Vd769 man2man winter 2018 medium

ISSUE 28 WINTER 2018

A WELLBEING RESOURCE FOR DSG PEOPLE

12 Who am I? Also in this issue:

06

Hep B Aware

14

PrEP on the PBS

20

Drugs & alcohol

+ signpost + superclap

From the editor

Winter edition

WELCOME TO THE WINTER ISSUE OF M2M, AND BOY OH BOY, AM I FEELING IT. WINTER THAT IS. And I’m not talking about feeling the cold. What I am talking about is the way my mood has taken a gradual downward slide that has coincided with the gradual shortening of daylight hours. Yep, along with many other people, I get the winter blues.

Lube:

natural light by getting outside as often as possible - especially on sunny days. While we’re are at, we can use our time outside to throw in with some moderate to high intensity exercise to increase our levels of the feel good brain chemicals serotonin and Lube: dopamine. But hey, even a brief, brisk walk at lunch can based help; we One litre water lubejust have try and get $17 as much natural sunlight as possible.

Four Seasons water based lube 75 ml $4

Medically known as Seasonal Affective One litre water based lube $17 Disorder, orFour SAD, the water winter blues isml Seasons based lube 75 $4 $10 Four based lube ml $10 Four Seasons water based lube 500 ml described as a Seasons mood water disorder that500 effects people who usually have normal mental And remember, whenever we are health throughout most of the year, but feeling down, it can be helpful to succumb toTasCAHRD feelings of depression during TasCAHRD talk to family and friends about 319 Liverpool Street, HOBART the colder months. As with many health OPEN 9am - 5pm 319 Liverpool the way we areStreet, feelingHOBART so they can conditions, people will experience different OPEN 9am - 5pm support us effectively.

Sometimes levels in the severity of symptoms – This publication is an initiative of the Editor: ranging from lacking energy to thoughts HealthLube: the right conversation and the right Promotion Program at the Matt Anning One litre water based lube $17 of hopelessness. And although experts Tasmanian Councilwater on AIDS, Hepatitis Contributors: This publication Four Seasons based lube 75 ml $4 difference. help can make all the Four Seasons water(TasCAHRD). based lube 500 ml Matteo $10 Senesi and Related Diseases, were once reluctant to acknowledge Health Promotio Sarah Lenehan SAD as a real thing, it is now recognised Views expressed in Man2Man are Tasmanian Coun Grant Blake those of the authors and do not as a common disorder and listed in TasCAHRD Bye forthe now and see Matt youNewell for spring: and Related Dis necessarily reflect views of 319 Liverpool Street, HOBART the American Psychiatric Association’s TasCAHRD. Tracey Wing I am really looking forward to it.

OPEN 9am - 5pm Views expressed Our colleagues at TasCAHRD Diagnostic and Statistical Manual of Mental Phone: 03 6234 1242 those of the aut Design & Layout: This publication is an initiative of the Editor: Email: projects@tascahrd.org.au Disorders.

Ede Magnussen refle Health Promotion Program atnecessarily the Matt Anning Post: GPO Box 595 Hobart Tasmanian Council on Contributors: Printing courtesy of:AIDS, Hepatitis TasCAHRD. So what actually causes SAD and how TasmaniaPROUDLY 7001 and Related Diseases, (TasCAHRD).

Matteo Senes SUPPORTED BY Xerox Hobart Sarah Lenehan do we combat it? One theory is that the Web: tascahrd.org.au Views expressed in Man2Man are Phone: 03Blake 6234 Grant Facebook: Man2ManTas those of the authors and do not problem has to do with the way our bodies Matt Newell Email: projects@ necessarily reflect the views of TasCAHRD receives funding from the Tracey Wing TasCAHRD. are affected by the shorter hours of daylight Post: GPO Box Our colleague Crown, through Department of Health Phone: 03 6234 1242 in winter. Specifically, the theory suggestsand Human Services, to provide these Email: projects@tascahrd.org.au Design & Layo Tasmania 7001 Ede Magnusse Post: GPO Box 595 Hobart that our levels of the sleep hormone services.

Web: tascahrd.o Printing court Tasmania 7001 Xerox Hobart melatonin are altered when we receive less Web: tascahrd.org.au Facebook: Man Facebook: Man2ManTas sunlight - causing lethargy and symptoms Would you like to see your business or service advertised in this mag?

TasCAHRD recei TasCAHRD receives funding from the of depression. Therefore, if the winter blues of Health Contact TasCAHRD for rates – pr ojec t s@t a sc ah r d .o rCrown, g .authrough . Department Crown, is about lack of daylight, it’s no surprise that and Human Services, to provide these through services. and Human Ser treatment usually involves getting more services. some of the content of this magazine may be offensive to some readers Would you like to see your business or service advertised in this mag?

A Health & Lifestyle Resource for Men in2 Men Contact TasCAHRD for rates – p r oje c t s @ t a s c 3a h r d . o r g . a u .

PROUDLY SUPPORTED BY

PROUDLY SUPPORTED BY

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WA R NI NG

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M2M A WELLBEING RESOURCE FOR DSG PEOPLE

WA RN IN G

Would you like to see your business or

some of the content of this magazine may be offensive to som

CONTENTS

Protect yourself against hepatitis B MSM hepatitis A vaccination program

CONTRIBUTORS:

4 8

Follow the signpost to good service

10

Who am I?

