The difficulty and reality of AIDS in our world today. — Page 2

There should probably be a very promoted re-issuance of And The Band Played On, by Randy Shilts. I urge anyone who isn't familiar with this history (as incomprehensible as that is, to me) to read it NOW. Every one of these issues, concerns and developments is discussed - in detail. There should also be an update written to include fun little things like bare-backing clubs and bug-chasers.

I'm sure Mr. Shilts would be willing to work on this project, but he can't. He, like SO many others, is dead.

SonofMamma: I'm with you on avoiding stereotyping about age and partying instincts. That's why I said most gay men outside of urban centers are no more (OR less) likely to be sexual saints than straight people. And shouldn't have to be. I'm not an advocate of the sex police, or abstenance vows, or draconian actions designed to make people feel sex is bad, dirty, 'wrong.'

This isn't about using the fundamentalist model to fix things. The real world issues now are the same ones that were always there: self-preservation, sane choices, and an ultimate sense of pragmatism about how AIDS is spread. Ten years in, when medicine made herculean strides and The Cocktail came into existence I remember reading articles like "Is unsafe sex an existential choice?" Pseudo-intellectual navel-gazing ruminations, as though HIV infection 'belonged' to gay men -- a little club disease that allowed "choices."

Personal responsiblity equals community survival, as it has from day one, which is what Kramer always preached. Interesting to read the obit appraisals of Arthur Miller -- who long advocated putting the needs of the individual 2nd to the needs of bigger society. How apt for this epidemic, and where it landed first in this culture.

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Updated On: 2/15/05 at 10:47 AM

People have been engaging in, and exhibiting, self-destructive behavior since the beginning of time. Smoking, Drinking, Drugging, Overeating, etc., etc. And as far as engaging in risky behavior that may have a negative effect or cause harm to others, two words... secondhand smoke. It's nothing new. While I agree with much of what Kramer has to say, I can't help but feel that there's a certain amount of self-loathing and inner shame on display here.

Fact:
Each year, a staggering 440,000 people die in the US from tobacco use. Nearly 1 of every 5 deaths is related to smoking. Cigarettes kill more Americans than alcohol, car accidents, suicide, AIDS, homicide, and illegal drugs combined.

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Updated On: 2/15/05 at 10:52 AM

Robbie,

I think you're generalizing regarding the "younger generation". I was born just before the infamous "41 Homosexual Men" article ran in the Times, and AIDS is more than a ribbon and a sound bite to me. I've lost three friends, one of whom was a 20 year old girl.

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robbiej - If everyone had the same mindset as you, then I wouldn't have a problem with promiscuity, but let's face it, they don't and if we want to survive as a community, we have to start taking some responsibility. With the decline in infections over the last 10 years, people began to feel safe and that is the WORST attitude we could possibly assume when we know the disease still exists and there is NO CURE. I think this deadly new strain of HIV is a huge wake-up call telling us that we have not done enough, have not been vigilant enough and that if we don't start taking some drastic measures, it will get much worse before it gets better. The problem is not "sex" perse, but it is apathy towards safe sex. HIV challenged us and we are losing. We've suffered the stereotype of being promiscuous. We then suffer the stereotype of AIDS. Then once more, we are stereotyped as promiscuous. When do we wake up and realize that maybe they are not just stereotypes? I have also had my promiscuous phase, but like you, I kept my wits about me and protect myself as well as those I was with. Promiscuity will always exist no matter what we do, but to encourage it unwisely is irresponsible especially when faced with a deadly epidemic. How many more people need to die before we finally take it seriously? The apathetic attitude towards HIV did not occur without reason.

CurtainUp2 - You're comparing HIV to second-hand smoke? Are you kidding? How many people have died from ONE exposure to second-hand smoke? It's not even communicable and RARELY deadly. Not even in the same league.

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"CurtainUp2 - You're comparing HIV to second-hand smoke? Are you kidding? How many people have died from ONE exposure to second-hand smoke? It's not even communicable and RARELY deadly. Not even in the same league."

I didn't mean to infer that. Sorry that's what you took away from my post. I was merely using it as an example of how people have been participating in, and demonstrating, self-destructive behavior; often with a flagrant disregard for others well being, since Eve took a bite out of that proverbial apple.

