Collective Thinking 70

The first information choice for HIV Positive New Zealanders

Collective Thinking The Newsletter for HIV+ people, their carers and supporters New Zealand ISSN 1170-2354

Issue 70 h August 08

HOW MUCH IS YOUR LIFE WORTH? Special Report on Life Insurance

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COLLECTIVE THINKING Issue 70 H August 08

I’m not interested in HIV I’m not all that interested in HIV. Perhaps this sounds like an odd thing for a positive person to say, but those who are HIV positive are not obliged to consider their disease of major interest or a major signifier of who they are. It’s a part of me, an important part, but I’ve known it long enough now to know it’s not everything.

There’s no doubt receiving an HIV diagnosis has a huge impact. Initially the knowledge was overwhelming and, for me, it remained so for a few years. I look back on finding out I was HIV positive in 2002 as a pivotal event in my life. There was an inevitability about my contracting HIV that didn’t make diagnosis a surprise. This inevitability arose from a dangerous and unconscious desire to self-destruct and an underdeveloped ability to value myself.

I didn’t think “oh, that can’t happen to me,” but nor did I care enough about myself to prevent it happening. I also think I got HIV simply because I was a randy young man doing what comes naturally..

After diagnosis I entered a part of life that I could now call “the numb years”.

Being diagnosed with a life-threatening disease, even if it doesn’t threaten your life immediately, is like bereavement. It is bereavement from the self, and bereavement demands a period of mourning. How long varies from person to person. There are no rules, no right or wrong, only we know when we are through it.

News of HIV infection is big and something you can never undo. At first it can seem both inescapable and terrifying. Some people deal with this psychological trauma by not dealing with it. They close down and ignore HIV until forced by illness to pay attention.

Others can’t stop dealing with it. In an attempt to take back control of their lives they become unpaid HIV treatment experts, sometimes struggling to remain on top of what is a powerfully complex and fluid subject. Crisis provokes extreme response, perhaps even more so if you are someone who already polarises between extremes of behaviour.

I thought life was over, that everything good had happened in the past. I didn’t feel there could be a future and so I didn’t try and make one, not for a few years. Whole months drifted by , I was depressed and numb at a deep level. At other times I crashed through every emotional state, from denial to anger, resignation, even elation, and drank too much. But I was still numb, even when I wasn’t quiet.

It was a sad time, yet I think HIV contributed to a breakdown that I needed to have.

Even in the most horrendous life experiences some lesson or some good can be found.

People fall apart so that they can put themselves back together. Being HIV positive and desiring to make sense of why I became HIV positive later caused me to reappraise both the past and potential future. I began to reach a true acceptance of myself.

There have be new lessons and obstacles as my physical health has deteriorated further, but after nearly seven years I am comfortable with my condition. I also don’t care who knows about it. If others feel prejudice towards me then they are responsible for that prejudice. It’s their business, not mine.

In saying, ‘I’m not interested in HIV,’ I’m not saying I don’t want to stay reasonably informed about it. As a positive person it is important to monitor our health, both physical and mental. It is important to take up activities and be with people that allow healing, change and spiritual growth to happen. But HIV isn’t me. It dominated my thoughts for a long time and it doesn’t now. I’d rather think about beautiful men, or architecture, or something funny and intelligent on TV. I’d prefer to do a few things in my local community that might be helpful to others and help me feel like a useful person.

I’d like, in some small way if I can, to help other positive people and other gay men have an easier time of it than I did. I’d like to write about lots of things. I’ve started to do some of this. I am going to do more.

Aaron McDonald = Editor c.thinking @nzaf.org.nz Collective Thinking is published quarterly by the New Zealand AIDS Foundation with funding from the Ministry of Health. The views represented here do not necessarily represent the views of the New Zealand AIDS Foundation or the Ministry of Health.

CONTENTS 3 Editorial 4-5 Local News 6-7 International News 8-16 Special Report: How much is your life worth? HIV positive people and Life Insurance

by Chris Banks

17 Opinion: “Memory, Loss and Memory”

by Michael Stevens

18-21 Trevor Mallard: Fighting AIDS Stigma at the UN

by Jay Bennie

22-23 Candlelight Memorial 2008 Report 24-25 Working With HIV: A Practical Guide 26 The British Debate on ‘Barebacking’

by Craig Young

27 Complacent at risk of HIV superinfection

by Dan Harrison

28-29 Obituary: Dr Matt Wildbore

by Jay Bennie

30 Quotes 31 Obituary: Darren Taylor aka ‘Bambi Slut’

by Matt Akersten

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(( LOCAL NEWS ))

Accountant Richard James joins NZAF Board

More HIV positive clients access Burnett Centre The New Zealand AIDS Foundation’s Auckland-based HIV testing and counselling clinic, the Burnett Centre, has seen a 27% increase in the number of HIV positive people using its services since shifting premises to Hargreaves St in College Hill.

The move from Poynton Terrace, off K Rd, took place in early March.

The decision to move was hotly debated by some sections of the community who raised concerns about lack of accessibility in the new location, as well as its proximity to NZAF’s national headquarters, which some felt would deter clients from using the service.

Analysis of data from the first six months of 2008 shows that there are now 27% more HIV positive receiving counselling at the Centre than during the same period in 2007. Also increased are numbers of gay and bisexual men accessing counselling (22%), and rapid HIV tests (6%).

“This is great news for all concerned and confirms that the move was necessary for us to better address the needs of those accessing the Burnett Centre services,” says NZAF National Positive Health Manager Eamonn Smythe. “The clients now have warm, comfortable, soundproofed rooms, which lends to a better counselling environment.”

The greater space available at the new premises has also seen several new counsellors employed to meet the growing need.

Burnett Centre “mother” moves on to new challenges

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Karen Ritchie, affectionately known as the “mother” of Auckland’s Burnett Centre, left her long-time front desk role in June to pursue new career .

Leather gear raffled for charity $800 was raised for peer support network Body Positive as part of the inaugural Mr Urge Leather 2008 contest in July, held at Urge Bar in K Rd, Auckland.

Items from the late gay GP Matt Wildbore’s collection of leather gear were among the items auctioned and raffled off on stage for the event, which saw contestants showing off their leather looks in front of a panel of judges, including NZAF National Campaigns Co-ordinator Douglas Jenkin.

“It was a great night with a genuine feeling of camaraderie that many older gay men ‘on the scene’ miss,” he told Collective Thinking. “It’s also significant that a Leather contest donate to Body Positive given that the Leather Community was first be decimated by HIV - both here and overseas - in the early days. Apart from one contestant thinking Robert Mapplethorpe was a member of the Village People, there was a high level of knowledge.”challenges.

She says she will continue to head the Cartier Bereavement Trust, the HIV/AIDS funeral-funding charity which is very close to her heart.

The New Zealand AIDS Foundation’s Board of Trustees welcomed its newest appointed member, Richard James, in June.

Richard is an accountant, providing financial and management services to small and medium-sized businesses.

He brings to the Board a wealth of expertise in the commercial sector in both accounting positions and general management. ”I have also been actively involved in a number of GLBT organisations.

I was on the executive of GABA – Gay Auckland Business Association and held positions of Treasurer and President. I am currently a Trustee on the GABA Charitable Trust, on the organising committee of Heroic Gardens and financial advisor to the Cartier Bereavement Charitable Trust,” he says.

“I have always enjoyed the opportunity to give something back to the community and see my position on the Board of the New Zealand AIDS Foundation continuing that personal commitment.”

$80,000 windfall for Body Positive The New Zealand AIDS Foundation’s Board of Trustees has made a oneoff grant of $80,000 to peer support network Body Positive.

The grant will allow Body Positive to expand into premises in Poynton Terrace left vacant by the move of NZAF’s Burnett Centre, and increase their range of services to include rapid HIV testing, counselling and massage.

Body Positive’s Bruce Kilmister says the organisation is “delighted” by the grant.

NZAF Board Chair Mark Henrickson said the grant confirms the Board’s support for Body Positive and their commitment to making HIV testing services available in the K Rd area.

COLLECTIVE THINKING Issue 70 H August 08

Respected GP Matt Wildbore dies Auckland GP Matt Wildbore, who once oversaw what is believed to be the largest caseload of HIV positive people in New Zealand, passed away in June aged 45.

“Matt had great empathy with his patients,” Body Positive’s Bruce Kilmister told GayNZ.com.

“He always wanted what was best for his patients and would do as much as possible for them... he was always there for them.”

The New Zealand AIDS Foundation also paid tribute to a man who had been a tireless supporter of its Burnett Centre during the early days of the HIV epidemic. “Matt was always a remarkable support for people living with HIV, at one point as an Auckland based GP he had the largest case load of HIV positive people in primary care in Auckland, if not the country,” said Executive Director Rachael Le Mesurier. “He has always been a significant friend and supporter for NZAF since the epidemic began. He will be deeply missed.”

See obituary pp 28-29

Collective Thinking is #1 Collective Thinking is officially the first information choice of New Zealanders living with HIV, according to results published in HIV Futures NZ 2.

The 261 participants in the five-yearly survey by LaTrobe University were asked to list which publications containing HIV information they read, and Collective Thinking came out at the top of the list, chosen by 44.7% of the sample.

Collective Thinking was listed streets ahead of overseas-based publications like Australia’s Positive Living (17.7%) and HIV Australia (2.3%). The New Zealand AIDS Foundation’s website was selected by 10.7% of participants.

The most popular sources of information after Collective Thinking were Body Positive’s Positively Positive (44.7%), and New Zealand-based gay newspapers, which were selected by 29.8% of the sample, irrespective of the reader’s sexual orientation.

“These results suggest that HIV positive New Zealanders prefer voices that are both local and independent when it comes to sourcing information about HIV,” says Collective Thinking editor Aaron McDonald.

“A lot of work has been done over the past eighteen months to make sure Collective Thinking does both jobs well, and I’m thrilled that we’ve come out on top.”

NZAF Wellness Fund: Over $100,000 will go to HIV positive New Zealanders Launched at the end of March, the New Zealand AIDS Foundation’s new Wellness Fund for HIV positive people has given out $50,000 in just three months to fund healthcare and services which are not publicly funded.

Many HIV positive people have used the Fund to pay for dental and facial restoration for conditions caused by the complications of living with HIV and long-term use of antiretroviral medication.

These treatments are expensive and not publicly funded, and some of the health needs can cause stigma, pain and low self esteem.

“Having been HIV positive for 22 years and on treatments for more than ten, I had developed severe lipodystrophy,” says one man. “My face was the most noticeable - sunken cheeks, hollow temples and an almost skeletal appearance.

“I had done research on what was available to remedy ‘the look’ but the procedure is very, very expensive. The Wellness Fund grant has enabled me to have a number of facial filling treatments helping me look ‘normal’ again.”

NZAF Positive Health Manager Eamonn Smythe says the Fund is still receiving applications, and another $50,000 will now be allocated for treatments in the next nine months, bringing the total allocated for treatments in a year to $100,000. This is double what had been anticipated.

