18 October 2014

Rings a little untrue…

Something funny happened during my sleep-deprived morning wandering in Paris waiting for my hotel room to be ready. An attempted scam that I almost fell for…until it happened all over again just minutes later.

We're walking down the street and suddenly a man stoops and "picks up" a gold (coloured) ring to ask if I have dropped it. I know it's not mine – I don't wear jewellery. But he continues and almost talks me into keeping it, although I am sure there is some kind of catch that he didn't quite get to that would have removed some of the weight from my wallet. We walked away.

Literally moments later, a woman made the same move. By now I was completely jaded and onto her and we just kept walking. But it made me think of what should have been inscribed on the inside of the ring:


One ring to scam them all,
One ring to fool them,
One ring to reel them in
and in the confusion rob them.

17 October 2014

Apps and Disclosure (There's HIV on my Phone!)

I don't claim to be a pioneer of the online dating world, despite my great age. I do, however, remember a time when BB meant bulletin board and the advent of the gay chat rooms was the great leap forward. Now I don't even know how much people still use those chats, but that isn't necessarily because I have sped ahead and moved on to other things, either. I've just moved from looking to, well, just looking, and those apps on your (okay my) smart phone are lovely for that. But let's take a moment to look back at the olden days before plunging headlong into the present.

When I first ventured into those chat rooms, disclosing one's HIV status was not the norm. Very few included their status in their profiles, other than those usual intolerant "D&D Free, UB2" statements, and the chat room reserved for Poz guys, at least on the Priape Chat that was my go-to, was most often empty (and you could see by nicknames who was in it, so that probably explains the emptiness). The disclosure, if there was one, took place in a private conversation with someone. I actually used that forum to test out my disclosure skills, as being rejected by someone with a fake name whose photo I couldn't see and who couldn't see mine was not nearly as hard to take as the face-to-face rejection you could go find in a club.

Fast forward to now and there are some interesting things going on via those apps. A lot more people are disclosing their HIV+ status in profiles that include head shots and often with some very clever text to accompany the news. I am also seeing more and more discussion (or notation, at least) of PrEP and declarations of openness from HIV negative guys. A couple of my recent favourites:

“HIV neutral, ub2. Life’s too short to be a douche.”

“Status I am STD free…and I want to keep it negative for life…But I’m not serophobic!”

I have three of these apps on my phone, each with its own advantages.


Grindr, probably the most used historically at least, now allows you to choose "poz" as one (or more) of your "tribes", but offers kind of a limited space to express yourself. The casual reader (notice how I have turned myself into a "reader" of profiles – sounds so much less offensive than "creeper", no?) has to click through to see the "tribes" and any other details you choose to share, including your brief texts, divided into "Headline" and "About me". The boys (oops, did I say that out loud?) tend to be younger on Grindr, with the usual exceptions. Downsides: you can't see who has looked at your profile (not with the free version, anyway), but (upside) you can creep away with impunity, even mark your favourites to keep track of their distance from you at all times, not that I would ever do such a thing.

Also of note: Grindr has won awards for the accuracy of its geolocation aspect. As an aside, I happened to be having a drink (or was it dinner?) on a patio in Toronto many years ago with my dedicated PositiveLite editor and I was showing him how Grindr worked. Much to our surprise and delight, and no small amount of embarrassment on the part of this WASP, the guy who showed up as being "a few steps away" was actually seated at the next table!



Scruff is probably my favourite of the apps for the level of self-expression it permits (oh, and scruffy guys are a big plus for me, so that helps). No, not everyone writes a short story that gives you a glimpse into their personality and some do write a novella that you have to be really dedicated (or entertained) to make it through, but the option is there and enough guys take the time to express themselves that it makes for good reading sometimes. That's where I have found gems like these:

"You wanna know if I'm 'clean'? Just so happens I shower every morning, I brush my teeth and even put on fresh underwear every day! I also happen to be Poz."

“Your tested date means only one thing…you have no idea about HIV. Post you’re on PrEP then it will show you’re responsible.”

