Gays Debate Radical Steps to Curb Unsafe Sex

New York Times ^ | 2/14/05 | Andrew Jacobs

[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."

[andysandmikesmom]

In the situations you describe, those are acute situations, which involve emergency workers, and hospitals...and those places are always allowed to know HIV status...but for some reason, nursing homes were not afforded the same information...because nursing homes are not institutions, that take in acute situations....most people in nursing homes, are there to receive help with their daily living activities, or receive custodial care, rather than medical care, tho residents in nursing homes are allowed IVS and meds and such....

So nursing home workers were always put into a different category from EMT workers, and hospital workers...yet nursing home care workers may into contact with the residents bodily fluids(sorry for being graphic), may have to perform CPR on a resident, may accidentally receive an wound from a combative HIV positive resident...

You are right about symptoms of advanced cases of HIV patients being evident...however, I know for sure, that while I was working in the nursing home, I cared for two men who were HIV positive, and neither was in the advanced stages, so it was not evident...I knew, only because my charge nurse, took me aside, looked me in the eye, said, "your patient has a blood borne pathogen, do you understand", and she did not let me go, until she was sure that I understood exactly what she was saying...that my patient was HIV positive...

[scripter]

Bump and ping.

Homosexual Agenda: Categorical Index of Links (Version 1.1)

Homosexual Keyword Search

[Richard Kimball]

People who work in nursing homes do a LOT of CPR. My first couple of years in the fire department, I was in a territory with three nursing homes, and they gave us a lot of CPR business. Nursing home workers are far more likely to come in contact with body fluids because of all the tending duties. Changing bandages, bedding, diapers, etc.

It takes a lot of patience, and the pay is generally not very good for any but the top brass.

I respect anyone who can do it and keep a good attitude. That being said, I always worried about AIDS less than I did the sixty zillion other communicable diseases around. When I started in the fire service (1970's), they didn't even issue gloves. Everything was bare handed, or fire gloves, and we worked car wrecks, burn injuries, you name it. Strangely enough, there was a lot of resistance to universal precautions when they were first introduced. Personally, I don't even begin an evaluation of someone now without gloves, even if I think all I'm going to do is take a blood pressure.

[Darkwolf377]

You're right, but it's not for want of trying. :)

[Darkwolf377]

I know I believe it. :D

[DirtyHarryY2K]

Homosexual Agenda Ping.

If you want on/off the ping list see my profile page.

[TheMole]

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.

That statement is so succinct I may have to steal it. Thank you very much. In return I shall extract for you the most relevant words from the article. Here they are in order of appearance:

methamphetamine abuse crystal meth methamphetamine meth crystal meth methamphetamine meth crystal meth crystal meth

[Mockingbird For Short]

.....then at least in this regard, you are a GREAT dad! Thanks for loving your kids.

[Free Vulcan]

The bottom line is that the gay community has with their own behavior funneled themselves to the point where they are backing into (no pun intended) their own contradictions.

With epidemics, death, pedophilia, skyrocketing health care costs, tight govt budgets, and other unignorable issues on the line, you either have to deal with the problem or officially acknowledge gays as a superior caste that is above all laws, morality, accountability, civility, and basic common sense.

You can only scream intolerance and discrimination to the point where you cross the line of trampling on other people's rights, and then the whole scam collapses on itself. Something has to be done to stop the carnage before people start really dropping like flies.

[Seeing More Clearly Now]

"Maybe at some point the psychiatrists will finally admit they were wrong in removing homosexuality from the diagnostic manual as an illness, something they did out of political correctness."

The book "Homosexuality and the Politics of Truth, by Satinover, is a must read on this subject for anyone interested in this subject, including gays. Among other things, the book recounts how a small group, with outside urging and support, used political maneuvering to commandeer the American Psychological Association's policy board into eliminating homosexual behavior from the list of illnesses, even while all of the medical literature supports the fact that homosexuality is a disease and people were choosing to seek treatment and benefitting from that treatement. The small group even tried to get the organization's leadership to deem it professionally "unethical" to treat anyone who sought to break free of the homosexual behavior pattern. The AMA followed the lead of the APA. No one has the nerve to campaign to reverse the politically correct, but scientifically erroneous policy.

[beyond the sea]

Keep de peepee out o de poopoo.

ROFL.

"See this?" "See that?" "Don't stick this in that."

[MacDorcha]

"Ultimately, we reap what we sow, and the homos are doing lots of reaping."

Ironically, they aren't actually sewing anything!

[gobucks]

I'll bill you for the new keyboard I need ....

[gobucks]

"as with most vices there are those that think legitimizing the vice in some fashion will somehow make people who are fundtamentally out of control suddenly find control."

On the surface, I agree w/ you; and its sad. But, I'll add that finding control ... well, in effect, a lifetime behind bars is what many men find is quite controlling and suffiently addresses a need they have seen to it that needed to be met. It is no accident that almost all men behind bars grew up w/o a dad.

Most gay men, as well, grow up in a similar dad-deficit environment. AIDS is another kind of prison, and thus the control they seek is found.

So, the rationale is nutty as you rightly observe, unless you put yourself in their shoes ... for what they pursue is after all, control.

Feminism, gay nuttiness, porn epidemic; all are the mold that grows by default when guys fail to grow into men and be the fathers God has called them to be...

[gobucks]

"I agree with Jesse. Further, I submit that AIDS is a product
of natural selection, ala Darwin"

Hmmmm. A mention of Darwin. Pardon me, democratslayer, but I would be interested if this comment qualifies as a rational point of view held by others .... or is this a misapplication of reason?

[gobucks]

"Men are the gas pedal in a sexual relationship females are the brakes."

Incorrect. Godlessness is the gas pedal. What many women fail to notice is that godless men are essentially recruiting women to be substitue 'gay men' for them. The bottom line is that God is the brake, and men and women will careen out of control unless they wake up to that reality.

In short, without Christ, a man will screw himself, his brother, and his sister, b/c it his nature.

[Ichneumon]

["I agree with Jesse. Further, I submit that AIDS is a product of natural selection, ala Darwin"]

Hmmmm. A mention of Darwin. Pardon me, democratslayer, but I would be interested if this comment qualifies as a rational point of view held by others .... or is this a misapplication of reason?

Yes, the HIV ("AIDS") virus has become what it is today via evolution. Here's a map of its "family tree", mapping its evolutionary relationships to the other lentiviruses:

I know that's a bit hard on the eyes -- better resolution versions can be seen here: An overview of the molecular phylogeny of lentiviruses

[Ichneumon]

In short, without Christ, a man will screw himself, his brother, and his sister, b/c it his nature.

Why do you hold such a terrible opinion of Jews?

And why do none of the atheists I know act the way you predict?

Something appears to be wrong with your hypothesis, it doesn't match reality.

[SauronOfMordor]

In a promiscuous environment, where gays on anti-HIV drug treatment get continual new infections, it is inevitable that a resistant strain will come up. And if they find a solution for this strain, yet another will arrive.

The problem is inherent: their lifestyle is a breeding place for plague

[SauronOfMordor]

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.

Part of it may be that they don't WANT to live past the point where they're too old to be sexually attractive to other gays. Remember, for many, the promiscuous party scene is the only life they know