Abstract
HIV prevention among gay men seems to be failing. Unprotected sex between men has been rising for some time and incident infections are increasing in many Western gay communities. This paper argues that our efforts in prevention for gay men have steadily become less effective. Risk reduction strategies that formed the central plank of HIV prevention among gay men for nearly 15 years need to be re-thought and prevention seen more as social intervention focused on sexual ethics and sexual cultures. To start this rethinking, this paper seeks to (1) re-theorize the relation between social change and behaviour change; (2) re-assess gay community purposefully beyond ‘queer’; and (3) re-conceive prevention education as cultural intervention and incitement. Hopefully, re-conceiving prevention in this way might lead to a renewed research agenda, focused on the social and less on the behavioural, and to renewed prevention efforts.
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Notes
I am following Mathew Adam's (2006) argument here that reflexivity has become a kind of habitus itself.
Many other definitions in research and practice are so imprecise as to be useless in comprehending the phenomenon (see Carballo-Diéguez et al, 2009).
A jibe sometimes thrown at Australian gay activists from gay men not interested in gay politics or activism.
US Gay newspaper, the New York Blade, listed crystal as one of the top 10 local stories of 2004 (Weinstein, 2004).
The gay newspaper Sydney Star Observer first canvassed the idea that condoms might be preventive in 1983, one year after the first AIDS diagnosis in Australia, and the same year as the San Francisco Sisters of Perpetual Indulgence (an order of gay male ‘nuns’) produced a brochure ‘Can we talk …’, probably the first advocacy of condom use among gay men worldwide. The Australian Order of the Sisters of Perpetual Indulgence distributed that San Francisco pamphlet in Sydney later in 1983, constituting the first gay community HIV prevention activity in Australia.
‘The Crystal Meth–HIV Connection: Challenging the Culture of Disease. A Public Forum with Harvey Fierstein’, held on Sunday, 8 February 2004, FIT Auditorium, New York City.
Who might produce it was even less clear, as the major New York City ASO serving gay men (and the world's first such agency), Gay Men's Health Crisis (GMHC), was silent during the forum and not represented officially.
As an aside, it is not necessary to discuss viral load here; the issue is the absolute nature of HIV-positive status; viral load is less than absolute both as science or self-knowledge. Also, I would argue that any such site that facilitates or encourages status disclosure is behaving ethically; less convincing are arguments from bareback party organizers that facilitating disclosure is not their problem.
‘Sero-sorting’ refers to seeking sex partners only of the same HIV serostatus, for example, both seropositive (‘poz/poz’) sex, in order to eliminate the need for condoms.
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Acknowledgements
Many thanks to Peter Aggleton, Richard Elovich, Michael Hurley and Duane Duncan for comments on the various drafts of this paper; to the reviewers for this issue of the journal for helpful ideas and suggested changes; and to the editors of this special issue for encouragement and assistance.
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Dowsett, G. Dangerous desires and post-queer HIV prevention: Rethinking community, incitement and intervention. Soc Theory Health 7, 218–240 (2009). https://doi.org/10.1057/sth.2009.1
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DOI: https://doi.org/10.1057/sth.2009.1