A Canadian campaign which asked gay men “If
you were rejected every time you disclosed, would you?” appears to have raised men’s understanding
of the dilemmas which men with HIV face. The campaign also succeeded in
reducing the number of men who try to avoid infection by relying on men with
HIV disclosing their status, researchers report in the October issue of Health Education Research.
The campaign was not intended to broadcast
a ‘message’ or give instructions, but to stimulate dialogue within local
communities. Moreover the authors suggest that the extensive community
consultation which went into its development contributed to the campaign’s
Staff from frontline HIV prevention work,
public health, government and academia participated in the consultation which
identified HIV-related stigma as a priority issue. Moreover they focused on
stigma within gay communities as it is manifested in the attitudes of some
HIV-negative men towards potential sexual partners who have HIV. The campaign developers
believe that there are links between the problems of stigma, disclosure,
conflicting assumptions and risk taking.
In particular, some of those involved in
this project have previously researched gay
men’s sexual interactions in which “potential
partners interpret risk by bringing sometimes conflicting and inaccurate
assumptions to bear in making decisions about safe sex”. For example, men may
make different assumptions about a partner’s willingness to have unprotected
sex, with some HIV-positive men assuming that only another positive man would
do so, and some HIV-negative men thinking the opposite.
To further complicate
the expectations and understandings of men seeking sexual partners, the
Canadian judiciary has also asserted that disclosure of HIV status is an
obligation for people with HIV before any sex in which there is a significant
risk of HIV transmission.
incompatibility of these different assumptions, the campaign was intended to
allow men to move beyond the conversations they had within their own social
circles and engage in “a more broad based community discussion” about stigma,
disclosure and sexual decision making.
The campaign drew attention to itself
through press advertising, outdoor advertising, online promotion and community
It was centred on the question “If you were
rejected every time you disclosed, would you?”. This question was intended to
be sufficiently provocative that it would encourage public reflection and
Moreover a key part of the campaign was its
website. Blogs on the website written by eight different HIV-negative and
HIV-positive men invited men visiting the site to respond to the issues raised
and to post comments.
Over five months, the web site had 20,844
unique visitors (80% from Ontario), who stayed an average of six minutes per
visit. Some 4384 visitors came back to the site ten times or more.
researchers describe the blog discussions as “lengthy and lively”. Topics
included the sources, forms and consequences of HIV stigma; how to separate
rejection of the virus from rejection of men who have the virus; the ethics and
practicalities of disclosure of status; challenging stigma; and responsibility
and consent in HIV transmission.