“The LGBT community, the queer community, can be the most supportive or the most stigmatising. We’re so fractionalised as it is – look at all those Grindr tribes. It's such a shame. You saw the community come together in full [almost] for the marriage equality referendum and you get tingles just thinking about that. But then I tell someone I’m HIV positive and they don’t want to know me. Even within the HIV community, there are factions. Some people are ‘cleaner‘ than others. Let’s say someone got HIV from their ex who cheated on them. Well, they’re apparently going to be seen as less ‘dirty‘ than someone who got it in a bathhouse or at an orgy". Robbie Lawlor has just finished his master's in sexuality studies and is a HIV advocate.
Despite his fluency in speaking about HIV now, it is still only relatively recently that Robbie became conscious to the complexities of the issue, "I was a 21 year old gay man who didn’t know HIV existed in Ireland". Since his diagnosis, he has brought himself back from the brink, calling it "the rock bottom" part of his life. "I was unemployed because I was ill. I had side effects from the medication I was on that gave me symptoms as if I was paranoid schizophrenic, but it was just the medication. I went into depression. I had to move back home. I studied zoology for four years to move over to Australia, I had a job waiting there for me, but once you’re given a HIV diagnosis you can’t have a visa. Nowadays you can get a visa but because medication is so expensive it’s only for the mega rich. So it might as well be a restriction in itself."
Having gone through what is known as a HIV identity transition – from negative to positive – and accepting HIV as part of his self, he created what he calls "a new normal" and embraced his status. "I set up the first peer support group for people living with HIV in the clinic at Saint James'. If [young gay men] want to get in contact with other people living with HIV I give them my number and we can go for a pint, or a coffee, or just a chat over the phone. It’s incredible because by the third conversation they don’t talk about HIV anymore. If I had that resource when I was first diagnosed, I wouldn’t have had to take my medication that was so bad for me for so long, everything would have been a lot easier for me. Robbie is now gearing up to roll out a national campaign for the 2017/2018 academic year to create a powerful sexual health and HIV youth movement and lobby to prioritse HIV and sexual health and to ensure equitable access to medication.
In every aspect of sexual health and HIV that Robbie talks about, inclusivity and intersectionality are to the fore given his experience of "erasure [and] feeling like a vector". He is acutely aware of how the issues he is passionate about are cross cut by class, gender, and race. Of race he says, "how we discuss migrants in Ireland is disgusting. How we discuss migrants with HIV in Ireland is even more disgusting", citing comments on the Journal as an indicator of this reality. "We need to direct our anger [away from] ‘why are these migrants coming in and taking up all the tax payers money for medication’ and ask the bigger question of why the medication is so expensive. And why are we allowing it to be up to €20000 per patient per year. When generic drugs could be thirty quid a month. We are demonising people who are just trying to live their life, who may be running away from issues at home, from dying at home, who want the best life for their children". Of disparities between developed and 'developing' countries he says, "the only reason I’m alive today is because of the country I was born in".
Even with living in Ireland, the full range of preventive measures that will play a huge role in ending HIV do not yet exist. On this, Robbie says, "We need PrEP. Because, condoms – they’re great if you use them but not everyone uses them. Everyone’s individual in terms of what they use or don’t use. We never talk about the people for who condoms cut off their erection, or they don’t know how to put one on, or they don’t get the same feeling, but yet they have a really high sex drive". I add that some people might not just be in the geographic position to get free rubbers either. Robbie continues, "What we need to do is to have every tool in our arsenal to stop HIV, and PrEP is one of the best out there". Ultimately, people are going to have bareback sex and tools additional to condoms to accommodate this are essential. As Robbie knows, it's not just a case of PrEP > condoms, “because anti-microbial gonorrhoea is increasing in the UK and if that’s happening there, we know it’s going to come over here in months".
