26 March 2015

Two Coats of Hypocrisy

For some strange reason, people seem to particularly enjoy the misfortunes of the fortunate. It happened in Québec a couple of weeks ago, as a prolific and openly gay radio and television star was revealed to have been ticketed in an area park for having done something he probably shouldn’t have (definitely shouldn’t have, if you ask the police officer). At first, when the news broke, he tried to say that he had urinated and the police officer ticketed him for that, but it only took a couple of days for him to issue a new statement saying that he had not told the truth, that he had masturbated, that he was ashamed of his actions and that he would now withdraw from his professional life for the time being.

No, I’m not going to name him. If you’re resourceful, you will probably be able to figure out who it is, even if you are not familiar with the entertainment stars of Québec. I won’t name him because I don’t want to get on that shaming bandwagon. I think that bandwagon is the thing we should be upset about, not his behaviour. I’m coming for the hypocrites who should be the ones to be shamed.


Read the rest of this post on PositiveLite

03 February 2015

The Stigma: It’s Coming from INSIDE the House!

My headline probably isn’t going to win me any friends. It’s conventional wisdom that stigma is one of the biggest problems we face in the fight against HIV — stigma related to HIV itself, and stigma related to the ways that HIV is commonly transmitted (we still can’t talk openly about sex and drugs after all this time and all these ruined lives). Stigma is the thing that keeps us from being able to communicate prevention messages to those who need to hear them, and stigma is the thing that leads to discrimination against people with HIV that plays out in criminal charges, denied jobs, rejection by those around us.

But I have to ask how much of that is real and how much is anticipated and built up in our heads. Oh, I have no doubt that there are experiences of discrimination and that people have to live through bad experiences because of the unfounded fears and ignorance of others. But do we all?

Let me be the first to point out the privileged positions from which I can issue such speculation — I’m an educated, fully employed white man in a society built for educated and employed white men. Oh yes, and my employer being an AIDS organization, it won’t be my status that gets me sidelined from there. I have still had some experiences of “outsiderness” based on being gay and then based on having HIV and they haven’t been pleasant to endure, but I’m not sure how much focusing on the negative experiences might be skewing my assessment of my overall experience.

I had a conversation at work the other day that brought this home in a broader way. In our society, we have support groups for people who have had bad experiences — botched operations, difficult medical conditions, mistreatment by authorities of one sort or another. What we don’t have is a focus on what goes well or smoothly. We’re really set up to bask in the bad things and let the good ones pass us by. So, in that sense, let me re-examine my own experiences of HIV, always bearing in mind all those pesky advantages I have on my side.

When I came out as gay to my family, I put myself through hell getting there. My sisters were the easiest for me, so they were the first, and I pretty much got acceptance and not much surprise from them. I’ll leave out the one thing one of my sisters said that wasn’t the best, because she is horribly embarrassed to have said it at all. That didn’t really help me to tell my parents, and I went through years more of agony and hand-wringing, tinged with depression, before finally writing a letter from afar. Their reaction was immediate and very positive. My hell was for nothing, and what a relief that was. When it came to telling them about my HIV diagnosis many years later, I had no hesitation, and I had all of their support again.

Thinking on the parallels between the two comings out, I have to say that when I consider most of the people I know who are gay, lesbian, or anywhere else on the queer continuum, I know very few who have been rejected. I’m aware of the horror stories of some unfortunate individuals, but the positive ones and the neutral ones are far and away the majority of the stories I’ve heard out there. I don’t think that’s because I am insulted or sheltered from them, or that I travel only in privileged circles. I think it’s that most of the stories out there are positive, or at least not negative. That doesn’t make the negative ones any more acceptable, but it ought to help us put them into perspective, and hold up the good experiences as models to follow and learn from.

