Wrapped or raw: pos-pos sex

This presentation was given by Kathy Triffit, Positive Life NSW, at the AFAO HIV Educators Conference, May 2010.

2. Content and context -

 Campaign development is evidence based with research
data and community consultations providing the background
to this work.

 ‘WRAPPED OR RAW (POS-POS SEX)’ engages with
sexually adventurous HIV positive gay men who have
adopted sero sorting (or are considering sero sorting) to
minimise the risk of passing on HIV, manage disclosure and
HIV stigma, and maximise pleasure.
These men were invited to take part in the development of
campaign content and imagery. This included discussion
groups, community forums, interviews and a one-day ‘video
stories’ workshop.

3. Content and context is also -

Guided by the evaluation by Blue Moon, in particular the
recommendation to build on ‘the facts’ serious of previous
campaign work.

(This evaluation found that ‘the facts’ engage, and
therefore have the opportunity to persuade. This approach
hands responsibility to the individual and maybe harder to
reject on the grounds that it is not patronising.)
Developed in line with the Positive Life/ ACON ‘Risk
Reduction Framework’.

4. Content and context
Specifically -
Sero sorting amongst some HIV positive gay men in order to
engage in UAI has been reported in research including TOMS
(2009), PASH (2010), Periodic Survey (ongoing), Quickie
Report (2007) as well as international research.
Research also shows that gay men make assumptions about
sero status of casual sex partners (HIV Seroconversion
Study: Newly Diagnosed Men in Australia (2007-2009); PASH
(2010)).
Disclosure as a means of selecting partners in order to have
UAI, reduce risk and enhance pleasure has been reported in
PASH (2010) and also in Positive Life community
consultations and campaign evaluations.

5. Aims -
Support informed decisions about sero sorting by HIV
positive men to minimise HIV transmission
Ask men to challenge assumptions about HIV status of
unknown casual partners and enhance the knowledge, skills
and understanding of men who sero sort or are considering
sero sorting
Inform men about the importance of STI testing and
strategies to prevent further transmission (in particular
syphilis)
Increase awareness that hep C is a sexual health issue for
some gay men
Consider ways to respond to questions or concerns about
HIV re-infection.

6. Aims (continued)-
Use online dating sites to deliver social marketing messages,
and, via links, direct access to resources that support sexual
negotiation and help to build skills and confidence about
managing risk and discussing HIV status (e.g. Barebackrt,
Recon, Manhunt).

7. Target audience -
 Sexually adventurous HIV positive gay men who sero sort
(or are considering sero sorting) and their partners (casual)
Assist and support -
 Peer workers in individual or group settings
 Community and health-care professionals
 HIV positive gay men negotiating sex with HIV negative
gay men

8. Resources -
Campaign specific website – www.wrappedorraw.org.au
Booklet (pocket size) – ‘WRAPPED OR RAW (POS-POS
SEX) WANT THE FACTS’
Re-branding of KNOW THE FACTS –Syphilis and GET
THE FACTS Sex and Hep C
Banners Manhunt, Barebackrt, Recon
Videos – restricted access on YouTube, Manhunt
Advertisements (community media- SSO, SX)
Poster (sex-on-premises venues)-decision support tool
Community and online forum

9. Context -
Campaign resources will be available:
 on line (campaign specific website, and social networking
websites – YouTube, Manhunt, Barebackrt, Recon)
 print resources - limited distribution (sex-on premises
venues) [and]
 distribution to and by GPs , peer workers, community and
health-care workers

13.  Decision support tool -
reiterates the ‘preconditions’
to sero sort and minimise
risk of HIV transmission

15. Introductions

16. Participants from the target focus group reported the
campaign –
 re-affirms their standing on pos-pos sex (‘reflects reality’)
 touches on subjects they ‘think about’ or ‘sometimes
discuss’ when negotiating sex
 offers an image (videos) of gay men that speaks to their
experiences

17. And –
 ‘allows gay men to use their own judgement based on their
experiences and the facts’ (not patronising)
 gives permission for the discussion to take place on
negotiating sex without condoms between HIV positive gay
men (personal stories also ‘normalise pos-pos sex’)
 resources (booklet and poster) are useful tools to assist pos
guys to explain issues such as viral load, disclosure and
other risk reduction strategies to HIV negative partners.

18. Non-target group -
 Responses reflect those reported by the target group (e.g.
experiences and issues are real). Significantly, one
participant reported ‘while you sometimes may not agree with
it [i.e. opinions of those represented in the videos], it’s honest
and upfront’.
 Videos were particularly liked for their ‘grass roots quality’
(unscripted), ‘differing perspectives’ (e.g. length of time of
diagnosis, different cultural backgrounds), ‘honesty’.
 Participants liked the campaign’s ‘capacity to invite
discussion and challenge [HIV] stigma’. (The video stories
were a constant reference point in both focus groups.)
 Guys represented in the campaign were seen as ‘potential
role models’ and counter to ‘the stereotypes (i.e. buffed and
nude gay men)’ found in some campaigns (‘they are guys
you can identify with’).

19. Conclusions -
Successful HIV prevention and education need to:
fully accept the changing realities in gay men’s sexual lives,
which have become more complicated than just saying ‘use
a condom every time’
recognise there are different limits and boundaries for gay
men in different sexual circumstances

consider choices made about ‘ditching condoms’ and offer
options to support a more informed risk reduction (e.g.
provide the facts on group sex, hep C, syphilis, viral load).

20. www.wrappedorraw.org.au