HIV This Week

Rowe MS, Dowsett GW. Sex, love, friendship, belonging and place: Is there a role for ‘Gay Community’ in HIV prevention today? Cult Health Sex. 2008 May; 10(4):329-44.

The decade since highly active anti-retroviral therapy arrived has been a time of change for gay men in the West. HIV incidence rates have been levelling off-and in some cities, increasing markedly-for the first time since the early years of the pandemic. New sexual subcultures have found expression, including Internet chat rooms, ‘poz-only’ sex parties, ‘barebacking’ and crystal methamphetamine use. These circumstances force a re-evaluation of HIV prevention targeting gay communities. Rowe and Dowsett examine the antecedents of current HIV-prevention dilemmas in findings from a qualitative study of gay men who were personally and professionally engaged in HIV in Sydney, Australia, in 1997-1998, immediately after the ‘protease moment’. The men’s lives were characterized by constant and difficult negotiation of gay subjectivities. They did not find a place of uniform belonging in the gay community; rather, ambivalence-toward the gay community and HIV prevention-and fragmentation emerged as themes. The authors’ findings suggest that by the late 1990s, the ethos of safe sex developed in the early HIV period was no longer a unifying cultural value. They explore the conditions that led to this shift and the implications for HIV prevention in the 21st century.

Editors’ note: These Australian findings from 1997-98 suggest that the advent of effective combination treatment constituted a turning point in gay history from which the logic of the safe sex culture as a unifying and enduring cultural value began to falter. With potential resonance for HIV prevention programmes elsewhere, this underscores the need to recognise that much of what gay men experience as gay community lies outside what are traditionally understood to be a community’s geographic, social, and conceptual boundaries.