Posted on 02/14/2005 8:25:09 PM PST by Callahan
After all the thousands of AIDS deaths and all the years of "Safe Sex Is Hot Sex" prevention messages, it has come down to this: many gay men who know the rules of engagement in the age of AIDS are not using condoms. As news of a potentially virulent strain of H.I.V. settles in, gay activists and AIDS prevention workers say they are dismayed and angry that the 25-year-old battle against the disease might have to begin all over again.
While many are calling for a renewed commitment to prevention efforts and free condoms, some veterans of the war on AIDS are advocating an entirely new approach to the spread of unsafe sex, much of which is fueled by a surge in methamphetamine abuse. They want to track down those who knowingly engage in risky behavior and try to stop them before they can infect others.
It is a radical idea, born of desperation, that has been gaining ground in recent months as a growing number of gay men become infected despite warnings about unsafe sex.
Although gay advocates and health care workers are just beginning to talk about how this might be done, it could involve showing up at places where impromptu sex parties happen and confronting the participants. Or it might mean infiltrating Web sites that promote gay hookups and thwarting liaisons involving crystal meth.
Other ideas include collaborating with health officials in tracking down the partners of those newly infected with H.I.V. At the very least, these advocates say, gay men must start taking responsibility for their own, before a resurgent epidemic draws government officials who could use even more aggressive tactics.
"Gay men do not have the right to spread a debilitating and often fatal disease," said Charles Kaiser, a historian and author of "The Gay Metropolis." "A person who is H.I.V.-positive has no more right to unprotected intercourse than he has the right to put a bullet through another person's head," he said.
While not endorsing specific strategies, even mainstream organizations like the Gay Men's Health Crisis support the idea of trying methods that would have been anathema a few years ago. "It makes a community stronger when we take care of ourselves," said Ana Oliveira, the organization's executive director, "and if that means that we have to be much more present and intervene with people who are doing this to themselves and others, then so be it."
For many others, however, even talk of such steps provokes hand-wringing. "We don't want public health vigilantes going out and taking matters into their own hands, particularly if it means breaching the confidentially and civil rights of people with H.I.V.," said Jon Givner, the director of the H.I.V. Project at the Lambda Legal Defense and Education Fund. "Frankly, I find it pretty scary."
Whether such ideas gain acceptance, the fact that activists are even thinking about curbing gay sexual freedom is a huge shift.
In the early years of the AIDS epidemic, gay men protested attempts to close down bathhouses and strenuously opposed efforts by health officials to trace those infected with the virus. Until now, those advocates, driven by concerns about privacy and the stigma associated with the disease, have successfully fought off efforts to impose a traditional public-health model for tackling the spread of the virus.
"You have to remember that was the era when Jesse Helms and others were saying that gay people got what they deserved, and that the government shouldn't spend any money to help them," said David Evans, an H.I.V. treatment advocate who writes about prevention. "There was a time when people thought, 'Oh my god, they're going to put us in camps.' "
Such fears have faded in recent years, thanks in part to laws that protect people with AIDS against discrimination. Although the number of AIDS-related deaths has plummeted since the advent of a more potent class of drugs in the mid-90's, the rate of new infections has remained unchanged at about 40,000 cases a year, frustrating many advocates.
That frustration has been ratcheted up by the growing popularity of crystal meth in New York, which many say has led to an abrupt increase in unsafe behavior and a spate of infections. Although exact figures are difficult to determine, a recent survey of gay men found that 25 percent had tried crystal meth in the last few months.
Those frustrations were given voice in November by Larry Kramer, the playwright and activist who himself has AIDS, in a widely discussed speech at Cooper Union in which he criticized gay men for their behavior. "You are still murdering each other," he said then. "Please stop with all the generalizations and avoidance excuses gays have used since the beginning to ditch this responsibility for this fact."
In an interview, Mr. Kramer said on Sunday that the warning of a possibly aggressive new strain of H.I.V. confirmed his fears and filled him with a sense of hopelessness. "Even in the days of the worst infections, no amount of prevention seemed to work, and that's probably the scariest thing of all," he said.
Even if the warning turns out to be a false alarm, many AIDS experts say it is only a matter of time before a supervirus does emerge.
"You can't have a core group of people having sex with large numbers of people without amplifying any sexually transmitted disease that enters the system," said Gabriel Rotello, author of "Sexual Ecology: AIDS and the Destiny of Gay Men." "I don't have any doubt that a resurgent H.I.V. epidemic will hit the gay population in the near future," he said.
