Richard Elliot, executive director of the Canadian HIV/AIDS legal network recently stated: ”It’s become very clear that we have a health minister, and presumably a government behind him, who are denialists.” Awesome. Let’s talk about that.
The Alberta government recently approved $14 million for prevention efforts (mostly awareness-heavy) to combat the pathetically high STI rates in the province. While writing a wish-list for that cash for sexyedmonton, I researched provincial, territorial and federal STI prevention efforts; I was shocked to discover that they existed in only two provinces - Quebec and Ontario. Not one of the territories, nor the Federal Government of Canada, have a targeted HIV/AIDS prevention strategy targeted at men who have sex with men. Uh, that is kind of a problem. Read on.
HIV/AIDS is, we all know, a loaded issue (no pun intended). The AIDS pandemic and ensuing hysteria of the 80s still plays heavily in people’s imaginations. Also, the homophobia – the moral panic jelly to the AIDS peanut butter – persists. For those reasons, there is big resistance on the part of governments, corporations and non-profit organizations to target men who have sex with men (MSM), lest anyone be accused of drudging up and reigniting the fears and prejudices that reversed LGBTQ rights advances to something resembling the days of Boston marriages.
Unfoturtunately, and obviously, avoiding the issue doesn’t change the fact that MSM still represent the greatest population and highest number of new HIV cases, and of people living with HIV/AIDS and dying of AIDS in Canada.
Our (and by ‘our’ I mean us straights and straight majorities) desire to be PC and inclusive and in order to avoid addressing our shameful homophobic past – and less-obvious but still rampant homophobic present – we have avoiding acknowledging the huge health and social implications. While ignoring the truth helps us look all gay-righteous and shit, it does little to help prevent HIV/AIDS in what is statistically still a population at a higher risk for a serious illness and is a major public health issue. Ignoring reality to pay lip-service to equality means ignoring a very real issue that contributes to inequality for MSM people; an issue that kills.
Right now, grassroots LGBTQ organizations, especially in large urban areas (shout-out to AVERT! Here is a great article from AVERT on HIV/AIDS infection in men who have sex with men), are acknowledging this issue and therefore better at serving their clients than our government or non-LGBTQ specific agencies. (ACCM in Montreal is another great example.) However they need government funding to support their clients and pay for their own HIV/AIDS prevention campaigns; without the government’s targeting of MSM people, they have to compete with all other HIV/AIDS organizations for funding that should be going proportionately to at-risk populations. But governments in Canada seem quite happy to turn a PC-blind eye to the fact that guys who fuck other guys contract and spread HIV/AIDS at a greater rate, and therefore are greater need of preventive efforts.
So, just so you don’t think I am making anything up, let’s look at some real Canadian HIV/AIDS statistics, shall we?
According to The Public Health Agency of Canada, in 2009 approximately 65,000 people in Canada were infected with HIV/AIDS. It is estimated that about 30% of those are unaware they are infected. Men who have sex with men make up 44% of new HIV infections in 2009 (largest proportion, includes those who are both MSM AND use intravenous drugs). For comparison, hetero intravenous drug-users (who make up the second largest proportion) account for 22% of all new HIV infections. The largest majority of new HIV infections of MSM in Canada occur in Ontario, Quebec and BC. And, “just for fun”, I have dug about to find the best and worst places in Canada to find out you – a man who has sex with other men – are HIV positive. Results are in:
Best place to test positive: Toronto. Tons of resources, close ties with the gay community, provincial AND municipal strategies to address HIV prevention and treatment among MSM. Many different levels of government, corporations, non-profits and individuals championing HIV prevention.
Worst place to test positive: Nunavut. NU stats claim that there are 0 people living with HIV in the territory. However Inuit people, who make up the majority of the population, are less likely to be tested for HIV/AIDS. Politicians there are also notoriously idiots when it comes to reality. Sure, Paul Okalik isn’t the Premier anymore; but he did run for MP under the Liberal banner in the 2011 Federal Election. There are also no LGBTQ organizations, HIV strategies etc.
So what are some of the craptastic problems of not singling out men who have sex with other men for a targeted HIV/AIDS prevention strategy? Here are a few:
- Men who have sex with other men, but don’t identify as gay or bisexual, are left out of typical prevention strategies, and are isolated from LGBTQ grass-roots prevention campaigns. This includes transexual women, transexual men, men who are sex workers, men on the DL, etc.
- Doctors, nurses, social workers and other front-line health and wellness providers are trained to counsel patients and clients on HIV and STI prevention based on a heterosexual default model. These professionals are not given appropriate training to sensitively discuss not only sexual orientation, but sexual activity and partner choice when talking about risk.
- There is a “climate of optimism” growing among many men in the LGBTQ comminity. Seeing as how a lot of advances in AIDS research have been made, people are living a lot longer and are getting sick less, which can lead to a public attitude that AIDS just isn’t so bad anymore. Men who have sex with other men are not targeted with real information.
- HIV/AIDS research and funding targeted at men who have sex with men does not correlate to the number of new HIV/AIDS cases in this population.
- There is a complete lack of federal standards for sex education programs for students across the country. This means a serious and obvious lack of sex education programming that engages LGBTQ youth in discussion about safer sex and how to protect themselves when having sex with a same-sex partner.
- Nothing is being done at the governmental level to undermine or dislodge the double stigma of being LGBTQ AND being infected with HIV/AIDS.
So what do I think needs to happen?
We need to stop pretending that we are all the same. We aren’t, in a lot of ways, especially when it comes to HIV/AIDS. Men who have sex with other men are at a higher risk of contracting and spreading this virus, for many reasons. Our governments are doing (practically) nothing to prevent further infection in an at risk population, leading to more illness, more deaths, more tragedy and higher cost to the public. Our national AIDS strategies need to start acknowledging and tackling these very real and serious issues; we are failing our MSM citizens and that needs to change.