- 50% of respondents in a survey agreed that a campaign raised their awareness of issues facing people in serodiscordant relationships and people living with HIV. - Personal stories from the campaign helped some feel more comfortable in their relationships and normalized serodiscordant relationships. - Some HIV-negative men wanted information on how to lower risk while being intimate and how to discuss risk with HIV-positive partners. Stories helped demystify living with HIV. - Disclosure of HIV status affected how men approached relationships due to preconceived notions, but learning facts helped build understanding and focus on the person rather than HIV over time. - Undetectable viral load and

1. Changing the rules

2. SERO DISCO 1

3. Messages draw on personal stories
Personal stories and perspectives provided reference
points from which to develop and shape new attitudes
The survey found that:
 50 per cent of respondents (namely, HIV negative gay
men) strongly agree or agree that the first phase of the
campaign raised their awareness of the issues facing
gay men in serodiscordant relationships [and]
 strongly agree or agree that they have become more
aware of the issues facing people with HIV.

6. Messages draw on personal stories
This is how focus group participants put it:
 “… personal stories helped me feel more comfortable
with the relationship I am in. [The campaign] de-mystified
and humanised a really complex issue in my life!”
 “It says serodiscordant relationships are possible and
exist.”
 “A magazine aimed at demystifying pos-neg relationships
and challenging the taboo – our dirty little secret.”
 “By showing pos-neg relationships happen we take away
the stigma.”

7. HIV negative men wanted campaigns:
 “That help us in talking to positive men … how we can
lower our risk and what to do if we go too far!”
(HIV negative, aged 30)
And, demystify HIV:
 “They were open and honest... they [personal stories]
took a little of the mystery away from knowing someone
with HIV!” (HIV negative, aged 39)

8. Opinions affect how men approach their pos-neg relationships:
 I didn’t want to tell my friends until they had gotten to
know him. I thought that would allow them to react in a
more supportive way.
It was hard to know who to tell because not only are
they going to have preconceived notions about him and
his HIV status, they’re also going to have preconceived
notions about me getting involved in the relationship.
(Quentin, HIV negative)

9. Opinions affect how men approach their pos-neg relationships:
 I pulled back from asking friends for support because
they’re going on even less information. Not only
are you trying to answer their questions, you’re also
trying to suppress people’s anxieties and preconceived
judgements around HIV. (Quentin, HIV negative)

11. Moving forward (post-disclosure) was mediated by learning
(knowledge) and a re-examination of their attitudes:
 Once he got the facts (rather than what was going on
in his head) we took it one step at a time. It took time
for the relationship to build. We talked about HIV in our
relationship to the point where Patrick was comfortable
with it – HIV was a big issue at the start, but its slowly
fading into the background. (Richard, HIV positive)
 It’s about getting to know someone. Once you meet
someone and you share experiences with them their
humanity overrides HIV, whatever their orientation or
ethnicity. (Quentin, HIV negative)

12. Moving on is about day-to-day routine not defined by HIV:
 I think there are a few stages after disclosure.
The first stage is shock. After that is a short period of
trying to get back to normality, not talking about HIV at
all. The great thing he did was get on with the day-to-day
routine of our relationship. As a message for me that
meant it was fine - we were moving forward.
(Robbie, HIV positive)

13. “No” is not always about stigmatising views, but more about
someone knowing their limits:
 When I disclose, 20% or 30% of the time I might
get a reaction like “well I might leave it then”. That’s
really okay with me because I don’t want to have sex
with someone who is nervous or uncomfortable about
my status.
If someone says “no”, I don’t really see that as rejection.
I just see that as someone knowing their limits and what
they are prepared to do to engage in sex. (Stuart)

15. Being in a relationship changed the rules for John (HIV
positive and Patrick (HIV negative):
 I took Patrick to one of my doctor’s appointments mainly
for reassurance. We also wanted to find out more about
viral load. I consistently came back with an undetectable
viral load so after a while my partner and I agreed that
we could fuck without a condom. That was along the
lines of 'talk, test and trust'.
As a couple we agreed that sex was better without
condoms. We both agreed that outside the relationship
we stick to using condoms.

16. While Chris (HIV negative) and Tony (HIV positive) were
using undetectable viral load without condoms not only
to reduce their risk of passing on or getting HIV, but
also ‘for intimacy and connection’:
 Condoms take away the spontaneity and intimacy.
Tony’s got an undetectable viral load and we’ve been
told so many times that the likelihood he’s going to
pass on HIV to me is low.
You know, good sex is something that is fulfilling and
satisfying, you shouldn’t have to worry about it. It’s
about intimacy and connection.

17. For Tom, who is HIV negative and has been in a
relationship with Greg (HIV positive) for fifteen years,
saw Greg’s undetectable viral load as more of an added
reassurance, rather than a replacement of condoms and
safe sex:
 Safe sex, using condoms, obviously does work. Greg
also takes HIV treatments and his viral load is
undetectable, and that gives us an added sense of
security, if we needed one.

18. ‘Viral load disclosure’ is not only an indicator of ‘risk and
safety’, but also Sean’s overall health:
 When Sean disclosed he also told his t-cell count is
within the normal range and his viral load is undetectable.
I had heard those terms before, but I
didn’t know what it meant as far as our relationship
was concerned. (Quentin, HIV negative)

19. Lessons learned
 Intervening ideologically into areas of daily social
practice the campaign magazine challenges a
straightforward communication approach and
reproduce ways of relating and learning about pos-neg
relationships and sex.
Specific attention is paid to practices (e.g. narrative
culture) that mobilise possibilities for representing
the social, relational and subjective life of these
relationships.

20. Lessons learned
 Our campaign evaluations concur with research
(Hassan, M et al., 2008) where it was found that “there
were fewer stigmatising attitudes in HIV negative
participants who were (a) educated about HIV; or
(b) had a personal relationship with an HIV positive gay
man.”
Many reported they had gone through ‘some kind of
learning’ when a partner had disclosed his HIV status,
causing them to re-examine their attitudes or ‘get better
educated’.

21. Lessons learned
Campaign development found:
 gaps in support for men in or considering pos-negs
relationships
 viral load monitoring is being used as a non-condom
based risk reduction strategy, however, there are
differing levels of understanding between pos and
neg men.
As Quentin (HIV negative) commented: “I had heard
that term before, but didn’t know what it meant as far
as our relationship was concerned.”

22. Recommendations
 Over time the experiences of HIV-positive people and
their relationships have been reduced to risk practices.
HIV prevention and health promotion must continually
re-negotiate the privileging of certain lines of enquiry
in order to be effective.

23. Recommendations
 The challenge is to develop campaigns and support
(peer learning) that adapt to the changing dynamics
of pos-neg relationships.
In this discussion, the social and relational aspects
that impact on the quality and longevity of these
relationships rather than only talking about them in
the context of sexual negotiation and managing risk.

24. Thank you to all the men who have taken part in
campaign development. It is an act of generosity
on their part to share their stories with us.
For more information contact kathyt@positivelife.org.au