AIDS Action Council Newsletter January/February 2012

Issue Jan - Feb 12

UPFRONT: Andrew Burry

UNUSUAL PENILE DISCHARGE Why do parents sometimes struggle to get their kids to see things the way they want them to? Why do teachers need special skills to manage students’ behaviour? In essence, it is the nature of the relationship, where one is in a position of authority and human nature has an innate need to challenge.

These are parentÅÆchild relationships having an imbalance in power and control.

We approach our work with our priority populations with a commitment to peer education. This isn’t because of some wishy-washy idealistic community sector fluffiness. No, it is because peer to peer sets up adultÅÆadult relationships and notions of power, authority and control are more or less eliminated. This generates an essential credibility on both sides. continue reading➲

It’s easy to prevent HIV transmission.

Acting safely and using condoms mean you can simply fear less and live more.

Trust what you know and let your love life take off.

www.FearLessLiveMore.org.au Produced by the Australian Federation of AIDS Organisations and the National Association of People Living with HIV/AIDS Printed 2011

UPFRONT: Our work involves health promotion. In simple terms this means giving people information that encourages a set of behavioural choices that reduce risk to an acceptable level should they choose. It doesn’t involve judging their decisions.

In reality, adverse outcomes through risk decisions should cause us to think our information was not relevant and provided no incentive to think and act differently. For us to be relevant, we have to be able to communicate in a way that connects and engages our target audience. We are not the government and should present our authority only in terms of subject expertise. More importantly, we are peers and this must be inherent in our communication style and message. This means we are dependent on our image as an organisation and dependent on using the language and terminology embraced by those we are seeking to influence.

Keiran Rossteuscher has written a very thoughtful piece in this newsletter about the difficulties we are increasingly facing with conservative media that wants to edit our language for fear of offending those for whom the messages are not intended. So instead of talking about ‘pissing razor blades’ to highlight a possible indication of a gonorrhoea infection, we are asked to refer to ‘uncomfortable urination’. Instead of referring to a ‘drippy dick’ we are encouraged to use a term like the title of this piece.

The implication of this is that we have to be creative in our media choices and find different opportunities to maintain a sense and sound of being peers.

But, I also think this raises another question, which is whether we have lost some of our ability to communicate in a peer way. It remains relatively

easy to do so in directly communicating in workshops, but how about when our messages are presented through a third party conduit such as a magazine or bus shelter? How are we perceived by our community after a decade or more of bland (at times) and authoritarian (at times) communication? It is often argued, correctly, that the success of gay men in minimising the epidemic of HIV in the early days was because it was gay men themselves who responded in a collective way. A definitive example of peer education.

These days, we in health promotion are bureaucratised within a sophisticated national and international sector, buried under tons of behavioural and epidemiological research and dependent as workers on government largesse to fund our professional lives. In other words, it has become more and more difficult for the communities most affected and/ or at risk of HIV to control the message.

It took half a century to cut the road toll and not much less to reduce the rate of smoking, and all with authoritative and Government sponsored messages; frequently built around fear. In only a handful of years, gay men devised and executed programs that resulted in most men choosing condoms most of the time, decimating the rate of new infection by 1988 and most gay men still use condoms most of the time.

Given that early success, one would have supposed that HIV would have disappeared by now, but it hasn’t and $140 million of government sponsored research over the last decade hasn’t told us why. I think we need to wake up and stop TELLING gay men what to do. Let’s stop being bland and act like the peers we supposedly are.

Mandi Collins

STIGMA AND DISCRIMINATION

WILL WE EVER BE ABLE TO NORMALISE HIV? Thirty years on since the beginning of the AIDS pandemic and we’re still trying to normalise HIV. I ask myself what has really been achieved in all these years to dispel the myths that surround HIV/AIDS and lessen the stigma and discrimination that people living with HIV face? Well the answer is a lot has been done, but obviously not enough yet. Without the early activism action that groups like ACTUP took, many more lives would have been lost for sure. These people fought when stigma, anger, discrimination, hatred, homophobia and violence were at their peak and helped Australians get access to antiretroviral and achieve basic human rights for people living with HIV.

