Barebacking and AIDS 2009
New ways to reach out and touch
It used to be that when a problem arose within the gay community; coping strategies were to be found on posters plastered throughout the "gayborhood" as well as roving researchers and outreach workers who met their target audience on their own turf. But these days, notes Roque, "We can no longer go to bathhouses and find gay men. Everyone is online, so it’s important for us to have an online presence." GMHC has worked hard to establish that electronic presence, and make sure they have a variety of programs and strategies "that target young people"-such as "My Ballrooom Life" (www.myballroomlife.com), a microsite designed to bring the safer sex message to young lesbian, gay, bisexual and transgender youth (primarily black and Latino) in the house and ball scene.
Outreach and prevention work on Face book and MySpace has also proved effective. Roque: "We work with folks within the community to develop blogs, messaging and online chats." By "infiltrating social networks and disseminating information," and "folks are more likely to pass along information via the Internet than they are in person."
That method is quickly eclipsing (although not entirely replacing) previous social marketing efforts which relied on calling one’s attention to a poster on a bus shelter or handing out cards and pamphlets in the bars. The Internet’s anonymity, says Roque, creates a sense of security in which people are ultimately more likely to contemplate a difficult message: "The data folks report that if you give somebody a palm card with information about HIV testing, they’re not as likely to give it to somebody who needs, it; but they’re more likely to forward a link to someone online. It’s less in your face; there’s a certain comfort that may seem small, but it’s really significant."
But is the dissemination of information online really effective, any more or less so than what a potent message on a poster can accomplish? Roque admits "That’s very hard to measure. It’s difficult to say people are having less unprotected sex because of our work on the Internet. But dialogue is occurring in ways that it didn’t before. We’re reaching folks that might not be at the gay bar, might not come into our building; so we’re having new dialogue with new people that we would otherwise not reach."
The real goal in such outreach work, says Roque, is not to focus on increasing condom use-it’s to shift the social norms.
Davis also agrees that the Internet is the present, and future, space in which micro targeted audiences will be found, and will be most receptive to information and coping strategies. But that alone, she says, is not enough-and does not speak to the root cause of one’s decision to have unprotected sex. Davis: "We know that safer sex is not a compelling message. It’s a medical model to looking at HIV, when we really need to be thinking of it as a public health concern."
That medical model, she says, has already been received and absorbed. "Queer young people know the drill. They could teach a class on" condom use and safer sex practices. What Davis is more concerned about is "looking at the entire lives of young people; what stigma do they face, what’s their home and school environment like; what messages are they receiving from our culture that make them feel worthwhile?"
In the broadest sense, she says, altering the cultural message to one of affirmation instead of accusation is the answer; a significant shift in prevention strategy that has everything to do with creating a sense of self-worth which ultimately convinces a young person that their health is worth protecting. When Davis does an assessment with someone, she’s not launching into a lecture about the evils of barebacking; instead, she’s "listening to the areas in their lives where they are struggling disconnecting and isolating. At the same time, I am trying to assess what gives them a sense of worth and value. At the same time, we want to look at risk factors and reduce them. It’s a simple matrix, but it doesn’t focus on condom use at its center. It’s about individuals and the complexity of their lives."
Ultimately, asserts Davis, the problem is not going to be solved by "making people feel bad because they don’t use a condom. Very few people will change their behavior just because they’ve been made to feel bad about something. That’s a very short path to failure."