Gays do not want to be prisoners of condoms in France

It is in a relative discretion that the Department of Health launched on 4 November, the National Plan against HIV / AIDS and sexually transmitted infections (STIs) 2010-2014. While the broad outlines were disclosed by Roselyne Bachelot in early October release, but one could imagine that after the big slap had taken the first draft of the Plan at the end of spring, roundly criticized by the National AIDS Council and the National Conference of Health, the Department would have to heart to show it had carefully reviewed a copy. Above all, this Plan 2010-2014 marks a major paradigm shift from the policy of prevention and HIV testing. To simplify, it still relied on the three pillars established in the 1980s, when the epidemic started: 1 / everyone is concerned; 2 / screening is an individual, 3 / everyone must protect themselves with condoms.

In a quarter of a century, all that changed. First, in France, HIV is no longer about "everyone" in the same way. Homosexual men and to a lesser extent, migrants from sub-Saharan Africa, are much more affected than heterosexuals. A study by the Institute for Public Health, published in 2009 without setting a noise, and reappeared in September in The Lancet, this time with drums and trumpets, suggesting that the HIV epidemic was "out of control" in gays in France. It was a bit exaggerated but it reflected a reality: there is no equality vis-à-vis the AIDS virus. Plan 2010-2014 incorporates finally made it, including the recommendations of various reports. It emphasizes a general screening, to be proposed by the city doctors and funded to the tune of one billion euros, and early treatment with antiretroviral drugs now proven their effectiveness. The goal is to quickly identify HIV who are unaware: there are about 50,000 in France (with obviously a significant turnover since 7000 are newly infected each year) and this pool constantly renewed fuels the epidemic .

These figures show that the current policy of prevention, based on the use of condoms has reached its limit for several years. As I said Bruno Spire, research director at Inserm and president of the Aides, "believe that people will protect 100% all the time with a condom is the method Coue. As if people were going to be perfect all the time ... It's like advocating abstinence: after all, is a good way not to be contaminated! "Even if the condom market is doing well in France the systematic use of the hood is down. Which, in a population heavily affected by HIV such as homosexual men, is a real danger. I wanted to understand the reasons for this decline in the vigilance or fatigue, and how gay people were considering taking risks. Here are the stories of three of them.

Vincent is 22. He is a student pass an Erasmus year in England:

"The lassitude vis-à-vis the condom came quickly to me in every sexual frustration is to use the hood, a feeling that one can never reach the end of pleasure. My difficulty is not technical, nor related to a lack of information or a lack of will to protect me. I want to protect me against HIV and I do not want to catch any STI. But my sexuality is very important in my life and the natural relations have always been nothing without the best and those that excite me the most. I go into the same mold as many people I do not like condoms. Wherever possible, I put, I force myself to put on. "

"Generally, I resist my urge to do without. But this difficulty arises to protect me or is exacerbated in two situations. Or when I have low morale because I'm using sex as much as that occupation as an outlet with casual partners: when I had a bad day, my only desire is to compensate and it is in these sexually moments that I can go far in both practices at the level of my prejudice. Or when I have an affection for a person. In these situations, my strategy is reached only after the fact: I talk to the person after the risk, I make regular screenings (every 6 months or one month after a risk), and it happened to me once take a post-exposure treatment. But given the heavy stuff, I think I will think twice before they resume. "

"I say that being well informed about what it means to live with treatment, being HIV positive, etc.. But the sexual behavior and arousal do not obey rational elements. This is also why the best prevention tool for me, in the absence of a vaccine or other pre-exposure treatment, remains to be supported, encouraged and reassured by people who hear me and understand me without judging me . Some find irony to be engaged in the fight against AIDS and have taken risks. Now I just think if the fight against AIDS and there are still blocks of new infections in countries where we have high access to screening and prevention is partly because it refuses have a different approach to people who take risks. "

Christopher is 36 years old. He is an actor in prevention Aides.

"For me, sex without a condom is normal. It must be added. It is an act that is not "planned" and that aims to sneak in time and feelings between the two bodies. That said, fifteen years ago, HIV was still connected to death and I was very careful. There was an emergency and he was out of question for me not to protect me. Today that has changed: I no longer see three people die of AIDS each month. Therefore I make an effort at condom. There are times where I do not think simply. It should be understood that many homosexuals are sexually more liberated than most straight: when I go back room, which can happen several times a week, I can do ten blowjobs in 25 minutes, which means say that I am in contact with at least one person with HIV. "

"The growing number of partners, which is a way of life for many gay causes a proliferation risk. I have hundreds of partners in a year and I think that 10% of my sex is unprotected. I'll get tested three or four times a year for HIV and annually for syphilis and hepatitis C. Half the time, I use the screening community. By 1:20 it's done, it's fast and it's done by people who are like me and do not judge me. "

Jean-Louis 55. It is responsible for aid mission. And positive.

"After I separated from my wife of 45 years, I had a very active sex life and at this point that I was contaminated. The hood is not natural nor spontaneous for those who, like me, have had sex before AIDS. When, in 2006, I discovered my HIV status during a loan application (which I did not have with that bank ...), I was not at all informed. I went for tests at the hospital Saint-Antoine in Paris and the first doctor I saw told me: "Are not you ashamed, at your age?" But again, use condoms is not easy when you have known the time when we did not put ... "

"The homosexual of a certain age are not seen elsewhere in the field of prevention which is made for urban youth: these people are therefore more difficult to grasp, less related to associations, they live most part, does not attend the same places that young. And what is the use of condoms is another problem, the harder erections: when you start to bend less, is more complicated. It is a taboo subject than the loss of virility, difficult to express. It touches something intimate, the fragility of the man who ages ... "

Pierre Barthélémy
Slate... by actup.org