Health professionals

Background

CHAPS has identified three key areas to be the focus of long term work programmes providing information and skills so that men can better negotiate their sexual relations. All three seek to inform men about preventing HIV transmission through increased knowledge of:

• the biology of HIV transmission (how the virus is passed on during sex between men)
• Post-exposure prophylaxis (PEP)
• condom use

Recent findings from the Medical Research Council-funded INSIGHT study of recently diagnosed HIV positive men confirmed what many people in gay men’s sexual health had suspected for sometime; that the use of poppers are indeed an increased risk factor in HIV infection¹, more so than any other drug.

This programme of work originally planned to build on 2003’s campaign Biology of Transmission, which focused on how variables in rectal health could effect HIV transmission. In light of the research from the INSIGHT and previous studies, this was reviewed by the CHAPS Programme Development Group, the body charged with defining the parameters of a given programme. Consequently, the aims of the press campaign were modified to focus on the role poppers play in HIV transmission during unprotected anal intercourse (UAI).

Target audience

The campaign is aimed at all gay men, regardless of HIV status who have (or may have) unprotected anal intercourse with an emphasis on men who use poppers. According to data from the 2005 Gay Men’s Sex Survey, poppers are the third most used drug by gay men after alcohol and tobacco².

Programme aim

The aim of the Poppers programme comes from the Making It Count strategic aim 2a: reduce the number of occasions of serodiscordant unprotected anal intercourse where the infected partner is insertive.

Essentially, the message of this programme is that if an HIV negative man using poppers while the receptive partner in serodiscordant UAI, whether cognizant or not, they will increase the risk of HIV being passed on.

This is not intended to be anti-poppers or anti-sex and care was taken to avoid the early 1980’s message that ‘poppers cause AIDS’. We have attempted to highlight that it is UAI which is the risk activity which can in turn be exacerbated by popper use.

For a more detailed look at the history and research into nitrite inhalants, please refer to the CHAPS Sector Summary Report, ‘Poppers’ available for download here.

Programme elements

Press advertising

A major part of the programme will be the press advertisements in gay publications. This will comprise of a single execution running from 19 December until mid-February.

Posters

Single-sided posters will be available, adapted from the press advertisements. A Welsh-language version will also be available through THT Cymru.

Website

Unfortunately there was no web presence for the original Biology of transmission programme, so this microsite contains the messages from that programme as well as the those relating to Poppers.

Ready for action

A new 32-page booklet containing basic information about HIV will be launched to coincide with the Poppers programme. It also will cover information from both Biology of transmission programmes and is intended to become a long-standing resource alongside The Bottom Line and Below The Belt. The booklet will detail how HIV is passed on and how to reduce the risk including choosing and correctly using the right condom and lube as well as information about post-exposure prophylaxis (PEP), HIV and the law as well as, of course, poppers.

Condom packs

A new condom pack has been produced adapting the artwork from the press advertisements on the outside. The inside contains information on correctly using a condom and a reminder about PEP.

eXposed! 11

This new edition of Exposed! magazine recaps much of the information in Ready for action in a fun, and highly pictorial way. This is designed to be placed in gay venues alongside other scene publications.

For added appeal, however, CHAPS have secured involvement from Richard Newman and Gerry Stergiopoulos, gay housemates from Channel 4’s Big Brother 7 and 8 respectively. This means that as well as vital programme messages, readers will also get non-sexual health related interviews to give the publication more credibility as a ‘magazine’ and less the appearance of a ‘resource’.

There will be two covers; one with a pantomime theme for use around Christmas and New Year and another more generic version for use after this period.

This edition includes: information about how poppers and rectal bleeding can increase the risk of HIV being passed on, reducing risk during anal and oral sex, an explanation of viral load, general information and a photostory about accessing PEP, and tips for successfully using condoms and lube. Readers can also enter a draw to win a range of prizes including a professional photoshoot.

Confectionery

A number of cola bottle gelatine sweets have been produced containing the full copy of the press advertisement for use by outreach workers to engage men on the scene. These are designed to be most valuable when used in conjunction with an outreach intervention and may be of less use if distributed without discussion.

CHAPS Poppers Sector Summary Report

One of this programme’s most important resources for health professionals is the Sector Summary Report on Poppers. The launch of this coincides with the launch of the programme and contains vital reading for anyone planning on implementing the campaign in their area.

The report deals with the basics of nitrite inhalants: what they are, how they work, how uses them and their legal status. It also contains a detailed section on how poppers effect the body and health as well as a history of research into poppers and HIV seroconversion

For more information on the Poppers campaign and material contact Campbell Parker at THT on 0207 812 1783, email campbell.parker@tht.org.uk

To download the Sector Summary Report on Poppers, click here.

¹Factors associated with the HIV seroconversion in gay men in England at the start of the 21st century, N MacDonald, et al, Journal of STI, November 2007
²Consuming passions: findings from the United Kingdom Gay Men’s Sex Survey 2005, F Hickson, P Weatherburn et al, Sigma Research, London 2007.