posted to LifeLube via Fran...Statements circulate at the International AIDS Conference, in news media and quoted by "authorities" that "confidence in drug therapy"is a strong reason reason MSM fail to prevent themselves from getting infected with HIV.
But that talk is glib and ignores the complex set of factors, circumstances and situations (some involuntarily) that result in a person becoming infected.
It's also a principle that hardly applies to a meaningful degree outside of a narrow band and geography in developed countries.
Every city, every location, every group has different characteristics. Better if agencies were to take more responsibility to go out and DO prevention in detail in each group rather than attributing infections to simple broad answers as a defense to why numbers remain high. If attitudes about drug therapy are a partial factor in doing prevention, take the effort to put things right.
The challenge in public messages is how to make people of every stripe - MSM in particular - understand how to act when they hear all at once together a jumble of news headlines which may sound - in bites - like:
1) Drugs dont work well if you are late to get them or non-adherent- if you are late, don't feel confidence in them; but if you get them, we want you to stick with them because HIV is now a successfully managed chronic disease, have confidence
2) In Switzerland heterosexual couples are not infecting each other because drugs "work"
3) In the US we don't endorse the Swiss view, the Swiss are wrong, don't have confidence
4) But we do tell you - infected persons- that lowering your viral load on drugs will reduce the number of infections by 30-50% - have confidence in drugs
5) Having confidence in drugs - non-infected persons - causes infections- don't have confidence in them .
That's a jumble to most people who are not actively working in HIV programs. There is no question that messages should instill confidence in drugs both for treatment and prevention- confidence based on accurate facts and knowledge- does anyone want people to lack confidence in drugs?
Dumb idea.
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