Coming back to HIV, I have to say my experiences have been similar. A lot of anticipation of rejection and hostility going on in my head, but it doesn’t play out that way most of the time. I can’t bring myself to attach much value to the fears or judgements of people whose own attitudes will deprive them of the opportunity to get to know more about me than my HIV status, and the people whose opinions and reactions matter the most in my life — family, friends, colleagues — have been very supportive. When I overcome the anticipation of rejection to actually share, it tends to turn out just fine.

I know that stigma and discrimination exist because I do see them at work every day. I just wonder how much we are immobilizing ourselves with the fear of something that is not as pervasive as it may appear.

This article is also published on PositiveLite.

29 January 2015

The Barber of Gaza?

I always need to start out with the disclaimer about my lack of credentials in terms of critiquing music of any kind, and especially something as complex and storied as opera. And yet here I am sharing my experience of the Opéra de Montréal’s current production of Saint-Saëns’ Samson et Dalila. (Yeah, I’m going to keep using the French spelling just because…)

It was prescient of me, I thought, to have gone for a haircut earlier in the day, not even thinking about the connection with the popular interpretation of the story. It seems that I was mistaken, however, and Samson’s true loss of power came when he was forced to face his inability to resist his passion for Dalila. Defeated, his arrest leads to his haircut and somehow to his blindness, but I’m getting ahead of myself here.

The first striking thing about this production is the set. It was nothing short of amazing and innovative. A collaboration with Circo de Bazuka, it consisted of a series of stark l-shaped surfaces that could move forward or back, but which mostly served as surfaces for the projection of dynamic images. We got to start with slowly billowing clouds that transformed into a gathering darkness. We were treated to the set’s transformation into a series of columned spaces (I don’t know how the projections were so controlled as not to stray onto neighbouring panels!) and to a very stylized performance of two acrobats moving gracefully and cloudlike above the crowd. Very impressive.

The story is a theme that plays a bit mirror-image to current (or recent) events: the Hebrews revolting and liberating themselves from their enslavement by the Philistines in Gaza. (I know, right?!) Doubly insulted by their success in liberating themselves and then their thanking their foreign god for it, the Philistines, in particular Dalila, will not take this lying down! She deploys her feminine wiles to lure him to a secluded spot and to seduce and disarm him to render him vulnerable to arrest. Note to Dalila: let go of the headdresses! A big flowery thing at the beginning, a big metal crowny thing at the end, but she looked so lovely in her bare-headed seduction of Samson in between…

The next time we see Samson, he is in a dungeon on his knees with his hands chained. I knew it was time for an eye examination as I squinted to see what was going on on his head. Shorn, yes, but there was something else…blindfold, or headband that had fallen? And why didn’t he just pull it off with his chained together but otherwise freely moveable hands? It wasn’t until he was led into the Philistine temple by what I can only call a seeing eye child that I realized the blindfold was just a way to portray the blindness. I presume some enhanced interrogation techniques led to the blindness itself. Then there was a crazy display of 1%-ness as the high priest and Dalila watch all the congregants deposit all their bijoux on the collection plates while they themselves keep theirs firmly on. Then the synopsis tells me that Samson calls on his god to destroy the temple and it happens, but I don’t recall any destruction!

So I’m raving about the set, I’m laughing at the over-the-top (operatic) storyline, but I’m not saying much about the music. I feel bad about that. Excellent voices, but Saint-Saëns doesn’t really do it for me. Now who’s the Philistine?! I liked the chorus numbers better than the big solos and duets and that really shouldn’t reflect on the stars, only on the composer and my own naïvité and ignorance with respect to music. ‘Nuff said.

Side dishes:

Opening remarks by the Mayor of Montréal (that guy is everywhere!) and by the Minister of Culture (and a bunch of other things) to underline the 35th anniversary of the Opéra de Montréal. There was some giggling in the crowd at the way the Mayor pronounced Saint-Saëns (enough to discourage me from saying it aloud!) and the Minister didn’t use the opportunity to apologize for her government’s cuts to culture, notably in music conservatories, so I couldn’t bring myself to clap for her.

