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Réjean Thomas, Actually: HIV/AIDS, and the problem with campaigns

More : AIDS, Arc en ciel d'Afrique, Bristol Meyers Squibb, Clinique l'Actuel, Fondation l'Actuel, Gay men's sexual health, HIV, HIV/AIDS, Line Beauchamp, One Life, Réjean Thomas

by Jordan Arseneault on December 1, 2011

Réjean Thomas is a leading researcher in the field of HIV/AIDS, and the head doctor at the Actuel Clinic in Montréal. We sat down with the founder of the Fondation l’Actuel to reflect on the 30th anniversary of AIDS and the confusion that still reigns today.

The very day we sat down with Réjean Thomas for this interview, the pharmaceutical giant Janssen released the results of a survey that showed 75% of Quebeckers still believe that having sexual relations with an HIV positive person counts as “high-risk” activity, even if they are on effective tritherapy. The Clinique l’Actuel, located in Montréal’s gay Village since its founding in 1987, has worked with Dr. Thomas’ foundation to study and raise awareness about HIV/AIDS in Québec and around the world. Their speciality: proving that early treatment for HIV reduces the risk of transmission. Even though UNAIDS released its report last week that the global rate of infection has finally stabilized, major causes for concern remain. People everywhere still hesitate to get tested, transmission rates amongst gay men (and Men who Have Sex with Men, MHSM) have not decreased, and worst of all, the government is ignoring its public health responsibility by removing sex ed from high school curricula since 2003. On this final count, Réjean Thomas let slip some possibly good news for 2012…

2B: One could say that the world of HIV/AIDS is in a state of transformation, both in terms of its origins, and with this 30-year milestone. Would you agree that our society is undergoing such a transformation?

Réjean Thomas: I have the impression that there is a lot of confusion about AIDS right now. When we look at the data released by the UN last week, it would seem that the pandemic has finally stabilized. Meanwhile, here in Canada the infection rate has been stable (i.e high) since 2004: all of which amounts to mixed messages when it comes to prevention methods. They’re even talking about a global elimination of AIDS in 10, 20, 40 years, which would be great news, but it’s something that requires that we invest in it. The other main tranformation we have seen is with the massive increase in access to tritherapy, which has resulted in lowered rates of infection: this is not necessarily due to a change in sexual behaviours, but shows rather that the treatments are effective in reducing infection.

2B: And your clinic (l’Actuel) has been instrumental in showing the link between reduced infection and early treatment…

RT: Indeed, we have been one of very few who have come out and said it, since it is still a touchy subject… encouraging people to get tested and to get treatment early. For people who want to live a “normal” life, who don’t want to wait until their immune system has hit rock bottom, or who want to have couple relations without the fear of infection. The most important thing to highlight is that right now (in Qc), 20-30% of HIV positive people do not know their status, which is a huge problem related to social stigma and criminalization. This means that the approx 25% of people who do not know they are HIV + are responsible for 50% of all new infections.

2B: In terms of prevention campaigns, what do you think about the fear-based video PSA that the One Life campaign showed at the Image + Nation Festival, sponsored by Bristol Meyers Squibb (knowing that BMS is one of your Fondation l’Actuel’s funders)? Do fear-based campaigns work?

RT: When it comes to prevention campaigns, it’s hard to know what works, and not many people saw that one. That video is old (from 2008) and was probably directed at people who “feel” less at risk. The “Je me fais tester” project was a collaboration between One Life (BMS) to improve access to rapid HIV testing. What we know works is having regular prevention campaigns, which is something we sorely lack. We’re not going to get rid of HIV by talking about it once a year on World AIDS Day. What works the most is to increase testing and treatment, not mere campaigns. Prevention is effective for about 25% in reducing the rate of infection, male circumcision is about 55% (in certain parts of Africa, at least it can protect men), and treating people for HIV is about 96% effective. I believe more strongly in the kind of sexual education that is long-term, that takes homosexuality, contraception, and safer sex into account- and that’s what we’re missing here! There has been no sex ed (in high school curricula) since 2003, and we have seen that as a result, youth today have very little knowledge of the issues…

2B: Are you part of the intervenors trying to pressure the Government to put sex ed back in high schools?

RT: I have been working with the unions and women’s organizations to get support for that, and it’s supposed to happen next year, I think. It’s not one class a year that’s going to make an impact on prevention… What I understood is that the new Education Minister (Line Beauchamp) is open to it (being put back in school curricula).

2B: So, are HIV and AIDS still huge issues for the gay community?

RT: AIDS has been placed in a kind of bubble, we don’t talk about it anymore, even in the queer world. Homophobia, youth suicide, same-sex parenthood, etc have really taken a lot of the focus lately. What seems to have happened is that this entire category of resistance which throughout the years defined the gay community (politically) has all but disappeared, and now people think that HIV affects everyone the same way, which is not true. Gay men and MHSM are far and above the majority of newly infected people, and that is true as much for the older as for the younger generation, which is sad. In Québec, 15% of gay and bisexual men are HIV positive, and it remains a fact that between 60 and 65% of new cases are amongst MHSM. Here in our clinic, that rate is even higher. The primary health problem amongst gay men remains and is HIV, and the problem is that there are not currently enough resources, social, psychological and financial, to prevent high-risk negative men and youth from getting infected.

Diane Dufresne w/ Les Violons du Roy

TONIGHT, Dec. 1^St, for the Fondation l’Actuel ($250)

Monument National

1182 boul. St-Laurent

fondationlactuel.ca