HIV is increasing in young gay men. Will Hollyoaks help raise the alert?

http://www.theguardian.com/society/2014/nov/19/hiv-increasing-young-gay-men-hollyoaks-ste-hay

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More than 30 years since Aids emerged, Britain is to have its first gay soap opera character with HIV. In January, Channel 4’s Hollyoaks, which next year celebrates its 20th anniversary and which is aimed at young people, will launch a major, long-running storyline following Ste Hay (played by 28-year-old Kieron Richardson) as he comes to terms with the diagnosis. Viewers will witness Ste receiving the results and coping with the social, medical and psychological aftermath.

Although soaps have tackled the issue before – most notably EastEnders’ Mark Fowler, played by Todd Carty, during the nadir of the Aids crisis, and Emmerdale’s Val Pollard (Charlie Hardwick) this year – neither character was gay. This is perhaps surprising, given that around half of new infections each year occur from sex between men, with a continuing rise in infections among young gay men.

“I was worried about telling this story – that it would amplify a long-dead belief that HIV is a gay disease,” says Hollyoaks producer Bryan Kirkwood. “But then I started reading the shocking statistics that 2012 was the all-time peak of new diagnoses among gay men and I thought by not telling this story we’re doing the gay audience a disservice. We want to convey the message that HIV hasn’t gone away, but is no longer a life-threatening illness – as long as you get tested.”

Ignorance, fear and silence around the issues are of particular personal resonance to Kirkwood.

“I was brought up by my gay dad in the 1980s when Section 28 [which prevented teachers from discussing homosexuality] was all around and that affected my childhood profoundly. My dad forbade us from mentioning he was gay to anyone for fear of us being snatched by social services and I think that fear of talking openly about gay sex in schools still lingers.”

For Richardson, who came out publicly in 2010, that was certainly the case.

“I was uneducated about HIV – we didn’t have much sex education in school. It was an option, a class where you learn how to put a nappy on a baby and a condom on a carrot.” He says he was not taught how HIV was transmitted, and at 17 needed an STI (sexually transmitted infections) screening.

“My first HIV test was after one of my first gay sexual experiences. I was a bit stupid and had to get fully checked out and one of the tests was HIV and I remember thinking, ‘Oh God, if I’ve got it, I’m going to die. Waiting for the results was terrifying. I associated HIV with the 1980s.”

It is, he says, “a massive honour” to portray this story. “And if people think I’m HIV-positive in real life, let them.”

Richardson’s experiences of inadequate education are far from unique. Luke Alexander, a 19-year-old student, discovered he was HIV-positive last June, and now campaigns to raise awareness of the virus.

“I never learned anything [at school]. I just knew a little bit from watching old films like Philadelphia, that HIV equals Aids and Aids equals death. But because there’s so much talk about HIV in Africa I thought, like a lot of people my age, ‘It’s over there, it’s not a threat’. I never thought I’d be at risk. I thought if I got an STI I would get antibiotics because the education at school was mostly about chlamydia and gonorrhoea.”

On 21 November, the sex and relationships (curriculum) bill will have its second reading in the Commons. The bill, which aims to expand lessons beyond the biological basics, is expected to fail. The Terrence Higgins Trust, Britain’s largest HIV charity, is campaigning for it to succeed after the next election. So far, both Labour and the Liberal Democrats have pledged to include increased education on sex and relationships in their manifestos. Will Harris, head of media at THT, hopes the Hollyoaks storyline will help.

“A well-researched storyline in a national soap is worth any number of health campaigns,” he says. “Currently, whole generations of young gay men are entering adulthood without the confidence to negotiate healthy sex and relationships. Until we have a statutory programme of sex and relationships education in all schools that doesn’t just teach ‘what goes where’ but covers issues like self-esteem, preventable scenarios like Ste’s will continue off-screen.”

The timing and backdrop of the Hollyoaks storyline is sobering. On 18 November Public Health England released the most recent figures on HIV diagnoses in the UK. Last year saw 462 cases of HIV infection among 15- to 24-year-old men who have sex with men (MSM): more new cases in this age group than ever and an increase of 3.36% even on the year before, which was also the highest figure to date. Numbers among the next age group (25-34) peaked too. This compares to a downward trend among young people overall – in the last decade there has been a 22% decrease in diagnoses among 16- to 24-year-olds.

Why then are safer sex messages failing to reach young gay men? Many cite education, and a long shadow cast by Section 28, which was repealed in 2003. A qualitative study this month by the University of Glasgow found widespread confusion among 18- to 29-year-old gay men about safer sex. But, according to many gay public figures, there is a more complex context beyond the gaps in education.

Andrew Sullivan, the prominent political columnist and blogger, who is HIV positive, wrote last month “almost every man who ever had sex hates condoms”. Indeed, a survey this year by the University of Westminster found 70% of gay men think sex without condoms is more pleasurable. This is amid what many see as an increasing normalisation of “bareback” sex, with many pointing to its almost standard depiction in pornography, to websites such as BarebackRT.com and to mobile phone dating apps that enable users to search for unprotected sex.

Sullivan fears particularly for gay men coming of age today, who did not witness the horrors of the 1980s. “The young generation has fewer psychological resources or experiences with HIV to grapple with the whole issue of getting infected,” he wrote.

And in an interview in this month’s Out magazine, Zachary Quinto, the gay Star Trek actor, warned of attitudinal shifts among gay men toward HIV. “I think there’s a tremendous sense of complacency in the LGBT community,” he said. “Today’s generation sees it more as something to live with and something to be much less fearful of. And that comes with a sense of, dare I say, laziness.”

His comments have caused uproar, not only for their explicit judgment, but because the ramifications of unsafe sex are becoming more divergent, due to medical advances.

Improvements in antiretroviral treatment since 1996 have meant newer drug combinations not only have fewer side effects, but, when successful, make the carrier unable to transmit the virus even during unsafe sex. The sex might therefore be unsafe, as other STIs can be passed on, but poses almost no risk of HIV infection.

Dovetailing this is the recent introduction among a small, high-risk cohort (notably partners of HIV-positive people) of Prep (pre-exposure prophylaxis) – an antiretroviral drug called Truvada prevents HIV-negative people from contracting the virus, even when exposed to it.

Quinto remains concerned. “We need to be really vigilant and open about the fact that these drugs are not to be taken to increase our ability to have recreational sex,” he said. But many, including Sullivan, consider this unrealistic, as the decision to use a condom comes at the very moment when self-control is hardest.

UKip leader Nigel Farage seeks to ban HIV-positive immigrants from entering Britain, but the evidence is clear: the majority of infections are among those born and educated in the UK, making ours a homegrown problem, the solutions of which lie not, it seems, with our borders but within our schools, our culture, and on our TV screens.