Tag Archives: sexual health

Blood Test

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I took an HIV test yesterday. Not that I was seriously concerned I might have contracted the virus, mind: rather that I work for an HIV/AIDS organization, and a sister organization, as part of national HIV Testing Week, was utilizing our premises to offer instant antigen/antibody tests to clients and staff. Kinda weird in the former instance, since being HIV+ is a prerequisite for referral for treatment; but staff-wise it seemed like good form to – and be seen to – attend to one’s sexual health.

My ‘tester’ explained that which might once have been semi-taboo to voice, that as a ‘straight’, white man, the risk of my contracting HIV thru sex  was somewhat lower than it might be for a man indulging in regular homosexual relations.

One aspect of the testing procedure surprised me: I filled out a form with personal details prior to the blood test which included my sexual orientation; from which I could choose ‘straight’, ‘gay’. ‘lesbian’, ‘bisexual’, ‘Transgender (Male to Female), ‘Transgender (Female to Male), ‘other’. Perhaps you can guess from whence my surprise sprang? As something of a ‘gender sceptic’, I’m familiar with the line that ‘sexual orientation’ and ‘gender identity’ are discrete ‘boxes’ as it were. So goes popular, contemporary ‘queerthink’. Could it be that the UK’s preeminent (and admittedly gay-male-centric) HIV charity missed the memo or is their use of language deliberate and candid?

As it happens, I agree, to a point: both ‘cis’ and ‘trans*’ people can be attracted to either/both (biological) sexes and/or to folk presenting as one, other or both. But underlying that fact is the reason that sexual orientation is such a deal, even now, in terms of  personal identity. Andrea Dworkin delineated this so well in the ‘Law’ chapter of her magnum opus, Intercourse [1987](p. 185-211):

‘The laws regulating intercourse – prescribing how we must use each other (be used) as well as proscribing how we must not use each other – are supposed to protect the authentic nature of men and women. Men being fucked like women moves in an opposite direction … [t]he regulation of men by men in sex for the sake of upholding men as a class is the least recognized, least scrutinized aspect … of social control…’

During this chapter, the author also states ‘…[e]very detail of gender specificity was attended to in the Old Testament, including cross-dressing ‘A woman shall not wear that which pertaineth unto a man, neither shall a man put on a woman’s garments; for whosoever doeth these things is an abomination unto the Lord thy God…’

Dworkin remains on record as the least ‘transphobic’ of radical feminist thinkers; yet she clearly and succinctly apprehends the symbolic and real dichotomy between ‘masculine’ and ‘feminine’ modes of attire/behaviour inherent in historical conceptions of gender: deeply-rooted (radical) correlations which are not easily dismissed or over-written by superficially-neutral jargon.  The inference I take from the previous quote is not that the consumerist-patriarchal monetization of gender-nonconformity is to be embraced (which can be discerned even in the presumably-positive notion of the ‘pink pound’, as well as the ‘Transsexual Empire‘ to borrow Janice Raymond‘s epithet) but, rather that in her radical vision, we might reach a point where ‘gender’ ceases to hold sway over our estimation of interpersonal – and specifically sexual – relations.

Until that day arrives, ‘gender’ and sexuality truly cannot be conceived as being entirely separate aspects of our malleable, shifting sense of human identity…

“When the environment makes gender salient, there is a ripple effect on the mind. We start to think of ourselves in terms of our gender, and stereotypes and social expectations become more prominent in the mind. This can change self-perception, alter interests, debilitate or enhance ability, and trigger unintentional discrimination. In other words, the social context influences who you are, how you think and what you do.”

Cordelia Fine (Delusions of Gender…, [2010])…

…even as living in the relatively-liberal West – and especially here in the city of Brighton, UK – the aggressive hetero-normativity and entrenched (Judeo-Chistian-Islamic) conservatism of most human cultures is easily-forgotten, or at least ignored. As Stephen Fry reminded us in his recent TV documentary, this is something of a luxury: in a gender-free, more sane world it ought not to be.

And to return in the end to the matter of HIV testing, if you or any of your loved ones are concerned about the risk of HIV infection, it’s HIV Testing Week until November 29: you can find information here and here.