“It is wonderful that the fundraising of so many New Zealanders is making a difference for people living with HIV,” says Smythe. “With the cap lifted we can make sure those dollars reach as many as possible, but it does mean we will have very little left.”

The Wellness Fund relies entirely on bequests and donations from the public, chiefly on World AIDS Day, December 1. An automatic $10 donation can also be made by phoning 0900 RIBBON (742266) (you must be the bill payer).

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)) INTERNATIONAL NEWS ((

“It is astonishing how badly we have done with men who have sex with men. It is something that is going to have to be discussed much more rigorously.”

- Kevin De Cock, Head of the WHO’s Department for HIV/AIDS

Medication side effects now more tolerable for some, study finds Adapted from an article by Michael Carter for www.aidsmap.com

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HIV positive patients with undetectable viral loads now rarely change their treatments due to side effects, according to a British study published in the May 31st edition of AIDS. The researchers believe that in many cases, patients doing well on treatments will be able to stay on their combination of drugs for a long period of time.

Heterosexual women and gay men were more prone than heterosexual men to treatment change due to side effects, as were older people.

Although the investigators think that the true rate of treatment changes due to side-effects is likely to be higher than that reported in their study, they do believe their findings suggest that “so long as virological failure is avoided, some regimens are so far proving to be sufficiently stable to suggest that very long-term use is potentially feasible.”

Treat newly diagnosed HIV positive gay men for other STIs, researchers urge -Adapted from an article by Michael Carter for www.aidsmap.com

Gay men who test HIV positive should automatically be treated for gonorrhoea and chlamydia, American researchers are recommending. A study published in the May 1st edition of the Journal of Acquired Immune Deficiency Syndrome found a high prevalence of these STIs amongst gay men testing HIV positive in San Francisco.

People at risk of infection with HIV through unprotected sex are also at risk for other STIs, and in people with HIV, many STIs can increase HIV levels in semen or vaginal fluids, heightening the risk of onward transmission.

The 6,864 men in the study had swabs from the anus,

throat and urethra. The investigators then compared the rates of STI infections in HIV positive and HIV negative men.

26% of men testing HIV positive also had gonorrhoea and 19% were also infected with chlamydia. This was significantly higher than the HIV negative men: 11% had gonorrhoea and 8% had chlamydia. HIV positive men were more likely than HIV negative men to have rectal infection with gonorrhoea or chlamydia, and to be infected with gonorrhoea in the urethra or throat.

The investigators comment that the prevalence of both gonorrhoea and chlamydia amongst gay men testing HIV positive in their study was “substantial…and significantly higher than in the men who have sex with men testing HIV negative.”

Because gonorrhoea and chlamydia often show no symptoms, half of the HIV positive men coinfected with these STIs were not treated until after laboratory results became available. Investigators are recommended that protocols be changed to assume infection before testing, and administer treatment immediately.

Rest home for HIV positive people to open in India Adapted from an article on ndtv.com

Gay and HIV positive people in India who have faced a lifetime of discrimination can now look forward to acceptance in their twilight years, with plans for a rest home to be opened by the end of 2008.

The project is the brainchild of Manvendra Singh Gohil, gay scion of the 600-year-old Rajpipla dynasty in Gujarat. ‘’There is a need for such a home for homosexuals and AIDS affected elders as they are not being understood by the heterosexual and homophobic world,’’ Gohil said. ‘’As these people are generally discarded by their relatives and society even in the prime time of their lives, one can easily imagine what they will have to face during old age.”

Jayendra Trivedi, a non-resident Indian from Canada has already donated two acres of land at Kumbheshwar, about 60 kms from Vadodara, and construction is already underway. Initially, the home will be able to accomodate 50 residents.

“It will be equipped with all facilities including [an] advanced medical unit for aged homosexuals and HIV

COLLECTIVE THINKING Issue 70 H August 08

“We’ve had to find new ways to engage with gay and bisexual men about HIV/AIDS.” Susan Cohen, director of health education and prevention, Los Angeles Gay & Lesbian Center

patients,’’ Gohil said. ‘’We have also planned to build a crematorium for them as we want to ensure that the gays and HIV positive people receive the same honour even after death.”

In a society where gay sex is still a criminal offence, the 39-year-old prince, who was disowned by his royal family when he came out two years ago, felt that there was a strong need of a support system for elderly gay and HIV positive people. ‘’Homosexuality is not a sin but a natural preference of a man or woman. But those who are accepting it are being thrown out of the society. At this time of desertion, especially in old age, money alone can’t help such people but they need a kind of support system,’’ he said.

Online soap opera raises HIV awareness Adapted from an article on www.kaisernetwork.org bvvv

A new online soap opera produced by the Los Angeles Gay & Lesbian Center is aiming to raise awareness about HIV and AIDS and promote safe sex among gay and bisexual men, the Los Angeles Times reports.

The show, called “In the Moment,” is a “racy, unvarnished portrait” of gay/bi men in Los Angeles, but “at its core” is about HIV/AIDS. The show has drawn more than 80,000 viewers in the last few months, and most production costs (about US$8,500 per episode) were funded by the city of West Hollywood, says the Times. Most of the people working on the show are volunteers, including the actors.

The Times reports that the show has “struggled to land more government money,” mostly because the federal government is “squeamish about funding images deemed ‘explicit,’”.

Susan Cohen, director of health education and prevention at the Los Angeles Gay & Lesbian Center, said that in terms of reaching gay and bisexual men to raise awareness about HIV, the center “needed to be where the guys are,” which is on the Internet. James Key, chief public affairs officer at the center, said that “we’ve had to find new ways to engage” gay and bisexual men about HIV/AIDS. “Times have changed,” Key said, “and we’ve had to change with them.”

Global HIV prevention efforts for gay/bi men ‘astonishingly bad’, says WHO Heterosexual prevention efforts may have been misdirected The head of the World Health Organisation’s department for HIV/AIDS, Kevin De Cock, says the threat of a global heterosexual pandemic has disappeared, and prevention efforts should be concentrated on high-risk groups such as gay and bisexual men, injecting drug users, sex workers and their clients.

This is the first official admission from the WHO that prevention strategies targeting general populations may have been misdirected.

Dr De Cock, an epidemiologist specialising in HIV/ AIDS, told British newspaper the Independent on Sunday in June that there is no risk of a generalised HIV/AIDS epidemic in the heterosexual population outside of subSaharan Africa.

“It is very unlikely there will be a heterosexual epidemic in other countries. Ten years ago a lot of people were saying there would be a generalised epidemic in Asia. That doesn’t look likely,” he said. “But we have to be careful.

As an epidemiologist it is better to describe what we can measure. There could be small outbreaks in some areas.”

AIDS still kills more adults than all wars and conflicts combined, and the numbers of new diagnoses dwarfs current efforts to address it. “AIDS still remains the leading infectious disease challenge in public health. It is an acute infection but a chronic disease. It is for the very, very long haul. People are backing off, saying it is taking care of itself. It is not,” De Cock said.

De Cock identified HIV/AIDS among gay/bisexual men as a crisis area.

“In the developing world, it has been neglected. We have only recently started looking for it and when we look, we find it. And when we examine HIV rates we find they are high.

“It is astonishing how badly we have done with men who have sex with men. It is something that is going to have to be discussed much more rigorously.”

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>> SPECIAL REPORT

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HOW MUCH IS YOUR LIFE WORTH?

HIV positive people and life insurance cover

By Chris Banks

COLLECTIVE THINKING Issue 70 H August 08

T

sun and Toni have been in New Zealand for eight years.

During that time, they’ve gained degrees, fallen in love, and married (each other). They’ve saved hard for three years for a deposit on an apartment, and topped up their savings by guilt-tripping Toni’s parents for some extra.

They love the Kiwi lifestyle, and with a relentless enthusiasm unique to the young, they’re keen to get ahead. The property ladder beckons, but they worry about their tight finances. Then there’s the prospect of starting a family – they’ll both be over thirty soon!

The happy couple head off to see a financial adviser, and afterwards are fully convinced of the need to have a financial safety net. It’s time to get life insurance to cover the mortgage on their first home – a joint policy, worth $300,000 each – to see them through should either one of them die.

Tsun and Toni, are of course, a figment of the imagination. Specifically, Sovereign Insurance’s imagination – this is one of the fictional scenarios provided on their website to help consumers decide which insurance products might be best for them (I merely added a little extra cynicism for taste).

But what’s likely to happen if you’re an HIV positive person in the same scenario? In many cases, getting life cover is not just for peace of mind, it’s a requirement of the mortgage.

For many years, applying for any kind of insurance as an HIV positive person has been like driving through a city with every traffic light on red.

The potentially exclusionary HIV screening questions virtually leap off the page.

Many HIV positive people are understandably cagey about disclosure.

What happens to this information once you hand it over? Will your privacy be protected, and do underwriters at major insurance companies have the knowledge base to allow them to fairly treat an insurance application from an HIV positive person in 2008? After all, we’ve come a long way since 1985.

MedPage Today is an online medical news source, co-developed by the University of Pennsylvania School of Medicine. All of its news articles are reviewed by physicians. On June 27, they published an article with the headline: “HIV Life Expectancy Approaching Normal”.

Anti-retroviral treatments have changed everything, reports MedPage.

While there is still a gap in life expectancy, “it’s a far cry from 1993, when one study estimated a lifespan of just 6.4 years for an HIV patient entering care with a CD4 T cell count of about 500 cells per microliter of plasma.”

A Denmark study based on 3,990 HIV positive patients and published in the Annals of Internal Medicine journal in 2007 estimated the median survival for a young person diagnosed with HIV today to be more than 35 years. Another study published in the Journal of the American Medical Association used a large, multinational cohort of 16,534 HIV positive people and reached similar conclusions: that the mortality rate for HIV positive people in industrialised nations has become much closer to that of the general population since the introduction of treatments.

And so the big question remains – have insurance companies kept up with trends in modern medicine, or are they still relying on stereotypes of decades past? We formally approached eight underwriters from New Zealand’s leading insurance companies with the same eight questions, and received responses from six. We also asked Poz Correspondent, an HIV positive consumer,to review each answer and give it a rating out of ten.

Overall, our investigation showed that New Zealand insurers generally have little or no experience with HIV positive applicants, and knowledge about the effects of HIV vary wildly. While some companies have clearly progressed and are making an effort to keep up to date with advances, others are not complying with Human Rights Commission guidelines.

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>> SPECIAL REPORT

AMP

Slogan: “Financial security through life” Veronica Ruddenklau, External Relations Manager: “AMP consider applications in the same way irrespective of the health status of the applicant. We assess a number of factors including currently available information on the seriousness of the condition the applicant may have and an individual’s risk factors related to the condition.

Once these factors are assessed, we will offer people terms and conditions for their consideration. The terms and conditions reflect the assessment of the above factors.

Premiums for those with a serious or terminal illness will generally be higher than those for non-terminal conditions.

Applications are seen only by those required to in order the application be processed. AMP deal with applications for the full range of conditions.”

Poz Correspondent rating: 3/10: Evasive and non-committal.