All I'm saying is don't preach to me about the virtues of condemn use and the evils of recreational sex, while you're buying me a 2-4-1 cocktail, serving me mac and cheese and German chocolate cake, and blowing smoke from your after-dinner cigarette in my face.

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Updated On: 2/15/05 at 11:36 AM

I also believe that everyone has a personal responsibility to protect them self. And those with a sufficient amount of self-respect usually do. (As with alcohol and drug addiction, no matter what you do, or how hard you try, you can't help those who aren't willing to help themselves.) If you do everything within your power to act responsibly and avoid engaging in risky activities, then you wouldn't have to worry about what anyone else was, or wasn't, doing. In my 25 years of living as an out and proud gay man, I have never once sweated the results of an HIV test. And believe me, I've had my fair share of promiscuous and, yes, even anonymous, sex. Like robbiej, I'm neither especially proud, nor ashamed, of my sexual past. It's a part of who I am, and the person I've become. I'm currently in a very healthy and loving long-term relationship. But I have no regrets about anything (or anyone) I did in the past. You can have hot, sweaty, uninhibited, unbridled man-sex, and still be responsible. Safe does not = Boring.

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Updated On: 2/15/05 at 12:20 PM

I second robbiej. It's not promiscuity that spreads HIV--it's unsafe sex. Whether you have one sex partner or 300, unsafe sex increases the liklihood that you will catch HIV.

Barebacking and all of the bizarre and twisted bug chasing or feelings of immunity have led to this new strain. It's cognitive dissonance. People will do think anything to justify their actions. And any warnings or ad campaigns get scoffed at by these people. So, it's the impressionable that we have to reach out to.

And as has been stated--it's not just a gay issue. But--we're the ones being talked about in the media. So, it's our face out there.

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I have an honest question that I hope won't get me a lot of hate mail. I have never understood why people are so supportive of things like Broadway Bares. Now I've never gone to one, so cut me some slack. It seems to me that something like that just titillates people into having more sex. It seems to me that it encourages sex while trying to raise money to fight a disease passed on in part by sex. Can someone explain this to me?

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I just can't read through all these posts because what I read in the first few got me very agitated. (Although something tells me Robbie's is closer to my POV.) When I see Kramer and Shilt's names being invoked with a "so, they were RIGHT," attached, I just really need to remind people that there are grains of truth in EVERY simplistic "answer" to complicated questions. But they dishonor the multi-faceted lives that people live as they negotiate their way through a world, and through our culture that has been telling them for the past four and a half years that they could be killed at any minute by terrorists. I'm not saying that's a big HUGE part of it, but I do remember when 9/11 happened I quickly thought that morning, "Geez, all those condoms for all those years just to have it end THIS way?"

Let me just say this, the drug resistance issue is not "news." The "rapid progressor" may or may not be anything new either. It may really be just about that one person's system that has been destroyed by crystal meth and not about a "new mutation," which is one of Kramer's buzz phrases.

Remember, in the early days of the epidemic, Kramer tried to "tell gay men to stop having sex." As if sex is a luxury, just something extra people do, and not a DRIVE like the drive to eat food and breathe. "Tell gay men to stop having sex." Can you imagine, if HIV got established in the straight world first, "telling" straight people to stop having sex?

But other visionaries, like my late friend Michael Callen and his physician Joseph Sonnabend, really ended up being the "Cassandras" when they crafted their groundbreaking, lifesaving pamphlet, "How to Have Sex in an Epidemic." It asked gay men to make substantial changes to the kind of sex they have, but never, ever did it say "STOP! STOP HAVING SEX!" And guess what? They did! It was an unprecedented change, the likes of which had never been seen in the annals of public health in such a short period of time. Let me repeat that. THE LIKES OF WHICH HAD NEVER BEEN SEEN BEFORE. Did gay men ever know that they're my heroes?

Remember, Shilts was big on wanting the baths shut down (and many people wanted to extend that to bars too, since "people go there to hook up"). But the bars and the baths were the very infrastructure through which safer sex information like Callen's and outreach and education happened that saved many people's lives. There was no internet then, although there was more of an independent gay press than there is now. Through the press and the existing community establishments, a LOT of health information (and rubbers) were distributed very quickly in the early-'80s.