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GBHIV

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North Shields resident, Les Pringle has been jailed for 3 years (on a charge of Grievous Bodily Harm) by Newcastle Crown Court for infecting his partner, identified only as Ms ‘X’, with HIV. With respect to Ms ‘X’, who has undoubtedly been wronged, the details of the case make me uneasy (for reasons I detail below) and it seems to me that it ought to be possible to address her injustice differently and in a way that might not unfairly – albeit unintentionally – stigmatize thousands of people living – in some cases unknowingly – with HIV.

Man jailed for infecting partner with HIV

Disclaimer: As a worker within Brighton’s HIV/AIDS community I must make it clear that any opinion expressed within this post is entirely my own, and is not necessarily reflective of opinion either within that community in general or my workplace in particular.

As an adolescent and teen during the ’80s I was aware as many were, of the sudden emergence of HIV/AIDS into the public consciousness. In fact, its appearance wasn’t as sudden as the explosion of information via the press, medical and governmental sources then suggested. Scientific research during the ’90s suggests the virus may well have entered the human population as early as the late 1900s – scroll down to ‘When?’ – taking its own time – as viruses are wont to do – to mutate into the pandemic HIV-1 strain that is devastating many parts of Africa, South/Central America, Asia and to a much lesser, though scarcely insignificant degree, Europe and the USA today.  Much has changed in the intervening years – at least in the relatively affluent minority world – both in terms of scientific understanding and medical treatment options. In the ’80s, people, mostly gay, were dying of ignorance, in defiance of the infamous government campaign. The ad hasn’t aged well, and appears melodramatic and alarmist by today’s more ‘enlightened’ standards; nonetheless it presents factual information succinctly: there was then – as now – no known cure; sex was – and still is – the main route of transmission; and anyone can get it. Given that this campaign was launched during the Thatcher administration – originator of Section 28 – it’s not insignificant that an easy opportunity to stigmatize minorities was bypassed in favour of responsible advice. Nonetheless, stigmatisation quickly emerged, and persists to this day. As much as we’re spoiled living in Brighton – a city that at its best welcomes, oftentimes celebrates, and at least tolerates attitudes, ideosyncracies and persons that more frequently provoke consternation and rub-up against taboo elsewhere – I’ve personally been taunted with cries of ‘batty boy’ and ‘AIDS man’ when leaving my workplace. Homophobia, racism and misogyny are still prevalent, here as elsewhere, and these bigotries bear strongly upon attitudes to HIV/AIDS and those affected by it.  It’s been said before, and bears repeating that anyone can contract HIV: in Brighton, Britain’s gay Mecca, it’s forgivable – perversely – to an extent to perceive HIV/AIDS as a mostly gay issue – not because it actually is but because we have a higher-than-average openly gay population from which most of the longstanding support networks and organizations have sprung. The Brighton AIDS Memorial notably features two figures, one male and one androgynous (but no female); scarcely reflective of the fact that nearly half the HIV+ population of the world are women. As our support networks – both established and emerging – begin to increasingly embrace the needs of women living with the condition it becomes ever more apparent that the burden they bear – in terms of stigma and responsibility – is as great as that of men if not more so. Many of those women belong to ethnic minority groups, African and Carribbean in particular – and whilst prevailing scientific concensus suggests Africa as the origin of HIV it is again important to emphasize that HIV/AIDS is no more a ‘Black’ issue than a ‘Gay’ one: such reductive thinking leads to taboos that complicate the path to diagnosis, treatment, management and – one hopes – eventaul cure (it’s worth mentioning at this juncture that African conservatives often employ the reverse strategy – stigmatizing HIV as a ‘White’, ‘Western’ issue to political advantage; a common dictatorial trope historically employed my Mao and Stalin; and contemporararily by Muslim extremists).