“AMP is the only company we received a response from who chose to issue a statement rather than address our questions individually.”

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TOWER HEALTH & LIFE

Slogan: “Because you can’t predict, but you can protect…”

Matthew Banham, Chief Underwriter: 1. Do you provide life cover for HIV positive people?

We will consider applications from HIV positive persons for Life, disability and medical insurance.

2. What effect does being HIV positive have on an applicant’s ability to be covered?

Terms for Life, Disability and Health insurance are assessed based on the risk of claim relative to other applicants and members of the insured population.

HIV positive applicants would be deemed to have a higher risk of death and disability than those who are HIV negative. To reflect the higher risk, the terms of the policy would need to be modified (higher premiums charged or other changes to the terms and conditions of the policy).

For Life cover, insurers use guidelines derived from

actuarial data supplied by international reinsurers. Until recently, these guidelines would state that no terms could be offered for Life cover for HIV positive applicants. With new data into survival rates and management of HIV now coming to the fore, these guidelines are gradually being reviewed.

Terms may now be considered on those applicants in the “best case” category. The actual premiums / modifications to cover what would be required are not specifically detailed as each case would be considered individually, and the Chief Medical Officer would be consulted. The criteria for “best case” selection include: CDC Stage 1 or 2 CD4 (T4 cells) > 400 µl CD4/CD8 (T8 cells) > 1.2 p24 antigen negative virus equivalent < 10,000/ml plasma 3. What effect would it have on premiums?

For Life cover – premiums charged would have a substantial increase on the standard rate (to reflect the increased risk of claim relative to other policy holders).

4. How does this compare with applicants who have terminal illnesses such as cancer?

For terminal illnesses such as cancer – assuming that a terminal diagnosis has been made, an insurer would not be in a position to offer Life cover (as by definition – a claim is certain). If an applicant has a history of cancer which has not been diagnosed as terminal, an insurer may be able to offer Life cover with an increased rate of premium to reflect the increased risk of death – this would depend of the type of cancer, the stage of the cancer, and how long it had been since treatment was completed.

5. How does this compare with applicants who have chronic, but manageable illnesses such as diabetes?

Chronic conditions such as diabetes can be accepted for Life cover with an additional rate of premium. The rate depends on the control of the diabetes, the duration of the disease, and the presence (or otherwise) of any complications. As the data available for people living with HIV increases, actuaries will be more able to analyse the additional mortality risks for HIV positive applicants.

Due to the small size of the sample in NZ, it would be difficult to get statistically valid information. It is likely that overseas data would be used.

6. Once an HIV positive person has filled out one of your insurance applications, who has access to the data?

Disclosures made on application forms are only available to be viewed by New Business administrators (for processing purposes), Underwriters (for risk assessment) and in the event of a claim being made, Claims staff. Access to personal information is restricted to those staff who need to view it for the purposes of performing their job tasks. TOWER complies with the privacy act in this regard.

COLLECTIVE THINKING Issue 70 H August 08

7. What happens if you are an applicant who declares themselves to be the partner of someone who is HIV positive?

Partners of HIV positive persons would be deemed to be a higher risk for HIV infection than those who are not.

To assess the risk, we would request an HIV test.

Assuming that the test was negative, and no other risks for HIV infection were present (eg Intravenous drug use) then we would be able to consider all covers.

8. How much experience does your company have in working with HIV positive clients?

We have very little experience in dealing with HIV positive applicants. I can only directly recall one HIV positive applicant in my time at TOWER (not including applicants who tested positive for HIV on routine screening for high sum assured cases).

Two main reasons: low prevalence of HIV infection in New Zealand, [and] very few of these people applying for insurance.

Poz Correspondent rating: Comprehensive reply. Acknowledges changing views. Clarifies partner position well. Excellent non generic response.

7/10:

“Terms may now be considered on those applicants in the “best case” category.”

- Tower Health & Life

ASTERON LIFE LIMITED Slogan: “Life - we’re in it together” Kim Harrison, Chief Underwriter: 1. Do you provide life, disability and/or medical insurance cover for HIV positive people?

Restricted-term Life covers can be provided these days due to the improvement of medical understanding about the early stages of HIV, viral loading, and treatments available.

2. What effect does being HIV positive have on an applicant’s ability to be covered?

Obviously it creates some challenges from an underwriting point of view in that there can be many differing circumstances for each individual we see, e.g. illicit drug use, stage of disease at diagnosis, response to treatment, other existing medical conditions, etc.

We will always aim to offer some form of cover wherever possible, but in some cases it can be necessary to defer our decision for a year or two to see how things are progressing or whether a particular aspect of the

medical condition makes itself clearer over that time span.

3. What effect would it have on premiums?

Premiums are calculated to reflect the level of risk that an insurer is taking on. Standard premiums are calculated from tables of mortality and morbidity published by government health agencies.

These allow us to calculate the probability of an ‘insured event’ occurring for any age group or gender in individuals with no known health problems. Where a known health problem exists, however, we need to alter the premiums to reflect the increased likelihood of the ‘insured event’ occurring at an earlier stage of the policy life.

In this regard, being HIV positive will definitely lead to higher premiums to reflect the risk level.

4. How does this compare with applicants who have terminal illnesses such as cancer?

The process is exactly the same. First we need to gather all the facts and then determine the ‘probability’ associated with the condition. This can only be done by comparing the applicant’s situation to that of other known cases and their published survival statistics.

We rely heavily on published medical data to give us the statistics we need for calculating likely survival time and hence the resultant premium level.

5. How does this compare with applicants who have chronic, but manageable illnesses such as diabetes?

Again, the process is the same - gather all the facts pertaining to the applicants specific situation and then compare against known data to calculate the appropriate premium. Most chronic, manageable conditions will still attract a premium loading dependent on likely survival statistics.

6. Once an HIV positive person has filled out one of your insurance applications, who has access to the data?

Any application that comes into our office is sighted by a New Business team member who will capture basic data about name, address, type of cover, etc on our computer system, no specific medical data are recorded.

The application is then passed to an Underwriter for medical assessment. The Underwriter will then request necessary medical information pertaining to the case. The Underwriter is the only person who sees this information, it is kept confidential at all times.

Asteron adheres strictly to the guidelines of the Privacy Act with all information that we gather.

7. What happens if you are an applicant who declares themselves to be the partner of someone who is HIV positive?

We would want to know if that person had recently had their own HIV status checked. As long as they were negative themselves and demonstrated an understanding of how to avoid contracting HIV, then we wouldn’t anticipate any greater risk level.

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>> SPECIAL REPORT

8. How much experience does your company have in working with HIV positive clients?

We would see no more than 3 applications per year from HIV positive individuals, so our experience is very limited.

As a parting comment, and in response to your e-mail, Asteron is well aware of the current review of Human Rights legislation [More info at the end of this article – Ed.]. Our own General Manager has been involved on the ISI panel in terms of formulating an industry response to the Human Rights Act review and our CEO is Chairman of the ISI (Investment Savings and Insurance Association) panel.”

Poz Correspondent rating: Excellent reply that seems ‘onto it’ especially acknowledging the role of education in assessing the partner.

8/10:

“We will always aim to offer some form of cover wherever possible, but in some cases it can be necessary to defer our decision for a year or two.”

- Asteron Life Limited

FIDELITY LIFE ASSURANCE COMPANY LIMITED 12

Slogan: “The New Zealand-owned and controlled life insurance and investment company” Neil Prestwood, Underwriting Manager:

1. Do you provide life, disability and/or medical insurance cover for HIV positive people?

With regard to life or disability insurance we have not effected any policies of this type in my time here (over 6 years) on HIV positive lives. In my underwriting career, which predates the advent of HIV/AIDS, I personally have yet to see a proposal on such a life.

2. What effect does being HIV positive have on an applicant’s ability to be covered?

Providing life and disability insurance covers requires us to have reinsurance support and it is these reinsurance companies who carry some or often much of the risk and provide the underwriting (assessment) guidelines. Given the significant extra mortality/morbidity that HIV/AIDS produces, these guidelines advise that cover will not

be supported for such lives and we would therefore be unable to offer terms.

3. What effect would it have on premiums?

Not applicable - see 2 above.

4. How does this compare with applicants who have terminal illnesses such as cancer?

We would not wish to offer terms to applicants with terminal illnesses.

5. How does this compare with applicants who have chronic, but manageable illnesses such as diabetes?

In general, chronic illnesses such as diabetes are insurable under special terms but this will depend on the details of the exact case –some may simply attract extra premiums (which may vary hugely) or special policy conditions or exclusions, or perhaps may not be insurable at all.

6. Once an HIV positive person has filled out one of your insurance applications, who has access to the data?

Any insurance application to this company is treated on a strictly confidential basis, medical files are available only to trained underwriting staff and are held on our in house scanning system which allows access on medical matters only to the above authorised staff (underwriters) 7. What happens if you are an applicant who declares themselves to be the partner of someone who is HIV positive?

In respect of the partner of an HIV positive life, we would wish to ascertain their HIV status-i.e.have they been tested and if so the results,plus confirmation of safe sex practices if applicable, before considering finalising terms.

8. How much experience does your company have in working with HIV positive clients?

None.

Poz Correspondent rating: Direct response but out of date. They are saying ‘don’t bother with us, you are in the too hard basket’.

4/10:

“Given the significant extra mortality/ morbidity that HIV/AIDS produces, reinsurance guidelines advise that cover will not be supported for such lives and we would therefore be unable to offer terms.”

- Fidelity Life Assurance Company Ltd

COLLECTIVE THINKING Issue 70 H August 08

ING LIFE (NZ) LIMITED

Slogan: “Get on with life without worrying about what’s around the corner” Sanjay Lal, Head of Underwriting: Firstly, I would like to mention that we have not had an HIV positive applicant. The answers to your questions are our processes that we would follow if we ever did have an applicant who was HIV positive.

1. Do you provide life, disability and/or medical insurance cover for HIV positive people?

We do not offer cover to HIV positive applicants through our normal underwriting process but would utilize our extreme underwriting process to offer terms and to also comply with the Human Rights Act. All our products cover HIV except Trauma and Medical Insurance which have a blanket exclusion for HIV and related conditions including AIDS. Extreme underwriting is the process used to offer terms to applicants who would otherwise be declined insurance. Before commencing this process, the adviser and applicant needs to be made aware of the following: Their risk to ING Life (NZ) Limited falls well outside normal underwriting criteria and is likely to incur a significant substandard loading. These loadings are in excess of the maximums quoted in the underwriting manual, and are: Life/Trauma/Complete Disablement/ Life Income +400, and Income Cover/Premium Cover +150 on a 4-week wait.

The sum insured and term of the policy may be altered.

There may be exclusions on the policy.

There may be a cost involved in arriving at suitable underwriting terms.

There may be a delay of a couple of weeks in arriving at a decision.

It is advisable to provide the adviser and applicant with an indication of the likely terms, and the effect on the premium, prior to the extreme underwriting process commencing in order to manage their expectations. This has a dual purpose of giving the applicant a warning of the financial cost and the opportunity to discontinue their application prior to the commencement of this process and the cost of this process. It also serves to highlight how we view their health.

