You wouldn’t think the recent International AIDS Conference at Barcelona would have much connection with Sydney Gay and Lesbian Mardi Gras going into voluntary administration, but it does.
The Barcelona conference reinforced an old lesson, that generally AIDS is a disease of poverty, the marginalised and the dispossessed. If people are economically and culturally weaker, stigmatised or powerless, they are more likely to contract and transmit HIV and succumb to AIDS.
The conference discussed increases in the incidence of HIV amongst gay male populations in northern hemisphere cities while we in Sydney have not seen anything like the same increases in the rate of new HIV infections. The epidemic in Australia is a lot older than in many countries. The remarkable achievement is that, unlike in other countries, HIV/AIDS here remains largely confined to gay men and, despite overseas trends, we still have one of the lowest HIV/AIDS prevalence rates.
Why hasn’t Sydney -“ the centre of Australia’s HIV/AIDS epidemic -“ succumbed like much of the rest of the world to an ever-worsening health crisis? The reasons are complex. We have a highly educated population, a first world economy, a national health care system providing free care and treatments, and we have a legal framework that supports people with HIV and those at risk of HIV. Our confidentiality is respected and, relative to other countries, we are protected from stigmatisation and discrimination.
We also have strong community institutions that are respected by our partners in health promotion -“ government and the health care sector -“ because they serve vital public health functions. They are the vehicles by which we generate and receive support for people living with HIV/AIDS and by which we generate and receive the information we use to work out ways of reducing HIV risk. Our community institutions are also the sources of our strength as self-identifying gays, lesbians, bisexuals and transsexuals. They are why we feel proud taking our place in an overwhelmingly straight world and why we can measure up against both the gay world and the AIDS sector overseas.
From the outset of the epidemic in Australia, we recognised the importance of the links between self-esteem, knowledge and disease risk. People are more likely to look after themselves and each other when they feel good about themselves, understand the dynamics of HIV/AIDS and are linked into their community. This is where our community institutions come in.
Mardi Gras is unique -“ no city in the world comes near Sydney for size and value in a gay cultural festival, parade and parties. It’s not just the members, staff and board or the thousands of volunteers and artists who get something out of Mardi Gras. It’s all of us who pencil the festival into our diaries each year and organise around Mardi Gras events. For many people outside Sydney, Mardi Gras is that time of the year when they can be themselves and for the vast bulk of Australian queers who don’t attend Mardi Gras events, its mere existence provides the psychic support for a more fulfilling and thereby healthier life.
The results in improved health are incalculable -“ reduced depression and improved social wellbeing are two outcomes with a direct relationship to disease rates. Also directly related is the reduced risk of HIV transmission around gay male sex as a result of education and support campaigns run jointly by Mardi Gras and ACON (the AIDS Council of NSW, a lesbian and gay health organisation).
This is why Mardi Gras’ financial problems have serious health implications -“ and not just as the potential loss of the major fundraising vehicle for our communities. The loss of this vibrant community institution and event would reduce the social cohesion and self-esteem which underpins the community and individual health of a significant part of the population.
Sydney, indeed Australia, has good reason to treat Mardi Gras like other cultural festivals and give it some public funding. Mardi Gras is not just another festival and party. It is a major reason why we have a world class response to the HIV/AIDS epidemic.
David Buchanan SC is a member of the board of ACON. The views expressed here are his own.