If readers charge that I’m labouring a point, then I plead guilty – albeit for good reason: 26 years since ‘Don’t die of ignorance’, stigma is still a huge issue around HIV. Common sense says it shouldn’t be – after all, it’s a virus, not dissimilar in many ways from the Common Cold, Herpes or Flu. The difference is the degree of stigma that accompanies these disparate illnesses: no-one is ashamed to admit they have a cold, even if stubborn pride prevents us from letting its effects disrupt our daily routine (worth noting how gender conceits play a role here too, however – ‘manflu’. anyone?). In the world of HIV, stigma can erect barriers that, in the absence of correct information and adequate support, can appear insurmountable. Fear of passing on the virus, or rejection in the face of declaring one’s status, can trigger depression and/or anxiety which in turn might lead to isolation and/or self-medication with alcohol and/or other drugs, which itself feeds into criminal/antisocial activity such as burglary and prostitution … And so on… The cost of turning a blind – or hateful – eye is often paid twice-over and more by protagonists and innocents alike. In a less judgemental world, the likes of Pringle may have had no qualms about declaring his HIV+ status. He may be a rampant misogynist with no concern for the welfare of his partners – I don’t know, I’ve never met the guy except thru press reports – but his is just one case among thousands and it would be a shame if it became a precedent – either legally or morally – for our society’s attitude to HIV transmission and the responsibility thereof. In an ideal world I’d not hesitate to hold him morally and legally accountable; but the fact is that we live in a society that, whilst undoubtedly fairer than some, is far from Utopian. The ethics of my workplace reflect this social climate: I’m held legally responsible under confidentiality policy to safeguard the HIV+ status of our client group. In practice this means not mentioning names of clients to third parties and not acknowledging clients – many of whom I’ve served and got to know rather well over my last decade in post – ‘in the street’, unless they first acknowledge me; the better to avoid awkward questions from others that might, inadvertantly, disclose their HIV status.

It seems incongruous, then, that an organ of the press is free to disclose the HIV status of a person – criminal or no – to the public at large. And let me clarify something: as much as I believe in human rights I don’t believe all such are sacrosanct. It seems perfectly reasonable to me to deprive (some) convicted criminals of certain of their liberties as part of their tariff; to suspend voting rights during the period of a sentence for example. Nonetheless, given the continuing stigma attatched to HIV+ status – and paticularly the potential for it to persist beyond the period of the sentence – it seems unfair for this information to be made public.

The challenge facing the legal system – and invariably impimging upon the notion of a free press – then, is how to balance the rights of the ‘offender’ with the safety of the public at large. In the main, I’ll err on the side of (potential) victims: this being of particular concern in the case of sex offenders – arguably including Pringle, given that he engaged in unprotected sex without informing Ms X of a potentially serious risk to her health – when the publication of the perpetrator’s (or alleged perpetrator’s) name may act as a catalyst for the testimony of further victims. The witholding (from the press) of alleged rapists’ names, for example feels counterproductive: on balance, I believe the need to redress a historic legal imbalance in favour of (mostly male) sex offenders oughtweighs an overemphasized regard for their material and moral reputation. In respect of HIV, if  there’s an argument for full disclosure as a means of counteracting misperceptions of the condition – and whilst that may find a historic precedent, in cancer for example, let’s not forget that that particular stigma took centuries to dissolve; with certain associations still lingering even now – then first-round trialling the process with convicted felons (risking an apparent vindication of bigoted associations of HIV/AIDS with criminality/immorality) is scarcely likely to raise public consciousness. It may, as Ms ‘X’ does – and as Jimmy Savile‘s posthumous unveiling as a serial sex-offender did – enable ‘victims’ to come forward; but at what cost?

HIV/AIDS has fallen short of its catastrophic potential in the minority world mostly because the improving efficacy – and wider availabilty – of treatment has begun to outweigh the social entropy that flows from stigma. We would do well to avoid enacting any kind of legal response that hinders that process. When Lord McAlpine acted – in fear and anger – to protect his besmirched reputation in the light of apparently mistaken revelations following the Savile scandal, it was natural to feel sympathy: nonetheless, one cannot help but wonder if his actions – however genuine their intentions – and the surrounding media furore, might have discouraged further victims from coming forward with testimony.

Stigma is a weapon of mass-destruction. In the early ’80s when AIDS broke big, the joke was that it stood for ‘Arse-Injected Death Sentence’. By 2001, in the words of Afrocentrist Hip-Hop artist Professor Griff it was an acronym for ‘Africa In Deep Shit’. Far from being a joke, his satire points up a serious issue that we can ill afford to ignore. McAlpine, perfectly understandably, acted in his own interest: as a society we need to act, and mould the law, for the greater good.