Has the Gay Lobby's Obsession with Civil Unions Led to a Rise in HIV? When the Only Serious Debate We Are Having about the Issue Is on a Soap, the Question Has to Be Asked; on the Eve of World Aids Day, a Writer Whose Partner Died of the Disease Starts a Highly Charged Debate

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Byline: SATURDAY ESSAY by Ger Philpott

THE MAN I had planned to spend the rest of my life with died in 1983. Paul had Aids. He became ill in the early days of the epidemic and was one of the first to die of the disease in this country. I was 26 years old at the time and his death has had a lasting impact on my life.

When Paul died, very little was known about Aids. The term 'safer sex' had yet to be coined. And as far as officialdom worldwide was concerned, this was a cut and dried issue - Aids was a 'gay plague'.

So it was left to gay people to mobilise and fight back. Act Up, the predominantly gay community group in the U.S., was born, with the phrase 'Silence = Death' becoming their mantra.

New York's Cooper Union building hosted its weekly meetings, where complex strategies of advocacy and direct actions were democratically decided.

That was the Eighties. And it seems like a lifetime ago. We've moved on - Aids is no longer the bogeyman disease it was back then, we've learned how to deal with HIV infection, how to live with it, and how to avoid having to live with it. Or have we?

The number of reported Irish cases of HIV is 5,243, according to the Health Protection Surveillance Centre. And annual costs for Aids medications (combination therapy) and treatment is e30,000 per head - at conservative estimates.

HSE boss Brendan Drumm has claimed that 'health services will be bankrupt unless they do more on health promotion'. Clearly, someone somewhere in that 'they'-land needs to do the math. And soon. Latest figures from the HPSC, up to the end of December 2008, showed that there were 405 fresh cases of the virus in Ireland.

This was a 3.6 per cent increase on the year before. This Monday, on the eve of World Aids Day, the HPSC will publish further figures, covering until the end of June. But, alarmingly, this time last year, The National Virus Reference Laboratory claimed that 15 per cent of confirmed HIV infection cases were not included in the surveillance centre figures from 2003 to 2007.

'I think there is certainly enough evidence to suggest that the current system is not working as well as it could or should,' claimed the NVRL's Dr Cillian De Gascun.

There is still a voluntary system in place for the notification of HIV cases to the HPSC. Clearly, a mandatory system is required to overcome the problem of under-reporting. Without this, we aren't even on the first steps to properly managing the challenges we still face from HIV infection in Ireland.

BEFORE Paul died, before Aids appeared on the global radar, I had previous experience of gay activism in Ireland - setting up UCC's Gay Soc, for example. Initially banned by the authorities, the group had more straight than gay members. However, I properly cut my teeth in Aids activism in New York's East Village at the end of the Eighties.

On my return to Ireland a few years later, my self-imposed remit in setting up the AIDSWISE organisation was to establish a comprehensive HIV prevention agenda in this country. Aspects of this work included promoting a significant media discourse on issues around Aids and HIV prevention. Interestingly, official figures for reported HIV infections at this time showed a marked decrease.

In 1992, there were just under 200 such new cases and this fell to less than 100 in 1995.

It's not rocket science to work out that keeping the issue of Aids and HIV prevention in the public eye helped to reduce the spread of the disease.

Given the absence of any significant debate in Ireland on the issue over the past decade, it is little wonder that the rise of HIV infections has escalated.

And worryingly so.

The only discourse around HIV in recent times has been concerning the storyline around the character of Lorcan in RTE's acclaimed medical series, The Clinic. We can only hope that the departed show will have had some impact on matters. …