And speaking of clapping, the curmudgeon and his friend who were seated behind me last time out for the Barber of Seville were now next to me, still complaining about Montréalers being too ready to applaud and give a standing ovation to anything, good or not. They didn’t even clap at the end, if you can imagine. I clapped, but I have to confess that their attitude (and possibly their surveillance) kept me seated, even though that deprived me of the usual view of everyone’s excessive bowing up on stage.

In a word: set. See it for the set. But also see it if you have a broader appreciation of music than this Philistine does.

14 January 2015

Pouvons-nous en parler?

(The English version of this article is published on Positive Lite)

Le titre est un petit clin d'oeil à Joan Rivers (Can we talk?), mais j'essaie de ne personne insulter par mes propos, même à la recherche de rires ou d'applaudissements. Ce billet se veut un aperçu de la qualité du débat autour de la prophylaxie pré exposition, dont vous avez certainement entendu parler beaucoup plus que vous auriez prévu il y a seulement une année. J'utilise le format anglais PrEP parce que PPrE est plus difficile à prononcer comme un mot.

Les débats que j'ai témoignés au cours des dernières années sur ce sujet ont rarement été calmes ou raisonnés. La première réaction de l'organisme américain AIDS Healthcare Foundation a établi le ton d'un côté du débat : une campagne qui déclarait à haute voix, et dans un nombre impressionnant de médias, qu'il n'y a pas de pilule magique. À mon humble avis, quand l'essence de ton argument se résume dans un court slogan de trois mots, il faut te demander s'il manque de nuances de ta position publique.

Étrangement, la réaction anti-PrEP est très forte, avec des prévisions apocalyptiques de vagues d'infections au VIH qui vont résulter du barebacking sans frein qui suivra certainement toute indication d'acceptation du concept de la PrEP. De plus, il y a les autres infections transmises sexuellement à une quantité pour bloquer les rayons du soleil! Toujours pas très nuancés, ces propos. Les gens anti-PrEP doivent respirer par le nez et prendre un peu de temps pour lire les résultats des études sur la PrEP. Ils vont peut-être sortir de cette pause avec des points de vue plus nuancés qui risquent de moduler le ton alarmiste qu'ils maintiennent jusqu'à maintenant.

La question se pose donc : l'autre côté de ce débat, est-il plus raisonnable et raisonné? À mon avis, pas tellement. J'ai eu l'occasion au cours des fêtes de poser une question – vous allez juger si c'était innocente ou bête – sur la validité statistique de tirer des conclusions sur les résultats d'un petit sous-groupe dans une étude de milliers de personnes. Un-e expert-e statisticien-ne dans la foule? Ce que j'ai reçu comme réponse était une demande d'amitié de la part de la personne qui a affiché l'item original (quel plaisir!) et ensuite un argument sans cesse sur mon « attaque » à la PrEP (moins agréable pour moi).

Même l'argument que la PrEP est « soutenu par la science » manque un peu de nuance. À part ma question très innocente (je vous l'assure!) à propos de l'analyse de statistiques, je vois beaucoup de proclamations des résultats d'études qui ne sont pas encore arrivées a leurs fins, telles que définies dans le design de ces études. C'est un terrain un peu moins que solide pour les champions de la science, je trouve. D'ailleurs il serait également une bonne idée de laisser tomber les comparaisons entre les études condom « vraie vie » et la PrEP dans son utilisation optimale. Quand on fait ce genre de comparaison inégale, ce n'est pas que les condoms qui perdent.

Je vois à répétition cette attitude : si on n'est pas pour la PrEP – probablement pour tous – à 100%, on est réactionnaire résistant au changement qui veux priver tout le monde des plaisirs de la sexualité. Ce n'est pas un chapeau que j'aurais voulu porter, donc je refuse de permettre à quelqu'un d'autre de me l'imposer. Si je peux me permettre de juger (quel horreur!), je trouve que la qualité du débat laisse à désirer.

