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The paper "The Impact of HIV-AIDS on Sexual Behaviour" highlights that HIV/AIDS has impacted society’s perspectives on sexual behaviours. Some people believe that abstinence is the only way to stay safe from HIV/AIDS, or that being with only one sex partner will prevent the spread and infection…
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Research Essay: The History of Sexuality
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Discuss the impact of HIV-AIDS on sexual behaviour and identities in one or more western countries.
Over the years, communities have established the contexts within which people negotiate their social lives, sexuality and identities. HIV/AIDS is one of the conditions by identities and modifications in sexual behaviour have developed. HIV/AIDS is a globally recognized epidemic and since its discovery in the human populations, various theories originated about its causes and means of transmission. In most countries, HIV/AIDS was recognized as a plague of the gay community as the prevalence was higher among these groups, where majority were also intravenous drug users. People’s concern about HIV/AIDS grew when they noticed that the epidemic also affected heterosexual populations, infants, and in non-sex, and non-drug use populations. The impacts of HIV/AIDS were devastating, considering that no cure or safety and protection measures could be identified at the time. Some people theorized the epidemic as a scourge from the divine; others thought government and scientific institutions introduced the plague so that they can reap pharmaceutical benefits; for others, the body was attacking itself over unresolved past, present or future issues; yet some were in denial that HIV/AIDS is present and sending humans to their deaths. Nevertheless, nations responded with preventive measures, initially targeting prevention to non-infected populations. Australia took a unique approach and led in low HIV transmission rates around the world. In this research, I focus on the impact of HIV/AIDS on sexual behaviour and identities in Australia and other western countries. First, the essay describes the history of HIV/AIDS and how it impacted identities and sexual behaviours. Second, I discuss how the ground that these impacts took in media, political, social and moral platforms. Third, the essay explains innovative ways adapted by Australia in promoting safe sex behaviours and lowering HIV transmission rates.
Health authorities first identified HIV in early 1980s and since then the society has persistently called upon for the realization of causes and conditions of HIV risk and protection behaviour (NAPWHA). The main questions that shaped HIV/AIDS discourses included where the virus came from, when it arose, how it entered the human system and why it was spreading. Some HIV/AIDS researchers relate the origin of the virus from chimpanzees, especially the Sooty Mangabey species which were common in West and Central Africa where the AIDS epidemic was also high (Gill et al 214). However, these apes had been present for a long time prior by which the HIV/AIDS epidemic did not spread among humans. HIV transmission rates were recognized as being high among men who have sex with men (MSM) in the U.S, U.K, and other Western Europe countries (Elford et al. 1; Fox 432).
In the U.S, the Centres for Disease Control and Prevention (CDC) published a morbidity and mortality weekly report that a rare lung infection, a type of pneumonia had been diagnosed in five young gay men in Los Angeles in 1981 (Curran and Jaffe 64). Two had already died by the time that the report was published after their immune systems weakened completely (65). During the same year, the CDC also received cluster reports of cases on Kaposis Sarcoma, a rare, aggressive form of cancer among the gay men of New York and California and the New York Times reported that 41 gay men had been affected (Altman). By the end of that year, it was reported that a total of 270 gay men experienced severe immune deficiency conditions and 121 of these individuals had died (CDC 448). In Australia, the term AIDS was first coined in 1982 but the cause was unknown and the first AIDS related death was recorded in Melbourne in 1983 of a gay man (Bowtell 20). Four babies in Queensland that had received blood transfusions from a gay man had died in the same year (Power 40). In the U.S in December 1982, the CDC received 22 reported cases of unidentified immunodeficiency and opportunistic infections among infants, and a case of AIDS identified in a baby that received blood transfusion (Curran and Jaffe 66).