It is also important to remember that the cost of assessing these cases can be very large, particularly if further investigations are required to quantify the risk, eg.

CT or MRI scanning, exercise ECG’s or echocardiograms.

As a result of this, ING Life (NZ) Limited have decided to charge the applicant an upfront cost of $250.00 to cover some of these investigations, and some reinsurers will also charge this prior to the commencement of this process.

Our reinsurers, do not charge an upfront fee, however, both reserve the right to seek compensation should the cost of investigation be large.

It is important to also note that the reinsurers are likely to bear quite a large cost during this process as they are

more likely to liaise with specialists, both in Australia, and internationally, to gain a better understanding of the risk profile.

When presented with a case which falls into this category we would call a meeting of our in-house Extreme Underwriting Committee which includes our Chief Underwriters, Head of Underwriting and Chief Medical Officer.

Once our in-house committee has assessed this risk, the appropriate reinsurer would be advised of this and a copy of the entire file forwarded to them.

Any decisions regarding the cost of investigating the risk and quantifying it would be made prior to the request of information.

2. What effect does being HIV positive have on an applicant’s ability to be covered?

See above 3. What effect would it have on premiums?

See response to #1 4. How does this compare with applicants who have terminal illnesses such as cancer?

As an industry we have many years of statistical and actuarial data on the incidence and mortality/morbidity of cancer, diabetes, heart disease etc. We do not have such data on HIV+ cohort as yet and therefore we cannot accurately price.

HIV+ / AIDS are approximately 25 years since discovery. We know that the data in the first 10 years showed that a diagnosis of HIV/AIDS most often lead to early death, however, there have been advances in treatment etc, which are indicating that this may not necessarily be so anymore.

The issue for our industry is that we don’t have enough credible data currently on the impact of these advances to accurately price risk. No doubt this will be available in the future.

5. How does this compare with applicants who have chronic, but manageable illnesses such as diabetes?

See response to #4.

6. Once an HIV positive person has filled out one of your insurance applications, who has access to the data?

The information is only available to authorized ING Life staff, Chief Medical Officer and our Reinsurers who share the risk with us.

7. What happens if you are an applicant who declares themselves to be the partner of someone who is HIV positive?

We would ask the partner if they have had an HIV test post diagnosis of the HIV positive partner. We would also request the results and ask if they practice safe sex.

If they have not had an HIV test, we would request for one to be done. If the partner is HIV negative and they practice safe sex, cover can be offered.

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>> SPECIAL REPORT

SOVEREIGN PRECIOUS MOMENTS WITH THE DYING 8. How much experience does your company have in working with HIV positive clients?

As mentioned previously, we have not had a HIV positive applicant, however, we can utilize our Extreme Underwriting Committee, Actuaries, Chief Medical Officer and the reinsurers to underwrite this risk if required.”

Slogan: “The country’s leading life insurer” Mark Collins, Head of New Business and Claims: 1. Do you provide life, disability and/or medical

A former Catholic priest reflects on the early insurance days of cover Newfor Zealand’s HIV positiveAIDS people?epidemic Poz Correspondent rating: They say there is not enough data around to make a correct risk assessment – there are screeds of studies and statistics. Ill-informed.

2/10:

“The cost of assessing these cases can be very large...as a result of this, ING Life (NZ) Limited have decided to charge the applicant an upfront cost of $250.00 to cover some of these investigations.”

- ING Life (NZ) Ltd

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POZ CORRESPONDENT’S SCORECARD 1. Sovereign 9/10 2. Asteron 8/10 3. Tower 7/10 4. Fidelity 4/10 5. AMP 3/10 6. ING 2/10 Failed to score AXA AIG

Sovereign does provide insurance cover to people who are HIV positive, where we can get sufficient information to make an appropriate and informed assessment of the risk. Not all people will be able to obtain cover immediately, as with all conditions (be it heart problems, back problems or HIV) the nature of the risk is not necessarily clear at time of application.

2. What effect does being HIV positive have on an applicant’s ability to be covered?

Each applicant is assessed individually, so terms will vary from client to client, but it would generally be expected that for life and disability cover an increase in premium (or loading) would apply and potentially a limitation to the term of the contract.

3. What effect would it have on premiums?

In most situations where we are able to offer cover the premium would increase, but as already noted, each assessment is based on individual circumstances and premium increases may vary.

4. How does this compare with applicants who have terminal illnesses such as cancer?

It is not possible to compare one disorder with another in terms of premium ratings, however it is important to note that Sovereign applies the same approach to underwriting the risk presented by the applicant irrespective of the condition suffered.

In the example you present, the risk of someone with a terminal illness may be substantially higher (and so high as to be effectively unquantifiable in terms of cost) than someone who is HIV positive, however it is the process of information collection, research and analysis that will ultimately determine the “price” each individual pays.

5. How does this compare with applicants who have chronic, but manageable illnesses such as diabetes?

Please see above.

6. Once an HIV positive person has filled out one of your insurance applications, who has access to the data?

This information is accessed by people within Sovereign who have a need to do so in order to help us provide the insurance. In the application process this usually means an administrator and the relevant staff involved in underwriting the application. In a claim situation this is extends to staff that are involved receiving and processing the claim.

We will also provide the information to our reinsurers, where we require assistance with pricing, research and

COLLECTIVE THINKING Issue 70 H August 08

reinsurance coverage for the risk. Information can also be accessed or provided to third parties where the insured has authorised the disclosure.

Sovereign has done some work on pricing insurance for people with HIV which has resulted in applicants being offered cover.

7. What happens if you are an applicant who declares themselves to be the partner of someone who is HIV positive?

If a partner of someone who is HIV positive applies for cover and declares this circumstance, we would require evidence of a recent negative HIV result, and if supplied, the application would be processed through our standard underwriting process.

Poz Correspondent rating: I would trust them. Seems open and honest and realistic. Good answer to the partner question. Seem to have an informed 2008 approach.

8. How much experience does your company have in working with HIV positive clients?

Our experience is that very few HIV positive people actually apply for insurance and therefore the amount of work done in this area is correspondingly small. This will increase as demand for cover increases. Having said that,

9/10:

“Sovereign has done some work on pricing insurance for people with HIV which has resulted in applicants being offered cover.”

- Sovereign

WHO WE DIDN’T HEAR BACK FROM AXA NEW ZEALAND Slogan: “Be Life Confident”

AXA describes itself as “a company that has a proud history of helping people for over 120 years.” Its parent company, the Global AXA Group, “has a firm belief that large companies such as AXA have a responsibility towards the communities and countries they operate in.”

AXA Re, a French reinsurance subsidiary, was awarded an insurance contract worth US$7 million by the World Food Programme in March 2006, in what it described as the “world’s first humanitarian insurance policy”. The policy provides “contingency funding in a pilot scheme to provide coverage in the case of an extreme drought during Ethiopia’s 2006 agricultural season.” The policy was questioned by Ethiopian authorities and some aid workers, who thought such a substantial sum should be spent directly on food.

In New Zealand, AXA’s operating earnings for 2007 totalled $59.1 million, up from $48.6 million in 2006.

The company said in a media statement issued in February this year that key contributors to this increase were “higher financial protection sales and lower-than-expected claims.”

CEO Ralph Stewart said that the company’s goal is to double its New Zealand enterprise value by 2012.

AIG LIFE

Slogan: “Protecting Your Future” AIG Life has been operating in New Zealand since 1982. Its parent company is American International Group, Inc, the world’s largest insurer. AIG relies on independent financial advisers to sell its products in New Zealand. “Our products perform very well in this ‘open market’ sales situation, because the size of our global operation allows us to provide exceptional benefits and value for money,” says their website.

In February 2006, the parent company was fined US$1.6 billion by the New York State Attorney General’s office following allegations of accounting fraud, over which its CEO resigned in 2005. Nasty public spats between the company’s board and management have continued. The Wall Street Journal reported in June that three major shareholders attacked the company’s financial practices, citing a “staggering breakdown of risk controls and an unequivocal loss of investor confidence.”

AIG Life is the preferred insurer for the New Zealand Police, which provides subsidised policies for its officers. In addition to Life, there is a “Vital Care Cover” policy offered which is designed to sit alongside Life Insurance, and provide financial support for convalescence and recovery from a range of critical illnesses. HIV is included among these, but only if it is “accidentally acquired”.

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>> SPECIAL REPORT

WHAT DOES THE HUMAN RIGHTS COMMISSION SAY?

I

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n December 2007, the Human Rights Commission released revised guidelines on insurance and the Human Rights Act, following extensive consultation with representatives of consumer groups, individuals and the insurance industry.

The consultation process highlighted a number of issues which could not be dealt with in the guidelines, and the insurance industry has proposed to develop a consultative group made up of consumers, the industry and the Human Rights Commission to address human rights issues in insurance as they arise.

However, Chief Human Rights Commissioner Rosslyn Noonan is convinced that the new guidelines will give greater clarity and understanding to all parties with respect to their rights and obligations under the law.

“The guidelines rigorously reflect the requirements of the Human Rights Act,” she said in December. “They will be central to ensuring that nobody in New Zealand is unlawfully denied insurance.”

The full guidelines are available on the web at www.hrc. co.nz but based on the answers we received from insurance companies for this article, we have investigated some of the relevant passages from the guidelines below: Insurers cannot refuse to insure you or treat you less favourably because you are HIV positive.

The Human Rights Act does not allow insurers to refuse you insurance, but they are allowed to offer policies on different terms and conditions in relation to sex, disability (which includes HIV status) and age.

Insurers may defer their decision about what policy terms they can offer you to allow time to assess your risk.

Ideally, such a decision should take no longer than six months.

Deferral is sometimes necessary if your individual risk is difficult to quantify at the time of application, but deferral should not become a substitute for refusal. It should be for the minimum time necessary, and the process should be fully explained to you.

Medical advice or opinion should be relevant to your condition and provided by your clinician with your consent, although the insurance company may still need to seek a second opinion. However, advice or or opinion should ideally be provided by a doctor who has experience or training in HIV/AIDS and is aware of advances in treatment.

If you’re needing cover while your risk assessment is being completed, there are other options you can discuss with your insurance company. These include (a) providing

cover with a temporary exclusion or (b) deferring the right to claim for a specified period.

You may be charged a higher loading initially to offset the cost of assessment for your application, which may be reduced when information about your actual risk becomes available. Alternatively, the fee could be waived if the information would be of benefit to the company in assessing future claims.

The insurance companies we received answers from all had either limited or no experience of processing an application from an HIV positive person. Some of the information obtained in assessing these applications would increase the insurer’s understanding of HIV and therefore be useful in assessing similar applications in the future.

If deciding to go ahead with a policy offer, you may be charged for the cost of assessing your individual risk, but you should not have to pay for costs which increase the company’s wider understanding of HIV. Any costs charged should not be at a level that effectively acts as a deterrent and could be perceived as a refusal to insure. Once again, the decision-making process should be fully explained to you.

