Louise Holland
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.
Friday final words
RELATIONSHIPS AND COMMUNICATION
These words were repeated today in all sessions I attended.
What is a relationship for gay men?
How successfully do gay men communicate with each other? And why is this important for HIV and STI prevention?
The session today titled Gay Men, Sex and HIV Prevention thoroughly explored the various combinations spoken of relationships that gay men talk about in the Monopoly study. Different aspects such as Agreement whether formalised or implied, which cohort of gay men are more likely to make these agreements and why or how are they broken or bended?
What did I learn today?
WORDS words Words!!
In USA they use " steady" instead of "regular" and the chasm between regular and casual is very wide in relation to what the researchers say gay men are negotiating.In Australia the fallaback option is monogamy, so if it is not then what is it? According to one researcher about three quarters of men in the study said they had a regular partner , but only 40% of the men also stated that they were in a relationship; so men are often in a relationship with a fuckbudy, where does this behaviour get discussed in relation to HIV transmission risk? Typical consultations may miss these types of relationships if prior knowledge of regular partners is known.
Relationships according to how old a gay man is was then explored, with the aversge age of gay men in the Monopoly study being mid thirties , the question was posed do young gay men behave or think they behave the same way?
Generally the evidence was that young gay men had fewer explicit agreements, it was surmisec that they assume monogomy until it wasn't! Young gay men were less likely to discuss HIV risk reduction and relationships were of shorter duration. However somewhat surprising engaging in condomless sex was relative similar despite the age.
The use of the term now condomless instead of unprotected sex was discussed, this term accurately describes the act of sex, however, any person may have taken other steps into reduce the risk of HIV and STIs by choosing who to have sex with, know the Viral load status of themselves and sexual partner or even take PrEP.
This was discussed by Martin Holt who presented results that HIV positive men, HIV negative men both took other measures to reduce the risk of HIV transmission, with knowing their undetectable viral load as the most commonly practiced method. A question from the floor added about what do we know about those who are unknown or not tested; it was thought that these men assumed they were negative.
Then onto the lively session on PrEP
In a nutshell: IT WORKS, IT IS REASONABLY SAFE, GAY MEN WANT TO USE IT, SOME GREAT GPS ARE CREATIVE IN SUPORTING CLIENT CHOICE AND ACCESS AND DEMAND IS GROWING. WHAT WE NEED IS ACCESS SOONER THAN LATER AND RESEARCH INTO THE LONG TERM EFFECTS.