In 1982, a Gay Men’s Health Crisis community was founded in New York City and in September that year, the CDC used the term acquired immune deficiency syndrome (AIDS) for the first time (CDC 430). In 1983, the CDC established the National AIDS hotline to respond to public inquiries about the epidemic (433). Prestage et al (931) conducted a face-to-face interview on a Health in Men (HIM) cohort in Sydney and found that gay men engaging in casual sex are at increased risk for HIV transmission as majority reported having unprotected anal intercourse (UAI). Furthermore, majority admitted to using illicit drugs, attending sex orgy parties, and engage in esoteric sex practices, and generally exhibited sexually-adventurous behaviours (933). In Western countries affected, activist groups were formed such as People Living with AIDS (PLWAS) formed in 1983 in the U.S to recognize human rights of people with AIDS.
The CDC then finalised that AIDS is caused by an infectious agent transmitted through sex or exposure to infected blood, and blood exchange tools such as needles (430). However, the public was still cynical and in denial regarding the transmission and spread of AIDS. People living with AIDS and populations at risk were isolated in fear that they would infect others (Curran and Jaffe 66). The term ‘gay plague’ was used by public, media and politicians to describe HIV/AIDS during the first years after its discovery (Clews; Curran and Jaffe 67). In Sydney Australia, telecom engineers declined fixing repairs because there were too many gay phone operators and could be having AIDS while in Queensland, police halted checking breaths for alcohol in fear that HIV might be passed through motorists’ saliva (Sendziuk). Many people looked at the HIV/AIDS epidemic from a moral perspective considering some of its mode of transmission was sex and drug injection among MSM (Clews). The AIDS’ causative agent was confirmed as Human Immunodeficiency Virus (HIV) in 1986, after scientists Luc Montagnier in France and Robert Gallo in U.S had previously isolated identical viral characteristics LAV (Lymphadenopathy Associated Virus) and HTLV-III respectively (Associated Press).
However, the prevalence of AIDS increased and incidences were reported in many countries affecting female sexual partners, men having sex with men, people having sex with multiple partners, straight men having sex with other men, Haitians, intravenous drug users, haemophiliacs and heterosexuals too (AVERT; Curran and Jaffe 66). The public was captured in fear and panic and governments knew that they had to react quickly in order to contain the epidemic. Traditional HIV/AIDS prevention interventions targeted uninfected persons through models promoting risk-reduction behaviours (Fox 432). In the U.S for example, there were concerns about HIV transmission in health care settings and the CDC (429) published the first standards of occupational exposure precautions. Still in the 80s, Western media delivered blunt messages that warned against HIV-risk behaviours. There was controversial TV advertising that featured ‘grim reaper’ rolling a ten-pin bowling top toward a group of people standing in the position of pins. This inspired Australia to use blunt TV advertising to make intimidate people into changing sexually risk behaviour but this approach was changed after seeing that it promoted stigmatisation among people with AIDS and other sexual identities (Bowtell 41). In Britain, newspaper articles were headlined as the ‘gay plague’ in reference to HIV/AIDS stories (Clews). The notion that HIV is a homosexual disease was held for a long time even with evidence pointing to other causes and political platforms decriminalized homosexuality in majority of nations (Gay in the 80s Page).
HIV/AIDS has impacted sexual behaviours and identities in the sense that response actions were targeted towards at-risk groups and sexual attitudes (Lert et al. 72). Response tactics have targeted lesbians, gays, bisexual, and transgender (LGBT) people and females in heterosexual relationships seen as more prone to HIV infection than their male counterparts (Manji, Tena and Dubrow 991). Other at-risk groups include injection drug users, commercial sex workers, and adolescents/teenagers among others (Manji, Tena and Dubrow 991). Another group targeted was people practising bareback, which is anal sex without a condom among gay HIV positive partners or even discordant partners who have developed an attitude to embrace the epidemic (Carballo-Dieguez et al 52). HIV-positive people with such attitudes were educated on the importance of staying safe from infection with a new strain of HIV.