I was working on the Positive Living ACT HIV/ AIDS awareness raising stall which we held during World AIDS Awareness Week this year at The Canberra Hospital. I had a few encounters during the display which were disturbing to me and prompted me to write this article. One fellow would not let his child have a balloon, despite her pleas for one, and I believe this was because it had World AIDS Day on the balloon and maybe he was afraid people in his community would think he had the virus. This is of course my own assumption. Some people purposely took as wide a berth from us as they could when they realised what the display was about. Another person who I actually know from my social circle questioned why I was doing the display and had a look of disdain on his face whilst looking at the information on the table.

He did not want to take any of the information and I even offered him a free red ribbon and he just walked away with his nose screwed up. I have not seen this person since the display, but will be curious to see if his interaction with me has changed now that he associated me with HIV, which has happened to me in the past.

Fast forward to 2011 and the battle has changed but we are still fighting to end discrimination and stigma towards people living with HIV. The lack of awareness and education about HIV in the general community is still an issue we need to continually address. I believe we are definitely addressing these issues in the GLBTI community; however, many people in the general community are still scared of HIV and confused about methods of transmission. Most people are not aware that anybody can This was demonstrated to me very clearly whilst get HIV and that 52% of people living with HIV

globally are women and girls and we highlighted this fact at the display. The usual stereotypes of gay men and intravenous drug users are still the groups that people recognise as those who get HIV and don’t see themselves at risk of contracting the virus because they do not fall into these groups. They certainly don’t figure women into their equations.

We encountered the same old questions such as can you get HIV from sharing cups, from the toilet and from saliva. Most people were actually surprised that HIV can only be transmitted through blood and body fluids and there needs to be a way in for the virus to penetrate, i.e. through an open wound.

Whilst I felt that the empathy displayed seemed to outweigh the prejudice, we must continue to raise awareness, dispel myths and normalise HIV. So I will continue to wear my World AIDS Day t-shirts when I go out in public which attracts the attention of people. This in turn prompts them to ask why I am wearing the shirt and gives me the opportunity to engage another person and have a conversation about HIV.

www.aidsaction.org.au Jan - Feb 12 | 03

Sex sells. Well, that’s often true. How often do we look at a magazine at the check outs to see pictures of (usually) young, toned, tanned bodies in various states of undress, intertwinement and suggestion? Watching the serious media probity of programs like Today Tonight, we are frequently reminded that billboards adorn our larger cities with ads for erectile dysfunction, shoe ads that look like BDSM teasers, and Best & Less catalogues with pictures of children’s underwear that looks increasingly like Playboy magazines.

Keiran Rossteuscher

IS THE MEDIA BAD FOR YOUR HEALTH? SO WHEN ISN’T THIS TRUE? WELL, APPARENTLY WHEN TRYING TO COMMUNICATE WITH GAY MEN. WAIT. WHAT? Yes. Over the last year or so we have noticed a disturbing trend when engaging with various media and media distribution agencies. Now I’m not talking about the posters of rough’n’ready porn-stars midcoitus that some might have seen in sex on premises venues. No, I’m talking about just trying to inform gay men that there have been recent outbreaks of Gonorrhoea in the ACT, or reminding guys the importance of using condoms.

Does anyone remember the outcry when AdShel in Queensland pulled a condom reinforcement ad featuring two fully clothed gay men embracing each other after a contrived outcry of disgust and ‘won’t someone think of the children’ from the Australian Christian Lobby?

Now the AAC is somewhat trapped in this progressive modern age.

