Negotiating HIV prevention: the talk, test, trust story and beyond

Abstract

In May 1996 the AIDS Council of NSW launched Talk Test Test Trust …Together (TTTT), an HIV prevention campaign aimed at decreasing risk of infection within gay men’s relationships. The rationale behind TTTT was ‘negotiated safety’: that it was safe not to use condoms for anal sex in primary relationships if specific steps were followed. TTTT generated contestation within AIDS Councils in Australia and New Zealand, but also amongst researchers, policy makers and gay communities. Arguments about TTTT and negotiated safety appeared logical and reasonable and did not fall neatly along an Australia/New Zealand divide. This study used a qualitative approach to interview key HIV educators in New South Wales who were involved in the development of TTTT and New Zealand educators who did not promote negotiated safety. This thesis argues that in order to understand the contestation around negotiated safety and TTTT it is necessary to understand the broader social and historical factors that shape HIV prevention contexts and practice. These include factors arising from the epidemic itself (which, to some extent, were responsible for the difference between Australia and New Zealand) such as the increasing complexity of gay men’s risk reduction strategies, the rise of a positive voice, and impact of treatments and factors associated with and the broader context such as the rise and continuing history of a gay political and social movement and associated identity and community formation, and later, fragmentation, changing concepts of love, intimacy and relationships and of risk and the uncertainty, anxiety and fear from living in a complex individualised detraditionalised world. This approach will show that a focus on a dynamic epidemic, and the broader social and historical context can shed light on arguments made about negotiated safety and TTTT. Further, applying Bourdieu’s formulation of the complex interaction of habitus, fields and practice (1977) makes sense not only of the arguments made about negotiated safety and TTTT, but of educator practice and of HIV prevention, of the broader HIV and AIDS sector, and of how societies continue to learn to live with and adapt to the epidemic.