The world has been watching Melbourne this week as the city hosts the 20th International AIDS Conference. Despite initial reports from the event focusing understandably on the delegates killed by the missile attack on their flight over eastern Ukraine, the conference agenda hit the airwaves visibly on this week’s episode of the Australian Broadcasting Corporation’s QandA panel forum.
As a result a range of new and unfamiliar language has been presented to mainstream and social media audiences. From ‘Sero-Discordant Relationship’, ‘PEP’, ‘PrEP’, ‘TasP’, ‘ART’ and ‘PMTCT’ to phrases like ‘heteronormative’ and ‘men who have sex with men’, we have been experiencing a higher-than-average dose of HIV/AIDS-related vocabulary.
Unfortunately the word use is not coming with enough interpretation. ‘Conference-style’ or ‘industry-speak’ acronyms and sound bites occur in every sector, but with its ‘Stepping Up The Pace’ mission statement, this particular conference and its media delegates could have done with more plain talking and less weasel words to get the important messages about HIV/AIDS through to the communities they are seeking to engage.
With new HIV infection levels in Australia at a 20-year high, one of those communities is surely ours.
The international conference has a focus on tackling new infections and raised questions about the direction new HIV/AIDS awareness campaigns should take, considering the scare-factor of the Grim Reaper ad campaign of the late 1980s, and new data which reveals the 96 per cent protection rate for sero-discordant sexual encounters if one of the partners is being treated with ARV.
If you’re confused it’s no wonder. I thought I knew plenty about HIV/AIDS, but, like writer and HIV activist Nic Holas who was on the QandA panel, I am torn about whether this should be an opinion piece or a community service announcement.
One of the terms the conference has chosen to focus on is ‘Men who have Sex with Men’ (MSM), although the focus is mainly on this HIV/AIDS risk group outside the western world.
“It is a key objective of the 20th International AIDS Conference to shine a light on those men who have sex with men, sex workers, transgender people and people who use drugs who do not have the same access to treatment, care and prevention as their western colleagues may do,” UNAIDS Executive Director Michel Sidibé said at the start of the conference.
Ever since the phrase was coined in the 1990s as a means of de-stigmatising HIV infections which were the result of heterosexual men who engaged in sex with other men, it has sat rather uninterpreted outside the HIV/AIDS community.
But is it effective when addressing westerners in the media?
To answer that it’s important to underline that MSM does not mean ‘gay’ or ‘homosexual’, in fact the term was invented to shield MSMs from any hint of ‘gay’.
Many in the gay community have sexual encounters with MSMs in sex-on-premises businesses (read: ‘saunas’ and/or ‘bathhouses’) or at beats (read: ‘public toilets’, although beats are also located at road-stops, sports fields, and can often crop-up right in the high street at bookshops or other businesses).
It doesn’t take long at a gathering of gay men for the stories about baby seats in the backs of cars at beats, or wives dropping husbands at saunas, to enter the conversation with an awkward mixture of laughter and understanding. MSM do not identify as ‘gay’ and they (and therefore their heterosexual sexual partners) remain at very high risk of HIV infection, in part because they tend not to get tested regularly.
Post Exposure Prophylaxis (PEP) is a mouthful, but it’s also something westerners could develop a greater understanding of. Essential to start before 72 hours have passed since exposure to the HIV virus, PEP is a four-week course of anti-HIV medication with a decent success rate.
Pre-Exposure Prophylaxis (PrEP) is similar, but it’s engaged as a means of preventing HIV infection. Sero-discordant couples (when one partner is HIV positive and the other is HIV negative) are in the demographic which can benefit from PrEP, including couples who are trying conceive a child while protecting the uninfected partner from contracting HIV.
Treatment as Prevention (TasP) is an approach to HIV prevention which acknowledges that a sexual partner taking antiretroviral (ARV) medication has a greatly-reduced viral load (the amount of HIV virus in body fluids). It’s important to acknowledge that ARV’s side-effects means this form of treatment program is not for everyone.
TasP has made a significant difference in Prevention of Mother-to-Child Transmission (PMTCT) of HIV during breastfeeding.
‘Heteronormative’ is a term that has often cropped-up in HIV/AIDS debates, generally at the queer theory end of the spectrum, and it’s used to tackle the assumption that gender and sexual orientation fall into fixed categories of ‘man’ and ‘woman’ according to abstract ‘laws of nature’ that have led to the shaming of same-sex attracted people.
Such stigmatising only increases the conditions in which higher rates of HIV infection occur, no matter which country you live in.
There are many other new elements to HIV/AIDS, from home testing and rapid testing at clinics (which have the potential to ensure a higher rate of MSM testing), to new measures for assisting the ongoing health of long-infected PLWHA (‘People Living With HIV/AIDS’).
It’s a veritable alphabet of acronyms which many LGBTQI (there we go again) remain grateful for because this kind of language aims to avoid assumptions of ‘victims’ and blame.
While it’s tempting for westerners to believe that HIV/AIDS in a third-world issue, that we have tackled the problem, and there is plenty of good news to get our heads around, the issue of how to communicate that message without an increase in new HIV infections is now one of the main HIV/AIDS challenges facing us. I believe unlocking the acronyms will help.
Michael Burge is an Australian journalist and writer. He is Arts Editor and feature writer for No Fibs, and has written for Fairfax, News Limited, Intermedia and United News and Media in the UK. In 2006 he gave a live submission to the Australian Human Rights Commission’s Same Sex : Same Entitlements hearing about his experiences after the sudden death of his partner Jonathan, the findings of which were instrumental in the Rudd Government’s removal of almost 100 pieces of legislation discriminating against same sex de-facto couples in Australia. Follow Michael at his blog burgewords or on twitter @burgewords