Life, Liberty and the Pursuit of Gay Men’s Health
Jim Pickett spends most of his time in what he describes as “the greatest job in the world” thinking and talking about men and sex. As advocacy director for AIDS Foundation Chicago, Jim focuses on building grassroots support for gay men’s health issues including HIV/AIDS from the local to the international levels. Fueled by mass quantities of caffeine, Jim is a key player in AFC’s partnership with other AIDS organizations on Sexual Health Xchange, oversees Life Lube and its accompanying blog, heads up the International Rectal Microbicide Working Group and chairs the Chicago Crystal Meth Task Force.
Jim and I discussed a few his favorite topics: gay men, sex and building a stronger, healthier gay community.
MC: What are the most pressing issues facing gay and bisexual men?
JP: I think there are a number of things that are important for gay and bisexual men. Certainly, our catastrophic rates of HIV infection are of huge concern. And the fact that gay men and MSM are on the short end of the stick in terms of attention and funding – and this is across the globe – is absolutely criminal. But the conditions that are intertwined with this epidemic also need ongoing, focused attention and resources – our high rates of depression, our use of substances (beyond crystal meth and including legal substances like alcohol), and the levels of partner violence and childhood sexual abuse in our community that inhibit us from wellness.
MC: What health issues do you think are not getting enough attention among gay men?
JP: As I began to discuss in my answer to your previous question, there are other mental health, emotional health, spiritual health physical health and sexual health – issues that are important to gay men, beyond HIV, beyond crystal meth.
For far too long, gay men’s health has been defined by and limited to the area between the navel and the knee. As if HIV and STD acquisition are the only concerns gay men have! It is wrong, it is preposterous, and it negates the wholeness of our lives. Similarly, crystal meth is not used by the majority of our community.
In Chicago, for instance, about 10- 11% of gay men indicate having used crystal in the last year – that could be once, or that could be more frequently. So what does that mean? It means that the vast majority of gay men here – 90% or so – DO NOT USE CRYSTAL. But are they using other substances – both licit and illicit? YES. Are we doing folks a disservice by being so concentrated on one substance. Yes, absolutely. Should we continue to pay attention to crystal? Of course, but it needs to be in context – our attention must be wider. After all, no one begins using substances with a snort of crystal. It starts elsewhere.
I would love to see our community really take a critical look at the significant role alcohol plays – in terms of funding our work, and in terms of causing serious harms. We all love to get excited about the latest “bogeyman” drug. When have we allocated similar energy to alcohol and how it is both used and abused in our community? Finally, we can’t ignore issues of stigma, discrimination and equal rights – HUMAN rights.
MC: Where are we in terms of building a robust movement focused on the broader gay men’s health issues that you mentioned?
JP: I think we are getting there. More and more there is discussion – and ACTION – from the community moving in this direction. The Gay Men’s Health Movement can and should take credit of this shift from the deficit-based, HIV-centric, crisis-of-the day to something that is broader, holistic, and celebratory. We have gotten a good start. Do we have a long way to go? YES! Is everyone on board who should be? Um, that would be a resounding no. We have a lot to do – beginning with our own communities and including local/state/federal policy and resource allocation.
MC: How are you using the internet and online strategies to reach guys with health promotion messages?
JP: I am most excited about LifeLube – both the site and the blog. I think the blog is especially fun because it is so dynamic – with tons of new content every day. And we have the ability to post on lots of different topics that appeal to gay men – sexual health, physical, mental and emotional health – including but not deferring to HIV. It’s important to continue our HIV work, but as I said, we must not limit ourselves to that one issue. The blog also allows us to post items that are political and cultural as well as items that are funny/campy/goofy and SEXY. It needs to be an entertaining place to stop by – just a bunch of dry info is not going to be very appealing or inspire repeat visits. And while we post on the challenges we are facing as gay men – it is always from a place that recognizes and celebrates our ASSETS.
