sex : prevention, not risk reduction

These sexual constraints are forced on us by the reality of how HIV is transmitted, and by the absence of any other effective means of prevention currently available than the condom (used with a water-based lubricant for anal sex), the femidom, dental dams or latex squares for cunilingus, and rubber or latex gloves for fist-fucking. According to our sexual practices, we don’t have any other choice than to use these prevention tools and to accept their constraints if we want to protect ourselves and our partners.

These basic facts of prevention are currently being questioned : by so-called barebackers (who advocate risk-taking), people like Guillaume Dustan, who continue to spread their criminal ideology of unsafe sex. However, Dustan has now found an unexpected ally in prevention workers themselves… in the organisation AIDES. During a recent conference on the state of AIDS work in France, organised by AIDES and Sida Info Service, AIDES distributed an alarming series of prevention leaflets. On the front, erroneous catchphrases like « Without condoms, more partners, more risk », or else « Without condoms, better to pull out before coming ». On the back, arguments inciting people not to protect themselves, but to « reduce the risks » they take. So, we are informed that « if you’re HIV-negative and another man ejaculates in your arse, you risk being contaminated by HIV. If he pulls out before coming, you reduce the risk of possible contamination (even if there is still a risk !) ».

So, has AIDES given up on HIV prevention ? These leaflets aren’t concerned with prevention, but rather with informing people on the probability of contamination - weighing up which sexual practice is less risky than another. Alarmingly, such an outlook takes unsafe sex (« Without condoms… ») as the ground for prevention. AIDES seems to be supporting unsafe sex as the norm ; if not, why advertise it as such ? Condoms are mentioned, in small print on the back of the leaflets, but only in the context of a sliding-scale of sexual risk : « The condom is still the best means of HIV ». It’s not the « best » means, it’s the only means of prevention.

The aim of these leaflets is to explain to us « how to take fewer risks of being contaminated whilst fucking without condoms ». Yet, how can AIDES believe that it’s possible to halt the increase in HIV contamination through this sort of unambitious damage-limitation ideology ? This only gives weight to all those arguments that claim that condoms aren’t a reliable means of prevention. Such arguments are not the goal of organisations fighting the spread of HIV/AIDS.

What’s more, the AIDES prevention leaflets are misleading : the actual risk of contamination is confused with a statistical risk based on promiscuity - « Without condoms, more partners, more risk ». More importantly, AIDES are mixing up grass-roots level prevention work (the aim of which is to assess all aspects of HIV contamination) with poster prevention campaigns. This message of « risk reduction », without any essential information or explanation of HIV contamination, is in itself a thoughtless risk.

We have sent a letter to Christian Saout, the director of AIDES, inciting him to ditch this project. According to his response, and future AIDES prevention campaigns, an unprecedented power struggle could emerge between Act Up and AIDES : if they persist in this irresponsible message of risk reduction abandoning HIV prevention, Act Up will view them as an enemy. You can’t one minute sign up to a charter on responsibility with gay bars and clubs, and the next distribute irresponsible prevention campaigns.