Sex Outside the City challenges taboo to improve takatāpui health – New Zealand Herald

Sexual wellbeing in the regions of Aotearoa is getting a shake-up with the launch of Sex Outside the City.

The project is dedicated to delivering the same standard of inclusive healthcare, sexual health innovation, and public health promotion for rainbow people or tāngata takatāpui in rural areas as those in cities get.

“Accessing safe or affirming healthcare services as a queer person in rural Aotearoa can be a significant challenge,” says project lead Josh McCormack.

“Conversations about queerness can be highly stigmatised, particularly about our health needs. Sex Outside the City is a kaupapa that wants to change that,” says the 22-year-old Taranaki med student.

The project kicked off last week with an educational billboard in Ngāmotu (New Plymouth): Takatāpui Are Whānau, promoting HPV prevention, followed by the launch of Finish the Job with a Rectal Swab – a billboard McCormack says depicts a powerful celebration of affection between rural men.

Takatāpui Are Whānau

The Takatāpui Are Whānau campaign was created to encourage people in the regions to support loved ones who are takatāpui to access HPV vaccination services.

“It’s time we made sure that our regional-rural takatāpui or LGBTQIA+ whānau can see themselves represented in health messaging for HPV prevention,” McCormack says.

HPV is a common virus that can cause several types of cancer in people of all genders, commonly including cervical cancer, throat cancer, anal cancer or head and neck cancer.

HPV is mainly transmitted through sexual skin-to-skin contact and can be prevented with the vaccine. Vaccination is free for all people in Aotearoa from the day they turn 9, until the day they turn 27.

The artwork for Takatāpui Are Whānau was designed by Pounamu Wharekawa, a fine artist illustrator and muralist who makes art that speaks to intersections of identity through the lens of a queer small-town-turned-urban Māori.

“As a small-town kid who moved to the big smoke of Hamilton it was kind of bittersweet seeing such a wealth of resources available to the queer community over here when in the places I grew up there was literally nothing – or at least nothing I knew of unless you were able to get to the cities,” says Wharekawa (Ngāi Te Rangi).

“I just hope people feel seen and represented and that they are made aware of the resources that are available to them.”

Finish the Job with a Rectal Swab

The slogan of this campaign intends to educate the wider public that gonorrhoea and chlamydia testing is not complete until a rectal swab has at least been offered.

Men who have sex with men are reported to have heightened rates of gonorrhoea and chlamydia transmission in Aotearoa.

McCormack says it is time to put an end to the misconception that sexual health inequities happen because of the personal irresponsibility of queer men.

“We need to shift accountability for health inequities away from blaming queer people, and instead onto the systems and drivers that are failing queer people.”

He says there is a breakdown in sex education in this country, and assumptions by health providers that men going to them must be straight men engaging only in heterosexual practices need to be challenged.

Evidence shows half of all gay and bisexual men in Aotearoa are not “out” to their GP. International evidence suggests over 60 per cent of gonorrhoea and chlamydia infections might be missed among queer men if urinary and genital testing is all that is performed.

Taranaki has a sobering history when it comes to the health and wellbeing of gay and bisexual men. New Plymouth Prison was used primarily to house people convicted of homosexual offences from 1917 to 1952, before the 1986 decriminalisation of homosexuality. The first life lost to Aids in Aotearoa also happened in Taranaki in 1984.

Finish the Job with a Rectal Swab was designed by Matthias Bucher, a graphic designer for Burnett Foundation Aotearoa, formerly New Zealand Aids Foundation & Ending HIV NZ).

Support from the port

The campaign has caught the attention and support of Arapuni Tāne Te Awa Mana, a health worker in the secluded Waikato community of Port Waikato, who was diagnosed with HIV this year at the young age of 21.

“To have a kaupapa implemented in the health system in Aotearoa like Sex Outside the City is exactly what I feel that this system needs right now,” he says. “Our communities and most importantly rangatahi who are living in the rural areas of Aotearoa need to know and have a safe space to be able to go to such as GP clinics, iwi-based clinics and sexual health clinics and know that they are well-represented from the minute they walk in the door.

“As someone who’s proudly gay and works in a rural-based health clinic I do see the need for a stronger representation in rural areas for our LGBTQA+ community and having a kaupapa like this advocating for people like myself, makes me proud to be Kiwi and more importantly a part of an amazing rainbow community.’’

Te Awa Mana is part of the push to improve the sexual wellbeing of people who identify as takatāpui, and is working with his employer, Te Whare Oranga o te Puaha health clinic to provide a comprehensive range of support services within a kaupapa Māori framework, including peer support, HIV testing, treatment and sexual health check-ups.

The response

“Since launching the billboard, we’ve even had doctors reach out to say they didn’t know that a rectal swab was a complete part of health testing for queer men,” says McCormack.

“Many people – doctors and patients – will have had minimal access to queer education throughout their lives. High rates of STIs among queer men is not a culture problem, it’s an education problem and a clinical communication problem. It’s time we started talking about it like that.”

“Thousands of queer people should be alive today who are not, due to silence and stigma around important health conversations. It is time to learn from that history, and hold no place for taboo.”

Sex Outside the City was funded by the New Plymouth District Council, through their Creative Communities Scheme with Creative NZ, as well as through a local Taranaki grant provider. The remaining costs were covered by grassroots fundraising.

Read more about Sex Outside the City here.

What’s the deal with pronouns? Click here.