Reducing HIV transmission through Sexual Health Principles

Reducing HIV transmission through Sexual Health Principles

I just read a wonderful article by David Stuart  who works at 56 Dean Street in London. In 2016 there was a dramatic reduction in new HIV diagnosis and transmissions in London. He speaks to personal responsibility and the casting off of shame around sex to both protect ourselves but also our loved ones and our community. I’m going to high light the parts I love best about his article. “You did this.” is the sentence that first caught my eye and makes this a stand out article. All efforts and rewards in his article were refocused back onto the community and the individuals and their personal responsibility for taking steps to elevate the love and community that exists within sexuality and sexual health.

“Many people, teams, organizations, campaigns, medicines, and initiatives to thank for this. From the doctors and public health leaders doing brilliant work addressing HIV epidemiology, to the nurses who made us welcome in clinics. From the campaigners and activists who brought unavailable medicines to the masses to the people developing HIV prevention campaigns that kept us aware. To all the healthcare professionals, including therapists who nursed us through those periods when we didn’t care about our health or others… all contributed to this city celebrating this happy breakthrough. “

Shame challenges the speaking of truth and morality can block access to competent care when a client feels shame. He speaks as a voice within the community that not only speaks truth but also challenges the shame that constantly keeps truth from being seen. He talks about the gay community getting on with life. He actually talks about sexual health principles from a community voice.

“You looked for shags, you looked for love. You looked for friends, you looked for that job, or pursued that college application. You tried chems, or you turned them down, you had that condom mishap, and tried to get your head around what “undetectable” really means. You got rejected on Grindr – you rejected others on Grindr, and woops… not always kindly. You felt sexy and you felt ugly, and sometimes both in the same moment. And there was that rotten weekend. That rotten weekend that turned into a rotten month.

Did you lose a friend? Not a close one, just that guy you used to know from the clubs; that one who took too much G. You found out about it from Facebook.

It wasn’t an easy year.”

David spoke to the struggle that comes from being and living an authentic life that includes choices, competing motivations, risks and loss and sometimes rejection. But he doesn’t forget to mention love, connection, growth, courage and change. What he does so skillfully is through all the negative things that we have to face daily he reinforces the positive. He speaks of and tells stories of personal micro-choices to help counteract the micro aggressions we deal with on a daily basis.

“you do have this to celebrate. This breakthrough in the HIV epidemic – this is your success.

But this was you. And I want you to feel connected to it, ownership of it. Like you caused it.
Because you did.”

His article highlighted the small decisions like each time you chose to wear a condom even though one might have broke before and how that not just protected yourself but it also connected you to the community that you also are protecting.

David speaks to the ever present challenge that each HIV positive person feels every time they have sex with a new partner. Highlighting that to negotiate sexual intimacy ultimately reconnects them to humanity through intimate contact with another human being. Choosing to respect that hook-up by respecting yourself to have “that awkward but necessary HIV discussion.” He ties each decision back to how the individual community members helped reduce new HIV infections.  He speaks to the small things like taking mediations on time each day as doing your part. He speaks to having the courage to ask about PREP. He talks about advocacy work and how that helped education the community so that each person can be prepared to make sexual health decisions.

He highlighted the social media work that gets people positive reinforcement about having regular screening done for STI’s and knowing your relationship to HIV by knowing your status and how that helps to break down stigma both for having but for talking about sex. And he keeps tying it all back to how each person is doing their part in reducing HIV transmission.

I absolutely love the focus directed at social community apps that bring our community together. He talks about how changing your Grinder/Scruff/A4A profile to say “I care about my health & yours”… you were protecting your community from HIV.”

He even spoke to the courage that individuals have when they face the nervousness that it takes to keep going back for follow-up PREP appointments. HIV stigma is being tackled by each and every person in small beautiful ways when we participate and own our sexuality authentically through sexual health principles. I also love how he speaks to the fear and anxiety that happens when people feel alone and happen to get “night sweats and fever, and you came to see a nurse, just in case it was HIV seroconversion. It was scary… it would have been easier to stay in bed and hope it passed.” He keeps focusing on how the community pushes forward in living life and choosing to have sexual integrity in a vastly complex sexual space constantly challenging individuals to make minute by minute decisions about our sexual health.

I love how he breaks down the choices that face gay men that don’t seem to be dealt with here in the midwest of USA around chemsex. He talks about the process of seeking help.

“That month when you got some help with chems, faced that fear and talked about your sex life with a chems advisor… that was awesome. That was you caring about yourself and your community, and making this HIV breakthrough all yours.

And that time… that time your friend was being a dick, being irresponsible, doing too many chems and being unsafe; and rather than reprimanding or chastising him, you were sympathetic, and nurtured him back to a place of better self worth and self care. It took months. Maybe more. He’s really having a difficult time of it. That was you being a great friend, a great community member, and yes – contributing to this HIV victory. “

I personally caught myself choking up with pride and love for David Stuart as he speaks to the truth that is the lived experience many gay men have around chemsex. He acknowledges the isolation and loneliness that men struggle with given all the choices they navigate through living a sexually informed and principled sex life.

He does this by allowing the community to have ownership and highlights the autonomy in that ownership.

“This is yours. This epidemic has always been yours, shackles and all. But the shackles are off. This is now our epidemic to beat. And it’s in reach.

Less of us caught HIV last year than we have in decades.

Sure; it was PrEP, and undetectable viral loads. It was medicine and science and the NHS.

But it was also you. You negotiated your sex lives, and you were kind. You were imperfect and stumbled, but you tried, you’re still trying. You tested regularly, you negotiated your own kinds of HIV prevention, you got informed. You were there for your brothers who weren’t doing so well at it, and you looked after your own health and others. When you could.

You did this. You made this great leap forward in gay history last year. Feels good, doesn’t it?

Congratulations, you.”

Our Kansas City community mirrors all that David speaks of. We still have room to continue to grow but we’ve come a long way. Through my work as a therapist I continue to work with individuals to develop sexual health plans so they can move toward sexual health.

Thank You David Stuart for being a role model to many others. Keep up the great work.

I’ve been following David on twitter for a while @DavidaStuart. To learn more about David Stuart and Chemsex listen to him here.

Chuck Franks