What can (or should) be done regarding the rise in HIV among gay men?

[-:Undertaker:-]

What can (or should) be done regarding the rise in HIV among gay men?

In recent years, the HIV rate among gay men (already disproportionately high) has begun rising again with statistics putting the figure at around 43% of all new HIV cases every year being men who have sex with men. In London the (known) figure is that 1 in 10 gay men is HIV positive which is a lower (but still high) 1 in 20 elsewhere in the country.

One side of the debate would argue that more sex education is needed whereas others would argue that gay sex by it's nature is risky and that despite campaign after campaign and endless sex education, the HIV rate has continued to rise amongst gay men regardless. So where do you stand on this issue? what should be done (if anything) or indeed what can be done?

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The debate is open to you.

[RandomManJay]

Could you give the reference for the statistics you quoted? I'd like to see if there were any conditions or standards met prior to calculate them. As with illnesses and diseases which can take many years to display symptoms, it's rather difficult to argue that an increase in a particular disease is related to present day influences or influences of the past (for example: whether or not the Chernobyl disaster can be directly related to modern day increases in Leukaemia and Thyroid Cancer in Europe when the event occurred in the mid-80s), and I'd like to see if any consideration about HIV's lack of immediate symptoms was taking into account, as well as frequency of condom use and trends of sexual behaviour which can increase the risk of spreading the virus.

With regard to the actual question, I was first taught about sex in my last year of junior school before moving onto secondary, to which after I was taught some but not as much as I would've liked about sex, the dangers of sex, the variations of sex, and the dangers those variations can introduce. I was only taught the basics of vaginal, oral and anal sex and the importance of a condom during (and I'll be frank, how it was taught was boring as hell!). However spreading HIV in each of these instances isn't the only way. Sexual behaviours which go beyond the 'norm', such as using drugs during sex and fetishism, can significantly increase the risk of exposure, especially if other bodily fluids which hold the active virus are exchanged. I think sex education should be taught as a specific part of the curriculum year on year, with the information being more detailed and 'mature' (including such aspects as role-play, foreplay and fetishism) as time goes on, as opposed to being taught the majority of what I learned in one year (which wasn't much to what I learned through personal interest) and a short review of the 'basics' each year thereafter. This may be the case now, however as I left state required education over six years ago, I'm not as well versed on the curriculum as I could be.

I also think society's attitudes towards sex is an issue. I recall watching an episode of 'Embarrassing Bodies' focussing on young people and sexual health and being shocked by people my age and younger knowing less than I do (me being 18 at the time). Some of them mentioned the poor quality of education (which I addressed in part above), but some mentioned that they weren't told because they weren't old enough when they first asked, which made me realised I wasn't exposed to any kind of restriction with regards to sex while at home. Once I reached adolescence, my parents were open and truthful about sex and didn't shy away from my curiosity with "you're not old enough." I don't know if this is actually true of society or just niches of it, but when I look around and see people wanting to remove sexual images from the media to ensure young people aren't exposed to them, I think this is the wrong attitude to take. We shouldn't be removing the exposure, but rather embracing the questions that arise from it and help young people understand the truth behind this crucial role in our species' existence, including the dangers. I don't mean to say we should tell children the 'dirty' details about sex and glorify it to insane proportions, but we shouldn't keep the truth from those growing and becoming sexual beings, because no matter how hard we as a society may try to hide it, younger generations will grow up and they will eventually learn the truth, whether it’s in a safe environment before they can legally have sex, or during, where the opportunity has been missed and they go into sex blind. I also think instilling, at a young age, a desire to be routinely tested once active or be tested at the beginning of a sexual relationship (even if a condom is to be used) would go a long way to presenting the true scale of the epidemic and may aid in building a sexual safety culture which focuses on ensuring safe sex in every possible instance.

I haven't really focused on the sexual orientation aspect as although it is an issue, HIV is an epidemic which affects all humans regardless of orientation. I think given our culture at the moment, teaching young people about sexual intercourse beyond the basics of those acts required for procreation would cause a backlash from parents and perhaps religious figures (I can't imagine many would to too happy knowing schools are teaching pupils how gay men and women have sex). I think it would be good though to have a main class overviewing the basics of sex, then separate classes for the sex you assume you'll be having, be it heterosexual or homosexual. This presents an issue however where our culture isn't at a point where 'coming out' isn't required and homophobia still exists in most or part. Also given we are talking about young people in education, they may not be aware of their orientation as yet so it would be a difficult balancing act presenting a balanced argument which would suit everyone while providing the most information possible. However, in the interests of providing the most benefit for young people as they enter into adulthood, I don't think we should be worrying ourselves over whether or not their parents are happy, as their parents aren't going to be the ones having the sex, and shouldn't be deciding which sex their children have, know about or enjoy.

[HE-Joshua]

Could you give the reference for the statistics you quoted?

Found a reference - http://www.nat.org.uk/gb.aspx

[FlyingJesus]

Are there stats somewhere about the actual numbers of new cases per annum? "40% of all cases" could still be a 5 trillion percent decrease in overall numbers for all anyone knows, so this is a rather incomplete picture being painted. If for example we say 100 people in a given period have contracted HIV, and 40% is obviously 40 gay or bisexually active males that could still be a vast improvement on a previous period where 600 people contracted HIV and only 20% were involved in homosexual acts. More figures are needed to draw real conclusions rather than shock headlines.

On the statement about the increased risks of homosexual activity, the CDC notes that "Blacks represent approximately 12% of the U.S. population, but accounted for an estimated 44% of new HIV infections in 2010. They also accounted for 44% of people living with HIV infection in 2009." with Hispanic citizens also disproportionately represented, but I don't think a ban on interracial relationships would be a very popular proposal. Safe sex is the issue in all of these cases, and it's safe sex that needs to be taught and applied. Some people just don't want to learn anything and will always present a risk to those around them, but the amount of people who are totally clueless about these things just because they've never been taught is horrifying

[Ardemax]

Well a cure is one thing. Science is always promising new solutions to these kinds of problems (including Alzheimer's) and I'm going to assume it will be a waiting game, though hopefully sooner rather than later.