It is not unlawful for proposal forms to include questions that appear to infringe the Human Rights Act 1993.

In other words, insurance companies are perfectly entitled to ask questions about HIV status or sexual orientation, although they are advised to take care to comply with the Human Rights Act. Companies need to be aware that a particular pattern of questioning may indicate an intention to discriminate.

Reinsurers are exempt from the Human Rights Act as the service they offer is to insurance companies, not to individuals.

Reinsurers provide services to insurance companies, not to the public. As a result, reinsurers are exempt from the application of s. 44 of the Human Rights Act. Furthermore, as all the reinsurers that New Zealand insurers contract with are based offshore there are jurisdictional issues. The requirement to always offer cover does not apply in international markets. However, there are times when New Zealand insurers have to offer cover to individuals even though they are unable to obtain reinsurance.

For further information, phone the Human Rights Commission’s Infoline on 0800 496 877 or email infoline@ hrc.co.nz . This is also the first port of call if you wish to make a complaint. The bulk of complaints to the Human Rights Commission are resolved within three months.

COLLECTIVE THINKING Issue 70 H August 08 >> OPINION

“It seems sad to me that the struggles and amazing bravery displayed in the face of terror and hostility are so quickly slipping from our collective consciousness.”

Memory, Loss, and Memory

T

he tragic death of Dr Matt Wildbore (see obit. pp 28-29) has made me think of a few things.

One thought that I keep returning to is the way our history, individual and collective, is so fragile.

For many younger men in Auckland, Matt Wildbore is not a name they’d know. For me, and I guess for my generation, he was a symbol of compassion, of care, of fun, of bravery and support through the worst days of the plague. He was vocal, he was courageous, he cared.

The effort he put in, and also the efforts of many others, through those dark days when all you could expect after an HIV+ diagnosis was to get sicker and sicker and die – usually terribly – perhaps in your own shit...emaciated, blind, demented, unable to recognise those around your bed who loved you...it seems that history, that part of our culture, has been lost to some extent.

It’s as if the generation coming straight after a terrible war had no idea of the struggles their parents had been through. Tragedy is now ephemeral.

Before, the stories of a culture’s suffering and bravery, generosity and struggle, all formed part of the collective memory, something that could be referred to, something that was passed down from generation to generation.

The essentially fragile, tenuous nature of gay culture and community makes this hard enough in the first place, but given that so many who did fight so bravely, who nursed, fed, wiped the arses of and cleaned up the vomit of their friends, lovers, or even strangers; who quietly looked after them as they descended into AIDS related dementia - these stories are now, it seems to me, largely gone, and certainly I think unknown by many younger gay men. They just don’t know what it was like. And that is maybe a good thing. But somehow it seems sad to me too that the struggles and amazing bravery displayed in the

face of such terror and hostility are so quickly slipping from our collective consciousness.

But then the work of Dr Chris Brickell gives me heart.

In his new book “Mates and Lovers”, he has undertaken meticulous scholarship to find out the hidden history of gay men in New Zealand from the 19th Century on. He has taken active steps to recover our past. If we are to ever really have a gay community, if it is possible, then understanding where we come from, our whakapapa, our heritage, our past, is essential. Knowing that men in the 1860s or 1920s looked to other men for love, for sex, for joy and for support, just as we do, is a tremendously important thing for us all to take on board.

The stoic in me remembers the words of Emperor Marcus Aurelius - “So many who were remembered already forgotten, and those who remembered them long gone” and it is true - the world is full of unsung or forgotten histories and biographies that are filled with acts of love, bravery, sacrfice, joy and tragedy that have been forgotten and blown as dust to the wind.

But I want to remember - and I want young gay men coming up to remember too. I want you to know where we came from, what we went through, because it matters, because without all this we wouldn’t be here today, and so you know a bit of what we had to do to get here, to this place where you are able to live in a level of social acceptance that seemed impossible to even imagine for me 30 years ago.

Remember. Remember all of it - the good and the bad, the extraordinary and the banal. It is part of us all, part of who we are and how we all got here.

Celebrate your life, love it, enjoy it, embrace it. But remember.

Check out Michael’s blog “The Gay Blade” at: http://gaynz.com/blog/gayblade/

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ELIMINATING STIGMA AND DISCRIMINATION

NEW ZEALAND LEADS THE WAY AT UNAIDS

by Jay Bennie at GayNZ.com

W

18

hen Cabinet Minister Trevor Mallard recently told nations to get real about their HIV epidemics, he got one of those rare things at the United Nations: a silent, focussed hearing followed by enthusiastic applause.

The crux of Mallard’s speech was that nations should follow New Zealand’s lead by decriminalising and destigmatising affected groups so that they will come forward and be identified, counted, educated, and supported. No nation can know the true nature of its HIV epidemic if those most affected have to hide or lie about themselves, he told government representatives gathered for the two-yearly UN General Assembly on HIV/AIDS. Rachael Le Mesurier, Executive Director of the NZ AIDS Foundation, was in the audience as Mallard spoke of the need for pragmatic, evidence-based HIV and AIDS prevention programmes, and the conditions which enable the gathering of reliable information.

“The most crucial part of Trevor Mallard’s speech was the focus on the promotion and protection of human rights,” Le Mesurier says. “All aspects of increasing access to anti-retrovirals, care, support and prevention have to work through a human rights framework. His speech highlighted how even data collection will be unreliable if people are not safe enough to be honest about how they became infected or how to stay negative.”

It was a message many of the assembled national representatives seemed ready to hear. “As there were over 140 countries providing speeches, regrettably many got very little attention and were often talked over. For New Zealand, however, the background murmur died down and the applause, which only a few got, was sustained and emphatic.”

Le Mesurier says a group of “like-minded countries,” such as Canada, the UK, Ireland and the Netherlands also gave strong speeches in line with New Zealand’s strategies. “In fact it was heartening to hear that almost all had the same human rights focus as NZ did - nice

too as we were one of the first countries in that group to speak so it appeared like we led the pack!” GayNZ.com understands that the Swedish representative went so far as to make a beeline for Mallard to shake his hand.

Human Rights: a New Zealand export?

The hard work towards the human rights framework underpinning New Zealand’s HIV initiatives began 35 years ago, with the formation of Gay Liberation in Auckland. Other organisations formed throughout the country until New Zealand’s glbt activists, stridently opposed by bigots and religious conservatives, but supported by fair-minded organisations and individuals, managed to get male homosexual contact decriminalised with the passing of the Homosexual Law reform Bill in 1986. It is worth noting that, although Fran Wilde MP fronted up the political campaign to get Law Reform passed, it was fellow MP Trevor Mallard who was in the background, doing the thankless but vital job of meeting with recalcitrant MPs and working the numbers.

Ironically, New Zealand’s burgeoning HIV epidemic amongst gay men lent weight to a similar and successful campaign to outlaw discrimination against many people, including homosexuals and those with illnesses. The Human Rights Act came into being in 1993.

If there is a part of the world that New Zealand is in a position to directly influence and assist, if only due to geographical proximity, it is the Pacific, where legalised human rights and protections have been slower to become enshrined in law, much less in social change.

HIV has already gained a strong foothold in homophobic Papua New Guinea, where the epidemic is characterised as being a heterosexual one. But logic, supported by a recent UN announcement debunking the much trumpeted straight HIV epidemic threat, in most countries at least, points to it being spread in PNG by undercover bisexual and homosexual contact.

COLLECTIVE THINKING Issue 70 H August 08

Other Pacific nations have yet to feel HIV’s full force.

But, with only limited resources for prevention and support, it would not take much for countries such as Tonga, Samoa or Fiji to succumb to HIV. Le Mesurier says New Zealand has been active in supporting human rights and HIV organisations across the Pacific. For instance, “the NZAF has been a strong friend of our fellow nongovernment organisations, working in HIV, human rights and on issues for men who have sex with men, lesbian and transgender people’s rights,” she says.

“Our Pacific People’s Programme shares many networks and ideas with our colleagues in the South Pacific,” advises Le Mesurier. The AIDS Foundation hosted both the Pan Pacific Regional HIV/AIDS conference in 2005 and the second Love Life Fono in Auckland last August which was supported by funding from NZAID so a large number of representatives from around the South Pacific could attend.

The NZAF has also supported the Samoan AIDS Foundation since its inception in 2005. “We have provided a seeding grant, hosted their governance board, provided training, and peer support - all at no cost to them or to our focus on the epidemic here in New Zealand,” Le Mesurier says, adding that the NZAF is “often asked to provide stronger partnerships with our fellow NGOs.” “It was so good to meet up at the UN with the Pacific country NGOs such as the Fiji AIDS Task Force, Pacific Island AIDS Foundation and Samoan AIDS Foundation,” says Le Mesurier. “I was so pleased to see that they were all integral members of their countries’ delegations.”

Optimism tinged with concern At a global level, Le Mesurier came away from this year’s UN meeting with a cautious sense of progress since the last such meeting, two years ago. “Most significantly, the symbolic shift seen in the majority of countries now explicitly naming gay men or men who have sex with

men, sex workers and intravenous drug users and with the complete absence of calls for prevention programmes based on sexual abstinence and regular references to condoms.”

Two years ago to even name the groups most at risk was deemed too contentious: ‘vulnerable communities’ was coined as “an annoying euphemism, and condoms barely got a mention in the Political Declaration - once, on page 36 I believe.”

As another indicator of progress, this year nongovernmental organisations and community groups, ‘Civil Society’ in UN-speak, had “far more profile and more opportunities to have their message heard by politicians and policy makers.”

Le Mesurier says she was heartened to hear about the strong progress in decriminalising homosexuality and pro-human rights moves by some countries, such as El Salvador. But that optimism was tinged with “sadness at hearing about the resurgence of new infections in Uganda, the poster boy for African HIV prevention work in the early 2000s” and “annoyance at some countries’ inability to name any group other than orphans.”

Grand words spoken by government representatives at forums such as this, Le Mesurier warns, are easy. Nations must be judged on their follow-through and results.“How much of this will be mere ‘sales puff?’ Many Civil Society organisations were critical of what was being said but not done. As there was no specific declaration from this meeting there was no way to hold those countries to account. The discriminatory ban on people living with HIV and AIDS from travelling for short stay trips to countries like the USA was clearly a major concern, as are the retrogressive steps on harm minimisation policies by some countries.”

Clearly there is much work to be done. But, just as clearly, New Zealand remains in the forefront of those nations whose approaches to practical HIV education, based on interlinked government, NGO and community prevention and support initiatives, are an example others could do well to follow.

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“To make every person count, we must ensure that we count every person” - Trevor Mallard’s speech to the UN

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This is the text of the New Zealand Government’s statement, delivered by Cabinet Minister Hon Trevor Mallard, to the 2008 United Nations General Assembly: High-level meeting on a comprehensive review of the progress achieved in realising the Declaration of Commitment on HIV/AIDS and the Political Declaration on HIV/AIDS.

