Rising infections in gay men under 30

If current rates continue in 2009, new cases of HIV in gay men under 30 will be double their number in 2007. That goes against the overall trend for gay men in Victoria, which levelled off in 2008.

I have expressed concern in a couple of interviews about the lack of campaigns targeting gay men under thirty — I think the last one was in the nineties. That gets taken as an attack on the current Victorian AIDS Council campaign using porn images, but I actually think the plateau in overall infection rates shows the current mix of campaigns is doing good.

I also acknowledge the Victorian Government Department of Health for funding and coordinating a reinvigoration of our state’s HIV response.

While I think the explicit sexual imagery matches the sexual confidence and sophistication of men in their thirties and above, it doesn’t work as well with younger men, who are generally less confident, more conservative, and dealing with different issues, like coming out and the gay scene.

Not invariably, but generally.

That’s not just my opinion: it shows up in the social research. Garrett Prestage from the National Centre in HIV Clinical and Epidemiological Research has reported that while they have around the same total number of sexual partners as men in older age brackets, younger men tend to organise their sex lives differently, practicing “serial monogamy” (long strings of short, supposedly monogamous relationships).

Campaigns targeting young gay men need to include relationships and the scene as themes, and they need to address prevention issues relevant to guys in relationships.

Older men might remember the campaign advising men in relationships to close out the HIV test “window period” before they stopped using condoms with each other, but there hasn’t been a campaign about that since the nineties; how is a 23yo guy supposed to know that?

I feel quite uncomfortable raising the alarm about rising infection rates, because I don’t think infection rates should be the focus of campaign strategy in the first place.

The cultural processes that influence sexual behaviour are like a P&O cruise liner: they take a long time to stop. So by the time infection rates begin to rise, you’ve got a big job ahead of you, just trying to turn them around; and you are no longer doing prevention, only damage control.

In their report on The Contemporary Context of HIV Infection in Victoria, researchers Sean Slavin and Marian Pitts quote one young newly HIV-positive man saying:

Then I had my risk re-evaluation. I think a lot of people have it in
their early twenties. As a teenager I was really a safe sex fundamentalist. I redrew my risk profile a bit and started taking more mid-level risks, which were fine by themselves. They probably wouldn’t have caused me to convert. Then I started to top bareback. (p17)

Many of the attitudes our campaigns target in men aged 30 plus were formed in the intense sexual and social learning process men undergo in their twenties. It’s just good sense to invest in campaign work specifically targeting gay men under 30. I am only forced to make a fuss about the infection rate because that good sense has not yet been acknowledged.

Victoria’s HIV cases at highest level in 20 years

By Carol Nader, The Age  (10 March 2007)

NEW reports of HIV have reached their highest level in Victoria in 20 years, prompting criticism that State G0overnment efforts to reduce the numbers have failed.

The Department of Human Services was notified of 334 cases of HIV last year, 17 per cent higher than the 285 in 2005 and the highest number since 1987.

But the Government says 70 of the notifications were for people who had first tested HIV-positive in another state or country. A doctor tested them again here and by law must alert the department.

When that is taken into account, there were 264 new diagnoses last year and 242 in 2005 — a rise of 9 per cent. The figure is double the number of new diagnoses in 1999.

The latest rise has prompted Michael Wooldridge, chairman of the Federal Government’s advisory committee on sexually transmissible infections (STIs), to say: “The effort in Victoria has been an abject failure.”

In NSW, the number of new cases has been stable since they peaked at 414 in 2003. They fell to 391 in 2005, and the AIDS Council of NSW expects the final 2006 figure to reflect a further reduction of at least 10 per cent to about 346.

Dr Wooldridge, a former Howard Government health minister, praised the “spectacularly successful” efforts of NSW.

“There’s a great challenge for the Victorian Government to show leadership here, and NSW has shown that leader- ship in this area can make an enormous difference,” he said.

Victorian Health Minister Bronwyn Pike said the rise in HIV notifications was concerning and authorities would have to examine ways of spreading the safe-sex message. The State Government announced an extra $2.7 million in funding for HIV and other STIs in October.

But the money still hasn’t been allocated because tendering is under way.

The executive director of the Australian Federation of AIDS organisations, Don Baxter, said the NSW Government had taken action to reduce new HIV infections as soon as the numbers started to rise.

However, the Victorian Government had been slow in allocating new funding.