A new discussion paper developed by the Queensland Association for Healthy Communities (QAHC) will attempt to tackle the issue of unprotected/unsafe sex and general HIV prevention risk reduction strategies (RRS). It follows increased attention on the issue in Queensland following comments made by the Health Minister Lawrence Springborg regarding Kirby Institute report data about an increased rate of ‘unsafe’ sex between men who have sex with men (MSM).
While plans for the discussion paper were underway last year, QAHC executive director Paul Martin said he hopes that the paper will examine the issue in much greater detail than the minister is willing to acknowledge.
“The paper was written well before the minister’s comments, however it does reinforce our point that unsafe sex is not always the same as unprotected sex,” Martin told the Star Observer.
The discussion paper, titled HIV Prevention Risk Reduction Strategies, is a means by which those working within the Queensland HIV sector can engage in a conversation about MSM [who] engage in anal sex without a condom. Members of the LGBTI community are also welcome take part in the discussion through means such as Facebook.
“[The paper] is based on an analysis of the best and most up-to-date research evidence and is one way we are attempting to work more effectively with gay men and other men who have sex with men to prevent getting or passing on HIV,” the report states.
According to Martin, Springborg has a simplistic view on the issue of sex without a condom and doesn’t understand the difference between ‘unprotected’ and ‘unsafe’ sex.
Martin has previously pointed to the rise in the rate of ‘sero-sorting’ (where men of the same HIV status are engaging in unprotected sex) as not being the same as ‘unsafe’ sex and hopes that the discussion paper will examine RRS in greater detail than other studies currently being undertaken.
“While condoms remain the simplest form of safe sex, for many men using a condom every time for the rest of their lives is not realistic. Men are using other strategies to reduce the risk of HIV transmission, where condoms are not used,” he said.
“Some of these strategies can be safe or safer if based on accurate information and negotiation. But at other times men are basing their decisions on inaccurate or partial information and placing themselves and/or their partners at risk.”
The discussion paper lists RRS currently being practiced within the MSM community in Queensland, including using sero-sorting, undetectable viral loads, sexual roles/positioning, ‘negotiated safety’ and withdrawal.
“The purpose of the discussion paper is to get clear Healthy Communities’ approach to risk reduction strategies. We acknowledge that for some people any shift away from ‘condoms all the time’ would be seen as undermining the safe sex messages,” Martin said.
Whilst Martin acknowledges that QAHC will face some criticism for not focusing all of their efforts on condom-only messages, he says that the reality of MSM sex needs to be addressed.
“A few people have expressed concern about diluting the safe sex message, but for a significant number of men a ‘condom every time’ message will not work and will turn them off safe sex altogether.”
“Most people acknowledge that risk reduction is already being used by gay men, whether HIV ‘experts’ support it or not. We need to ensure decisions are based on fact and a true awareness of risk.”
QAHC plans to engage the community with its findings through updates in LGBTI media, social media and other methods.