12

Be PrEP-ared

14

To a small club in Harrington Street

16

Superclap

18

Hello readers

20

Services Directory

22

Andrew Badcock

Robert Johnston

Grant Blake

Nigel S

Dr Jackie Hallam

Nikole Lane

Dr Faline Howes

Kate Turner

Did you know you can buy beppy sponges, condoms and lube at the TasCAHRD office?

TasCAHRD 319 Liverpool Street Hobart Open 9.00 am – 5.00 pm

WARNING: some of the content of this magazine may be offensive to some readers.

TasCAHRD receives funding from the Crown, through the Department of Health and Human Services, to provide these services.

Views expressed in M2M are those of the authors and do not necessarily reflect the views of TasCAHRD. This publication is an initiative of the Health Promotion Program at the Tasmanian Council on AIDS, Hepatitis and Related Diseases (TasCAHRD).

Would you like to see your business or service advertised in this mag?

Contact TasCAHRD for rates – projects@tascahrd.org.au

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• VIP invites to events and fundraisers Email or call now to join TasCAHRD or renew your membership. *all fees go directly towards providing material, emotional and social support to people living with HIV.

TUMN

2018

ISSUE 26

Join or renew now and receive: • Free copy of this magazine to your home

27 AU

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13 06 ity Divers ls schoo

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2018

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Impulse Control

10

Australia says YES!

12

U=U

+ Hear and + Dorothy Queer Awa + Harm Redu rds ction

Email: mail@tascahrd.org.au or Phone: 03 6234 1242 M2M A WELLBEING RESOURCE FOR DSG PEOPLE

3

by Robert Johnston

Protect yourself against hepatitis B OUR LIVER IS A TRULY AMAZING AND UNIQUE ORGAN. IT IS RESPONSIBLE FOR LITERALLY HUNDREDS OF VITAL FUNCTIONS THAT KEEP US ALIVE AND FEELING WELL. BUT GET THIS, THE LIVER IS THE ONLY INTERNAL ORGAN WITH THE ABILITY TO HEAL ITSELF BY REPLACING DAMAGED TISSUE WITH NEW CELLS: A MIRACULOUS PROCESS KNOWN AS REGENERATION. NONETHELESS, IT HAS ITS LIMITS. SO, IF WE WANT OUR LIVER TO DO THE INCREDIBLE THINGS IT DOES, WE NEED TO NOURISH IT AND PROTECT IT AGAINST DISEASE. ONE SUCH DISEASE IS HEPATITIS B.

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M2M A WELLBEING RESOURCE FOR DSG PEOPLE

WHAT IS HEPATITIS B? Hepatitis B is a potentially life threatening, highly contagious liver infection caused by the hepatitis B virus (HBV). It is the most common cause of liver infection and liver disease worldwide.

When someone has hepatitis B, it can be considered to be either acute or chronic.

Acute Hepatitis B virus infection is a short-term illness that occurs within the first 6 months after someone is exposed to the Hepatitis B virus. Most healthy adults, who are infected, will often not show any symptoms, and their bodies will clear the virus without any medical intervention.

But, some people may become ill. Their symptoms will usually appear about 90 days after infection and may include flu like symptoms, joint and muscle aches, nausea, vomiting, fatigue and, in severe causes, jaundice (yellowing of the eyes and skin).

It is very important to understand that with or without symptoms, a person with acute hepatitis B is able to pass the virus to others until they have cleared the virus.

The likelihood of developing chronic hepatitis B largely depends on age at time of infection. Chronic infection develops in about 90 percent of children who are infected at birth, in 20 to 50 percent of children who are infected between the ages of 1 and 5 years, and in less than 5 percent of people infected with hepatitis B during adulthood.

WHY IS HEPATITIS B SO DANGEROUS? Hepatitis B is dangerous because it is highly infectious: 50 to 100 times more than HIV. Additionally, a high percentage of individuals with both acute and chronic hepatitis B don’t realise they are infected. Consequently, they don’t take the necessary precautions to avoid transmitting the virus to others. So far, more than 2 billion people have been infected with the hepatitis B virus, and over 260 million people are now living with a chronic hepatitis B infection.

Chronic Hepatitis B virus infection is a long-term illness that occurs when someone is unable to clear the virus within the first 6 months of infection. This will result in the Hepatitis B virus remaining in a person’s body for the rest of their life. If left undiagnosed and not treated properly, chronic hepatitis can cause severe liver related health problems including cirrhosis (liver scarring), liver failure and liver cancer.

However, many people with chronic hepatitis B do not experience any symptoms until the liver has become damaged.

For those who do experience symptoms earlier, they will include those typically seen in acute hepatitis B. These earlier symptoms are often mild to moderate in intensity, but can either come and go or never seem to go away.

M2M A WELLBEING RESOURCE FOR DSG PEOPLE

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Moreover, every year nearly one million people die from hepatitis B, and unless infection rates are lowered, 20 million people will die from hepatitis B related illness by the year 2030.

Compared to many other regions and countries, Australia has a lower rate of hepatitis B and a lower percentage of undiagnosed chronic infections.

Nonetheless, nearly 400 Australians die every year from hepatitis B, and over 232,000 people are living with a chronic infection. Of those with chronic hepatitis B in Australia, about one third remain untested, are unware of their illness, and are not seeking or receiving treatment.

