IT may be time to explore the systematic causes for the reasons that gay men’s health is being generally ignored by governments. Before our health needs will be addressed appropriately we need a strong lobbing or advisory group who is not government funded and it free to take a strong stand on important issues.
An example of poor government action on gay men’s health is PEP. PEP will effectively halt HIV infection in persons who have had a risk the previous day (or two). PEP has been made available by many governments around the world. Even in what some may think of as a slow and backward country like South Africa has made PEP available for years. But, not in BC. Why are we so slow? Why have gay men become infected by HIV for years when they did not need to be? I believe that it is because we have not had a strong independent voice to harass the government and force change. HIM over a year and a half ago wrote a paper on the benefits of PEP and quietly lobbied the government. An influential gay physician wrote a strongly worded letter to the government body responsible for PEP, pushing for PEP. Yet still we have only a local trial of the use of PEP that begins this month. If you do not live in Vancouver you are out of luck.
A local gay agency has had some of its funding withheld because this Conservative government did not approve of their actions. We cannot count on our non-profit agencies to take strong stands against government. If they do embarrass governments then we risk them losing funding, and us losing these effective agencies in our community.
In the early 80s the agency which preceded Positive Living (PWA) was loud and unrelenting in forcing proper care and treatment for persons with HIV. Guys were literally fighting for their lives, and it is because of this that they were able to force governments to address the needs of those with HIV. We now have no group who can forcefully stand up to the government to demand proper policies and services for gay men.
When profit is part of the equation then policy advancement slows dramatically. It took almost 20 years of research to “prove” that cigarettes cause cancer. Everyone admitted that there was a link of cigarettes and cancer but no real proof of the cause for over 20 years. In our case we have a study that was done that saw that people who used water based lube for anal sex were three times more likely to get HIV or STIs. Upon exploring this relationship more it was found that likely most water based lube damages anal lining. Now we are two years after the original research but no authority will advise you to consider not using water based lube, until it is further understood. Though there may not be “proof” of water base lube causing HIV and STI transmission you should know there is an apparent link and you can choose lube according. Who is advocating for us?
Another example of poor government policy came to light when I was writing about condoms provided to our community. I was told that the Ministry of Health formulates it policy for the entire province. They would not tell me what criteria was used to select “proper” condoms, or who was on the committee that is charged with this task. If 10% of the population is gay, then 5% of the provincial population are gay men yet they account for over 50% of the HIV! It seems only sensible that the most useable and effective condoms be made available to gay men. No changes will come about until the government is forced to take action.
I am calling for the Provincial government to formulate a committee of gay men who are not part of the government or government agencies who are not afraid to ask difficult questions and push for effective public policies for our community. Current policy that is formulated seems to come from persons who read about gay men and their sexual behaviour, but I wonder if any of them making policy affecting gay men really understands the complex dynamics that are part of our sexual community. It seems only reasonable to ask “the experts” – in this case the experts are not those who read about gay men’s sex but those who know and understand the complexity of gay sex.
This is my last regular column in Xtra, but you can follow some of my thoughts on my blog – bcoleman.ca where you can find writing that did not make it into print and other random thoughts.