ASHM Report Back

Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.

What meanings are gay men ascribing to safe sex in other countries?

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Dr Adam Bourne from La Trobe University in Melbourne spoke to four statements about safe sex drawn from his experience working in many countries.

1.  Sex is safe if it feels safe 

In some countries e.g. the Netherlands, HIV is being transmitted within regular sexual relationships rather than casual sex due to beliefs around the person being a risk rather than the type of sex being had. Familiarity, trust and a romantic halo effect led to more unsafe sex whereas perceptions about a person led to safe or no sex at all - e.g. in the U.K., 70% of men are not willing to have sex with a positive person.

2. Safe sex is what is possible

A world map of countries providing PrEP highlighted how PrEP is not an option in much of the world for safe sex. In some countries there is poor access to viral load testing making it not a tool for decision making. In some African countries water based lube is not available and it gets confiscated at customs due to association with gay sex.

3. Safe sex is about safe environments

Safe sex is non-threatening.  What does safe sex mean when there is lack of consent or threats to physical safety? Nearly one in 5 MSM in Southern Africa have experienced blackmail, entrapment or rape. What about safe sex when under the influence of drugs or alcohol?

4.  Safe sex is what I understand or appreciate 

For many condoms still equals safe sex.  For example in the UK only 30% of people have heard of PrEP and only 50% would use it if it was available. Other questions included can a pill really protect against HIV? Or what does undetectable mean? 

 

Dr Bourne commented that Australia is ahead of many countries in Europe and UK with MSM knowledge about PrEP and also knowledge about safe sex within relationships i.e. talk test trust together. 

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