By Bruce J. Little
We sat around the pool chatting and laughing about stuff we’d gotten up to over the weekend. We loved to do this; get together and compare dating war stories, and this always left us both wheezing from too much cackling and not enough breathing. I was still mid the descending voiced sigh that usually ends a long spell of laughter when he said: "I need to tell you something."
The news left me completely stunned with absolutely no idea what to say. This is a guy that I could usually tell anything to, a person that shared my un-PC sense of humour and also loved to play in the realms of the inappropriate. He and I sang Gaga together and flirted outrageously with petrol attendants. But I knew that what he had said was not meant to be funny.
He wasn’t the first person I knew that was HIV-positive, but he was the first person that I knew well, and the last person I thought would ever acquire it. My first lesson, HIV is indiscriminate.
I said so many tactless things, and looking back I admire how well he coped with some of the stupid things I said and asked. Knowing that I can't go back and change how I reacted then, at least, I can now help people to know what they should say if they ever find themselves in the same situation.
My first big mistake: I got all formal and not like myself. Because I felt unsure of what to say, I suddenly started to edit myself and to speak in a way that wasn't authentic. I must’ve sounded like a call centre agent from a complaints hotline. He picked it up immediately. Authenticity is the best first response. "I'm sorry to hear that", wasn't the wrong thing to say so much as it wasn't the kind of thing I would usually say to him. It was the kind of stuff you say to an acquaintance or disgruntled customer. I should have sworn out loud and grabbed and hugged him; that would've been more me. What you say is not as important as the way that you say it.
The Anova Health Institute welcomes the move by the Medicines Control Council (MCC) after they officially registered the use of a combination of two antiretroviral drugs as a form of pre-exposure prophylaxis (PrEP) medication. This pill, taken daily by the HIV negative individuals, can drastically reduce HIV infection.
Prof James McIntyre, CEO of Anova, says: “This is a major advance in HIV prevention in South Africa, with the potential to save many lives. The evidence is clear, PrEP works if you take it. Not everyone will need or want PrEP, or require it forever, but it can provide almost complete protection against infection if taken consistently. Our challenge is to educate users and move rapidly to ensure access for those who need it.”
Dr Kevin Rebe, Specialist Medical Consultant at Anova’s Health4Men Initiative, says: “The approval of PrEP is a major step forward in the fight against HIV. It is extremely effective and safe to use. It can reduce the risk of HIV by more than 90% in HIV negative people who use it correctly. This announcement will greatly facilitate the work that Anova conducts in HIV prevention. Our challenge now is to create demand for PrEP and to work towards removing barriers to access.”
Anova, in collaboration with the Desmond Tutu HIV Research Unit, already has a PrEP demonstration project underway within state sector clinics. Anova is working to develop tools that will allow PrEP to be nurse-driven and scaled up by the Department of Health.
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Shortly before my 28th birthday, I discovered that a friend of mine was HIV positive. He wasn't a very close friend, but I knew him quite well and it came as a shock to me because he was well educated, intelligent and financially established in the world, and I believed that people like him did not get HIV. I couldn't understand how someone like that could be "dumb" enough to have unprotected sex. In the nineties almost every gay movie I could get my hands on was about gay men struggling with HIV or AIDS. How could he not have known to wear a condom? It was constantly drummed into us.
After a few years I moved to the big city and met other clever, educated people with HIV, and assumed it was drug or alcohol related. Why else would they have had unprotected sex?
The buzz-word in terms of HIV prevention among gay and bisexual men plus other men who have sex with men (MSM, which includes straight men who occasionally play) is undoubtedly combination prevention. This implies a combination of bio-medical, behavioural and related strategies that, in various combinations, offer the best prevention against STIs and HIV.
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