Niche marketing vs. spreading the word to the masses. Culturally appropriate vs. marginalising and reductive language. Expectation to carry the weight of the universe vs. a community organisation’s meagre budget. We can’t rely on churning out a message on the old cyclostyle and distributing it at the gay nightspots and saunas, and assuming we have done our job. While most LGBT people didn’t go to these venues 20 years ago, even less do so now, especially as the need for these social safe houses has crumbled away, and the remaining locations aren’t compelled anymore to engage with the health needs of their patrons – let’s face it, it can be hard to make STI’s as sexy as the poster for the next naked night or theme night.

Where once we could have syphoned the majority of our press-based advertising into FUSE-style magazines, we are told by our target groups that they don’t want to have to rely on these mediums for the messages, instead wanting to see them in the Canberra Times or Chronicle, bus shelter panels or the sides of buses. Unfortunately, there are two very big problems with this: firstly, the budgets required to comprehensively use these modes is very high, especially in proportion to whom we are actually trying to communicate. Our highly public campaigns recently have been time and space limited, not flooding the market. And secondly, we often have to compromise the actual content of the messages to make them consumable for the mass market. There is a very real hesitation to allow public forums to communicate directly with gay men.

Like QLD and their bus shelter drama, we were asked to move one of our recent ‘On the Rise’ bus shelter ads because of a ‘number of complaints’, which turned out to be only one, away from CISAC (Canberra Indoor Sports and Aquarium Centre) onto a bare, human traffic-free, road. This was knocked on the head when AdShel, which is based in Sydney, were reminded that this was a campaign that we were provided with specifically

www.aidsaction.org.au Jan - Feb 12 | 04

by the ACT Health Directorate to target young gay men about a health issue that needed addressing, and that our approach was evidence based not only from up to date research on health promotion, but also a lot of money that we have invested into focus testing the campaigns. We have also had ads rejected because they wanted a man standing in his underwear to be changed from jocks to boxers.

Similarly we recently attempted to use a street media distribution company that installs posters and postcards around the ACT, such as cafes, to distribute a pamphlet sized card of ‘On the Rise’. The company refused to distribute the card because they said it was not promoting an event and therefore would turn audiences off other materials on display. The particular content of the cards was not discussed. The company’s website offers tailored services to meet the client’s needs, which we have used before to advertise SpringOut Fairday, but does not state that publications need to be limited to events. Further clarification was sought, but to date there has been no response from the company.

We are frequently criticised in and out of our community about our lack of broad public campaigns about HIV. This is usually followed up with people lamenting the absence of modern-day Grim Reaper styled advertising. We have commented on these ads before in previous editions of the Newsletter. Just to reiterate, THEY AREN’T COMING BACK! There appears to be an acceptance of maintaining an idea of fear because it looks like something is being done. Something being done with the end result of either not working or causing more harm is completely counter-productive to the work that we do here.

So why not go with FUSE? Thank god we have FUSE. Well unfortunately gay press isn’t as gay friendly as it used to be. This vexing conservatism has not been limited to mainstream media outlets. FUSE is, always has been, and always will be, a business. And as much as whenever someone picks up a copy, there are assumptions about the content.

While the personal values held by the editors might be more congruent with our own, these aren’t necessarily held by other stakeholders. We have a history of healthy discussions with FUSE to get our ads into the magazine in the format that we originally intended. According to FUSE other advertisers and the locations that the magazine is distributed have expressed concern with our ads – too explicit, too ‘gay-oriented’ or not inclusive of or appreciable by lesbians, or even worse, the majority heterosexual audience of the magazine. This is problematic when we are expressly funded to target gay men because still, they are the most likely to be affected by HIV, and research has demonstrated time and again that risqué or explicit language and sexual imagery is culturally acceptable across age, racial and socio-economic lines of gay men. Ultimately FUSE has the final word on the content of their product and it is up to them as to where they choose to receive or sacrifice their funding.

FEAR LESS LIVE MORE AFAO’s new national education campaign called Fear Less Live More encourages gay men to communicate more openly about HIV in sexual settings.