And untreated hepatitis B is the leading cause of liver cancer in Australia. What’s more, the occurrence of liver cancer is on the increase: more so than any other cancer.

HOW IS HEPATITIS B SPREAD? Before we discuss the details of how hepatitis B is spread, let’s be clear about a couple of things. First, hepatitis B is a vaccine-preventable disease. That is, hepatitis B can be prevented with a series of safe and highly effective vaccines – more about that later. Second, although hepatitis B is highly contagious, hepatitis B is not transmitted casually, or with social contact or by food and water. Therefore, you can’t get hepatitis B from hugging, kissing, coughs, sneezes or from meals prepared by someone who has hepatitis B. Back to how hepatitis B is spread.

Blood borne and sexually transmissible, hepatitis B is spread via blood and sexual body fluids i.e. semen and vaginal secretions. This includes infected blood and sexual body fluids accessing the blood stream via open wounds. It also includes blood and sexual body fluids accessing the blood stream via tiny, barely noticeable breaks in the skin. This is why high risk sex activities like rough sex and anal sex can lead to hepatitis B transmission and why sex without a condom is the most common cause of adult transmissions of hepatitis B in Australia.

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Although other body fluids - saliva, breastmilk, and even tears – can carry the hepatitis B virus, they are not in concentrations high enough to transmit the virus. And hepatitis B cannot penetrate unbroken skin.

Along with sexual transmissions, the most common cause of hepatitis B infections in Australia occur when people share equipment when injecting drugs. This includes performance enhancing drugs like steroids or Human Growth Hormone (HGH).

Less common is infection from a needle stick injury. Most likely to occur in a health care setting, a needle stick injury can also occur when someone is pricked from a discarded needle. Hepatitis B is an extremely tough little virus and can stay alive and remain infectious in dry blood for up to seven days.

This resilience is why equipment used for personal hygiene, body piercing and tattooing can also spread hepatitis B. It is best to avoid sharing razors, nail clippers and even toothbrushes (think bleeding gums) and always make sure proper sterilisation procedures occur when getting body art or piercings.

It is also possible for a mother to transfer the hepatitis B virus to her baby. This can occur during the gestation period or during the time of birth. Although mother to child hepatitis B transmission is not uncommon on a global scale, in Australia the risk has been significantly reduced through vaccination programs.

HOW DO WE PROTECT OURSELVES FROM HEPATITIS B? Prevention is better than cure is an often used phrase in health care discussion and it definitely applies to hepatitis B. You see, unlike hepatitis C, there is no cure for chronic Hepatitis B: but there is a vaccination. Hepatitis B vaccinations are considered safe, are highly effective and can be administered to infants, children and adults. Hepatitis B vaccinations are available from a GP and are given in 3 monthly injections over 6 months. If you have been vaccinated but are unsure of whether you received all injections, you can ask a GP or a sexual health clinic for a test to see if you have immunity to Hepatitis B. This test will also indicate if you have immunity because of a previous acute hepatitis B infection that cleared itself.

Currently, the National Immunisation Program provides access to free hepatitis B vaccines for all infants and school aged children, while a state funded program in Tasmania offers free vaccinations to high risk groups including men who have sex with men, people who affected by HIV or Hepatitis C, people who inject drugs or people who have household and or sexual contact with someone who has hepatitis B. Regardless of risk factors, every person may be at some risk of a hepatitis B infection during their lifetime, so getting the hepatitis B vaccine should be considered by all people.

In addition to vaccination, here are other ways to protect against hepatitis B: • Wash your hands thoroughly with soap and water after any potential exposure to blood and clean up blood spills with a fresh diluted bleach solution.

• Wear disposable gloves when giving first aid.

• Practice safe sex. Use condoms, lube, gloves, and either don’t share sex toys or make sure they are thoroughly cleaned and disinfected.

• Avoid sharing toothbrushes, razors, needles, syringes, personal hygiene items and grooming aids or any object that may come into contact with blood or body fluids.

• Do not share injecting equipment including tourniquet, spoons and filters.

Use new and sterile injecting equipment for each injection.

• Cover all cuts and open sores with a plaster or bandage.

• Throw away personal items such as tissues, menstrual pads, tampons and bandages in a sealed plastic bag.

• Avoid tattooing and piercing where equipment is not sterilised.

But remember: the most effective protection against hepatitis B is vaccination. If you have been vaccinated against hepatitis B, you are protected from the virus for life.

In the event of possible exposure to the hepatitis B virus, contact your GP, sexual health clinic or local public hospital a to have the risk assessed and to have a blood test to check your current hepatitis B status. Even after expose to the hepatitis B virus, there are treatments that can reduce the risk of a hepatitis B infection from developing. But it is time dependant, and the sooner you seek medical advice the better.

THE GOOD NEWS The good news is that with early diagnosis and proper care and treatment, the majority of people with chronic hepatitis B can expect to live a long and healthy life.

And because hepatitis B is a chronic medical condition (such as diabetes and high blood pressure), it can be successfully managed if you take good care of your health and your liver.

