Targeted prevention

While a rapid response was formulated to the increase in HIV notifications, research also commenced to investigate why the increase was occurring at all. This was particularly important for organisations like the VAC/GMHC, to ensure that prevention campaigns were effectively targeted at those groups most at risk. By this time most people had a reasonable understanding of what HIV was and how to prevent it, so it was clear that providing information and raising awareness of HIV and safe sex was no longer a priority. The challenge for the staff and volunteers of the Community Education Program was to develop a new and innovative strategy to ensure that prevention campaigns continued to have an impact. President Darren Russell wrote in 2002:

The old days of saying, ‘Just use a condom every time’ are well and truly gone … Overly simplistic messages, while appealing, do not take into account the complexities of people and their relationships.7

To ensure that its activities continued to prove effective and relevant to the community, in the context of a rapidly changing and increasingly complex epidemic, the VAC/GMHC needed to evolve too. In a reflection of this shift, the Community Education Program implemented a restructure as a result of its own internal review process under the leadership of new Manager Colin Batrouney in 2001, and was renamed the Health Promotion Program.8

The Health Promotion team sought to find out why people did not seem to be applying their knowledge of HIV and were having unprotected sex in particular contexts. While there was some debate over whether the increase in notifications represented an actual increase in cases of HIV or simply an increase in the number of people presenting for testing, research clearly showed that there was a rise in the number of people having unprotected anal sex. This was occurring most often in the context of casual sexual encounters, particularly when drugs and alcohol were involved, and in the first few months of new relationships.9 There was also a simultaneous rise in cases of gonorrhoea, chlamydia and syphilis – sexually transmitted bacterial infections that can make it easier for HIV to be transmitted.10 Community education forums were particularly important in addressing these issues. ‘Pleasure Principles: Gay Men’s Sexual Behaviours in Context’ for example, looked at how particular sexual circumstances influence men’s sexual practices and how the community could work strategically and collaboratively to reach those people putting themselves at risk.11

In 2003 the Health Promotion Program obtained funding to conduct a Victoria-wide sexual health promotion and testing campaign aimed at homosexually active men, in response to research that revealed that a significant number of these men were unaware of their current sexual health status, including their HIV status. This campaign was a prime example of the strong collaborative approach that characterised the response to the epidemic in Victoria, with the VAC/GMHC working in partnership with a broad range of organisations, including the Australian Research Centre in Sex, Health and Society, the Melbourne Sexual Health Centre, the Burnet Institute and many others.12 Syphilis presented a particular challenge in 2007, as cases rose significantly among both HIV positive and negative men. Fortunately, additional funding was again received through DHS for condom and testing campaigns, putting the VAC/GMHC in a strong position to address this issue collaboratively with other organisations.13 The VAC/GMHC Centre Clinic also played an important role in this area through the provision not only of sexual health tests, but also individual risk counselling.

Research highlighted the importance of sex-on-premises venues being vigilant about having condoms readily available, but it also revealed where education campaigns needed to be targeted to reach those most at risk. It seemed that the increase in HIV notifications was particularly prevalent among young gay men.14 David Menadue has described the tendency of younger men to neglect safe sex messages when in the heat of passion and ‘when you are just finding your confidence in the often intimidating gay scene’.15 What’s more, HIV/AIDS had little or no relevance in the lives of many young people. As VAC/GMHC volunteer Dan Tang explains, younger gay men ‘weren’t around to see those ads, we weren’t around at the core of the epidemic when HIV was a prevalent disease. And we didn’t see our friends dying around us’.16 In 2003, Adam Carr reflected on 20 years of the VAC/GMHC:

I recently asked a friend of mine, a very socially active gay man in his mid 20s, how many AIDS funerals he had been to. The answer was none. The nearest he had come to the AIDS epidemic during a busy decade in the gay community was that he had heard about a friend of a friend testing positive for HIV.17

The VAC/GMHC began looking at ways to re-engage young people. A youth access program named Fresh was launched in July 2000. It was managed by Youth Access Officer Gina Greco through the HIV Services Program and was aimed at young positive people less than 30 years of age. Fresh provided participants with peer support, information and fun events and activities designed to develop confidence and encourage the forging of strong and supportive relationships. Each year the program continued to look for new and innovative ways to reach out to young positive people and engage them in the VAC/GMHC community.18

Young & Gay, a six week workshop program for same-sex attracted men under the age of 26, was first established by the Education Program in the early 1990s and is still going strong. For Dan Tang, the Young & Gay program is particularly effective at delivering the safe sex message to the younger generation, as information and advice on HIV and sexual health is provided alongside fun activities and discussions about sexuality, coming out, self-esteem, homophobia and relationships. The program is facilitated by people who have previously participated in the program themselves, which Tang says has given him an opportunity to give back to the community:

… at the end of week six when you realise that you’ve made at least a difference to one person’s life, that they know something more than they did before, that you’ve imparted some type of knowledge … has made it very worthwhile for me.19


References


Colin & Jason

After a restructure in 2001 under the leadership of new Manager Colin Batrouney, the Community Education Program was renamed the Health Promotion Program. Colin Batrouney (left) with Health Promotion Team Leader Jason Asselin.

Young and Gay1

Young and Gay2

Young & Gay, a workshop program for same-sex attracted men under the age of 26, was established by the Education Program in the early 1990s. Information and advice on HIV and sexual health is provided alongside fun activities and discussions about sexuality, coming out, self-esteem, homophobia and relationships.