lack of awareness by existing public health authorities”.
“So we are taking it into our own hands, and we are talking about bareback sex when no other group will,” SeeItClearly2020 stated.
“PrEP is the most effective means to avoid HIV transmission, with years of research and thousands of users to backup the scientific evidence – PrEP works and everyone needs to be properly educated on it, we hope this prompts people to seek information and involve themselves in informed discussion on the benefits of PrEP.”
In a joint statement released this afternoon, Victorian AIDS Council (VAC) and Living Positive Victoria said the community response to the posters shows how “now, more than ever, people at risk of HIV need access to PrEP in Australia”.
“This is a passionate issue for our community, and the vocal response to the posters’ strong language demonstrates that,” VAC acting chief executive Kent Burgess said.
He agreed with SeeItClearly2020 in that PrEP is still an effective HIV prevention method, but harboured some concerns over the language used in their posters.
“We still have a lot of work to do to inform the community about how it works,” Burgess said.
“We have some concerns about how the posters might stigmatise gay sex and people living with HIV through simplistic, inflammatory language, but one message is clear: our community wants and needs PrEP.”
PrEP is not currently approved for use in Australia by the Therapeutic Goods Administration (TGA) — the country’s peak regulatory body for medicines — nor is it listed under the Pharmaceutical Benefits Scheme (PBS), limiting access to and substantially increasing the cost of the medication.
Currently, HIV-negative men in Australia can only access PrEP through clinical trials, by purchasing the drug from the manufacturer which can cost as much as $13,000 a year or by importing the medication from overseas via the internet which can cost considerably less.
US pharmaceutical giant Gilead Sciences recently began the application process to have Truvada as PrEP approved by the TGA, and there have been calls for its the process to be fast tracked.
“We’ve been working with the government to get PrEP approved in Australia for some time now, but the process is too slow — unless TGA approval is fast-tracked, PrEP might not be approved before 2017,” Burgess said.
Living Positive Victoria chief executive Brent Allan agreed, highlighting how having PrEP readily available as part of a full range of HIV prevention methods would help reduce stigma around HIV.
“PrEP isn’t about giving gay men a licence to ‘fuck raw’, it’s about putting them in control of their sexual health by ensuring that they have the tools they need to stay HIV negative,” he said.
“It’s also about breaking down the barriers between (HIV-)positive and (HIV-)negative men, reducing anxiety about HIV, and challenging stigma.”
Referring to the posters, Allan said: “While we have concerns about the appropriateness of the messages conveyed by this campaign, we think it shows the level of interest in and demand for more effective HIV prevention in our community.
“And though I am not sure that having a discussion about PrEP on the streets of Melbourne is the best place, it’s pretty clear that we cannot ignore this call to action, and we have no desire to silence those who rightly demand access to lifesaving forms of proven HIV prevention.
“Both state and federal governments should consider their own capacity to act and make PrEP available.”
The posters come just two days after UNSW’s Centre for Social Research in Health published the 2015 Annual Report of Trends in Behaviour, which revealed that the number of gay men having condomless casual anal sex is at an all-time high.
According to the report, the number of gay men engaging in sex without condoms climbed to a record high of 39 per cent in 2014, up six per cent from 2005.
The report also revealed that condom use among HIV-positive men with detectable viral loads had declined 10 per cent over the past decade.
Centre for Social Research in Health director John de Wit said a lot of strategies work together to prevent the transmission of HIV.
“The statistics continue to illustrate that these different things work together,” he told the Star Observer.
“Getting tested, the risk reduction, the condomless sex.”
Wit also mentioned serosorting, where a person limits their sexual activity to partners with the same HIV status, as a measure that has been around for a long time.
“Serosorting is one of the earlier risk-reduction strategies that gay men came up with themselves,” he said.
“People started thinking, if I have a particular HIV status and my partner has the same one then there’s no risk.
“These days, people talk much more openly about their HIV status.”
The report also highlighted record numbers of HIV-positive men on antiretroviral treatment, jumping from 60.3 per cent in 2005 to 83.5 per cent last year.
The number of these men reporting undetectable viral loads also went up by 25 per cent to 76.7 per cent.
Wit believes this is an indication that Australia is on the right track to reach its target of zero new transmissions by 2020, as well as getting 90 per cent of HIV-positive people on treatment.
“The targets are very ambitious but what we can see is that things are moving in the right direction,” he said.
“People are getting tested more frequently, particularly people at higher risk.
“The treatment uptake is fabulous and while it’s a gradual thing that’s been going on, we can really start to see that we’re approaching that 90 per cent.”
The 2015 Annual Report on Trends in Behaviour was released during the World STI and HIV Congress in Brisbane earlier this week.
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