M2M A WELLBEING RESOURCE FOR DSG PEOPLE

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by Nikole Lane

The Hobart Out Tennis MSM Doubles hepatitis Tournament

A vaccination program

IN A PREVIOUS ISSUE OF M2M WE TALKED ABOUT A NATIONAL OUTBREAK OF HEPATITIS A MOSTLY AFFECTING MEN WHO HAVE SEX WITH MEN (MSM).

SINCE MID-2016, SEVERAL HEPATITIS A OUTBREAKS ASSOCIATED WITH MSM HAVE ALSO BEEN REPORTED IN MANY EUROPEAN COUNTRIES, THE UNITED STATES OF AMERICA AND SOUTH AMERICA.

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M2M A WELLBEING RESOURCE FOR DSG PEOPLE

In response to this outbreak, the Tasmanian Government is funding a hepatitis A vaccination program for all Tasmanian MSM aged 16 to 69 years.

WHAT IS HEPATITIS A? Hepatitis means inflammation of the liver.

Hepatitis A is an infection caused by the hepatitis A virus. A person who has hepatitis A will feel unwell, have aches and pains, fever, pale faeces (poo), dark urine and be jaundiced (yellowing of the skin and eyes). This illness usually lasts one to three weeks and people usually have a full recovery.

HOW IS HEPATITIS A SPREAD? • Eating contaminated food • Drinking contaminated water • Handling contaminated objects (including condoms and sex toys) • During sex it is mainly passed on when licking skin, condoms or sex toys which have faeces (poo) on them. This could include licking skin near the anus (rimming), buttocks, groin or penis (giving oral sex after anal sex).

HOW CAN I PROTECT MYSELF AGAINST HEPATITIS A? The most effective form of prevention against hepatitis A infection is vaccination.

by FINNIAN DANGER

WHO IS ELIGIBLE FOR THE FREE VACCINE?

All Tasmanian MSM who are aged 16 to 69 years at any time during the program are eligible for free vaccine. At the same time, check whether you are eligible for a free hepatitis B vaccine.

WHERE IS THE VACCINE AVAILABLE? Vaccine is available from General Practitioners and Sexual Health Clinics.

The vaccine is free, but a consultation fee may apply when you visit your General Practitioner.

HOW MANY DOSES OF VACCINE ARE REQUIRED? Two doses of vaccine given at least six months apart will provide long-term protection against hepatitis A disease.

If you have had one dose of hepatitis A vaccine in the past, there is no need to start the course again. You only require one further dose for lifetime protection.

If you want to know more call the Public Health Hotline – Tasmania on 1800 671 738 to speak to a Clinical Nurse Consultant.

Also: • Wash your hands after sex (ideally buttocks, groin and penis too).

• Change condoms between anal and oral sex.

• Cover anything which is shared during sex with a fresh condom or fresh latex glove for each new person.

• Use a latex barrier (e.g. a condom cut into a square) for rimming.

• Use latex gloves for fingering or fisting.

• Do not share sex toys.

M2M A WELLBEING RESOURCE FOR DSG PEOPLE

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byby Andrew Badcock ANDREW BADCOCK

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M2M A WELLBEING RESOURCE FOR DSG PEOPLE

Follow the signpost to good service WHAT’S AN EASY WAY TO FIND AN INCLUSIVE DOCTOR OR THOSE SHOPS OR RESTAURANTS WHO PROMOTE THEMSELVES AS LGBTIQQ AFE SPACES? OR TO FIND SERVICES THAT WOULD LOVE TO CATER FOR YOUR WEDDING? OR PLACES WHERE TRANS FOLK CAN WALK-IN KNOWING THE SHOP SEEKS TO BE A RESPECTFUL AND HELPFUL SERVICE? SIGNPOST.ORG.AU! We know everyone has the right to fair and equal treatment, understanding, information and resources: that fundamental truth is easy.

However, sometimes that’s not the case.

Finding the right support is essential, but it’s not always simple.

At Working It Out - Tasmania’s gender, sexuality and intersex status support and education service - , we look after Signpost.

Signpost is an online community directory to link LGBTIQ Tasmanians and inclusive Tasmanian services to each other. What a great idea you say. Well, we totally agree.

We’ve also been busy drumming up interest with these services to install signposts around the State - at least in the digital realm - and have split them into six areas; Advocacy & Allies, Education & Training, Health & Wellbeing, Professional Services, Retail, and Social Groups.

Signpost offers organisations and businesses an opportunity to prove themselves as inclusive, welcoming and informed and to promote their good work.

Businesses must show in their listing what makes them a Good and Trusted service for LGBTIQ people and their families.

Services start by showing they are keen.

When they have participated in LGBTIQ inclusive training, they can add it to their profile. If they have gained a Dorothies award from Working It Out, they can add that too. Because services, schools, retail outlets, etc. are still learning how to do this, they may need your help. They may not even know they can list with Signpost. You can play a role by encouraging services and organisations to recognise and name up their strengths such as; they provide a safe and welcoming environment, they have done LGBTIQ inclusive training, they provide gender and partner inclusive intake forms, or they have an award for LGBTIQ inclusive work.

This all adds up to pride in inclusion.

So, what are you waiting for? Follow the signs to these great LGBTIQQ ally businesses through Signpost.org.au!

Working It Out 278 Argyle Street, Hobart Tasmania, 7002 Andrew Badcock: Mental Health Project Officer.

Know of a Tasmanian business or service that should be promoting their great work? tell ‘em to jump on-board and get a new signpost added to our directory!