Scruff also allows you to identify yourself as Poz with a click and to identify that you are interested in Poz guys with a click, but I think the open-ended text areas are the most fun and interesting. Scruff also offers a couple of services like "woofs" and "would you meet"…you can see who has woofed you, but I don't know how exactly the "would you meet" function works, as I have never used it…and I guess no one has wanted to meet me…*sob*. Scruff also has several screens…international, which seems to pluck people at random from around the world (or maybe it's the most looked-at profiles?), local, by distance from oneself, and then the favourites, which allows for that stalking thing we don't ever do, right? And on that note, the other plus (or minus?) of Scruff: you can see who has looked at your profile and look back at theirs – really the closest thing to classic cruising that I have seen on an electronic device.



The third one I have on my phone is Hornet. Hornet has a few of the same limitations in terms of the space that is provided for self-expression, but it has two exceptional features and another one that I will discuss in greater depth after gushing about the first two. First, you can add multiple public and private photos to your profile. Okay, not completely unknown, but the ease of scrolling through them, I believe, is unmatched. I also can't decide whether the "Explore" feature trumps even that photo aspect: it allows you to search by the name of a place anywhere in the world and then explore the Hornet profiles in the general vicinity. Planning a vacation and don't want to be lonely? Want to anticipate the eye candy? This may be the app for you.

The feature I want to talk about more is called KYS (know your status). It is an optional feature by which you can choose to disclose the date of your last test and the result. It's interesting to be able to see the testing frequency (or recentness) of some of the guys, but, like the Scruff comment above, it might not tell you much about your status today, depending on what you've been doing since a few weeks before that last test. I tried to use this feature to disclose of my status and made it public, but it does not show up on my profile when I look for it. I wrote to the company to complain about that and was told that it shows up fine on an iPhone (I'm on Android), but none of the umpteen software updates that have eaten into my data quota since I wrote to them has fixed the problem. And come to think of it, I don't think I've ever seen a KYS that says the guy is positive. Protecting us from ourselves, Hornet? I have gone on to incorporate that into the brief text which is allowed for me to write "about me", but I have apparently not let go of the bitterness!

Probably the most surprising feature of all of these apps is the possibility to have a brief chat with someone you might not otherwise have the occasion to meet. I haven't been using the apps to actually meet people (as my profile on each of them says, "Not looking, just looking"), but I have had some rewarding and heartbreaking chats. An inquiry from a poz guy in France who was thinking of moving to Montréal and wanted to get information about immigration to Canada as a poz guy. Someone local for whom this was the first time he'd had a discussion about HIV with someone who actually has it. A guy in Morocco who hadn't been tested, but who I was able to assure of the openness of the local organization, which works with gay men despite the institutionalized homophobia in the country's laws. A recent trip to Burundi yielded both an occasion to share information about what treatments are like, especially in a developed country like Canada, and the worst heartbreak in the form of a young gay man in Uganda who was just hoping to live more freely somewhere else where, in his words, "gayism is legal".

So you see, I am not just stalking when I open up those apps on my phone – I'm educating, I'm observing the dynamics of communication around HIV in this new electronic context. Oh, and if you're into that sort of thing, I understand they can also be used to meet guys and have sex. ;-)


(This article is also published on PositiveLite.com)

UPDATE! The people from Hornet have contacted me anew to express their concern that the KYS positive status affirmations seem not to be visible on Android phones. I have to admire their reactivity and I’m looking forward to seeing this fixed in a future app update. 

Second UPDATE! I can now see my status on my profile in Hornet. Excellent and efficient responsiveness. Thanks!
 

21 September 2014

Nabucco!


I just had a very lovely evening. Dinner with a friend at Nyk’s on Bleury and then we went for the première of Nabucco, first opera of the season for the Opéra de Montréal. I try to tweet from the opera, but only in the intermissions, so I have saved my observations of the third and fourth acts for this blog entry. But let’s start at the beginning, shall we?

An opening parenthesis: the première of the opera was performed at La Scala in 1842 in an Italy under the domination of Austria. The performance begins with a well-heeled Austrian public arriving at La Scala for the show, taking their places in three levels of loges off to the left of the stage. They watched the opera with us.


Photomontage from the Montréal production

This historical parenthesis (remember that parentheses come in twos, so you will see how that closes toward the end) excused the set, which I found rather flat and painted, unlike the inventive and dynamic sets I am used to from the Opéra de Montréal. But when I say it was excused, I mean it: the set for Nabucco was as a set would have been at La Scala in 1842. Once I accepted that, I calmed down about the quality of the set and appreciated it.