Mr President, Let me first thank the Secretary-General for his report and acknowledge the work of the co-facilitators and UNAIDS for organising this 2008 review. We also want to acknowledge the extraordinary leadership of Dr Peter Piot and thank him for his commitment to our Pacific region.

New Zealand is highly committed to achieving universal access to prevention, treatment, care and support for people affected by HIV and AIDS by 2010.

However, we must all understand what needs to be done. We, therefore, strongly support UNAIDS focus of ‘knowing your epidemic: making it count’. To build on the work done to date we have to be brave enough to seek out the correct evidence and to know the truth about our epidemics.

We need to have the right information to know the epidemic. Our data collection cannot reflect reality when people are afraid to tell the truth: - if, for example, a young sexually active woman or man says they are not sexually active out of fear that their parents and community will punish and condemn them; - if, for example, a drug user cannot get access to clean needles out of fear of being discriminated and imprisoned;

COLLECTIVE THINKING Issue 70 H August 08

- if, for example, a man who has sex with another man says he got HIV from a woman out of fear of public condemnation; - if, for example, a positive sex worker is forced to lie about her HIV status because she knows that there is no other way to feed her children; - and if, for example, a wife cannot get the sexual and reproductive health services she needs because her husband does not support her wish to use condoms.

We have witnessed the ‘feminisation’ of HIV/AIDS. We recognise the vulnerability and inequality for so many women in all societies. Violence against women and negative and harmful practices that subordinate women are fuelling the HIV/AIDS epidemic.

Human rights approaches are essential. We in the global community must eliminate stigma and discrimination from the lives of all people affected by and infected with HIV. We must integrate HIV and sexual and reproductive health programmes. Bringing HIV-related programmes into the mainstream of health systems and through multi-sectorial approaches will deliver cost-effective outcomes.

HIV/AIDS is a major obstacle to development and is a constraint to achieving the Millennium Development Goals. It cuts across all sectors and the response to HIV and AIDS is linked to the reduction in child and maternal mortality and gender equality.

We believe that better coordination at country level promotes stronger country ownership and leadership.

An example of our approach can be seen in our support to countries in the Pacific region to implement the Pacific Regional Strategy on HIV/AIDS. This includes working with all partners to strengthen the health systems and to build workforce capacity to sustain the progress made so far.

New Zealand is one of the world leaders in evidenced-based prevention. We have one of the lowest rates of HIV prevalence.

We have achieved this by putting human rights at the centre of our response: decriminalising men who have sex with men and making discrimination on the basis of sexual orientation and HIV status illegal; decriminalising prostitution and establishing needle exchange programmes. This could only happen through true partnerships between civil society, most particularly people living with HIV, and the New Zealand government.

To make every person count we must ensure that we count every person. The only way to do this is to eliminate stigma and discrimination. Let us act together in solidarity to ensure that when we meet again in 2011, we have met the 2010 target of universal access to prevention, care, treatment and support. That way we can count our success and know that it is true. “

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Report by Eamonn Smythe, Regional Co-ordinator for Oceania

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The International AIDS Candlelight Memorial is one of the oldest and largest worldwide events focused on HIV/ AIDS awareness and advocacy. The theme for this year, the 25th anniversary was `Never Give Up, Never Forget`.

This yearâ&#x20AC;&#x2122;s official opening ceremony was held in Lilongwe, Malawi, one of several sub-Saharan African countries hard hit by this disease. However, many of these 25th anniversary events were also held here in New Zealand.

It was decided to use the international poster this year, rather than a New Zealand specific one, as a show of solidarity with the other 119 countries celebrating this event around the world. Local details of each of the planned events were added and a total of 2,500 posters printed and spread across the country from Invercargill in the south to Kaitaia in the north.

Each of the regional co-ordinators met with their local groups, members of the community and staff and developed unique events that reflected their region.

Some memorials were held in churches while others were not, a reflection that those attending the memorial come from many different backgrounds and hold different beliefs.

Letters of support were given by the Prime Minister, the Leader of the Opposition, the Governor General and the International Co-ordinator of Candlelight as well as many moving speeches on the night from those with their own stories to tell. These ranged from HIV positive people to members of boards, clinicians and politicians across several different ethnic groups.

The ribbons mentioned below, marking the 25th anniversary, were developed in Auckland by the Candlelight committee, distributed to each of the regional co-ordinators and were well received across the country.

The Candlelight memorial held in Christchurch was the culminating event in Christchurch Pride Week, which celebrates the contribution of gay, lesbian bisexual and transgender communities in Canterbury.

Auckland Co-ordinator, Wayne Otter: Candlelight 2008 was a very multicultural event, giving a realistic picture of how the virus has affected so many different groups worldwide. Here in New Zealand, however, it is still men who have sex with men who are becoming infected in higher numbers compared to other groups.

We had approximately 250 people attend this year which is a steady increase over the last three years.

There was one year we thought that it may be the last, but with a group of dedicated people we have been able

to reinvigorate the event.

Over the years there has been many a word spoken about us holding our event in a church, St Matthew In The City. I however combat this argument by saying St Matthew is what I call a fringe church, and is one that acts as it preaches by supporting anyone regardless of gender, age, ethnicity etc and has done so for many years. It also has a LGBT church service put on by Auckland Community Church after the event.

Ribbons were created marking the 25th anniversary of Candlelight. We do not have the calling of names now and have not done so for a few years. The way we incorporate the remembrance into the event is by playing reflective music. Whilst people go forward to light a candle they are invited to recall the names of people they remember, and spend time thinking about them.

This year we also had a pohutukawa tree in the church with tags people could place names on and hang on the tree. This was to mark 25 years. This tree is soon to be planted at the Circle of Friends memorial in Western Springs Park along with all those names placed on the tree that evening. The names will be placed in the ground before it is planted to assist in the nurturing and new beginning process.

Hamilton Co-ordinator, Geoff Ruaine: Candlelight in Hamilton went very well and was attended by around 45 people. The local Hamilton Pride committee did a wonderful job in assisting me to organise a beautiful and respectful ceremony. We were fortunate to have Dr Paul Bohmer (NZAF Board) speak for us and Sue Moroney (Labour MP) and David Bennett (National MP) both attended.

Candles, in the shape of the red ribbon, were lit in the courtyard of the Lady Goodfellow Chapel with time for people to reflect on those they have lost to AIDS. Dan Coomey, a life member of the NZAF spoke of his personal experience and cut our 25th AIDS Candlelight Memorial cake. People stayed on to enjoy a lovely supper and the evening wrapped up at about 8.30pm with a blessing.

Tauranga Co-ordinator, Susan Kennedy: The Bay Area AIDS Support Service regrets to advise that the planned 25th Candlelight Memorial Ceremony, at Tauranga Memorial Park, was cancelled.

This is due to a paucity of personnel to assist with the arrangements, and to numbers attending, apart from the organisers, declining to almost negligible.

We realise that this late cancellation decision was disappointing for the few who do attend and for whom it is an important time of remembrance of their loved one, and also for those responsible for the publication of the event. We would like to extend our good wishes to other participants at ceremonies held on the 18th May.

COLLECTIVETHINKING THINKING COLLECTIVE Issue 70 H August08 08 Issue 70 H August

Wellington Co-ordinator, Camille Smith: This year’s Candlelight Memorial was held in Wellington at the Ilott Theatre, Town Hall. There were over 150 people in attendance. The programme included several musical performances, speeches, and messages from dignitaries.

The service was attended by community members, volunteers, people affected by HIV, as well as the Hon Maryan Street, the Hon Annette King, and Marion Hobbs MP. Following the performances, guests were invited to light a candle at the front in memory of those we have lost.

Christchurch Co-ordinator, Laura Jones: Our memorial took place in the Great Hall in Christchurch Central with the main stained glass window lit. We had approximately 80 people attend with three great speakers covering the experience of HIV/AIDS in Zimbabwe, New Zealand and a very personal story for one person.

Three MPs attended from both Labour and National parties. There was a jazz trio and two choirs, one local group and one kapa haka group. Being able to hold individual candles was very meaningful for many involved. The local press was there to attend and take pictures.

Dunedin Co-ordinator, Sarah Loftus: I was thrilled with our Candlelight Memorial and all the arrangements worked out fine – as it always does.

I would say we had about 40 attendees altogether. The lighting of candles and placing them in the shape of the ribbon was a new part of the service this year, and was spectacular and moving.

The acting Dean of St Paul’s Gavin Yates – only a week in the job – took part readily and with great passion and preparation. St Paul’s has a strong ongoing commitment to the event.

NEVER GIVE UP, NEVER FORGET The 25th Candlelight Memorial 2008

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WORKING WITH HIV: Returning to the workforce after illness

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n early, and important decision you’ll need to make is what work do you wish to do.

You might want to pick up where you left off. However this may not be an option, particularly if it’s a long time since you were last employed. Alternatively, you might want to use your return to work as an opportunity to change direction and enter a new line of work. For some people with HIV, it’s not a question of ‘returning’ to work, but of entering the workplace for the first time.

Whatever situation you’re in, there’s a good chance you’ll need some training to help you prepare, both practically and mentally, for work.

Training If you want to gain new skills or experience, you could perhaps do some voluntary work, enrol in a course, or register on a training scheme.

Volunteering can provide an opportunity to gain new skills and at the same time gain a familiarity with working conditions. The routine of volunteering can also help simulate the routine of working, and if you are volunteering in an area similar to the one in which you’d like to work, it can provide an opportunity to discover if this really is something you’d like to do.

Many people find that volunteering helps boost their self-confidence and acts as a useful bridge back to work.

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Studying To gain employment in your area of interest, it might be necessary to gain specific skills or a qualification.

Universities, polytechnics and wananga around the country have part-time study opportunities for adults, ranging from open access courses with no entry requirements available on campus and extramurally to higher degrees. Many tertiary institutions run 0800 information lines as well as seminars and open days which can be a good way to introduce yourself to university life.

As well as equipping you with skills and qualifications, studying can help focus your attention on what job or career you’d like to undertake, and build your confidence.

Equally, it can provide you with new relationships and lasting networks once you have completed your study.

Help for applying for jobs When seeking employment, it is essential to have the following: An updated CV (resume) Your IRD number Bank account in your name

Original copies of existing qualifications In New Zealand, Work and Income New Zealand (WINZ) has a nationwide network of job centres that display employment opportunities. It also has staff that can facilitate a job interview, provide advice on upskilling options (such as free computer courses) if you register as a job seeker.

Furthermore, WINZ hold job seeker seminars to share insights into what a job seeker can expect, as well as stories of people who have successfully secured enduring employment from using this service.

Recruitment agencies are another path to employment, especially as agencies are now specialising in certain industry sectors and job roles. They work on behalf of employers to seek out and introduce candidates who have the right mix of experience and qualifications.

Recruitment agencies welcome job seekers to contact them and undertake a pre-employment test, which will differ depending on the industry you wish to engage with, and then recommend you to prospective employers (their clients).

Student Job Search is another excellent resource for seeking workplace opportunities, with a focus on studentoriented work experience. Your family or friends may also know someone who is in your preferred industry who can offer advice or guidance.