M2M A WELLBEING RESOURCE FOR DSG PEOPLE

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FINNIAN byby Grant BlakeDANGER

The Hobart Out Tennis Doubles Tournament

Who am I? IDENTITY FORMATION IS AN IMPORTANT ASPECT OF DEVELOPMENT THAT HAS BEEN OF INTEREST TO PSYCHOLOGISTS FOR MANY DECADES. IDENTITY IS THE SENSE OF KNOWING WHO YOU ARE. THIS IS TYPICALLY MADE UP OF YOUR GOALS, VALUES AND INTERESTS. UNDERSTANDABLY, OUR GOALS, VALUES AND INTERESTS CHANGE AS WE AGE. WHAT INFORMS OUR IDENTITY AT 15-YEARS IS DIFFERENT TO WHO WE ARE AT 25-YEARS, AND DIFFERENT AGAIN AT 65-YEARS.

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M2M A WELLBEING RESOURCE FOR DSG PEOPLE

Changes in identity tend to happen gradually rather than being sudden, frequent, and drastic. When sudden, drastic changes occur repeatedly, a person might be described as having identity issues. Conversely, some people feel that they don’t know who they are and make little effort to figure that out (e.g., no changes). They typically have a history of unemployment, repeatedly start and stop study, and feel persistently unmotivated and disinterested in life. If they are studying or working, they are typically in a field that was expected of them because they didn’t know what else to do. Identity issues are often associated with a history of trauma or failure to individuate. These will be explored further in a minute.

Before we examine where identity issues might come from, it’s important to know the difference between personality and identity. Personality is the interplay between the ways we think, feel and behave. For example, an introverted person might think that they prefer their own company, feel uncomfortable being the centre of attention, and spend more time alone than nonintroverts. At the same time, this introverted

person might value achievement, has the goal of being promoted at work, and enjoys competitive sport. Can you see the difference between personality (thoughts, feelings and behaviours) and identity (goals, values and interests)? Whilst identity and personality certainly interact - such as how we feel after engaging with a hobby or achieving a goal they are distinctly different.

According to Marcia (1966), there are four statuses of identity development. These are described in the table below. Marcia explained that Identity Achievement typically occurs after a person learns more about themselves after experiencing adversity. He also theorised that people who reach Identity Achievement have typically progressed from the Identity Diffusion and Moratorium statuses; although, this is not always required. Marcia’s theory has been applied to adolescent and adult development, and to various aspects of identity such as religious/ spiritual, political, and occupational identity.

Foreclosure - The person makes an identity commitment without considering alternatives. The commitments are often made on parental expectations, such as political and religious identities.

Identity Diffusion - The person has no real sense of identity and they have not explored or considered making identity commitments in any life-defining areas (e.g., work). They are indecisive, do not take risks, and have little interest in self-development.

Moratorium - The person is in a state of crisis due to difficult circumstances or experience.

They have either vague commitments or none at all; however, they are actively exploring alternatives to create a more predictable, stable life.

Identity Achievement - The person has experienced adversity and other life challenges. They have learned valuable lessons about themselves and others from those experiences. They have explored identity options and are committed to their values, goals and interests.

Figuring out who we are is a critical part of adolescent and early adulthood development.

Psychological trauma - experiencing or witnessing something horrifying - can

suddenly and drastically change what we value, and how we think, feel and behave.

These impacts can be positive, for example, finding a new sense of meaning, a new direction in life, or feeling gratitude. Or negative, for example, intense anxiety, avoidance and depression. When the impacts are negative and the person struggles to incorporate the trauma into a personal narrative, they may struggle to know who they are. These people may make sudden, rapid changes in their goals and interests, or become avoidant of living life.

On the other hand, some people fail to individuate. This is similar to Marcia’s Identity Diffusion and Foreclosure statuses.

Individuation is the process of experimenting with values, goals and interests that are different to those expected of you. This process often features conflict between the young person and their parents, teachers, or friends. This is because the individuating person is attempting to assert independence and challenges the expectations of those around them in an effort to figure out who they are and who they want to be.

Young people who fail to individuate - due to a lack of interest, trauma, or severe punishment for attempting to individuate - often do not have a sense of who they are and go through life without passion or motivation. They do what is expected of them and feel depressed at the lack of self-direction they feel about life. Their personality becomes affected because they think they have no control over their own life, feel chronically depressed, and act passively. They can be needy or dependent in relationships because they rely on others to give their life direction and meaning.

If you think you might be struggling to figure out who you are and lack goals, consistent values, or interests of your own, it could be worth speaking to your GP or a mental health professional for support.

Grant Blake is a Clinical Psychologist at ForensiClinic Consulting (199 Campbell St, Hobart).

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by Faline Howes

Be PrEP-ared 14

M2M A WELLBEING RESOURCE FOR DSG PEOPLE

WHAT IS PREP? • PrEP is short for “Pre-Exposure Prophylaxis”.

• PrEP involves taking HIV medications to prevent HIV infection.

• When taken daily, PrEP can reduce your risk of HIV dramatically • PrEP is one of many tools used to reduce the risk of HIV transmission.

The others are condoms and undetectable viral load (with an undetectable viral load (UVL), HIV cannot be transmitted).

• PrEP does not prevent other sexually transmissible infections. Use condoms as well to protect against other STIs.

