In response to an online video on stigma made
by Cass Mann, the founder of holistic gay men’s HIV charity Positively Healthy UK, one
viewer commented:1
‘I, as an HIV-positive gay man, have
experienced more HIV stigma and discrimination from other gay men than from any
other members of human society. These HIV-negative gay men treat me as if I was
a piranha in their goldfish bowl and a ghost at their banquet…..’
Some
of the findings of a 2009 Sigma Research paper on criminalisation of HIV
transmission make for very disturbing
reading.2 Couched within the responses is an unexpected
stigmatisation by gay men towards HIV-positive gay men.
We have to look from within, deal with our own demons, be comfortable in our skins, ask ourselves what we are afraid of, learn not to be apologetic for getting on with our lives and...remain productive members of society and equal citizens. Winne Ssanyu-Sseruma
Overall,
57% of gay men supported the imprisonment of people with HIV who had infected a
sexual partner with the virus. One of the factors involved in the support for
criminalisation seemed to be an outdated view of the inevitably lethal nature
of HIV, with little appreciation of the effectiveness of HIV treatment. Some
individuals equated the transmission of HIV with murder. One of the components
of stigma is ignorance – ignorance often clung to because it justifies
stigmatising views.
“These
responses reveal the perception that there is little capacity for living well
or longevity among people with diagnosed HIV”, write the researchers, “getting
HIV is regarded as utterly disastrous.”
The
researchers believe that the findings of the report have important implications
for HIV health promotion. They note that “the perception that HIV equals
certain death helps to maintain the stigma related to HIV, which in turn,
negatively impacts on the environment in which prevention interventions occur.”
Because
HIV–positive gay men often fear reaction from disclosure, they may seek out
sexual situations where they are not obliged to disclose. Another Sigma
Research survey, for instance,3,4 found that many men used saunas, not just
because sex was readily available, but also because they rationalised that
almost all other sauna users were HIV-positive. Some men tried to avoid
disclosure but maintain their sense of moral integrity by suggesting to sexual
partners that it would be a good idea to use a condom, but even this was
fraught with the risk of rejection; for instance, one man described how this
suggestion prompted one sexual partner to ask directly whether he had HIV. When
he said yes, the man became angry and left.
UK
Community Advisory Board member Robert James,
who is not gay but does have HIV, sees it this way: “I suspect that reduced
risk of rejection versus the hard task of disclosure and the likelihood of
rejection makes going to saunas feel like a rationally made choice. The fear of
being prosecuted may also increase the preference for anonymous venues.”
Understandably,
but unfortunately for its impact on HIV prevention, gay men with HIV feel that
it is much harder to disclose in sexual situations than in social situations.
Gay men recently interviewed for GMFA’s FS
Magazine emphasised how difficult this was.5
James, a 29-year-old recruitment
consultant, said he talked with friends about HIV “almost every day, because a
lot of my friends have HIV.” But when asked if he spoke about HIV before having
sex, he said: “Never, I just wouldn’t. It’s bad enough trying to get someone to
put a condom on, let alone talking about HIV.”
Andy, a 22-year-old art dealer, said he
thought that gay men had trouble
talking about HIV because “there’s a real stigma attached to being
HIV-positive and gay. But,” he acknowledged, “the less people talk about it,
the more stigma there is, so not talking about HIV creates a vicious circle.”
Even
in the relatively anonymous environment of internet cruising sites, few men
explicitly advertise their HIV status on their profile, though more may mention
it during private instant messaging. HIV-positive men often report looking for
clues in other profiles.
I
conducted an ad-hoc survey in late March of the profiles of 200 UK men
using the ‘HIV cruising room’ on Gaydar. Presumably the majority of men using this chat
room were looking for an HIV-positive partner and were probably HIV–positive
themselves. But nearly 60% gave no clue at all of their HIV status, and only
14% stated it. The remaining quarter couched a possible HIV-positive diagnosis
under the sexual preference categories of ‘rather not say’ or by ticking the
‘safer sex needs discussion’ box. The few who did disclose directly in their
profiles often took an aggressive slant in a follow-up sentence; “I'm
HIV-positive – and if you can't cope with it then look elsewhere!”
HIV
is not the only infection that can stigmatise gay men. An increasing number of
HIV-positive men are also becoming infected with hepatitis C (see HTU 185, April 2009). In a small survey
of six co-infected men, all said they felt stigmatised by their own community.
Furthermore a hepatitis C diagnosis can lead to greater feelings of shame,
guilt, and ‘dirtiness’ as it is not ‘owned’ by the gay community in the way HIV
used to be, and is therefore even more marginalised and stigmatised.6