Reading the responses on Facebook gave us one of those jolted reactions. The dominant message about sexual health in relation to HIV prevention has been focusing on condom usage. Jamie’s question was one that I saw as challenging; given the propaganda that the HIV/AIDS field has been pushing around what it means to have safer sex. My colleague at the Harm Reduction Coalition, Michael T. Everett, was also raising this same question especially among young men who have sex with men (YMSM) of color given that their rates of infection have been steadily increasing while rates of infection among injection drug users has been on the decline.
The question for us became what (besides the exchange of needles) was accounting for the decrease in transmission of HIV among injection drug users, and how could we use what works in harm reduction messaging and education when it comes to drug use (if anything) for other high-risk populations greatly affected by the epidemic through sexual transmission. We considered this in light of the following:
a. We cannot exchange condoms like we do syringes.
b. We know people are not using condoms all the time, and the possibilities of HIV and other STI’s has not scared enough people into doing so, and so …
c. If people have been harboring condom use as the dominant end all be all harm reduction response- well then something is terribly wrong with this picture.