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1 "First line" topics

Here a list of "first line topics" which should be know by anyone who have sexual activities

• Main characteristic of HIV infection
  • HIV can be assymptomatic
  • Deathly disease
  • What medicine can do and cannot do.. and problems induced by treatments.
• Main characteristics of transmission
  • Specific sexual practices
  • Role of wounds (including STD)
  • Other ways of transmission (needle, breath feeding.. etc, but not mosquitoes nor saliva nor..) (this is NOT subject of our web site)
• Concrete logistical info's (Where? Price? Anonymous?...)
  • Condom, lubricant.
  • HIV test.
  • Concealing.
• Safer Sex rules
  • Allowed sexual activities when condom is available
  • Sexual activities when condom is not available
• Post exposure protocol . (How? When? Where?)

2 "First line prevention" and ethic

First line messages are not ethical messages. "Science" is not "Ethic" . First line message tell about a medical danger, not about the ethical value of the dangerous act. Encouragement of faithfulness is not first line messages.. This do not mean that ethical messages are not need in prevention strategies.

 

3 "First line prevention" and modesty

Modesty can be a problem during deliverance of "first line" messages. It is admit that anyone who do not feel relax to speak about sexuality (sodomy, fellatio etc) should NOT be obliged to make prevention because the uneasiness during presentation could be worse than silence.. Not all teacher are advisable for such duty and parents, sometimes, could find advantage to require the help by a family's friend to make children aware about HIV.. (NB the problem are the same in "second line prevention..)

4"First line prevention" and culture

Same as modesty, the cultural facts can give problems. To touch homosexuality or prostitution in some muslim countries.... To speak about sodomy in agrarian cultures...

Grass rooted example in Thailand.

Some limitations for the distribution of the prevention materials must however be mentioned. Thailand is a country which can offer some easy examples: In Thailand, it may be unrealistic to directly ask professors from universities or some health care providers or some representatives from communities or enterprises to teach about HIV/AIDS prevention. Such requests may easily produce contra productive psychological uneasiness. This is mainly due to some Thai cultural characteristics using hierarchic considerations and sophisticated politeness protocols between "server" and "client" or "provider" and "receiver" in any human contact and relationship. Real dialog and interactivity between teachers and students, doctors and patients, monks and laic's, even spouse and husband, etc. are often almost inexistent. This explains why school's teachers or university's professors, monks, parents or even health care providers are often reluctant to get too much involved with details in AIDS prevention. It is important for any prevention strategy to assume this restrictive cultural fact. Teachers, professors, nurses, monks, etc. will not be confronted with AIDS prevention work if they feel uncomfortable with sexual details. They may utilize AIDS specialized persons from outside their environment (external persons) to deliver the AIDS prevention information or they may refer to non metaphoric AIDS prevention materials that can be consulted in total privacy. One example can be described as per distribution of new AIDS prevention materials in universities. Professors will definitely be very reluctant to deliver themselves AIDS prevention materials that contain details on dangerous sexual practices. Relationship between professors and students is definitely not allowing such intimacy. A prevention strategy will, for instance approach rectors or deans to be granted authorization to distribute the prevention materials in their universities but will never use the "teaching" or "academic" structure to disseminate the AIDS prevention materials. The prevention project can utilize some already existent student's groups who are already quite involved in AIDS prevention work inside the universities. To disseminate prevention material, these students may use their own human resources or may even call for an external person to present the new material (for instance a video clip) to university students. If the material is a non metaphoric poster, these students may display samples of this poster in some private places in their universities. (toilets..)

5 "First line prevention"and "oral sex"

Prevention should forbidden unprotected fellatio or not. We must dare to say here that designers of prevention campaign can follow their own convictions. Scientists admit that such transmission of HIV is possible but will also tell that the risk is statistically not significant. Considering that campaigns forbidding unprotected oral sex " can have also dangerous side effects (especially in low layer of population) your have to make your own opinion to decide what is the worse...

Our position is:

Even if it is statistically not significant, it seems that oral sex can be a very rare cause of HIV infection. Here we have to make pragmatic choice If we recommend to avoid unprotected oral sex, in spite of very very little risk, we will be confront to a "more total" reject of rules of protection. If we deny the possibility of oral transmission, we accept a risk. For us, since the risk of oral sex is lower than the risk of infection with condom (tears, inadequate wearing) it is nonsense to forbidden unprotected oral sex. We feel that grass rooted realities make more reasonable to accept so little risk instead of promoting a "sexual stress" that induce more dangerous attitudes. We finally prefer tolerate oral sex. But we recommend in same time to not swallow genital secretions. In context of wound in mouth (including tonsillitis, sore throat.) or wound on genital area, we recommend -of course- to avoid any unprotected oral sex

 

6 Rumors, alternative medicines/protections and first line prevention