April 27, 2012
As it has been since the first day HIV emerged as a major threat, the condom continues to be one of the two most effective tools we have for preventing HIV transmission, responsible for preventing massive numbers of cases of HIV. The other, of course, is the sterile syringe when used by injection drug users. Millions of people have found condoms relatively acceptable and easy to use in the face of the risk of acquiring or transmitting HIV. Many other people find condoms difficult to use some -- or all -- of the time. Ours is not to judge, but to try to persuade.
Even as Project Inform advocates for medical forms of HIV prevention such as treatment as prevention or Pre-Exposure Prophylaxis, we believe in the primacy of the condom. Both of these effective forms of medication-based prevention are only 100 percent effective when combined with condom use.
So it is that I lament the absence today of creative efforts to once again promote condom use among gay men and others at risk for HIV. Recently, I attended a White House conference on HIV at which a featured speaker said what has become the norm among people working in HIV today. "We all know that sex without condoms feels better. We all know that condoms are a barrier to intimacy and love." A complete capitulation to the idea that efforts to reframe condoms as a good thing would be a waste of time and resources.
Not so fast.
What about the idea of reframing sexual pleasure as including the absence of worry? It feels better, and is actually more fun, to have sex with condoms! What about the idea of reframing condoms as the very epitome of intimacy? Two people taking steps to protect one another from harm is, after all, a very caring, loving and intimate act. What about any visible effort to promote condom use again at all?
We aren't likely to see any large advertising campaigns revisiting or encouraging condom use any time soon. But each of us who may think badly about them could reconsider the way we think about condoms. And each of us could have a conversation with people we care about to see how they regard the condom, and whether they could view them in a new light that results in using them more often.
At the same time, each of us could also have a conversation with friends and loved ones about the importance of knowing their HIV or hepatitis C status. Ending both epidemics now depends heavily on identifying everyone who currently has either virus, and linking them to quality care and treatment as quickly as they are willing and able. Even though we have come a long way in public attitudes about both diseases, however, it is still very difficult for many people to face a diagnosis of HIV or hepatitis C. Positive people fear -- and sometimes actually suffer -- the loss of important or potential relationships as a result of discovering that they carry either virus.
The antidote is for friends and loved ones to ask those they think may benefit from taking an HIV or hepatitis C test whether they have done so recently, and explore any reasons why they have not. Above all, it is essential that we make it clear that we will be supportive no matter what the result of the test. It can't hurt to offer to go to a testing appointment with someone if that is what will help them to take this important step.
Together, these two acts of caring, taken by each and every one of us, could play a significant role in ending these two unnecessary epidemics.
Dana Van Gorder is the executive director of Project Inform.