Costumes! There was a whole lot of fabric on that stage tonight. From the fabric-draped Hebrews (no exposing the hair!) to the rich robes of the Assyrians and especially the red and yellow burka-like robes of the priests of Baal all the way back to the front of the stage on the left where the Austrian opera-goers and the soldiers of the 19th century were installed — this was an amazing feat of costuming. Just the notion of producing outfits from two very different eras for the same production earns my applause, doing it well gets me on my feet.


Hebrew Slave Chorus (not from the Montréal production)

The singing! Apart from the fact that the music is quite lovely — there’s something I like about Italian operas with multiple duets, trios and quartets singing in parallel and backed up by a large chorus — the performers here acquitted themselves with flair and talent. Baritone Paolo Gavanelli in the role of Nabucco was excellent, and I so enjoyed soprano Tatiana Melnychenko in the role of Abigaille that I found myself coming down on her side, even if she was evil and doomed to die by the end. Team Abigaille all the way! I would also make special mention of bass Ievgen Orlov in the role of Zaccaria, who sang quite beautifully. I’m not trying to slight anyone else by not naming them; these three really stood out for me.

The closing parenthesis was the twist that really sold me. The opera finished, the principal characters come to take their bows. Not to us, mind you, but to the Austrian audience off to the side. A small bouquet is thrown for the baritone lead. He looks at it, picks it up and throws it angrily back toward the Austrian audience. The whole cast emerges to sing a patriotic Italian song set to the tune of the Hebrew Slave Chorus, with Italian flags held aloft in the background. While the use of the modern tricolour flag lacks historical accuracy, it helped us to understand in a glance what was going on and to appreciate the brilliance of the parentheses around the opera. Bravo!

Of course, there is always the possibility that this is the way Nabucco is always staged and I have just exposed my ignorance for all to see. Oh well.




Oh, and as an extra: swag! Because I am a subscriber, I and my friend both made off with a lovely reusable Opéra de Montréal bag. It will be my pleasure to promote them as I parade around town with it.

27 August 2014

Throwing Cold Water on Things



By now, we are probably almost as tired of the critiques of the ALS Ice Bucket Challenge as we are of the videos of people dumping ice water on their heads or the videos of people failing to do so in hilarious ways. Well, I have never shied away from going where others have already been, so I’m going to wade into the fray, head held high and dry.

As someone who has worked in charities and continues to be associated with an identifiable health cause, I’m terribly jealous of what the ALS organization that started this has managed to achieve. Not only have they succeeded in mobilizing a whole lot of people, many of them famous (more about this later), but they really managed to translate their internet phenomenon into actual donations. Watching the countless videos and the one live version I saw while waiting for a bus the other day, it is not really clear that the challengers and the challenged actually understand anything about the disease or that they are particularly attached to charitable giving. After all, the challenge is to do this OR give to the ALS cause in the next 24 hours. To go from that to tens of millions of dollars in donations over the course of the summer is phenomenal.

The critiques are as predictable as they are valid. The waste of potable water in a context in which large portions of humanity have no access to it, and even in the US there are serious water issues like drought in California and heartlessness toward the poor in Detroit. There is also no apparent link to anything relating to ALS in the action or in most of the words spoken in the videos.

I’ll add one more objection: name-dropping. I roll my eyes every time a minor star “nominates” three (sometimes more) people in that casual way that suggests they hang out on weekends. I doubt it. When that happens, the whole exercise becomes something more about promoting one’s own brand than actually helping with support and research.

The HIV/AIDS movement has challenges in fundraising, especially at the grassroots level, and especially since things got better on the treatment front. Oh, there are some big headline events that raise significant amounts of money, but the big stars seem to have moved on to other issues, some not even stooping to acknowledge the cause when they win major awards for depicting stories from our bad old days, right, Matthew McConaughey?

Our challenge now is to try not to undo our work with our fundraising messages (and to not undermine our prevention messages as we work to make a place in society for people living with HIV). No more death messages, no pity messages…we try to do actions that raise awareness of HIV and familiarize people in order to reduce stigma, but these have not proven to be very lucrative.

Maybe it’s because the organization I work for now is actually not a charity (non-profit, but we kept away from charitable status to avoid restrictions on our advocacy activities), but I prefer to spend time and effort encouraging people to get a better understanding of the realities of HIV today. How is and — more importantly — isn’t HIV transmitted? What might HIV stigma feel like from the receiving end? What can I do to prevent transmission of HIV and what can I do to help improve the quality of life of people living in my community with HIV?

