Changing the rules: SERO DISCO 2 - Why let HIV get in the way of a good relationship?


Published on

Kathy Triffitt (Positive Life NSW) discusses what's been learned about gay men's understandings of risk and safety through Positive Life's campaign for men in serodiscordant relationships, and what this means for prevention education. This presentation was given at the AFAO/NAPWA Gay Men's HIV Health Promotion Conference in May 2012.

Published in: Health & Medicine
  • Be the first to comment

  • Be the first to like this

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide

Changing the rules: SERO DISCO 2 - Why let HIV get in the way of a good relationship?

  1. 1. Changing the rules
  2. 2. SERO DISCO 1
  3. 3. Messages draw on personal storiesPersonal stories and perspectives provided referencepoints from which to develop and shape new attitudesThe survey found that: 50 per cent of respondents (namely, HIV negative gay men) strongly agree or agree that the first phase of the campaign raised their awareness of the issues facing gay men in serodiscordant relationships [and] strongly agree or agree that they have become more aware of the issues facing people with HIV.
  4. 4. Messages draw on personal storiesThis is how focus group participants put it: “… personal stories helped me feel more comfortable with the relationship I am in. [The campaign] de-mystified and humanised a really complex issue in my life!” “It says serodiscordant relationships are possible and exist.” “A magazine aimed at demystifying pos-neg relationships and challenging the taboo – our dirty little secret.” “By showing pos-neg relationships happen we take away the stigma.”
  5. 5. HIV negative men wanted campaigns: “That help us in talking to positive men … how we can lower our risk and what to do if we go too far!” (HIV negative, aged 30)And, demystify HIV: “They were open and honest... they [personal stories] took a little of the mystery away from knowing someone with HIV!” (HIV negative, aged 39)
  6. 6. Opinions affect how men approach their pos-neg relationships: I didn’t want to tell my friends until they had gotten to know him. I thought that would allow them to react in a more supportive way. It was hard to know who to tell because not only are they going to have preconceived notions about him and his HIV status, they’re also going to have preconceived notions about me getting involved in the relationship. (Quentin, HIV negative)
  7. 7. Opinions affect how men approach their pos-neg relationships: I pulled back from asking friends for support because they’re going on even less information. Not only are you trying to answer their questions, you’re also trying to suppress people’s anxieties and preconceived judgements around HIV. (Quentin, HIV negative)
  8. 8. Moving forward (post-disclosure) was mediated by learning(knowledge) and a re-examination of their attitudes: Once he got the facts (rather than what was going on in his head) we took it one step at a time. It took time for the relationship to build. We talked about HIV in our relationship to the point where Patrick was comfortable with it – HIV was a big issue at the start, but its slowly fading into the background. (Richard, HIV positive) It’s about getting to know someone. Once you meet someone and you share experiences with them their humanity overrides HIV, whatever their orientation or ethnicity. (Quentin, HIV negative)
  9. 9. Moving on is about day-to-day routine not defined by HIV: I think there are a few stages after disclosure. The first stage is shock. After that is a short period of trying to get back to normality, not talking about HIV at all. The great thing he did was get on with the day-to-day routine of our relationship. As a message for me that meant it was fine - we were moving forward. (Robbie, HIV positive)
  10. 10. “No” is not always about stigmatising views, but more aboutsomeone knowing their limits: When I disclose, 20% or 30% of the time I might get a reaction like “well I might leave it then”. That’s really okay with me because I don’t want to have sex with someone who is nervous or uncomfortable about my status. If someone says “no”, I don’t really see that as rejection. I just see that as someone knowing their limits and what they are prepared to do to engage in sex. (Stuart)
  11. 11. Being in a relationship changed the rules for John (HIVpositive and Patrick (HIV negative): I took Patrick to one of my doctor’s appointments mainly for reassurance. We also wanted to find out more about viral load. I consistently came back with an undetectable viral load so after a while my partner and I agreed that we could fuck without a condom. That was along the lines of talk, test and trust. As a couple we agreed that sex was better without condoms. We both agreed that outside the relationship we stick to using condoms.
  12. 12. While Chris (HIV negative) and Tony (HIV positive) wereusing undetectable viral load without condoms not onlyto reduce their risk of passing on or getting HIV, butalso ‘for intimacy and connection’: Condoms take away the spontaneity and intimacy. Tony’s got an undetectable viral load and we’ve been told so many times that the likelihood he’s going to pass on HIV to me is low. You know, good sex is something that is fulfilling and satisfying, you shouldn’t have to worry about it. It’s about intimacy and connection.
  13. 13. For Tom, who is HIV negative and has been in arelationship with Greg (HIV positive) for fifteen years,saw Greg’s undetectable viral load as more of an addedreassurance, rather than a replacement of condoms andsafe sex: Safe sex, using condoms, obviously does work. Greg also takes HIV treatments and his viral load is undetectable, and that gives us an added sense of security, if we needed one.
  14. 14. ‘Viral load disclosure’ is not only an indicator of ‘risk andsafety’, but also Sean’s overall health: When Sean disclosed he also told his t-cell count is within the normal range and his viral load is undetectable. I had heard those terms before, but I didn’t know what it meant as far as our relationship was concerned. (Quentin, HIV negative)
  15. 15. Lessons learned Intervening ideologically into areas of daily social practice the campaign magazine challenges a straightforward communication approach and reproduce ways of relating and learning about pos-neg relationships and sex. Specific attention is paid to practices (e.g. narrative culture) that mobilise possibilities for representing the social, relational and subjective life of these relationships.
  16. 16. Lessons learned Our campaign evaluations concur with research (Hassan, M et al., 2008) where it was found that “there were fewer stigmatising attitudes in HIV negative participants who were (a) educated about HIV; or (b) had a personal relationship with an HIV positive gay man.” Many reported they had gone through ‘some kind of learning’ when a partner had disclosed his HIV status, causing them to re-examine their attitudes or ‘get better educated’.
  17. 17. Lessons learnedCampaign development found:  gaps in support for men in or considering pos-negs relationships  viral load monitoring is being used as a non-condom based risk reduction strategy, however, there are differing levels of understanding between pos and neg men. As Quentin (HIV negative) commented: “I had heard that term before, but didn’t know what it meant as far as our relationship was concerned.”
  18. 18. Recommendations Over time the experiences of HIV-positive people and their relationships have been reduced to risk practices. HIV prevention and health promotion must continually re-negotiate the privileging of certain lines of enquiry in order to be effective.
  19. 19. Recommendations The challenge is to develop campaigns and support (peer learning) that adapt to the changing dynamics of pos-neg relationships. In this discussion, the social and relational aspects that impact on the quality and longevity of these relationships rather than only talking about them in the context of sexual negotiation and managing risk.
  20. 20. Thank you to all the men who have taken part incampaign development. It is an act of generosityon their part to share their stories with us. For more information contact