And now the internet is being mentioned the same way Shilts and Kramer mentioned the baths back then. Fact is, manhunt.net and other sites are very open to educators doing online outreach, the CDC is finally kicking off behavior surveys and educational sessions on gay matchup sites. I see info about syphillis, HIV and crystal on manhunt.net (and I've probably connected with about two people in five years of cruising that site -- I like to watch!) right when I log on.

The REAL issue, the thing that really needs to be discussed, is the scourge of crystal methamphetamines. I know I risk sounding like somebody from Reefer Madness, but that stuff is the real culprit in what is going on now.

SMART HIV prevention people are meeting people where they are at, talking about risky behaviors, offering help to people who want to make changes the way an entire generation made changes the likes of which Callen and Sonnabend suggested. And many people do. But that drug is so damn pernicious, it really gets people in its grip.

It's all very, very complicated, which is what is so appealing about the simple kinds of answers Kramer constructs. It just doesn't work in the real world. Fortunately, Crystal Meth Anonymous groups are multiplying, people who are attempting recovery from Meth addiction are working together to help others. If there were one magic "Tell gay men..." statement I wish would work, it would be "tell gay men to pick just about ANY other recreational drug (if they must pick recreation drugs) than crystal."

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Sorry to have agitated you, Namo. Everything you say is, of course, true.

Phew! I just reread what I wrote, cuz I was worried it wasn't clear. And I saw some more things in the previous posts. Let's just keep in mind that "the new strain" is something that has been picked up on in the media, but may not be at all real. It could be, but it could not be. Let's let some real epidemiologists figure that out and help us frame what's going on, rather than, say, The Daily News.

And lines like this: "But now, after years of the gay community *as a whole* not doing a thing, it's time to get a swift kick in the pants." This is simply not true. Simply. Not. True.

One thing that is really difficult is when people discount what the community HAS done, because it is extremely discouraging. I recommend looking, for example, for a history of how RAPIDLY the community of gay men struggling with crystal created a 12 step model and how RAPIDLY that has grown in a very short period of time. And they did that all on their own by piggybacking with the existing HIV prevention/education infrastructure, the EXACT one that Kramer has been decrying as useless FOR YEARS and that other critics say should just shut down.

At every given point in the epidemic, there are about 30% of men who, through negotiated safety (that means when gay men really know that what others are deriding as "unsafe" is perfectly safe for them because they BOTH know their status), carelessness, depression, frustration, inebriatedness, or what-have-you, have foregone using condoms for anal intercourse.

And just so you know, it's not just when people are feeling "bad" about themselves that they forego condoms. One major study demonstrated that when certain people are feeling GREAT and powerful and invinceable they often enjoy robust unprotected sex. These are the types who in another sphere of life would go skydiving and hang-gliding or do extreme sports. These are, in other words, people who are not risk averse. Alas, one of the things that crystal first does is make people feel great, strong, powerful. And also very horny. You see the intersection between those two conditions.

So again, I think it's worth being careful about how this is talked about and asking ourselves who is framing this discussion? And it's worth being careful about tossing out words that sound epidemiological like Mister Matt's "[W]ith the decline in infections over the last 10 years...," that don't actually bear out. Seroprevalence (how much HIV there is in a population] and seroincidence (how many new infections are happening in a time period) are two very important -- and DIFFERENT -- indicators of what is going on, but not the only things. Overall, the number of new infections remained steady, but did not decline. And that goes right back to my first point about the 30% of gay men foregoing condoms for anal intercourse, because, alas it is not always the same 30%. But what that does mean, is that 70% of gay men ARE using condoms for anal sex. And that, as Martha would say, is a GOOD THING.

PS to DGrant: This is a very valid personal choice: "I know, I know, that makes me a bad and horrible person. So be it. I've chosen to spend my time and energy with people (of any stripe or persuasion) who are willing to make choices that affirm life, rather than trash it." But what it isn't is an effective public health policy. Unfortunately, when "public opinion" is informed by a soundbyte media culture, it's prevailing sentiments like yours that actually DO have a negative effect on public health policy. I think the separation of "feelings" and "public health" is way more important than the separation of church and state (another "feelings"-based dichotomy to be sure).

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Updated On: 2/15/05 at 01:33 PM

That's me, keepin in real. F'reals, y'alls!

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