The impact of returning to work or study If you left work a number of years ago, or have never worked, the prospect of getting a job can be daunting.

Your confidence might be low, you might feel left behind or deskilled. Although you may be able to go straight into full-time employment, a more realistic plan might be to undertake some part-time work, either paid or voluntary, or study. The key is to find a working balance that suits you.

The impact that working or studying can have on your benefits can be a real worry. Many people with HIV have reported being in a ‘benefits trap’. If you qualify for the maximum rate of benefits, you might actually be financially worse off if you return to work, unless the job is very well paid.

You might also be deterred from thinking about work or study because you are uncertain about how long you’ll remain healthy, or are worried that working might damage your health.

Disclosure Unless you’re working in certain healthcare professions, there’s absolutely no requirement for you to tell your employer that you’re HIV positive.

COLLECTIVE THINKING Issue 70 H August 08

Nevertheless, you may choose to tell your employer in the hope that this will lead to a more supportive working environment. However, you may prefer to keep information about your health confidential in order to avoid discrimination or having to deal with colleagues’ attitudes towards HIV. If you need time off because of illness or for hospital appointments think about how you are going to explain this without disclosing your HIV status.

HIV testing There’s no law to stop an employer asking for an HIV test as part of a company medical for new employees.

However, they’ve no right to see the result of the test result without your consent.

The only way an employer can ask an existing employee to take an HIV test is if the initial terms and conditions of a job said that this would be the case.

Employment rights The Disability Discrimination Act provides important workplace protection to people with HIV from the moment of their HIV diagnosis. These rights are on top of those provided by other legislation, such as the Human Rights Act and Employment Relations Act. Basically, it is unlawful for an employer with 15 or more employees to: Discriminate against an HIV-positive person in recruitment and selection unless this can be ‘justified’.

Give an HIV-positive person less favourable treatment (including access to promotion, training and transfers, as well as dismissal and selection for redundancy) unless this can be ‘justified’.

Fail to make ‘reasonable’ adjustments to the work environment to enable an HIV-positive person to work.

An employer needs to be aware of the reasonable accommodation requirements in the Human Rights Act. Reasonable accommodation includes an environment which takes into account an employee’s needs in relation to a disability.

Reasonable accommodation can entail modifications or adjustments which will, for example, allow a job applicant with a disability to participate more equally in a workplace. It can involve physical adjustments such as ensuring access to a building or modifying the way a job is done, for example, allocating aspects of the job to another employee.

The Act does not require changes that would unreasonably disrupt an employer’s activities. The Act provides a number of defences but before an employer can rely upon them the employer needs to genuinely

consider whether the job could be adjusted by assigning those aspects of it that the job applicant is unable to do to another employee.

There is no case law in New Zealand on what is an unreasonable disruption. It is, however, likely that what is reasonable will depend on the circumstances, taking into account factors such as health and safety, cost (in relation to the size of an employer’s business), and the activities or business of the organisation.

For more information, you can contact the Human Rights Commission on their toll-free infoline: 0800 496 877.

Can my employer sack me because I’m ill due to HIV? The Human Rights Act says that it is unlawful for an employer to sack an employee because the employee is HIV-positive unless there is an applicable exception in the Act and the employer has satisfied the reasonable accommodation requirements of the Act. UK Government guidelines in the booklet AIDS and the Workplace state that: “HIV infection alone does not affect people’s ability to do their job until they develop illnesses that make them unfit... If they later become ill, they should be treated like anyone else with a life-threatening illness. Only if their illness affects their ability to do the job should their employer seek medical advice.”

In New Zealand, employers must have considered reasonable adjustments before dismissing you as a result of HIV-related illness.

If you are dismissed because you are unable to do the job, the employer must have sufficient evidence upon which to base that decision. This involves, preferably, both a report from the employee’s doctor and an examination by a doctor on behalf of the employer.

If you are physically unable to carry out your contractual job, then the employer should consider the possibility of a move to different duties. The likelihood of there being suitable alternative employment will depend largely on the size of the firm involved. Furthermore, there is no duty for the employer to create alternative employment.

Seek legal advice if your employer is causing you difficulties in relation to time off for sickness.

This article is based on the AIDSmap.com articles “Going back to work” and “Working with HIV”. It has been adapted for a New Zealand audience with the assistance of the New Zealand AIDS Foundation, the Human Rights Commission and the Department of Labour.

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The British Debate on ‘Barebacking’

By Craig Young of GayNZ.com In New Zealand, we’re fortunate that our own erotic DVD entertainment industry is tiny -and there seems to be no bareback product on the gay market from our own shores. Not so in the United Kingdom, United States and Eastern Europe, as Gay Times noted in its May issue.

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T

im Teeman opens an excellent article on the subject with a chilling story about a gay male participant in one barebacking (penetrative sex without condoms) DVD, who alleges that he was infected with HIV after unprotected anal sex with another participant, and he himself claims to have never had unprotected sex in his own private life, which ICreme, the producer, debates. However, and commendably, ICreme has withdrawn the offending DVD from sale, and has also curtailed production of any further bareback erotic DVDs. Commendably too, Teeman doesn’t flinch away from the issue of Gay Times own Millivres Prowler Group, which may be about to decide to cease further distribution of bareback erotic DVDs from its Prowler sex shops.

The above incident, also reported on Newsnight, a BBC Current Affairs programme, has made them think twice about selling the DVDs, and they’re talking with another UK gay sex shop chain, Clone Zone, about withdrawing their on-sale bareback DVDs from sale.

Could this happen in New Zealand? Probably not, as the Prostitution Reform Act 2003 imposes strict liabilities on any sex work management to ensure that sex workers use condoms during vaginal or anal sex. In the United States, industry heavyweight ChiChi La Rue also refuses to make bareback DVDs and includes a saucy safe sex segment before each of his videos.

Insofar as censorship policy debates go, the British Board of Film Classification notes that it isn’t against the law to have unprotected anal or vaginal sex in Britain, and any state prohibitions would mean the emergence of a substantial black market. At present, the Prowler sex shops estimate that one-third of all gay erotic DVDs sold are bareback.

What is to be done about this? I noticed an odd sense of disconnection in this article, with comments about P/ crystal meth use as if it hadn’t already been shown to be implicated in new HIV/AIDS cases through cognitive short-circuiting when it comes to unprotected anal sex.

There were some useful suggestions, though.

One ex-bareback DVD participant argued that gay male sex workers should be unionised. I support this idea, but sadly, compared to its praiseworthy advances in LGBT rights matters, the United Kingdom appears to be heading backward when it comes to sex work. Instead of debating decriminalisation of sex work in this context, it now seems to be envisaging Swedish style prohibitionist curbs on the occupation.

There are also issues related to lack of communication about HIV status amongst positive and negative male sexual partners, with one assuming the other shares their status because of willingness to have unprotected anal sex, whereas it might be simple ignorance when it comes to the negative partner.

It may also be possible that the United Kingdom is experiencing the delayed fallout from decades of age of consent inequality for gay men, and poor gayspecific content in school sex education programmes.

However, what would that mean in the New Zealand context, where we’ve had age of consent equality since decriminalisation back in 1986?

Teeman argues that we should be far more insistent when it comes to organised boycotts of gay DVD sellers, or even insisting that censorship bodies ban bareback DVDs.

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“This tells you that having HIV doesn’t protect you in any way from getting a second strain of HIV.” Prof Christopher Fairley, Director, Melbourne Sexual Health Centre

Complacent at risk of HIV ‘superinfection’

By Dan Harrison, WAToday.com.au

H

IV positive men who practise unsafe sex are becoming infected with additional strains of the virus, Melbourne research reveals.

The study, which appeared recently in the CSIRO-published journal Sexual Health, is the first Australian research on HIV “superinfection”, which refers to when a person becomes infected with multiple strains of the virus.

Researchers studied the viral load and the level of infection-fighting T-cells in the blood of 145 HIV-positive Melbourne men and concluded that up to 4% could be “superinfected”.

Christopher Fairley, director of the Melbourne Sexual Health Centre and one of the study authors, said that while “superinfection” had been the subject of some research overseas, the paper was the first Australian research implicating the phenomenon.

He said that if an HIV positive person became superinfected, they could contract a drug-resistant or more virulent strain of the virus, which could be more

27 difficult to treat and could progress more quickly to AIDS. “It provides infected people with a reason to continue to be safe, for their own individual protection,” Professor Fairley said.

Study co-author Sharon Lewin, the director of the infectious diseases unit at The Alfred hospital, said: “This tells you that having HIV doesn’t protect you in any way from getting a second strain of HIV.” The study found that a majority of participants engaged in unsafe practices, despite being aware of the possibility of superinfection and being concerned about its damaging health effects.

“What we’re seeing across the board in gay men is high rates of risky behaviour, even in people that are uninfected, and the reasons behind that, we just don’t know,” Professor Lewin said. “It could be complacency about HIV, that people don’t think it’s such a bad thing to have as they perhaps thought it was 20 years ago, because there’s treatments and less stigma.”

Obituary:

Dr. Matt Wildbore, 1963 - 2008

By Jay Bennie of GayNZ.com 25th June 2008 - 09:02 pm

Yesterday afternoon a large gathering of family and friends joined together in rotorua to pay their last respects to matt wildbore, who died alone in his auckland apartment last thursday.

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Unusually, for a predominantly pakeha gathering, Doctor Matt’s funeral was a soaring, plunging rollercoaster of emotion; the highs were witty and uplifting, the lows were moments of heartbreak and deep sorrow.

Matthew Paul Wildbore was born in 1963 in Morrinsville, but within a year the family moved to Rotorua, which remains the centre of the family to this day. His education started at Otanga Primary School and by the age of eight he was assessed as a gifted child.

In the coming years he would reach high academic achievement, learn to play the guitar, sing in the choir and in his final year was Dux of the school.

He moved to Auckland to become a boarder at Auckland Grammar where, remarkably for a boy who had no sporting skills whatsoever, he would mingle with some of New Zealand’s rugby elite. His headmaster was John Graham, his housemaster was Graeme Henry (whose children he frequently babysitted) and he gave his unwanted and unused rugby boots to a young Grant Fox. At age 17 Matt began his medical studies at Auckland Medical School and was soon living in a Remuera flat with Brock the cat and making ends meet by working as a silver service waiter at Orleans restaurant. A few of his fellow waiters were gay and, gaydar pinging madly, they advised Matt that he was probably gay. He was.

His medical career was smooth and distinguished, he had papers published, ran the usual gauntlet of long hours and stress as a registrar and did a stint as an anaesthetist. But general practice was his natural calling, appealing to his skills with people and the personal empathy which would eventually take its toll.

He ‘hung out his shingle’ in Karangahape Road, at the City Medical and Wellness Centre, doctoring to inner city residents and the area’s notoriously colourful characters, many of whom were gay. He artfully blended the techniques of conventional medicine with the subtleties of complementary therapies, a skill which became vital during those years when nothing could touch the relentless ravages of deadly illnesses occasioned by HIV infection.