The understanding that HIV is the causative agent of AIDS promoted preventive measures such as antiretroviral therapy, positive living, and healthy lifestyles to prevent quick progression to AIDS. The term safe sex was coined for campaigns that attribute for protected sexual intercourse, for example using condoms or having only one sexual partner. In Australia, at-risk groups including gay, lesbian sex workers were quick to form AIDS councils that demanded for recognition of their rights and supported positive-living (Bowtell 25-6). State and territory bodies were supportive of these at-risk groups and formed other models to help respond to the epidemic. These include National Association of People with HIV Australia (NAPWHA), the Scarlet Alliance, Anwernekenhe National Aboriginal and Torres Strait Islander HIV/AIDS Alliance (ANA) and Australian Federation of AIDS Organisation among others (Bowtell 19).
Safe measures to combat the spread of HIV include screening blood before transfusion, with Australia being one of the first countries to screen blood doors through antibody testing and questionnaires in 1985 (Bowtell 25). AZT was first shown to have some treatment effect for people with AIDS in 1986 and became available in Australia in the following year (Bowtell 29). Currently, there are more effective antiretroviral therapies to reduce viral load and also prevent mother-to-child transmission. The World Health Organisation (WHO 3) launched a global AIDS strategy emphasizing on availability of sterile injecting equipment for drug users to prevent transmission and Australia adopted the Needle and Syringe Programs despite controversy (Bowtell 30). By 1988, Australia had adopted a new definition for HIV and AIDS which was later adopted internationally; that people with HIV do not necessarily have AIDS unless they contract opportunistic infections of AIDS defining illnesses (Plummer and Irwin 789). The Commonwealth Department of Human Services and Health launched the Condoman initiative in 1988 that was widely circulated for safe sex (WHO 61). Another response included offering targeted AIDS education which addresses specific communities depending with risk factors that exposed them to HIV/AIDS (WHO 64).
Another HIV/AIDS responses used by Australians to minimize harm caused by HIV/AIDS was incorporating high risk communities into decision-making, which included selling safe sex. Prestage et al. interviewed HIV-seronegative gay men in Sydney Australia and found that majority were more likely to use condoms in the context of sex work (933). The Australian government established a National HIV/AIDS Strategy in 1989, which acted as a policy framework emphasizing on partnerships among the government, physicians and affected communities who were given the right to community participation without discrimination (Bowtell 41). Affected groups developed great trust and confidence in HIV researchers, scientists and clinicians and this allowed for high rates of participation in epidemiological and clinical studies, enabling effective delivery of HIV/AIDS treatment and care (Bowtell 42).
The Australian HIV/AIDS response is distinctive in that the government recognised and responded swiftly to the HIV/AIDS pandemic by supporting at-risk groups rather than bashing them. Compared to other countries in the world, Australia has maintained a low prevalence of HIV and avoided the second wave infection despite having a significantly high number of at-risk groups during the early years of HIV/AIDS discovery (Bowtell 19; WHO 6). Australia is applauded as the first nation to shift from traditional HIV prevention strategies which encouraged quarantine of infected persons, or people living with AIDS and naive abstinence campaigns that are embraced in other parts of the world (Plummer and Irwin 790).
In summary this research finds that HIV/AIDS has impacted society’s perspectives on sexual behaviours. Some people believe that abstinence is the only way to stay safe from HIV/AIDS, or that being with only one sex partner will prevent spread and infection. Others believe that having sex using condoms prevents transmission of HIV/AIDS to negative partners. Still, some couples especially among some gay community promote the concept of bare-backing, where couples already infected with HIV agree to have sex without protection. Many identities have sprung up as a result of HIV/AIDS some being at-risk groups communities while others are community and government bodies pledging commitment to fight HIV/AIDs. The aims of these identity networks are to connect, understand, and respond to circumstances of people living with HIV/AIDS. Australia became the first nation in the world to successfully reduce HIV transmission rates and this was through responses that were based on social action among government, NGOs, at risk groups and the public.
Works Cited
Altman Lawrence. “Rare Cancer Seen in 41 Homosexuals.’ The New York Times. 3 July 1981. Online.13 May 2014.
Associated Press. “Probable Cause of AIDS Found”. Daily Mail UK, 23 April 2014. Online. 14 May 2014.