Avant de vous laisser me classer parmi les pros ou les antis, permettez-moi d'exprimer ma position nuancée quelque part entre les deux. La PrEP est là pour y rester et démontre son utilité comme outil de prévention de transmission du VIH approprié pour plusieurs, sinon beaucoup, de personnes. Les condoms aussi sont là pour y rester et leur utilisation continue à être très pertinente pour plusieurs, sinon beaucoup, de personnes. Il y a aussi d'autres outils dans notre trousse de prévention, dont le dépistage, les traitements efficaces pour les PVVIH, le sérotriage,le choix d'activités sexuelles à moindre risque, et j'en passe. Toutes les stratégies ont des avantages et des désavantages, et ceux-ci devraient idéalement être évalués par la personne qui souhaite les déployer, à partir de l'information la plus complète que possible que nous pouvons fournir.

Donc j'encourage tout le monde à prendre un p… (oups, c'est pas le choix de tous et toutes). Que tout le monde prend une pause pour apprécier qu'il y a deux côtés (ou plus) à chaque débat et que nous devons tous et toutes arrêter de stigmatiser ou de ridiculiser les choix que l'autre peut prendre dans sa propre vie. Je suis assez certain que nous sommes tous et toutes du même côté de la lutte contre le VIH; on pourrait ressembler un peu plus à des allié-e-s.

03 December 2014

Bad Employers

Here in Montréal, we have been watching the ongoing pressure tactics of the municipal workers, including police and firefighters, with some degree of amusement, detachment and even derision. This last reaction when they seem to be getting away with tactics they were pepper-spraying and arresting students for just two short years ago. It's too bad that their actions from then are paying off in a lack of solidarity with them today. But they are right.

The government of Québec decided to go and change an element of legitimately negotiated contracts pertaining to the share of pension contributions paid by the employees and the employers. Not having been a party to those negotiations, I would have trouble explaining what might have been traded for the advantages they got – likely salary concession or other items. But the point is that one side of a legitimate contract is going in to change the terms it doesn't like about that contract and doing it in a way that undermines the original process. We should all be disturbed by that.

As for their tactics, well, they have been creative and sometimes destructive. I don't really care for the camo on the police, but it isn't hurting anyone. The Chateauguay police adopting the sheriff uniforms they bought in St-Tite (home of the Festival Western) is kind of cute, leaving aside their proximity to the Mohawk community of Kahnawake and some troubled history between the two (bad imagery for that). Super Firefighters? Why not?! And a seemlingly endless supply of stickers on their vehicles…I'm of two minds on that one.

On the federal front, those in charge are no better. They are on a path to roll back the gains of years of collective bargaining because they don't like the results today. In typical style for the current government, they have begun this process by trying to demonize their workers as being spoiled by excessive benefits. They are starting with sick leave, as many federal employees have accumulated large banks of sick time by not using over the years. It matters little to the government in its disinformation efforts that those days are not exchangeable for pay, nor are they convertible into vacation time or anything other than the sick days they are.

Oh, they will pick and choose some examples of employees who have taken large amounts of time due to serious illnesses that they will not mention in their public relations offensive. No, these people are examples of the excesses of the spoiled government employees, not individuals who have, along the way, traded other advantages for these things they thought were important to them. The government will also not be telling us about how many of their employees retire or leave their service with many, many unused sick days. That isn't a part of the narrative. On the whole, it seems like the government would like its employees to go to work sick and infect us all.

I am one of those people in our society who has no pension plan through my job. My sick days (and I'm luckier than some in having these) are not transferable from one year to another. But I don't think that my governments should try to ensure that they treat their employees worse than other employers. I expect my governments to set a positive example for employers, to show how a workplace can be healthy and supportive, not heartless and stingy.

I am sadly very aware of what a deluded Pollyanna I am in this.

