Community Summit: Group B session

This group was charged with discussing how community leadership and media can influence normative behaviors in the GBM community.

1.	What are the current norms among GBM related to unprotected sex, disclosure and testing? The group believed that there are no real norms about unprotected anal sex. Individual norms are set more by gut perceptions than by objective knowledge. Positive men "should" use condoms with negative men, but the sense is that many men don't. The old norm was universal condom use; this norm may not have changed but more GBM are dropping it. Pretending everyone is positive has collapsed with nothing to replace it. There is still a perception among Latinos that HIV is a white man's disease. The perception that tops are not at risk is prevalent. The receptive partner does more risk calculations. Variables that come into play include serostatus, race, top or bottom, situation and appearance. The norm around unprotected oral sex is clearer; it is OK with most men. The key decision is whether or not to swallow. Norms about disclosure are also unclear. This is an area where the group felt we could promote a norm. Ideas included disclosure as a shared responsibility between partners; positive men have more responsibility to disclose, and the negative partner has the responsibility to ask his partner. However, the group thought men wondered why they should disclose when the risk level is low. There are assumptions made about status based on people's silence. Some felt that men avoid relationships to avoid disclosure issue. Some also wondered whether it might be useful for negative men to proactively disclose. Norm about testing is "know your status" but some people resist testing for various reasons.
2.	How have things changed over the last 2 - 3 years? The old norm of using condoms all the time is no longer applicable in the era of perceived decreased seriousness and new treatments for HIV/AIDS.
3.	What norms should we promote? Compassion for partners and protecting partners. "HIV stops with me" for the positives Caring for the community; risking the spread of infection endangers the community (make sure that positive men feel included in the community) Know your status (address HIV test "phobia") Valuing our sexual culture; valuing sex Teach community how to calculate risk Address anonymous sex norms as different from relationship norms Address drug use and how it makes our community unhealthy Gay is good
4.	What negative messages do we want to avoid? Avoid negative sex messages and blaming messages.
5.	What positive messages do we want to give? See above - gay is good, etc.
6.	Who should be involved in promoting these norms? The group wasn't able to clearly identify community leadership, but felt the norm messages should come from multiple sectors of the community. The group pointed out that the community is so diverse that one leader doesn't fit all. Group noted that some GBM leaders haven't been outspoken on these issues and haven't used the bully pulpit well. Leaders are different for men of color. A number of leaders were mentioned, including national leaders, politicians, organizational leaders, GBM media and grassroots community leaders. We must coordinate messages across agencies to assure that messages are consistent and do more coalition building.
7.	What should be the role of the media? How important is the media? There was no real consensus on the role of media. There was discussion of media advocacy (using the media for free) but awareness of controversy around gay positive information. Some mass media campaigns have been effective (e.g. Hornaway). GBM media in Seattle is in transition.

Recommendations:

Target positive (and negative) men with messages around the importance of disclosing one's HIV status.
Coordinate messages across agencies, so that each agency addresses its target population with a consistent message.
Acknowledge that GBM use a "risk calculus" to make decisions about risk behaviors, and identify the likely variables and weights in the formula.