AVERT. “Australia HIV & AIDS Statistics.” AVERT, Online. 13 May 2014.
Bowtell, William. Australia: Fighting a Rising Tide: The Response to AIDS in East Asia, (eds. Tadashi Yamamoto and Satako Itoh). Tokyo: Japan Centre for International Exchange (2006): 19-52.
Carballo-Dieguez, A, Ventuneac, A, Bauermesiter, J, Dowsett, GW, Dolezal, C, Remien, RH, Balan, I, & Rowe, M. “Is ‘Bareback’ a useful Construct in Primary HIV-Prevention? Definitions, Identity and Research.” Culture of Health and Sex 11.1 (2009): 51-65
Centres for Disease Control and Prevention (CDC). “First Report of AIDS”. Morbidity and Mortality Weekly Reports (MMWR) 50.21 (2001): 429-456.
Clews, Colin. AIDS and the British Press.2008. http://www.gayeastmidlands.com/AIDS_Press.php. 13 May 2014.
Curran, James and Jaffe, Harold. “AIDS: the early years and CDC’s Response”. Supplements 60.4 (2011): 64-69 in CDC: Morbidity and Mortality Weekly Report (MMWR). Online. 13 May 2014.
Elford, Jonathan, McKeown, Eamonn, Doerner, Rita, Nelson, Simon, Low, Nicola and Anderson, Jane. “Sexual Health of Ethnic Minority MSM in Britain (MESH Project): Design and Methods.”BMC Public Health 10.419 (2010): 1-12.
Fox, Julie, White, Peter, Macdonald Neil, Weber, Jonathan, McClure Myra, Fidler, Sarah and Ward Helen. Reductions in HIV Transmission Risk Behaviour Following Diagnosis of Primary HIV Infection: A Cohort of High-Risk Men who have Sex with Men. HIV Medicine 10.7 (2009): 432-438.
Gay in the 80s: From Fighting For Our Rights to Fighting For Our Lives. 18 February 2013. http://www.gayinthe80s.com/2013/02/1980s-queenslands-war-on-homosexuals-part- two/. 13 May 2014.
Gill, Amy, Ahsan, Muhammad, Lackner, Andrew, & Veazey, Ronald. “Hematological Abnormalities Associated with Simian Immunodeficiency Virus (SIV) Infection Mimic those in HIV Infection.” Journal of Medical Primatology 41.3(2012): 214-224.
Lert, France, Sitta, Remi, Bouhnik, Anne-Deborah, Dray-Spira, Rosemary, and Spire, Bruno. “HIV- Positive Men who have Sex with Men: Biography, Siversity in Lifestyles, Common Experience of Living with HIV. ANRS-EN12 VESPA Study 2003.” AIDS Care 22.1 (2010): 71-80.
Manji, A, Pena, R, and Dubrow, R. “Sex, Condoms, Gender Roles and HIV Transmission Knowledge Among Adolescents in Leon, Nicaragua: Implications for HIV Prevention. AIDS Care 19.8 (2007): 989-995.
National Association of People with HIV Australia (NAPWHA). “HIV in Australia.” Media Release, 5 December 2013. Online. 13 May 2014.
Plummer, David and Irwin, Lawrence. "Grassroots Activities, National Initiatives and HIV Prevention: Clues to Explain Australia's Dramatic Early Success in Controlling the HIV Epidemic". International Journal of STD & AIDS 17.12 (2006): 787–793.
Power, Jennifer. Movement, Knowledge Emotion: Gay Activism and HIV/AIDS in Australia.Canberra: ANU E Press
Prestage, Garrett, Mao, L , Jin, F, Grulich, A, Kaldor, J, and Kippax, S. “Sex Work and Risk Behaviour among HIV-Negative Gay Men”. AIDS Care 19. 7 (2007): 931-934.
Sendziuk, Paul. Denying the Grim Reaper. Eureka Street, 18 June 2006. Online. 13 May 2014.
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