So, ALS, you won this summer’s internet and you managed to translate that into cash for your cause, too. But very few people who have been literally or figuratively swamped by your challenge have any better understanding of the realities of your disease. And let me tell you that living with HIV today, with all of the advanced treatments that have made our physical health better, can still be like getting a bucket of cold water dumped on you when you run headlong into the stigma and discrimination that many in our society reserve for us.

With a nod to people living with ALS (hey — do they call themselves PALS?), here is the ice bucket challenge of someone living with the disease, and then the video of an astute Australian newsreader who has some pertinent advice for us all.




28 July 2014

Encore une campagne pharma dans la rue


(The English version of this item is published on PositiveLite.)

Il y a des choses qui ne vieillissent pas, et d’autres dont la « peau neuve » ressemble trop à l’ancienne.

Ce qui ne vieillisse pas, c’est la Déclaration de principes publiée en 1999 par le Conseil canadien de surveillance et accès aux traitements (CCSAT) sur la question de la publicité directe aux consommateurs (PDC). Parmi les conclusions de la déclaration, on trouve :

  • Il y a une absence de preuve d’un lien entre la PDC et les meilleurs résultats de santé.
  • Il y a une absence de preuve par rapport aux coûts de la PDC. Attendu les sommes énormes dépensées en publicité, il serait raisonnable de nous inquiéter que ces coûts vont faire partie du prix des médicaments sur le marché.
  • Les données probantes démontrent un effet négatif de la PDC sur les pratiques de prescription des médecins et sur leurs relations avec leurs patients. Les médecins sentent une pression de la publicité et de leurs patients pour prescrire des médicaments particuliers, que ceux-ci soient les plus appropriés pour leurs patients ou non.
  • Il n’y a pas de preuve que la PDC mène à des consommateurs bien informés. La nature de la publicité est de promouvoir un produit, et non pas de fournir de l’information par rapport au produit d’un concourant qui serait peut-être un meilleur choix pour le patient.
Je n’ai nommé que quelques-unes des conclusions de cette déclaration. Je vous recommande de la lire au complet.

Avant de discuter la campagne courante, permettez-moi de citer l’expérience d’une autre, qui date de quelques années. Des personnes qui avait des problèmes à tolérer un certain inhibiteur non-nucléosidique de la transcriptase inverse (INNTI) se présentaient chez leur médecin pour insister sur une ordonnance pour le traitement « une pilule, une fois par jour » dont un des composants était le même INNTI qu’elles ne toléraient pas. Qui a profité de ça?




Et la nouvelle campagne?

Au premier regard, cette campagne fait bien plusieurs choses : une grande variété de personnes représentées dans les images, une emphase sur la préparation pour le rendez-vous avec le médecin avec une liste de questions à poser.

Mais elle n’est pas vraiment nouvelle, cette campagne. Elle essaie quand même d’influencer le choix de traitement avec peu de mots (c’est vrai qu’on ne lit pas des annonces avec beaucoup de mots en tout cas) et sans information équilibrée sur les alternatives ni référence à une source d’information plus complète et neutre. En fait, j’étais étonné de découvrir que, sur le site associé à la campagne, on peut bien choisir les questions qu’on veut inclure sur notre liste de questions pour le médecin et on peut même ajouter ses propres questions, mais la liste s’enregistre sur l’ordinateur avec un nom de dossier préétabli de « demandez à votre médecin si [nom du produit] est approprié pour vous » et ce message est imprimé tout en haut de la liste en format PDF.

J’ai parlé aux représentants de plusieurs compagnies pharmaceutiques à propos de leurs campagnes. Je demande toujours s’ils ont prévu de faire une évaluation de leurs campagnes et la réponse est toujours négative. Une évaluation coûterait presque aussi cher que la campagne, ils disent. Donc ils continuent avec leurs pratiques publicitaires et demandent aux payeurs de rembourser leurs produits à des prix de plus en plus élevés pour couvrir les frais de développement du produit. À la fin, nous payons tous et toutes.

J’ai porté des modifications aux images que j’affiche de la campagne : j’ai couvert le nom de la compagnie et du produit et j’ai substitué mon propre code QR. Le mien vous mènera à la déclaration du CCSAT et non pas au site de la campagne. Je ne voulais pas promouvoir le produit ou la campagne par ma critique. Et, pour m’amuser, j’ai inclus la photo d’à travers la station du métro qui démontre que les annonces illuminés ne peuvent pas être captées en photo…comme un vampire!




