via Aidsmap, by Roger Pebody and Michael Carter
The forces encouraging sexual risk behaviour are large and widespread, but the forces for precautionary behaviour are meagre and narrowly focussed, argued Ford Hickson of Sigma Research at the CHAPS conference of gay men’s health promoters in Brighton last week. Rather than describe HIV prevention in the UK as failing, he suggested it would be more accurate to say that it is inadequate.
Other sessions at the conference included one of the first qualitative studies of the experiences of gay men co-infected with hepatitis C and HIV, and an examination of how HIV-positive men have adjusted their behaviour in the light of prosecutions of HIV transmission.
In the plenary, Ford Hickson outlined the forces encouraging risk behaviour:
- The power of sexual pleasure. "If you do not understand sexual risk," he commented, "it is probably because you don’t appreciate sexual desire".
- The rapid expansion of the gay scene into "a large business sector supplying services for sexual contact and locations to have sex".
- The continued denigration of homosexuality in society, and the associated emotional isolation and low mood of many gay men.
- Men’s self-medication with alcohol and drugs, which is problematic in a culture which excuses risk-taking while under the influence.
- The widespread belief that ‘real sex’ is anal sex.
- The commodification and fetishisation of barebacking as a transgressive behaviour. "Gay sub-culture has long legitimised the eroticisation of unacceptable thoughts," Hickson suggested, and barebacking porn is one manifestation of this.
- Individualistic cultural norms that reject notions of responsibility. "The idea that you would sacrifice something yourself in order to protect or care for someone else seems, at the moment, to be deeply alien to gay culture and HIV prevention approaches," he said.
- Optimistic biases in our thinking: telling ourselves that risks are smaller than they really are.