Recent research has shown there is still a great deal of stigma in the areas of sex and relationships. Up to a half of HIV-negative men say they refuse to have sex with someone who they know is HIV positive.

This is creating an environment where HIV-positive men find it difficult to disclose their status because of fears about adverse consequences. It may also lead to gay men being hesitant to get tested for HIV. We are further hindered by online advertising. While it offers huge promises, it seldom delivers without having to compromise our messages. Google has in the last few years pulled down our PEP (post-exposure prophylaxis) ads because of unmoving concerns we are promoting a medicine or therapy. GRINDR has declared to other AIDS Councils around Australia that their punters don’t want to see health promotion ads (which is perplexing if you actually look at how ridiculous some of the ads are they have). And some of the larger gay dating websites create hurdles to advertising (inconsistent prices, demanding co-branding of survey results from those being recruited from the site, etc) which all tend to be drowned out by ads for porn, poppers and parties. Facebook, social behemoth that it is, frequently move the goal posts and make keeping up with their innovations quite cumbersome, such as changing the way groups and pages works, as well as increasing people’s ability to filter their content. The AAC may be ‘liked’ by someone, but they might also block all of our posts, rendering us invisible to them. This medium can also be filtered once people move away from their laptop or PC onto their smartphone or tablet, which has none of the ads we have just paid for.

Even within the confines of the AAC we are criticised for our health promotion. While gay men aren’t the only ones who use our foyer or other spaces in the building, we are limited by what is available and who we are ultimately trying to work with. We never want to marginalise people who use our building, likewise there needs to be an appreciation of the reality of the work that we do here and that it reflects the current state of the HIV epidemic. There will always be an abundance of posters targeting gay men; likewise, our workshops will reflect the needs of various segments of the community who have indicated a desire to learn about particular aspects of risk or sexuality, which may not always sit comfortably with everyone else.

It’s not all bad. We continue to look at the opportunities that some of the above, such as the social networking sites, have to offer. Street press, such as BMA (who have many of the same stakeholders as FUSE) have been exceptional to work with this year, and we will be looking at other mainstream or alternative advertising mediums that we haven’t tried in the past. Qradio has also recently been reinvigorated, and we are starting to develop more radio friendly content.

The creeping conservatism within the media outlets we work with, I feel, is largely based on unfounded fears, or from very small but loud squeaky wheels. We are unlikely to ever go back to 80’s and 90’s style marketing, and our messaging is as a reality, going to need to reflect the nuances of the communities we work with – hopefully the media outlets will come to understand this and come on board with us as well.

There is an increased perception of responsibility on HIV-positive men with three-quarters of gay men expecting disclosure of HIVpositive status before having sex.

In contrast, less than half of men expect HIV-negative men to disclose their HIV status.

The campaign covers five specific areas: communicating about HIV status; choosing casual sex partners; acknowledging concerns about HIV; negotiating serodiscordant relationships; and overcoming fear of rejection.

Fear Less Live More is being distributed nationally through posters, press ads, postcards and web banners on popular gay networking sites. A dedicated website www.fearlesslivemore.org. au has been created with detailed information along with Facebook pages allowing user generated content and engagement.

Locally the campaign is being rolled out through our local media and community agencies.

The AIDS Action Council will be running workshops in the first few months of 2012 including: • Looking Out – Gay, Bisexual and curious men 26 and above • Out There! – Gay, Bisexual and curious men 25 and under • Together – Relationships for single and partnered gay men of all ages • Online – a NEW seminar on understanding meeting guys safely online For more information or to RSVP contact Chai on chai@aidsaction.org.au or call

02 6257 2855 www.aidsaction.org.au Jan - Feb 12 | 05

WHEN YOUR PEERS ATTACK When I first started as the office person at SWOP my peers advised me not to trust the AIDS councils. Their advice was that councils would not support my ideas and the only reason they put up with us is because we do get funding and the councils would hate to lose it.

