Make testing a priority

I was ten when the Grim Reaper ad came out. It defined Australia’s aggressive public health response to AIDS, and was basically a government-funded scare campaign that drove home its safe sex message by employing shades of lurid 80s horror flicks. (Looking back, there’s something distinctly Wes Cravenish about the spectre of Death, complete with black shroud and scythe, knocking down men, women and children in a bowling alley.)

Despite its effectiveness, the ad attracted controversy: some believed it didn’t do enough to clarify that the virus was the Reaper, not gay men. I didn’t think that though. I was ten. I thought something along the lines of SEX WILL KILL YOU AND YOUR ENTIRE FAMILY and was pretty much determined never to go there, ever. Then the hormones kicked in, and condoms started appearing in the sock drawer.

The world has turned since the 1980s. With several generations of improvements in HIV treatment, the virus has gone from an almost certain death sentence to being in many cases a chronic illness, manageable over the long term through a combination of drugs. For many HIV-positive people in our community, their biggest immediate worry, health-wise, is the stigma attached to the disease.   

Every World AIDS Day (December 1) presents us with an opportunity to fight that prejudice and reflect on the current state of play. Whether it is because a lifetime of pharmaceutical inconvenience doesn’t have quite the same sting as Mr. Reaper, or something else is at play, Australia’s HIV infection is rising (up 8.2% on the 2010 figures).

Have we become complacent? Australian researchers have noted that the increased infection rate since the late 1990s has been accompanied by a parallel rise in reports of risk-taking sexual behaviour among gay men. You do the math. Not that a return to Grim Reaper-style tactics is desirable or even possible.

We all know that boring old condoms remain the first-line defence against HIV infection; we all know that, for a whole range of reasons, they don’t always get used. That’s why it’s important to know what’s risky and what isn’t – and what your options are if things go awry in the bedroom.

There are options now. HIV medication has been shown to have a role to play in preventing the spread of the disease: the drug combinations that arrest the progress of the infection also significantly reduce the chance of the person transmitting HIV to a sexual partner. Likewise, while they’re no magic bullet, these drugs can help to prevent the virus taking hold in the body if taken daily by an HIV-negative person, within 72 hours of potential HIV exposure.

This last is called Post-Exposure Prophylaxis (PEP). I know because I went through it in April, after an unfortunate casual encounter. Aside from a long wait in the emergency room (and running into my doctor ex as I was running out of the hospital clutching a bag of anti-retrovirals) it was all quite painless. I didn’t have any serious side effects from the meds – always good to know – and after tense waiting and multiple tests I was in the clear.

Regular HIV testing among the MSM community is a priority, and any policy that reduces barriers to it should be embraced, whether that’s the introduction of rapid HIV testing, or even self-administered home testing – both of which have met with success overseas.