I express my solidarity here and at the ballot box. Most of the union movement has always been supportive of legislation to improve the conditions of work of everyone in society. I hope the rest of those workers find their own solidarity with others in our society who ought to be their natural allies.

01 December 2014

Gains and Challenges

COCQ-SIDA's new campaign takes on HIV stigma by matching the gains in the fight against HIV/AIDS against the challenges that remain.

First of all, let's get the declaration of conflict of interest out of the way. I am the Executive Director of COCQ-SIDA and an HIV-positive participant in this campaign. The second role was more important in contributing to the content of the message, which was developed in collaboration with a number of COCQ-SIDA's member organizations and the participants themselves.

The challenge that many of us in the HIV movement face constantly is to present a real picture of what HIV is today, balancing the desire to encourage the HIV-negative to avoid transmission while ensuring that there is a place for people living with HIV in society. Fear messages have a short-term effect of scaring people into 'protecting' themselves against transmission, but these messages serve to stigmatize people living with HIV and the protective aspect is neither durable nor particularly credible in a context where the target audience might have acquaintances and friends living relatively well with HIV. People living with HIV, particularly those who might have been diagnosed recently, could see fear messages as discouraging, which is not helpful for them.

This campaign tries to find the balance of sharing the good news about HIV today – generally all about medical advances – and contrasting those things with the human rights challenges that do not seem to have moved in all this time, at least not in the right direction.

The messages of the campaign (with my added comments):

People don't understand my desire to have a child because I am HIV positive, but in 2014 a woman living with HIV can give birth without transmitting HIV to her child.
Most people announcing their pregnancy or their desire to get pregnant are greeted with congratulations and wishes of joy and happiness by those around them. Why should it be any different for a person living with HIV? Having to face the unfounded fears of those around you can rob you of the positive aspects of planning your life.

I have been refused medical services because I am HIV positive, but in 2014 the observance of universal precautions prevents the transmission of HIV.
Universal precautions are the simple procedures that health care professionals should be observing in all cases and not just when they are certain that the person before them might have a transmissible infection – that's why they are called precautions. Properly observed, these simple measures will prevent the transmission of HIV and many other infections…in both directions!

I couldn't get life insurance coverage because I am HIV positive, but in 2014 the life expectancy of a person living with HIV is more than 70 years.
Someone needs to redo the actuarial calculations that exclude people living with HIV from accessing life insurance. The combination of effective treatment for HIV and the fact that most of us have a regular medical follow-up that our HIV negative friends and family members do not have has brought us to a nearly level playing field with respect to longevity. It is telling that the only life insurance product we could find available to people living with HIV came with a price tag many times the cost of life insurance for someone without HIV. And how important is life insurance? Try getting a mortgage or a car loan without it.

I have been turned away as a volunteer because I am HIV positive, but in 2014 we know that HIV is not transmitted through casual contact.
Only fear and ignorance of how HIV is transmitted can explain a refusal to accept help from someone living with HIV. The impact on the individual – not "good" enough to offer help to others in the community – is one of isolation and rejection. No one should have to experience that, especially not when there is no justification for the refusal. There is no job that cannot be done by a person living with HIV, with the exception of blood or organ donor…but I don't think any of us wants to do either of those things.

I have faced a lot of obstacles in taking back my life because I am HIV positive, but in 2014 after a stay in a hospice a person living with HIV has regained the health necessary to return to active life.
It is telling that the person lined up to pose for this poster backed out before it was produced, being replaced with a drawn silhouette. Yes, people living with HIV can have crises in their health that require some additional assistance, and the role of housing resources for people living with HIV has evolved to the point that they are rarely now a place to go to die with dignity and much more a place to go to regain control of one's health to be able to return to life in the community. Our society's apparent inability to appreciate people for where they are, as opposed to judging them for where they have been, is completely unhelpful in the long run and quite devastating to someone trying to rebuild his or her autonomy.