My personal belief was that we are a small minority group and therefore would all stick together. Yes it might sound a bit on the utopian side of things but that was what I thought. How silly of me.

I found out just how wrong and starry eyed my idea was at my first AFAO (Australian Federation of AIDS Organisation) meeting. A gentleman stood up and was going through a long list of minority groups and the last thing he says is “oh (sigh) and the prostitutes.”

I was shocked. But I guess my peers were right. So I went away with a changed view and decided that the only people I could trust were my fellow sex workers. I stopped going to forums that were organised by the “gay men”.

I only went to forums that were peer based. These spaces become very empowering and the best part of this space is I can be Lexxie the whore. NO QUESTIONS. Are you a victim? Can I save you?

Is someone making you do this? What do you do in your service?

How much do you charge? I could go on but this is not about the questions I always get asked. When I am in this space I don’t have to explain or make excuses. The people in this space get it and for 3 days a year I can take my mask off and just be.

So imagine just how devastating it is when you feel like you are being “attacked” by these very same “understanding” peers. Who do you turn to when your peers - your own people – are attacking you? You are left feeling you have no space that feels safe to you AND no space that you can just be you. It is very isolating and disempowering when a minority group feels like they have no one to support them. BUT when it is your own peers, you feel like you have been put into solitary or you are Carrie at the prom!

So what do you do when you find yourself in that situation? I went home and slept for 4 days. Then called a friend and debriefed with her over a bottle of rum. Might not have been the healthiest option but where else could I go? After the debriefing I felt much better and I felt like I got a little of my power back.

The week after returning from this forum I have come back to work and find that I am turning to the very people I was originally warned against. The people who would never support anything us sex workers do are the very people who think that what I am doing is great. And the support I needed from my peers I now will get from the people I work with.

As I peer through my rose coloured glasses I am reminded that some ideas we thought would never work have come to fruition, including our work with the Australian Federal Police (which was interestingly the basis for the attack by my peers). There will be times when you may not like or agree with what some of your peers are doing BUT taking the time to listen and to just be there is often all the support that is needed. Being a peer does NOT involve a responsibility to conform to some homogenous idea or stereotype. Being a peer DOES involve a responsibility to be sensitive to and celebrate the diversity of ideas, opinions and approaches we as individuals, choose to adopt.

www.aidsaction.org.au Jan - Feb 12 | 06

ADVOCACY Advocacy can take several forms including individual, self and systemic; the role of an advocate is to support another person’s or group’s interest. At the AAC individual advocacy will often take the form of attendance at meetings or writing letters to ensure that an individual’s rights or concerns are upheld and heard while they remain in control of the process. With self advocacy the agency can encourage and support people to represent themselves by ensuring that the correct information is easily accessible. Another area of advocacy is around systemic issues where a change to system wide, policy or services will benefit a large group of people or a community.

As services providers we should not be intimidated by scrutiny of our activities.

Consumer feedback by advocates can improve the experience of all involved and can assist planning for the future and the quality of services provided. .

The AAC will often partner with other agencies to better understand and advocate for the needs of specific communities. One of the areas that affect people living with HIV (PLHIV) disproportionately is access to S100 medications with only one dispensing point for the whole of Canberra. Surely, this is extremely limiting and represents a lack of choice and accessibility. Stigma, labelling and discrimination remain very real issues for affected people and much of our work relates to these unacceptable behaviours, on an individual or systemic level.

People affected by HIV may also be unsure of the reporting requirements that service providers or GPs may have under government contracts. After all, clients have the right to know what type of information is passed on and how this may be recorded and used. The AAC is currently updating the fact sheet:

“In the Australian Capital Territory (ACT), what happens if a person appears to be knowingly placing others at risk of infecting them with the HIV virus?”

We are also liaising with the ACT Health Directorate regarding National Guidelines in this area to ensure continuity of understanding across all service providers.