I am interested to learn more about disclosing a positive status to potential partners, and how that has gone for Robbie [quite well, obviously – he's been in a relationship for almost two and a half years]. "If I’m dating someone, I want to show them who I am and when it gets to that point I’ll tell them. I have this five date rule. I had this five date rule before I had HIV but it just seemed right to me. I wouldn’t have sex until the fifth date because for me personally I have better sex with people who I have this connection with". Five dates is a lot. Robbie agrees before owning up that he only went to the fourth.
Be it four dates or five dates, Robbie's attitude remained constant, "if you go to someone you’re dating and you just look depressed and say that HIV is ruining your life, the person is going to run a mile. You need to be confident in yourself. You need to feel empowered in your status. You need to tell the person, ‘this is what I’m living with, these are all the facts I know, and if you don’t like it, that’s okay’". He continues, "because people can really take advantage when you’re very vulnerable and sensitive. We allow people take advantage, because we almost feel like we deserve it when we’re living with HIV".
Robbie is having "amazing" sex with his man Maurice – who has a negative status – and talk soon turns to common misconceptions about mixed status sex. Robbie cites the Partner Study which analysed 58000 sex acts between mixed status couples – not one new transmission occurred if the HIV positive partner was 'undetectable' [where the virus becomes so low in the body following medication]. That study is entering its second phase and Robbie and Maurice are taking part in it. On making this decision Robbie says, "I was apprehensive. Because if it’s someone you love, it’s the last thing you want to do. I told my partner about it and he was jumping up and down his seat with excitement. He really wanted to do it". I suggest that for a thing that is such a big part of Robbie's life, it is unsurprising that the person who is also such a big part of his life would be eager to get involved in a piece of leading research. Bringing Maurice into the research has only been good for them, "it’s my responsibility to take my medication every day, but after however many sexual acts over a year and he’s negative. I can say, with certainty, that he won’t get HIV. From making that decision, it opened us up to talking about what we want in our relationship and our sexual desires".
All of this means that sex is safer with someone who has a positive status – and takes their medication – than someone who does not know their status [and many do not]. "I have people coming to me constantly to say they got HIV from casual partners, or people they’ve been in long term relationships with because they didn’t get checked at the beginning – nobody knows. It is going to be safer with me". Robbie continues, "and even, let’s say, if I did go off and cheat – because let’s be honest, people cheat, it’s sexual desire, and we need to talk about cheating a lot more in a non sex negative way – and if I was to, if I’m on medication, I won’t give him HIV. I could give him another STI but I could not give HIV to him".
Sex negativity comes up a lot in conversation with Robbie. We both blame – in part, at least – Ireland's social history for people not feeling as empowered in their sex and sexuality as they could or should. Robbie refers to it as something of a "Catholic hangover". And he would know, "People living with HIV are the walking embodiment of the shame we attribute to sex. We are. I know people who have great sex lives, but they feel they can’t tell their friends or talk openly about it because they’ll be shamed. And if they can’t talk about it with their friends, how are they supposed to negotiate safer sex with people if they choose to? Will they feel obliged to get a sexual health check? What will they feel if they get HIV? All because we have so much shame toward sex. We’re changing. But we need to go a lot further".
"We live in a neoliberal world full of these messages of ‘look after yourself’. And if you’re given something like HIV it’s shame on you. You’ve done this to yourself. It’s your own fault, you deserve this – that mentality". Rather, Robbie maintains, a more sensitive and nuanced approach is key, be it in regard to chemsex, bug chasing, gift giving, or whatever. This seems like the most fitting way to end our conversation, and perhaps the most valuable thing to take away. "We demonise people who do drugs or have chemsex without every thinking about the person as a person. We need to think about the person individually and why they might want this to happen. It could be a number of things. It’s something we never talk about. What’s happening in their life that they want to get HIV? What services could we provide? What language do we have that they can relate to? You can’t just think about it in terms of responsibility and irresponsibility, you have to ask what brought them to that point".
Note: You may not know that Dublin now has its own ACT UP chapter, which Robbie has helped set up. The next general meeting, which is open to all, takes place at 18:30 on Tuesday August 16 at HIV Ireland, 70 Eccles Street, Dublin 7.
Note: Robbie is also giving a talk during Galway Pride on Wednesday August 17.