It is this fear of a drug-resistant virus that has driven some who track the spread of AIDS to suggest a more aggressive approach to prevention. Walter Armstrong, the editor in chief of Poz, a monthly magazine about AIDS and H.I.V., said the traditional fear-based model of prevention was at best only a temporary solution, especially if no supervirus outbreak materializes. A more effective way, he said, would involve gay organizations using traditional public health measures, such as more widespread screening and a partner-notification effort to track users of crystal meth who have been infected recently.
"Why would it not be possible to get them together to communicate to each other, and then to their sex partners, that lives are being put at risk by reckless behavior?" he asked. "I think there are ways to do interventions ethically, sensitively and compassionately. There's a huge window of opportunity between criminalization and empty prevention messages."
Still, others remain wary of such measures. Walt Odets, a clinical psychologist and the author of "In the Shadow of the Epidemic: Being HIV-Negative in the Age of AIDS," said he thought such intervention smacked of a witch hunt.
He and others said it would be more effective to try to identify the underlying causes of drug abuse and self-destructive behavior, including the difficulty of living in a society that rejects committed gay relationships while condemning homosexuals for having sex outside those relationships. Gay men, he said, are using methamphetamine as an antidepressant.
Many health experts suggest a more vigorous return to conventional H.I.V. prevention. Isaac Weisfuse, the city's deputy commissioner of health, said his agency was planning to place information banners on gay Web sites and devote more money to hard-hitting ads about methamphetamine use.
Others, like Mr. Rotello, were less optimistic. Until people really believe an unstoppable virus is out there, he said, they will continue to indulge in unsafe sexual practices. "People are not going to modify their sexual habits in ways that are difficult or unpleasant until they see their friends dying again," he said. "And to me that's just an unbelievably depressing thought."
One Simple Rule:
Keep de peepee out o de poopoo.
This line got my attention. If fear of death doesn't keep these guys from participating in "impromptu sex parties," what effect will gay marriage have?
I never understood that in SF, it took them years to close those sick Gay bath houses even while the members where dropping like flys......of course they could just have been the intitial version of "bug chasers" trying to get AIDS.
This is a fascinating article. I was just reading it while looking for more news on another story.
Are the radical gays finally getting a clue?
My brother died of AIDS, could partner tracing have saved him? I'll never know, but I'll never forgive the attitude of the radical gay community towards this disease, it has cost MANY lives.
They did more harm to their own group than Jerry Fallwell ever could have, or WOULD have done.
Homosexuality is self-destructive? Whoda thunk it?
that line stuck out to me as well. as with most vices there are those that think legitimizing the vice in some fashion will somehow make people who are fundamentally out of control suddenly find control.
Within a certain strain of the culture, there is no fear of death. My best friend is a doctor who works in a university clinic, and he sees a fair number of gay students. It really shocked him at the number who automatically assume that they won't live past 40, and won't listen to his recommendations on health because they are only expecting to live 15-20 more years.
I suggest that they wear one of those John Kerry blue bunny suits...
Surprise , surprise. They are discovering that males in heat act irrationally.
The Rump Rangers ride again.
That's right, if society would only accept rump rangers, all would be just ducky.
The fact that anal sex is extremely unhealthy, leading to countless bowel diseases plus HIV infections, wouldn't matter any more. Click your red heels three times and wish very, very hard....
The kind of madness that Paul of Taurus talks about in his letter to the Romans.
Are gay marriages know for the fidelity of the partners?
Everything they are considering is considered a sign of hoomophobia when straight people have suggested it.
Those interment camps they're building in Idaho really have 'em spooked.
... others said it would be more effective to try to identify the underlying causes of drug abuse and self-destructive behavior, including the difficulty of living in a society that rejects committed gay relationships while condemning homosexuals for having sex outside those relationships.
How did I know that it was my fault homos are infecting each other with AIDS? How will I ever be able to live with myself?! O', the shame!
The idea that gays lose themselves in self-destructive mindless hedonism to drown out the pain of being rejected by society is a common theme these days. I think it also has to to with the male sex drive being multiplied by two. If all the girls I knew in college were as willing as the guys, it would have been a real mess.
"He and others said it would be more effective to try to identify the underlying causes of drug abuse and self-destructive behavior, including the difficulty of living in a society that rejects committed gay relationships while condemning homosexuals for having sex outside those relationships. Gay men, he said, are using methamphetamine as an antidepressant."
Well, cry me a river! Somehow there is always somebody else to blame for sick and depraved behavior. I'm surprised this person didn't say "IT'S BUSH'S FAULT" as well. Sheesh.
"You have to remember that was the era when Jesse Helms and others were saying that gay people got what they deserved, and that the government shouldn't spend any money to help them," said David Evans
I agree with Jesse. Further, I submit that AIDS is a product
of natural selection, ala Darwin... mother nature cleansing
herself.
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