CONDOMS + PREP FOR PEACE OF MIND PrEP gives you the peace of mind for HIV, and condoms ensure that you are maximising your protection against many other STIs.

NB Many people who choose to use PrEP will also negotiate condom use with their potential sexual partners. Ultimately this is a decision that needs to be discussed before getting down to business.

WHERE CAN I GET PREP? PrEP can be prescribed by general practitioners, nurse practitioners and specialists e.g. sexual health doctors.

WHO CAN GET PREP? People considered at medium to high risk of HIV are eligible for PrEP. This includes gay men and other men who have sex with men (MSM), people who inject drugs (PWID), trans and gender diverse people, and heterosexual men and women at greater risk of HIV. Your doctor will talk to you about your sexual and medical history and determine your level of risk. Tests will be performed

to make sure you are HIV negative. Tests for gonorrhoea, chlamydia, syphilis and kidney function will also be done.

You must have a Medicare card to access PrEP through the PBS at a subsidised cost. Some people from countries that have a reciprocal health care agreement with Australia may also be eligible for PBS medications.

People ineligible for Medicare may still receive a prescription for PrEP, but must pay full price, or import it from overseas.

Patients wanting to import PrEP are encouraged to contact the Tasmanian Council on AIDs, Hepatitis and Related Diseases (TasCAHRD), PrEPaccessNOW (www.pan.org.au) or PrEP’d for Change (www.prepdforchange.com).

WHAT IS INVOLVED IN TAKING PREP? PrEP is more than just a pill; it is a program which involves regular testing. You need to have follow-up appointments every three months. HIV and other STI testing will be performed at these visits. Let your doctor know if you have any side effects.

ARE THERE ANY SIDE EFFECTS TO PREP? Tenofovir/emtricitabine, the drug used as PrEP, has few side effects, and few people ever experience them. For those who do experience them, the side effects usually clear up within a few weeks of starting PrEP. Side effects can include headache, nausea, weight loss, and depression.

In a small proportion of people, PrEP may lead to a loss of bone mineral density, or a decrease in kidney function. Doctors should assess kidney function at baseline, and ask their patient about any history of bone problems before prescribing PrEP.

HOW MUCH DOES PREP COST THROUGH THE PBS? Like all medications accessed via the PBS, general patients will pay $39.50 per month and Concessional patients will pay $6.40 per month.

M2M A WELLBEING RESOURCE FOR DSG PEOPLE

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by Nigel S

To a small club in Harrington Street

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M2M A WELLBEING RESOURCE FOR DSG PEOPLE

THOUGH I HAVE LITTLE KNOWLEDGE OR EXPERIENCE OF THE LOCAL HOBART SCENE, I REMEMBER A FRIEND MANY YEARS AGO (WHO FOR THIS ARTICLE I WILL CALL “PATRICK”) WHO WOULD OFTEN CONFIDE IN ME ABOUT HIS LACK OF CONNECTION TO OTHER GAY MEN. WHILE I WAS NOT SURE HOW TO OFFER HIM SUPPORT, ONE NIGHT HE PROPOSED THAT I “WING-MAN” HIM TO A SMALL CLUB IN HARRINGTON ST, WHERE WE HAD GONE ON A FEW OCCASIONS - THOUGH I GUESSED THIS TIME HE HAD MORE STRIDENT PLANS IN MIND. AT THE LAST MINUTE, THOUGH, HE DECIDED TO PULL OUT, THINKING IT WOULD ONLY LEAD TO UTTER DISAPPOINTMENT AND HIM GETTING DRUNK. I REMEMBER THIS TIME LIKE A MORRISSEY SONG, ONLY MORE UTTERLY REAL. This wing-man plan came up again a few months later, as did the last minute change of mind. But then Patrick and I decided to buy a cheap cask of red anyway and just chat. Talking about it, he’d say that his lack of connection reflected more about his ambivalence of the “club scene dynamic” itself than his lack of confidence per se.

There was also talk about staying with his friend in Melbourne for a while - where he would often visit; but on the other hand, the faster pace, he said, would eventually distract him from his studies.

As I now look back, I realise I might have been wrong about Patrick, how lonely I imagined he was. I say this because as the years went

by I learnt why many of the nonLGBTIQQ friendships he valued - like-minded people who actually

shared his interests, his views, his sharp wit - were perhaps, in total, just as meaningful as having a partner - though I did not believe for one second that this was all the compensation he needed. There was also the continued support of his family, support that contrasts with many folk I know whose brothers and sisters no longer talk to each other.

Years later, in our late 30’s, we fell out as friends; he concentrating on full-time study while I worked on the mainland. But the last time we ran into each other I remember thinking how happy he looked, while talking about how his postgrad’ studies were still on track. All through this time I had experienced similar difficulties in connecting to others and with my own livelihood challenges, but for all of Patrick’s solitariness I was reminded what it meant to stay true to yourself and not compromise your goals.

Another view had me wishing the LGBTIQQ Hobart community was more visible such as in Sydney or Melbourne, at least for people like Patrick. But then I realised that there will always be some who don’t fit in - if it is ever really possible for those uncomfortable attending nightclubs, hotels, or connecting up via smartphone apps to people they hardly know. Or similarly, perceive themselves to be not young enough or too “non-group” to attend university queer clubs or participate in local LGBTIQ organisations and their activities. Instead, they’ll be always be motivated by other points of connection, interests, mindsets, and then throughout the wider community. I remember watching comedian Hannah Gadsby - who originally hailed from Smithton - remarking in one televised performance how she would prefer celebrating her identity (I imagine with one other) ‘over a cup of tea’.