MC: There has been quite a bit of talk about developing microbicidal agents to prevent HIV infection among women. What’s the state of research around microbicides that will be effective in men?
JP: Well, the good news is that we are on our way. This year saw the very first human trial (a safety study) of a rectal microbicide at UCLA. But we are a long way from realizing a rectal microbicide that is safe, effective and acceptable. Please see www.IRMWG.org to learn more about where the research is at the moment – the site has tons of great resources.
We really need more gay men to be involved with pushing the research and development activities forward. And we also need more women and heterosexual men to be part of the DEMAND for safe and effective rectal microbicides – they are having quite a bit of anal sex themselves. It is a human issue, one fraught with stigma, denial, homophobia, resistance and some significant biological challenges. We need lots of people on the team to make this happen! The IRMWG is always looking for new members – so stop by the site and sign up for our listserv, get in the loop, and become a conduit for change.
MC: Crystal meth has had a devastating impact on gay men. What are some of the most innovative and effective efforts to combat meth abuse?
JP: Hmmm, I have seen little innovation actually – so many of our messages are just really ugly, fear-based and dehumanizing. We have moved away from that here in Chicago and I have seen this shift elsewhere – but we all still really default to the demonization of the drug, and the consequent demonization of the user. I think what is, and will be most effective, is a harm reduction approach that is asset based and empowering and addresses both the bad AND THE GOOD in crystal in a broad context of substance ab/use. After all, no one does crystal the second time because it was a horror show. They go back for more because the first time was ROCKING. That is true, and pretending it’s not is obvious to anyone who has used it, or is using. We need to meet people wherever they are on the continuum of use and abuse and provide them with appropriate, culturally literate information and support. Please, no more skeletons and crystal messes! No more “Meth = Death.”
The guys who are drawn to it are often guys who like risks and a sense of danger and being on the edge – our playing up the sssssscary aspects is an enticement. We really need to be just good presenters of clear, clean information and trust that men will make decisions for themselves using that info. They may make decisions that some of us do not fancy – tough. That’s the way it works honey. And we need to be there for everyone – whether they follow recommendations or not. We are all human, and we are all struggling with a variety of things – let’s let our response to crystal meth be led by compassion.
MC: Most of the educational campaigns around meth have focused on getting those addicted to quit. How can educational outreach be used to prevent guys from trying meth in the first place?
JP: This is what our Project CRYSP is attempting to achieve. A five-year program, we are in the first year which has consisted of research and development activities. I don’t know that we have the answers yet, but we are certainly interested in the holistic model I have been going on about. We know that a lot of guys in our community are grappling with depression, with loneliness, with a sense of loneliness and disconnection.
I think approaching these issues will go a long way towards preventing the use of crystal. Instead of chopping off the tops of the weeds only to watch them grow back, we want to dig out the roots and address the underlying needs and vulnerabilities of gay men. And as I have mentioned, our crystal meth efforts cannot neglect that other substances are at play in our communities, and we can’t ignore them, or pay attention to them intermittently.
MC: What kind of impact have you seen from the Crystal Breaks campaign?
JP: It was launched in 2005 and I think it was very successful in grabbing people’s attention, and providing information about crystal meth. I think, however, that it has seen it’s day and we are likely going to retire it by year’s end. For my taste, it is a bit too fear-based and stigmatizing. Though I do think we have strong harm reduction messages on the site, most if not all of our messaging that took front and center was a bit too on the “horror show” end of the spectrum.
MC: How are funding restrictions from governmental agencies impacting the ability to educate men in a frank and explicit way?
JP: The fact that we can’t “promote sex” is a huge, huge, huge barrier. I would question if anyone in this country has access to education that is frank in an explicit way. Just take a look at the amount of dollars we have thrown into the “abstinence-only” fire. It’s sick. I am most inspired by stuff that is done without government money in this country – where you can “keep it real” and make it fun and sexy and accessible to sexually active gay men.