A 6 percent year-on-year increase in the number of HIV infections (512 new cases recorded in 2016), as well as a 10 percent jump in other STIs, is depressing news. Half of that number is made up of men who have sex with men. So, another batch of mostly young, mostly gay and mostly healthy, men take on a lifetime of anti-retroviral drugs, that for many, will mean they have the same life expectancy as the general, HIV-negative population.

Wait a sec – doesn’t sound that bad, does it? The drugs get better and have fewer side effects all the time – one of them, Truvada, can even stop you getting HIV in the first place – and taken properly, you’ll live as long as anyone else. And sure, there’ll be actual cures and a vaccine sooner or later. No wonder the younger gays are throwing out the condoms at all the chemsex orgies they’re having. It’s difficult for older people, who experienced the wasting away and death of many bright and beautiful gay men in the 1980s, ’90s and even the ’00s, to accept what looks like reckless behaviour by the younger generation. Even if we understand that for some young ones, HIV is perceived as a different disease now, an easily handled life sentence rather than a long or short stay on death row (with its own lethal injections to further stretch the image), we still worry about the return of ‘gay plague’ headlines in the media. What effect would that scaremongering have on our hard-won rights and the less tangible, daily acceptance and visibility we all enjoy? What about the potential effect of resurgent HIV on the treatment of gays in places like Chechnya or Saudi Arabia?

“In the face of their own experience with the first HIV epidemic, the natural reaction of many older gays is to blame the younger generation for their fecklessness.”  says Stephen Meyler.

In the face of their own experience with the first HIV epidemic and homophobia, the natural reaction of many older gays is to blame the younger generation for their fecklessness. A recent opinion piece in the Irish Times seemed to be doing this. The author, Derek Byrne, who is described as a journalist “who lectures on HIV and sexual health transmission” (sic), said that the drugs are still dangerous and that Truvada made people less responsible for their own sexual health. In his opinion, the only long-term way to deal with the current rise in gay HIV numbers was ongoing support for the tried and tested methods of education and widespread condom use. He did allow that a dramatic decline in new HIV cases among gay men in the chemsex capital of London might be down to widespread necking of cheap internet Truvada, as studies by UK HIV organisations suggest.

Other natural reactions are at play here. HIV is not the same as it was, even a short ten years ago. You can take a pill that has been proven to reduce your chances of getting HIV from bareback sex from high to very low. The newest drug combinations are as safe as the many approved medications we drop thoughtlessly all the time – that’s what ‘approved’ means. With HIV, it’s likely you’ll live as long as anyone else and not have serious side effects from the drugs. All of these factors are now in play when it comes to deciding sexual behaviour. Making people feel guilty, especially a group of people for whom guilt is often intricately associated with homophobia, is not going to work. It didn’t work when HIV was lethal and it won’t work now.

Besides, since HIV still creates fear, prejudice and shame among most gays, those chemsex orgies are likely a minority activity and there is an argument that the 6 percent increase is at least partially imported, as a significant number of the new Irish cases were people who had moved to Ireland after a HIV diagnosis elsewhere.

Some of the older generation are influential opinion-formers with access to the people in government who make health policy decisions. You hope they have been able to put their own experience of the first HIV epidemic aside, so they can assess in an objective way this new, different challenge.

Surely, one change they should be trying to make happen is with regard to Truvada. It’s still a very expensive drug and it’s only effective at preventing HIV transmission during unsafe sex if it’s taken properly. Knocking one back during prinks isn’t good enough and of course, it won’t stop you getting syphilis, gonorrhoea, herpes, HPV, chlamydia, etc. That said, if it’s available here and at a price people can afford, then correctly used Truvada will reduce HIV rates. This alone surely makes it an essential component of the response to that 6 percent increase.

There are other dangers for all gay people here. It’s very possible that the homophobes – see them out there in the long grass – will jump on higher HIV rates to rehash their cryptically hateful narratives; think how easily they might change (or create) public opinion about the recent softening of rules on gays donating blood, for instance. Encouraging a perception of feckless disregard for our own health could easily translate into unease about reproductive rights, adoption or fostering. And what about a young trans person’s right to choose their gender identity, perhaps by medical means? Public opinion in these areas, already shades greyer than the ‘easy’ ones like marriage equality or employment protections, isn’t fixed and nothing changes it more effectively than some concerned, reasonable-sounding voices smoothing the way for an irrational fear becoming a state policy.

This piece was originally published in GCN Issue 330.