Still, it’s all about how one connects in the first place.

M2M A WELLBEING RESOURCE FOR DSG PEOPLE

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by Kate Turner

Superclap GONORRHOEA, ALSO CALLED “THE CLAP”, IS ONE OF THE MOST COMMON SEXUALLY TRANSMITTED DISEASES WORLDWIDE. SIMILAR TO OTHER COUNTRIES, THE NUMBER OF GONORRHOEA CASES HAS BEEN INCREASING IN THE LAST FEW YEARS IN AUSTRALIA, AND TASMANIA. Superbugs, antibiotic resistance and drugresistant infections all refer to the fact that bacteria and other micro-organisms are evolving, so antibiotics that were previously used successfully to treat these infections no longer work.

Drug-resistant gonorrhoea exists in many countries. Two cases of extremely-drug resistant gonorrhoea have been recently detected in Australia. They were resistant to ALL of the antibiotics that we routinely use against gonorrhoea. These strains can be difficult to treat and it is important to prevent further spread.

Gonorrhoea is a sexually transmissible infection caused by the bacterium Neisseria Gonorrhoeae. It usually affects the genital area, although the throat or anus may also be affected. Gonorrhoea affects both men and women and can be transmitted during vaginal, anal or oral sex.

The best protection against gonorrhoea is to always use barrier protection such as condoms and dams (a thin piece of latex placed over the anus or vulva during oral 18

M2M A WELLBEING RESOURCE FOR DSG PEOPLE

sex). Condoms and dams can be used for oro-vaginal sex and oro-anal sex to help prevent the spread of infection. Always practise safer sex at home, when travelling, and when engaging in all types of sexual activity.

You are not safe just because you or your partner are not experiencing symptoms like discharge or a burning sensation on urination. Many people may not have symptoms or may not realise they have an infection.

People who have new sexual partners, multiple partners, a sex partner who has other partners, another STI, or are taking PrEP are particularly advised to get tested regularly, regardless of symptoms. People who have symptoms are advised to see their GP or Sexual Health Clinic as soon as possible.

BENT AIR Hobart’s LGBTIQ Community Radio Show Thursdays at 10am on EDGE RADIO 99.3FM edgeradio.org.au

HOBART’S ONLY YOUTH STATION OVER 150 PRESENTERS OVER 80 WEEKLY SHOWS 24/7 WEB STREAMING

M2M A WELLBEING RESOURCE FOR DSG PEOPLE

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by Jackie Hallam

Hello readers, I’d like to give an update on how our local alcohol and other drug (AOD) service providers are going in the southern region of Tasmania. The first thing you need to know is that AOD services are provided by several organisations, both government, non-government and private providers. So for example, there is the government-run Alcohol and Drug Service, located in New Town, and you can phone them on 1300 139 641.

These guys offer withdrawal management, counselling and many more services. Then there are our community sector providers and there are many, for exampleHolyoake, Anglicare, The Link Youth Health Service and The Salvation Army Bridge program. These are the main ones in the South. Throw their names into google to find out what they provide and how to get into contact. Referrals can, in most cases, be made by you, family, friends, your doctor or another service or health professional.

You can also phone the Alcohol and Drug information Service, 24 hour freecall 1800 250 015. If you have private health insurance you may be interested in The Hobart Clinic which is located in Rokeby, call them on 6247 9960.

There’s a lot out there isn’t there? The key message here is that ‘treatment works’. If you are worried about yours or someone else’s use, don’t give up on yourself or them, get in touch with an AOD treatment provider in our community. They are staffed by friendly people who will not make you feel bad for using drugs. Across our sector we have a skilled and approachable workforce that will work with you for whatever outcome you choosewhether it be reducing drug use or quitting completely.

Drug use may not even be your number one concern anyway, it may be something else and drug use is just not helping. Either way, their doors are always open. And remember its best to get to a problem when it is smaller rather than let it get out of control- then it’s harder to address- I think that applies to most health issues.

Hope you are having a good day Jackie 20

M2M A WELLBEING RESOURCE FOR DSG PEOPLE

TasCAHRD in collaboration with Tasmanian Sexual Health Service

GET TESTED CLINIC 319

• No Medicare Card Required • Rapid HIV Testing • Full STI Screening • PEP and PrEP Appointments every second Thursday 4:00pm – 6:30pm (final appointment at 6:00pm)

FREE. CONFIDENTIAL. SAFE. For bookings call 6234 1242 319 Liverpool Street, Hobart

M2M A WELLBEING RESOURCE FOR DSG PEOPLE

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SERVICES ATTITUDE COUNSELLING

SEXUAL HEALTH SERVICE

Attitudecounselling.com Ph 0433 184 088 (Launceston) Affordable, confidential

http://www.dhhs.tas.gov.au/sexualhealth Toll Free: 1800 675 859

Q-LIFE, NATIONAL www.qlife.org.au Ph 1800 184 527 Counselling 7 days 3.00 pm til midnight