Quels sont les règlements aux Canada?
 

Ce serait facile à croire que les annonces pharmaceutiques sont généralement permises ici, car les États-Unis est un des deux pays dans le monde à permettre la libre publicité de médicaments d’ordonnance et les médias américaines traversent facilement la frontière.

La règle au Canada est que la publicité peut mentionner le nom de la compagnie et celui du produit ou la condition que le produit traite, mais jamais les deux ensemble ni en parallèle d’une manière qui permettrait aux personnes de voir le lien. Une compagnie souhaitant annoncer son produit pharmaceutique cherche une pré approbation de ses annonces auprès d’un de deux agences privées qui semblent avoir été mandaté par Santé Canada pour jouer ce rôle.

En 2014, l’absurdité de cette règle est claire : je peux trouver à l’intérieur de quelques secondes la condition traitée par le produit en utilisant mon téléphone et ses fonctions internet. La fiction que le règlement canadien nous protège de la publicité pharmaceutique sans contrainte est, en effet, une fiction.

Nous devons mettre fin maintenant à cette pratique qui coute cher et qui ne sert à rien.

22 July 2014

Nightfall in the Cinema of the Apes


Well, that was an interesting evening at the movies.

First, the woman in front of me (not even a teen!) kept pulling out her cell phone, until she was heckled by someone behind me, and then ordered by a cinema staff member to put it away...she must have been EXTREMELY important to need to be so in touch.

Then we got to see what happens when there are technical difficulties in the automated age — I am old enough to have seen film break and even burn in front of the projector, but here the bulb burned out and the soundtrack continued (dangers of not having someone watching the machinery). Since we were watching Dawn of the Planet of the Apes, people started hooting like apes, and some clever person actually went out to tell a staff member there was something wrong.

We didn't get a rewind, but we got a quick fix and a coupon for a free film on the way out. Highly entertaining, despite the few minutes we missed out on in the middle.

Oh, the film? I quite liked it, but I have always been a science fiction geek with a penchant for the post-apocalyptic. It was certainly seamlessly done, with full application of the latest technology, and having seen some “making of” moments, I am terribly impressed by the actors playing the apes despite their being covered in CGI effects on screen.



14 July 2014

Beauty, Admiration, and then Horror!

What a terrible week I have just lived through, made all the worse for the extraordinary week that preceded it. Let’s start with the good stuff.

I left home in the afternoon of July 1st to board a first long flight, followed by a second even longer flight to Bujumbura, Burundi via Brussels. It was the annual general meeting of the Coalition PLUS (http://www.coalitionplus.org/), and an occasion to see and better understand the work of the Association nationale de soutien aux séropositifs et aux malades du sida (ANSS) along with this small African country on the shores of Lake Tanganyika.


The organization does amazing work, treating thousands of people living with HIV with a level of care that rivals the developed world, within the technological limitations of the setting. Even at that, the ANSS now has equipment that allows it to do analyses of CD4+ counts, which is excellent. In a country where homosexuality is illegal, they even have prevention and testing activities aimed at gay men, another thing to admire.



Of course, in addition to visiting the organization and reflecting together on the issues facing the members of the Coalition PLUS on four continents, we had a chance to see the beautiful country and to experience the sounds and tastes and sun…lots of sun! I was clever enough to prepare myself for the sun and the possible biting insects by procuring and SPF100 (!) sunscreen and a little spray-pump bottle of insect repellent. I was also careful to drink only bottled water (and other bottled beverages) and even to brush my teeth only with the bottled water (beer didn’t seem appropriate for that).

I set out for the even longer trip home, and during the voyage the horror began showing signs of stirring. Several visits to the toilet in the airport in Brussels, a few more on the plane. By the time we landed in Montréal, I was so anxious to get to the bathroom inside the terminal building that I pushed past someone (something I really never do), causing him to call out “Dude, what’s the rush?” I spared him (and those around us) a detailed response.

So here we are a whole week later and my system is only now showing signs of returning to normal. I have missed a week of work (plus the next two days, to truly recover) and I am left with thoughts of what might be the true horror of this experience. Do I need to avoid travel to any but the most developed countries? At the price of what I have just lived through, I fear the answer may be yes.