This was during the onset of the HIV epidemic which in the coming years would terrify and decimate the gay community. While some in the medical and support professions preferred to stay at arms’ length

from homosexuals and our sexually transmitted death sentence, for there were no life-extending medications in the early years, Matt Wildbore was one of those who had no hesitation. In the coming years he would look after the biggest caseload of HIV positive patients in the country, helping them as best he could as they slid towards frequently awful and sometimes lonely deaths.

Matt was there for them, pragmatic and proficient on the outside, understanding and committed on the inside.

The little kid who had been bullied at school because he seemed different to the rest, blossomed into a highly respected doctor and human being, often too empathetic for his own good, but always there for his patients.

I can recall my then business partner Warwick Mickell teetering at death’s doorstep, lying semi-comatose in Auckland Hospital’s ‘AIDS ward,’ Ward 9, having succumbed to a vicious months-long infection of unknown and undiscoverable origin. His GP, Matt, and the impressive expertise of hospital specialists and staff had vainly struggled to identify and treat the infection, ordering up batteries of tests, to no avail. Eventually Warwick, grey, frail, trembling and sunken-eyed, unable to take food or drink, mostly unconscious, was brought home to die. It was clearly all but over, and friends and family from around the world began to gather in grief.

Then, a phone call from Dr Matt, who had been awake all night rethinking, reviewing, searching through his medical knowledge. “Can you get Warwick to the hospital? There’s one test we didn’t do... it’s a long shot, I don’t want to raise any hopes, but...”With much difficulty and little dignity Warwick was transported to the hospital and, when overworked technicians advised they were unable to spare time or equipment on a probably quixotic test, Matt left him there, sagging in a wheelchair. Just walked away: “There he is, he’s in your department, it’s up to you now.”

It was a grand bluff, and it worked. The obscure test revealed a huge infective cyst hidden behind Warwick’s pelvis. Treatment started within minutes and hours later he was sitting up smiling. Days later he went home and lived for several more enjoyable, productive years.

Warwick was not Matt’s only patient, and not the only gay man whose illness and associated stress brought out the best in a young GP who cared, sometimes too much. There was a generosity of spirit in Matt Wildbore that saw him dote on family and friends and shoulder the burdens of his patients. Those burdens sometimes took their toll and Matt frequently neared emotional breaking point.

Matt’s reputation grew and respect spread. As body piercings became ultra-fashionable Matt embraced the trend and provided professional piercings, particularly those inserted in anatomically sensitive areas. There must be hundreds of people walking about Auckland and further afield with some of Matt’s careful

COLLECTIVETHINKING THINKING COLLECTIVE Issue 70 H August08 08 Issue 70 H August

handiwork adorned with metal rings and other exotic and erotic jewellery.

Eventually, as new HIV treatments kicked in, he sold his practise and blended his love of medicine with his fascination and knack for technology (he was the first person I knew connected to the internet, always had the first gadgets, including NZ’s first iPod) to co-develop the medical practise computer programme which still underpins many of the country’s health clinics.

He settled into a quirky K. Rd loftstyle apartment, a one-time dominatrix’s den, and filled it with technotoys, Apple computers, fish tanks and two much-loved black cats, Denzil and Oprah. He took up a senior administrative position, as medical director of a large and expanding North Shore accident and medical centre.

Two weeks ago he resigned from that post and last Thursday was found dead in his apartment. Police soon advised that there were “no suspicious ciorcumstances.”

So, yesterday several hundred people gathered in the chill of a winter’s afternoon to pay our respects. We were an eclectic mix of people from the medical fraternity, HIV organisations, ex-patients, friends from NZ and overseas, and family including his parents Noel and Robyn and sister Jane and her family.

There were tears and heartfelt sobs.

There was laughter. And there was genuine pause for thought, to consider the too brief life of a man who just wanted to help people, and who in giving of himself burned so brightly that, like a distant and glittering star, he burned out and was suddenly gone.

Farewell Doctor Matt, thanks for everything.

- Jay Bennie

[In honour of Dr. Matt, this obituary was typed on an elderly but still working Apple Mac Centris 650, purchased years ago on Dr. Matt’s advice. As it loaded, the ClarisWorks word processing programme briefly flashed up the message: “This software is licensed to Dr Matt Wildbore, City Medical and Wellness Centre.”]

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“QUOTES” Our quotes in this issue are taken from messages of support received for this year’s 25th Annual AIDS Candlelight Memorial: “HIV/AIDS is still a significant public health issue that is affecting many communities in our own Pacific region.

My message in previous years has been to remind ourselves not to become complacent. It is still important that the next generation of New Zealanders is informed and able to continue working towards meeting the challenges this disease may bring in the future.

The 25th AIDS Candlelight Memorial is a sombre, but important event. It allows us to reflect on our own experiences, the lessons that can be learned, and how we as New Zealanders can contribute to this cause. . I thank the New Zealand AIDS Foundation, the communitybased groups, and the people living with HIV/AIDS and their families and friends, who play a pivotal role in promoting measures to combat HIV/AIDS.” Helen Clark, Prime Minister

“On behalf of the National Party and my colleagues in Parliament, I would like to salute the New Zealand AIDS Foundation and the amazing work it does. Your efforts along with the many thousands of New Zealanders who support the Foundation are truly inspiring…I would [also] like to acknowledge those of you who have HIV/AIDS. Your strength, your courage and your dignity is an example to us all.”

John Key MP, Leader of the National Party

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“Despite the recent advent of new treatments that have dramatically improved the quality of life of those living with HIV, the United Nations estimates that in 2007 AIDS still claimed the lives of about 2 million people, including more than 300,000 children…As the theme of this year’s Memorial states, we should never give up and we should never forget.”

His Excellency, the Governor-General, the Hon Anand Satyanand PCNZM, QSO

“Whilst Candlelight Memorial is a time for remembering those in our region who have died from AIDS, it is also a time to keep in our hearts the thousands who are living with HIV, living with the side effects of medication and also the stigma and discrimination which this virus carries.”

Eamonn Smythe, International Candlelight Memorial Co-ordinator for the Oceania Region

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Obituary:

Darren Taylor, AKA Bambi Slut 15 December 1975 29 May 2008

By Matt Akersten at GayNZ.com

We remember a prima drag diva, lip-syncher extraordinaire, fashion stylist, beloved brother, cherished sister and fabulous friend.

So many of us in Auckland’s gay scene were so devestated to see one of our gorgeous sisters become so ill over the last few months. It’s some comfort to know that numerous leading lights in our community rallied around to make sure her last few weeks were as comfortable as possible for her and her family. But now she has left us. We will always remember her at her best, shining under the spotlight...

Darren and Bambi were very different - Darren could be shy, while Bambi was always over-the-top. We know though, that Darren enjoyed Bambi’s celebrity status and loved being able to stop traffic!

Born and raised in Napier, Darren was from a large, close and supportive family, who were all proud members of Ngati Kahungunu iwi. As a teenager in the early 1990’s, Darren discovered gay life at Auckland’s legendary Staircase nightclub. Surprisingly, he didn’t like the drag scene at first - but entered a South Auckland drag competition as a joke, and won.

She was named Bambi Slut by her drag mother Bertha, and became really good at lip-synching by studying her.

Soon enough, Bambi came to be recognised through reputation and awards as the best lip-syncher in the country.

Bambi was known to be blonde, and was influenced early on by the sex kitten appeal of Marilyn Monroe.

Collaborating intensely with designer, make-up artist and DJ James Leuii throughout her drag career, together they were leaders in the shift towards ‘pretty drag’ and had a major influence in making New Zealand drag more fashion and beauty focussed.

Bambi was obsessed with new outfits and looks which could make drag an ‘expensive sport’ at times. An eclectic diva, she performed to tracks by everyone from

Marilyn Manson to Diana Ross and the Supremes. Bambi especially loved difficult songs that presented a challenge - and became renowned for her perfect interpretations of The Jackal by Dana Bryant, and Work This Pussy by Sweet Pussy Pauline.

Bambi performed for gay and straight audiences across New Zealand and Australia at nightclubs, parties, corporate functions, charity fundraisers and all kinds of events. Darren only came out to his parents after being sprung on national TV rolling down Queen Street on a Hero Parade float!

We know that our delightful diva got immense satisfaction from performing and from helping people and felt that Bambi had enabled Darren to help others in our community.

Darren was laid to rest at Tangoio Marae in Napier at 11am on Sunday June 1. Then, a Memorial Service was held at St Matthew-in-the-City in central Auckland on Sunday 15 June from 4:30pm, followed by an elaborate remembrance party at the Crest Hotel on K’ Road.

The Cartier Bereavement Charitable Trust - a charity which helps with funding funerals for those lost to HIVrelated illnesses - assisted with funds for the Memorial Service.

Rest in Peace our fabulous friend Bambi.

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Mali Malta Mauritius Mexico Moldova Morocco Myanmar Namibia Nepal Netherlands Antilles Netherlands New Zealand Nigeria Northern Mariana Islands Pakistan Panama Papua New Guinea Peru Philippines Poland Puerto Rico Romania Russia Rwanda Saint Kitts and Nevis Samoa Saudi Arabia Senegal Seychelles Sierra Leone Singapore Somalia South Africa South Korea South Sandwich Islands Spain Sri Lanka Sudan Suriname Swaziland Sweden Taiwan Region Tajikistan Tanzania Thailand Togo Trinidad and Tobago Turkmenistan Uganda Ukraine United Kingdom United States Uzbekistan Venezuela Vietnam Virgin Islands Yugoslavia Zambia Zimbabwe

www.candlelightmemorial.org

May 18, 2008

Never Give Up, Never Forget

Afghanistan Angola Antigua and Barbuda Argentina Armenia Aruba Australia Azerbaijan Bangladesh Barbados Belarus Benin Bosnia and Herzegovina Botswana Brazil Burkina Faso Burundi Cambodia Cameroon Canada Central African Republic Chile China Colombia Cook Islands Cote D’Ivoire Croatia Czech Republic Dem Rep of Congo Dominican Republic Egypt El Salvador Estonia Ethiopia Fiji French Polynesia Gambia Georgia Ghana Grenada Guatemala Guinea Guyana Haiti Honduras Iceland India Indonesia Iran Ireland Italy Jamaica Kazakhstan Kenya Kyrgyzstan Laos Liberia Lithuania Malawi Malaysia

www.nzaf.org.nz

Tauranga – 7pm at the Memorial Park Fountain Wellington – 6:30pm at the Ilot Theatre, Town Hall

TO BECOME A COORDINATOR, register online, or send your name, organization or community name, and postal address to: Candlelight Memorial, Global Health Council, 1111 19th Street, NW, Suite 1120, Washington, DC 20036, U.S.A. Email: candlelight@globalhealth.org

A Program of the

Auckland – 6:30pm at St Matthew in the City Christchurch – 7pm at the Art Centre Great Hall Dunedin – 7pm at the St Paul’s Cathedral Hamilton – 7pm at the University of Waikato Chapel Invercargill – 6pm at Bluff Hill

AP Photo/Gurinder Osan

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Anniversary

th