Another area of change is the personally controlled electronic health records project currently taking place. This may puzzle some people as to what they are signing up to and who has access to their records especially if your HIV status is known by only a few. This project is reported to have many benefits including: •

Patients for the first time will be empowered with easy-to-access information about their medical history - including medications, test results and allergies - allowing them to make informed choices about their healthcare.

•

They will be able to present for treatment anywhere in the country, and give permission for health professionals to access their relevant medical history

•

Patients will no longer have to remember every detail of their care history and retell it to every care provider they see. Parents will not have to remember the vaccinations their child has had, and doctors and nurses won’t have to thumb through paper records.

•

Patients will control what is stored on their medical records and will decide which medical professionals can view or add to their files, meaning privacy will be strengthened.

Ensuring that these and other issues are accurately communicated is part of our and other service providers' role; however what constitutes advocacy will differ in different circumstances and according to the skills and needs of the individual or group. In this instance, it is imperative that health consumers are fully aware of their rights and any potential issues that may arise for them.

As one of many human service agencies, we should always be watchful that near enough doesn’t become good enough and that we maintain an eye on what we and other service providers are doing to improve the living environments of all who use our services. In fact, we also have responsibility to enhance the living environment for people who may not use our services per se, but would benefit from systemic change.

FOR YOUR DIARY Thursday12

JANUARY SWOP Art Exhibition 10:00am - 5:00pm Tuggeranong Arts Centre Open until 5 February

Wednesday 18

PSN Dinner 6:00pm – 9:00pm Westlund House, Acton

Thursday19

SWOP Art Exhibition Official Opening

STRIP: FREE & EASY SEXUAL HEALTH CHECKS - MARCH 2012 Every Thursday night @ The Ranch and Saturday mornings @ Westlund House

(enquiries to Lexxie for details) 6:00 pm Tuggeranong Arts Centre

Call 02 6257 2855 for more information

Thursday 26

Australia Day

www.aidsaction.org.au/strip

Wednesday 01

FEBRUARY PSN Dinner 6:00pm – 9:00pm Westlund House

Saturday 04

Core Training (enquiries to Chai for details) 10:00am – 3:00pm Westlund House, Acton

Monday 07

RIP STSexual

health check-ups

Dietitian Clinic 10:00am – 3:00pm Westlund House, Acton

Wednesday 15

AIDS Action Council Volunteer Meeting 6:00pm – 7:30pm Westlund House, Acton

PSN Dinner 6:00pm – 9:00pm Westlund House, Acton

Thursday 16 Saturday 18

PACT Training

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NetReach Training

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AAC Legal Clinic (enquiries to Marcus for details) 6:00pm – 9:00pm Westlund House, Acton

Wednesday 29

Making positive lives count

(enquiries to Keiran for details) 6:00pm – 7:00pm Westlund House, Acton (enquiries to Chai for details) 10:00am – 5:00pm Westlund House, Acton

Thursday 23

HIV futures seven

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Cruising Online Workshop (enquiries to Chai for details) 6:00pm – 8:30pm Westlund House, Acton

PSN Special Dinner 6:00pm – 8:30pm Location TBA (enquiries to Mick for details)

Thursday 01

MARCH STRIP Sexual Health Clinic

Saturday 03

Sydney Mardi Gras Parade2012

www.hivfutures.org.au Australian Research Centre in Sex, Health and Society, La Trobe University

6:00pm – 8:00pm The Ranch at Fantasy Lane All Day Sydney, NSW

STRIP Sexual Health Clinic 10:00am – 12:00am Westlund House, Acton

Thursday 08

STRIP Sexual Health Clinic 6:00pm – 8:00pm The Ranch at Fantasy Lane

Saturday 10

02 6257 2855

STRIP Sexual Health Clinic 10:00am – 12:00am Westlund House, Acton

DATE: 7 February 2012 Extended clinic time until 6:00pm

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