EQUAL OPPORTUNITY TASMANIA www.antidiscrimination.tas.gov.au The office of the anti-discrimination commissioner

GAY & LESBIAN SWITCHBOARD www.switchboard.org.au Ph 1800 184 527 Counselling and referrals

SCARLET ALLIANCE TASMANIAN SEX WORKER OUTREACH PROJECT outreachtas@scarletalliance.org.au Ph 0451 835 897 www.scarletalliance.org.au

SEX WORKER OUTREACH PROJECT (SWOP) www.swop.org.au Resources for sex workers, including cis male and transgender sex workers

SOUTH AUSTRALIAN SEX INDUSTRY NETWORK http://www.sin.org.au/SINmale Outreach, peer education, information, referrals, support, advocacy, working tips, resources and safer sex supplies to all male workers

TASPRIDE

TASCAHRD - TASMANIAN COUNCIL ON AIDS, HEPATITIS & RELATED DISEASES www.tascahrd.org.au Ph 1800 005 900

TAS POLICE LGBTIQ LIAISON OFFICERS www.police.tas.gov.au Ph 03 6230 2111 (Hobart) Ph 03 6336 7000 (Launceston) Ph 03 6434 5211 (North West)

ATDC TAS – THE ALCOHOL, TOBACCO & OTHER DRUGS COUNCIL OF TASMANIA http://www.atdc.org.au/ Advocating and initiatives

NUFIT GLENORCHY (ANGLICARE NSP) 436 Main Rd Glenorchy Ph 1800 243 232 Mon – Fri 10:00 am – 4:30 pm

www.taspride.com Celebrating and uniting the Tasmanian LGBTIQQ community

Sterile equipment, information, education, support and referrals

WORKING IT OUT

www.shieldtasmania.org

www.workingitout.org.au Sexuality and gender support and counselling

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Clinic 60 - 60 Collins St Hobart Ph 03 6166 2672 Mon – Fri 8:30 am – 5:00 pm (drop in on Tuesday afternoon and Thursday mornings) Clinic 34 - 34 Howick St Launceston Ph 03 6777 1371 Mon – Fri 8:30 am – 5:00 pm (drop in on Thursday mornings) Devonport - Ph 03 6777 1371 by appointment only Counselling, support, referrals and STI and HIV testing

M2M A WELLBEING RESOURCE FOR DSG PEOPLE

SHIELD Uniting and Supporting LGBTIQ youth based in Northern Tasmania

DIRECTORY FAMILY PLANNING TASMANIA

FLAMINGOS DANCE BAR

http://www.fpt.asn.au

www.flamingosbar.com

421 Main Rd Glenorchy Ph 03 6273 9117 Mon - Fri 9:00 am – 5.00 pm

Tasmania’s nightclub committed to providing a tolerant, safe, informative and fun environment for people of alternative sexualities and their friends to be able to enjoy themselves and socialise in a non-threatening environment

269 Wellington St Launceston Ph 03 6343 4566 Mon - Fri 9:00 am – 5.00 pm 1 Pine Ave Burnie Ph 03 6431 7692 (Mon, Wed and Thurs)

EAST COAST QUEER LIFE SUPPORT (ECQLS)

Contraception and pregnancy counselling, sexual health checks, pap smears, information and referral

Email ecqls.tas@gmail.com Ph 0467 000 748

ANGLICARE NEEDLE & SYRINGE EXCHANGE PROGRAMME 18 Watchorn St, Hobart Ph 1800 243 232 Mon – Fri 12.30 am – 4.30 pm 24 hr vending machine ($2 fee)

SALVATION ARMY NEEDLE & SYRINGE EXCHANGE PROGRAMME 111 Elizabeth St Launceston Ph 03 6323 7500 Mon – Fri 8:30 am – 3:00 pm

THE LINK YOUTH HEALTH SERVICE & HEAD SPACE FOR PEOPLE AGED 12-24 http://www.thelink.org.au 57 Liverpool St Hobart Ph 03 6231 2927 Mon – Fri 9:00 am – 5:00 pm Counselling, outreach, case management, support for mental and sexual health, alcohol and drugs (incl NSP), family planning

HOBART COMMUNITY LEGAL SERVICE www.hobartlegal.org 166 Macquarie Street, Hobart Ph 03 6223 2500

Information and social activities

GAY FRIENDLY CAFES Basket & Green Cafe Bozzey Criterion Cafe Deloraine Deli DS Coffee House Fitzpatrick’s Inn Fleurty’s Cafe Lotus Eaters Ginger Brown Hotel SOHO Jackman & McCross King of Burnie Hotel Kusinat Lansdowne Cafe Lebrina Machine Laundry Cafe O’Keefe’s Hotel Pickled Evenings Indian Restaurant Red Velvet Lounge Republic Bar Restaurant Red Restaurant Waterloo Retro Café Stonies Fifties Cafe Tasmania Inn King of Burnie Hotel

7 Station Lane, Sorell Ph 03 6265 1911 Shop 3, Covehill Fair, Bridgewater Ph 03 6263 4755 M2M A WELLBEING RESOURCE FOR DSG PEOPLE

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Hepa titis B Testi and C ng kn owin g is t he fir st ste p

You can have hepatitis B or hepatitis C and not know it unless you have been tested.

Thousands are missing out on vital care. Are you?

Call: 1800 437 222