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Along the Latex Highway

Prevention in the 21st Century

December 2000

Last July USA Today reported that questionnaires handed out in San Francisco's gay neighborhoods show an increase in risky sexual practices (they mean unprotected anal intercourse) of gay men in the city. Then the health department of San Francisco reported that the new infection rate has jumped from 1.3% of those tested in 1997 to 3.7% in 1999. So the Centers for Disease Control and Prevention (CDC) stepped right in with a $1 million grant to focus prevention efforts on HIV-positive men, who have been largely ignored by campaigns geared toward HIV-negative individuals.

A million dollars. Wow. Isn't that the same amount of money some TV network gave a gay guy last summer for not getting voted off that tropical island by 15 other obnoxious survivor wannabes? Isn't that the same amount Regis Philbin promises contestants who can answer about a dozen trivia questions correctly on America's most popular game show, "Who Wants to Be a Millionaire?" Uh huh. You know, the last time I checked, there were a lot of gay guys in San Francisco and I'm thinking that CDC grant of a million dollars is pretty lame. And I suppose if I lived in San Francisco I'd be expected to be grateful and politely thank the CDC in that way we thank people who give us Christmas presents that practically scream, "I put no thought whatsoever into this gift!"

The city of San Francisco took the grant, of course, and city officials said they may also use their own $16 million prevention budget to highlight the side effects of AIDS drugs, remind gays that other sexually transmitted infections besides HIV have severe effects, and gear prevention messages to specific at-risk populations. And that's all very nice, except it begs the question, "What have you been spending your considerable budget on for the past fifteen years?"

The problem with prevention efforts in San Francisco is the same as it is everywhere else in the country. HIV prevention efforts suck. They suck out loud. They suck with teeth. Prevention efforts have been dumbed down to quickie statements. Abstinence is the only safe sex. Wear a condom every time. Please. Americans buy $4 billion worth of pornography every year. Forty thousand new HIV infections and 12 million cases of sexually transmitted diseases are diagnosed annually. Survey after survey tells us half of all teenagers are sexually active, advertisers use sex to sell us everything from cars to shampoo, and Madonna has sold over 100 million records by mastering the art of sexual provocation. So what I have deduced from this is that we can watch people have sex on video, buy things that make us think we're sexy, pretend our teenagers won't be sexually active as long as we don't talk to them about it, and tolerate a marginal singer as long as she's got a decent rack, but we can't seem to communicate openly or effectively about how to stop the spread of HIV. We are a seriously disturbed nation.

Prevention messages developed in the '80s have failed to stop the spread of HIV, largely because they were developed in a state of sheer panic and they no longer resonate with a generation of gay men who've never attended thirty funerals in one year. What needs to change? First, what we need to do, what must happen is a shift away from the shameless sucking up to pharmaceutical companies that we've done since the birth of protease inhibitors. We could start by demanding that HIV drug manufacturers like DuPont, Merck and Glaxo Wellcome stop running ads with rock-climbing, yacht-sailing, buffed, thirtysomething homos that make living with HIV look like fun. Diarrhea, sunken cheeks, neuropathy and liver irregularities are not fun. They're depressing. And these advertisements are ultimately sinister because they foster a false sense of security: It's okay if you become positive because we have all these drugs for you now…take the drugs...everything will be okay...take the will go on undisturbed...take the drugs...climb a mountain...take the drugs...everything will be okay. We're not talking about too much caffeine here, people. We're talking about HIV; it's irreversible.

Next, we ought to demand that all television networks run condom ads that specifically mention the significant role condoms play in preventing the spread of HIV and other sexually transmitted diseases. If the government can stop networks from running cigarette commercials, they can certainly make them sell condoms. Americans buys 450 million condoms a year. If sitcom characters can joke about using condoms, why can't advertisers sell them on the airwaves? I'll tell you why: the networks think condom ads are too controversial. The staggering hypocrisy of this mindset blows my mind. Let's see...we can use sex to sell products and boost ratings for waning shows, but we can't advertise products used for sex. What?!

Also, gay men need to hop on the microbicide research bandwagon quickly. Microbicides are products being developed for women to be used vaginally against sexually transmitted disease infection. In other words, a woman squirts a microbicide into her vagina and the solution kills potential sexually transmitted diseases, thus enabling her to enjoy sex without a condom. Great idea. Good for women. But what about gay men? Why isn't it being acknowledged that microbicides could be the answer for gay men having anal intercourse? Because we aren't demanding that the research and clinical trials include us. Microbicides are technically feasible and research is very promising. Marketing surveys indicated that 12.6 million American women would be interested in using a microbicidal product. They didn't ask us, so we have to tell them. Go to the following websites and politely, but firmly, tell them you want gay men and anal intercourse included in the research and clinical trials (, and The squeaky wheel gets the microbicide, boys.

Lastly, some gay men could use a swift kick in the ass. So many times I have to listen to statements like this: "Well, he didn't ask if I was positive, so I figured he was positive, too." "He told me he was positive afterwards, but I think we were pretty safe." "Oh, if he was positive, I'm sure he would have told me; he was a nice guy. " "He's in really good shape and he looks healthy, so I'm sure he's negative." I am still amazed by statements like these and the fact that gay men can be sexually intimate with each other and still not have a conversation about HIV status in the year 2000.

Let's demystify this virus. Let's talk about it. Let's abandon this fatalistic "Don't Ask/Don't Tell" policy that looms over every gay bar in America. Let's communicate. Let's learn to depersonalize rejection (because frankly, if someone doesn't want to have sex with you because you're positive, they're really rejecting the virus; their fear wins, and it's not about you - - it's about them). For gay men, the bottom (pardon the pun) line is that HIV infection rates would dip significantly if there was an end to unprotected anal sex between HIV-positive inserting and HIV-negative receptive partners. Those of us living with HIV, like myself, don't really need to be reminded of this fact by a million-dollar prevention campaign. Prevention is a choice we make. For me, it's a choice I make with each and every partner, whether he likes it or not, because I do not want to be responsible for infecting another human being with this virus, forever changing his life, jeopardizing his ability to secure health or life insurance, condemning him to a life of doctor visits, pill popping and side effects.

I have the power to prevent the spread of HIV. I am prevention. And so are you.

Editor's Note: After three years, this is David's last "Along the Latex Highway" column. He's moving to the Bay Area of California in December to pursue lifelong dreams of living by the Pacific Ocean and writing a novel. Don't worry, however -- beginning in 2001, his column will emerge with a new name and a new photo. David promises to continue reporting the latest safer sex and risk reduction information with a personal twist. He'll also be writing about his experiences as a gay man living with HIV in San Francisco, a city that David once observed, "seems to exist in some sort of parallel universe where sex is either commercial, public, promiscuous, more plentiful or simply better than any place on our planet." Everyone here at AIDS Survival Project wishes David bon voyage and much success in his new location.

This article was provided by AIDS Survival Project. It is a part of the publication Survival News.
See Also
Fact Sheet: HIV/AIDS and Young Men Who Have Sex With Men
Quiz: Are You at Risk for HIV?
10 Common Fears About HIV Transmission
More Personal Views on HIV Prevention for Gay Men


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