People have been afraid of me because I am HIV positive, but in 2014 a person living with HIV and adequately treated does not transmit HIV.
Here we get to the question of fear in a more intimate setting. Apart from all of the ways we know to reduce the risk of HIV transmission – condoms, choice of activities, choice of position, post-exposure prophylaxis (PEP), pre-exposure prophylaxis (PrEP) – we also know and have increasing evidence to support the position that people with a well-controlled viral load don't transmit HIV. Yes, a cautious public health authority will always insist on the multiple conditions that make that true – and those conditions are all about things that can influence variations in the viral load between tests or present uncertainty about those things – but those advocating earlier treatment as a means to control HIV transmission who are not also willing to recognize the near elimination of infectiousness to the benefit of the person living with HIV (reduced threat of criminalization, perhaps?) have some serious contradictions in their argument.

The T-shirt Challenge

Another aspect of the campaign was to challenge people to wear a t-shirt with the bold statement "Je suis seropo" (I am HIV positive) for a day and to share their experience of doing that. Many found support among their friends and family, some got some sideways looks from strangers and one of the Montréal participants, asking her boss in a food products setting if she could wear it to work was refused that permission, her boss insisting they would sell no product if she did wear it.

I had to ask, beyond the reactions of others, how the people wearing the t-shirts felt when they put it on and when they revealed it in a public place. Every one of them had the anticipation of poor treatment, or stigmatization, and every one of them expressed some relief about taking it off at the end of the day. That, perhaps more than all the rest, measures the stigma which all of us living with HIV experience every day.

You can follow the campaign (in French only) at jesuisseropo.org. Click on Campagne acquis/defis for this campaign and on Actualité for the blog.

On a personal note…

The last poster (afraid of me) is my poster. If you want a back story on a situation that I lived through because of someone else's fear, I would suggest a piece I wrote on criminalization in 2012. I accept my responsibility to not transmit HIV and to take all measures to ensure that is doesn't happen. I resent, however, bearing all of the responsibility to be a teacher of knowledge that people should be seeking on their own and a protector of the health of those who will not step up to take responsibility to make their own efforts. Sometimes you just don't want to be a teacher and a social worker in every moment of your life.

I'm probably not the best example of living with HIV stigma. I have all the advantages that our society has to offer – I'm white, educated and middle class, I have a supportive family and friends and I have a job I will not lose by being public about my HIV status. If with all of these advantages my first instinct is to lower my voice when talking about my personal experience with HIV on the bus or in a public place, or to approach unknown situations with a degree of trepidation, I can only imagine the impact of stigma on someone who does not enjoy all of the advantages I do.

If you've met me, you won't think I'm particularly scary. I was going to say I don't bite, but I know that some among you would cheekily ask if I would bite if they wanted me to. So let me revise that: I only bite reluctantly and only when asked to.

Still scared of me?

15 November 2014

Impersonating a Soldier

Big news this week, as someone was discovered to have impersonated a soldier at the Remembrance Day ceremonies in Ottawa. The ensuing uproar and demands that he be prosecuted have missed the point about the purpose of that article of the Criminal Code forbidding the impersonation of a police officer or a soldier (or a priest, for that matter, but I think that’s in a different article).

The true intent of those measures, even if the text of the law is not clear on this point, is to prevent people from assuming and presumably exploiting official positions of authority, using the legal status of those positions for some personal gain or other antisocial purpose. This is not about “disrespecting the uniform” or any other such nonsense. I don’t see any allegations of this guy doing anything other than pretending to be a soldier, not compelling people to do things because of his supposed role, nothing. Should everyone dressing up as a “police officer” on Halloween be arrested and charged with this? Of course not.

Is the act disrespectful? Yes. Is it extra disrespectful at an official ceremony on Remembrance Day. Certainly. Does that make it criminal. Uh….no.

Untwist your knickers, people.