Philosophical Statements: Risk Reduction & Safer Sex Guidelines


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PROGRAMS AND SERVICES MANUAL
POLICY
PHILOSOPHICAL STATEMENTS: RISK REDUCTION & SAFER SEX GUIDELINES

The AIDS Committee of Toronto (ACT) adopts a risk reduction model and the Canadian AIDS Society Safer Sex Guidelines for its safer sex education and counselling programs and services.

ACT affirms the principle upheld by the Canadian AIDS Society Safer Sex Guidelines that their risk reduction approach applies to all people, HIV positive and HIV negative.

RISK REDUCTION MODEL

This risk reduction model:

- imparts the needed information and strategies to reduce people's risk of HIV infection, rather than seeking to eliminate all HIV transmission.

- seeks to reduce and/or eliminate the frequency of activities which pose the highest risk of HIV transmission. When all high risk activities have been eliminated, i.e., through consistent use of latex condoms during vaginal/anal intercourse, the risk of HIV transmission is dramatically reduced.1

- acknowledges the options that can be exercised by people who feel comfortable with some risk, as well as validates the more cautious approaches of those who want greater assurance and safety. There are no-risk options for engaging in sex and some will choose them. For many people, however, some level of risk is probably either acceptable or unavoidable, making it necessary to include a broad range of risk reduction choices in safer sex education.2

- includes offering suggestions on how to reduce risk in individual high risk activities although this is still high risk. For example, in some situations a person may feel that it would be dangerous to insist on their partner using a condom. Suggestions are provided to help the person reduce the risk, as much as possible, in high risk activities the individual does not control.

SAFER SEX GUIDELINES

Risk reduction counselling and education require an understanding of what activities entail risk of HIV infection. The Canadian AIDS Society HIV Prevention Guidelines2 are the most widely accepted and thoroughly researched documentation of degrees of risk for HIV infection through sexual activities. The model of risk established for the Guidelines organizes sexual activities into four categories, based on the theoretical possibility of HIV transmission and on the documented evidence that transmission has actually occurred:


MODEL OF THE LEVELS OF RISK INVOLVED IN SEXUAL ACTIVITIES


High Risk of HIV Transmission


Low Risk of HIV Transmission


Theoretical Risk Only of HIV Transmission


No Risk of HIV Transmission



There is a great deal of agreement that for populations or groups of people, promoting the Safer Sex Guidelines with their risk reduction strategies are appropriate and effective. However, some people believe that the Guidelines should not be applied to individuals who are known to be infected. In other words, the goal for a person with HIV would be to eliminate any risk of transmitted HIV to anyone else. ACT holds that, to be workable, and most effective overall, it is important to apply the strategies to everyone, infected or uninfected.

References:

1. Adapted from Sexual Safety: A Guide, AIDS Committee of Ottawa, Michael Graydon, September, 1994.

2. HIV Transmission Guidelines for Assessing Risk: A Resource for Educators, Counsellors, and Health Care Providers - Fifth Edition. Canadian AIDS Society, 2004. (available on-line at: http://www.cdnaids.ca/web/repguide.nsf/pages/cas-rep-0307)