Ask gay men what they want and need

My Vision for a 2009 Gay Men's Health Agenda

by Michael Scarce
[Writer, researcher, technology consultant, and health activist - San Francisco]

Perhaps most exciting is how the progression of a gay men’s health movement is no longer a question of possibility, but rather exactly how it will take the shape of things to come.

1. Improve the care, housing and genuine health promotion for HIV-positive people.

As more of us become infected and now survive far longer than hospice waiting lists, HIV-positive people deserve a base quality of life that includes housing, adequate health care, and opportunities to fully participate in their communities. To this end, my ideal agenda for 2009 would include an overhaul and re-funding of “Prevention With Positives,” a movement that strives to improve the health of HIV-positive people as a means of reducing their likelihood of engaging in high-risk behaviors. HIV-positive people deserve health and wellness promotion even if it has no effect whatsoever on the incidence of HIV transmission. The message that public health’s primary concern for my wellbeing stems from my potential and capacity to infect others feels insincere and denigrating. Forgive me if I’m less than grateful.

2. Leverage technology to our advantage.

Organizing around gay men’s health can be immeasurably bolstered by better utilization of the Internet and other digital technologies. As a starting point, I propose the construction a global gay health wiki. A wiki is a collection of web pages that can be edited by a large number of people for the purpose of mass collaboration, including the sharing of data, media archiving, project planning, and building a repository of knowledge. My second recommendation in this area is the planning of a Virtual Gay Men’s Health Summit for 2011. Not only would this facilitate a greater breadth and depth of Summit involvement, it could also improve the representation of poor and economically deprived men. With the average cost of attending a Summit hovering around $1,000 including airfare and hotel stay, the $100 cost of a few months’ high speed internet connection could whittle away many of the disparities in participation that stem from class and geography.

3. Begin preparing for the depopulation of dense, urban gay neighborhoods and its inevitable impact on gay men’s health.

Factors such as the increasing popularity of Internet social spaces, gentrification of gay ghettos resulting in unaffordable housing, and the greater social acceptance of LGBT people in smaller and even rural communities are beginning to have noticeable effects on the density and demographics of traditional gay neighborhoods. Men are no longer migrating to coastal cities such as San Francisco, New York and San Diego to seek asylum as queer refugees in the same numbers as previous decades. This phenomenon has radical implications for everything from epidemiology to systems of social support.

4. Draw the line with self-interested and counterproductive HIV prevention.

I propose the establishment of a national watchdog coalition to monitor and respond to overly aggressive, inherently deceitful, and increasingly desperate HIV prevention efforts. This is not an attempt to bash all HIV prevention, but the widespread tactics of racism, misogyny, blame, shame, fear, and stigmatization must stop. Attempts to end the epidemic “by any means necessary,” including invasive surveillance and divisive community interventions, will only serve to further alienate gay, bi and trans men from public health. This runs the risk of accelerating infection rates rather than reigning them in. Local efforts to challenge the overstepping of these bounds have been met with varying degrees of success, and could greatly benefit from the advocacy and capacity building of a larger network of support.

5. Ask gay men what they want and need.

Too many organizations billing themselves as “community-based” are sorely out of touch with their constituents. Gay men’s health issues are different than gay men’s health concerns. The quality of men’s lives can only be improved if we seek a greater understanding of the qualitative ways in which men are affected by their health and the health of those around them within a larger context of how they live and love. The very definitions of health and wellness are subjective concepts, and we have much to learn from the perspective and vantage point of members of our communities.

In summary, my vision for a 2009 Gay Men’s Health Agenda involves a combination of accountability from existing institutions in conjunction with the strengthening and development of our own movement’s infrastructure. Perhaps most exciting is how the progression of a gay men’s health movement is no longer a question of possibility, but rather exactly how it will take the shape of things to come.

[LifeLube has been asking folks around the country to weigh in on what a 2009 Gay Men's Health Agenda might look like. Click here to read some of the ideas that have been circulated. Please feel free to comment here - share your own ideas, or spout off on whether you agree or disagree with Michael - or, you could send in a full post of your own here. We will be happy to publish it!]