Reducing the risk of HIV infection is a matter of education and conversation

BY: Saada Branker

Well before engaging in sex, Chloe Smith* will talk about it. Call it her prelude to passion. She also listens and observes carefully. “I really don’t trust somebody until I know more about his sexual habits,” says Smith, an African-Canadian who works in the health field. The thirtysomething says she currently does have sex with one partner at a time but — as is the case for scores of people throughout Toronto — she’s not in a committed relationship.

Smith’s goal is to reduce the risk of getting HIV or sexually transmitted infections, so she will “just have a conversation.” Her partner will learn she’s been tested for HIV at least six times and remains negative. She also won’t hesitate to tell a man that there’s a right way and a wrong way to put a latex condom on an erect penis. The possibility of getting it wrong is precisely why she watches her partner keenly. Smith explains it’s worth noting if a man carries condoms because, “that tells me he takes care of himself.” Other things she wants to know: has he ever had an HIV test? Is he comfortable discussing the use of protection? Does he instinctively reach for a condom before skin-to-skin contact?

“I always check to make sure that it is always on,” says Smith. “You have to roll it down because some people do not put on a condom properly. Following the manufacturer’s instructions is one sure way to get it right.”

Sex Education 101? Perhaps. But not everyone will learn the lessons easily. Since 2000, HIV transmission rates have risen dramatically among Canadians having heterosexual sex. Women are five times more likely to get HIV for a variety of reasons; a major one is unprotected sex. Black women account for two-thirds of women in Toronto infected with the virus that causes AIDS. In some cases women, single and married, are exposed to HIV through their partners who, at some point, became exposed. It happens to people because, unlike Smith, they might be unwilling or unable to negotiate practicing safe sex.

Dr. Charlie Guiang is a family physician by trade, with specialty training in HIV primary care. He works at the health centre at 410 Sherbourne St., a department of Family and Community Medicine at St. Michael’s Hospital. Guiang agrees communicating honestly with sexual partners and with the family doctor is a crucial step toward HIV prevention.

But talking about sex is not easy for many people, which makes being informed on the facts of HIV a challenge, Guiang concedes. For effective communication to happen, a person’s level of comfort has to be considered along with their habits. “With my patients, we look at sexual practices they engage in and discuss if that puts them at high risk for HIV,” say Guiang. Sometimes he’ll forgo the medical terminology and instead use language patients are familiar with. This way, they understand and they’re put at ease.

Women, he says, should become comfortable with carrying their own condoms and not rely solely on the man to follow through. “So the next thing is to convince their partner to use a condom, which may or may not be easy or possible.” Sometimes he’ll refuse and she’ll acquiesce. The common denominator in these cases could be a lack of knowledge about HIV and how it’s acquired. But people can get schooled. Throughout the city, there are healthcare providers and support-service organizations that specialize in safe-sex counselling.

As Smith puts it, once people become properly informed about HIV, they learn there’s a way to talk about sexual practices. In her case, she maintains condom use is non-negotiable. “For me, if I’m involved with somebody and he’s sleeping with someone else I’m hoping they’re ensuring their safety. I’m usually with people who strongly value their lives.” For added assurance though, Smith packs her own condoms. “I mean, we eat healthy, we work out and we try to value our lives,” says Smith. “Having safe sex is another way of doing that.”

HIV can thrive in environments where people can’t or won’t talk about sex.

Sexual Health & Support Services

1. The Black Coalition for AIDS Prevention (Black CAP)
2. Prevention program to support young women
3. The African and Caribbean Council on HIV/AIDS in Ontario

Did you know?

A trip to an HIV-testing clinic doesn’t necessarily mean you’re HIV-positive. But it does mean you’re taking responsibility for your own health.

HIV & STI Counselling & Testing

1. Hassle Free (anonymous testing in men’s and women’s clinics)
2. Women’s Health in Women’s Hands Community Health Centre

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