Despite the best efforts of educators across the country, there are gay men putting their lives in danger right now. They're continuing high-risk behavior when they know the consequences could be deadly. And many of them secretly believe that, if worse comes to worse, new treatment breakthroughs will save them in the end.
But enough about smokers.
Welcome to 2001: An AIDS Odyssey, where the disease feels routine, HIV-positive men are questioning authority, and we're all still patiently waiting for the word on oral sex. Along the way, there are six topics gay men are avoiding, such as:
AIDS has been normalized in the minds of gay men. Until the mid '90s we had tremendous prevention campaigns. They were called funerals. Nothing today offers such stark motivation. I once thought people who took sexual risks were blithely screwing on the memories of my dead friends. But any activist, educator or physician who feels this way needs a time-out.
The relative danger of risky sex now feels, for too many, on a par with plenty of other life-threatening habits (puff puff). And the fact remains that most gay men make thoughtful sexual choices, whatever they may be. I have known AIDS counselors who still seriously chastise HIV negative, monogamous couples who want to ditch the condoms because "you can't trust anybody." We should have bigger things to worry about than destroying intimacy between committed couples. It's just too jaded for the world I want to live in.
Disclose your status and be done with it. A gay man today who isn't ready to disclose his status isn't ready for sex, either. I dislike the debate about who bears more responsibility -- positive or negative men -- because it's a destructive dead end. That said, an HIV-negative guy has a lot more to lose by not having the conversation . . . and a poz guy who won't disclose might not have as much to lose . . . except his self respect.
Sex was never completely safe. Not so long ago, getting a sexually transmitted disease (STD) was embarrassing, not a morally reprehensible act. The idea of acquiring an STD makes me feel nostalgic for simpler times. While it is true that hepatitis poses a serious threat, its primary transmission route (rimming or handling a dirty condom) can foil even the safest sex. Have you had your shots?
Show us the research. The single Canadian report suggesting that re-infection of a positive person may be harmful, or even possible, came along quite by accident. There is still no formal study to investigate this possibility. Real studies to help us make informed decisions (the risk of oral sex, the effects of substance abuse on viral replication, the infectious degree of someone with no HIV viral activity) are desperately needed, and results should be used to design new education campaigns. Which brings us to . . .
In the absence of science, poz men are making their own rules. Imagine how difficult it would be to curb cigarettes if no research confirmed that smoking after you were diagnosed with cancer was harmful. Think Grandpa would give up his Lucky Strikes?
Many positive couples who forgo the condoms are -- stay with me here -- making a choice to embrace life, and intimacy, and defiantly thumbing their noses at years of grief and slaughter. Meanwhile, single poz men who seek out poz partners for unprotected sex are practicing their own form of natural selection, and preventing new infections in the process. If the worst we have to say about this practice is the unknown risk of catching a more virulent strain, expect them to continue. If research proves otherwise, let's share it.
This may not be pretty, especially to negative people who are shocked, simply shocked. Please, don't shoot the messenger.
Barebacking as psychotic behavior is a myth. I've questioned supposedly HIV-negative "gift receivers" online (men who fetish the idea of becoming infected), and they usually admit to being positive men who want to bareback. Or negative men who, as any Sexuality 101 class will explain, are eroticizing danger without further intent. Any man who actually wants to go through with it comprises a sick little corner of life only the internet could reveal. Focusing on this phenomenon tells me we finally got tired of demonizing circuit parties and needed a new target of abject scorn.
AIDS is tainted with too much grief, anger, judgment, and high drama for any of these thoughts to come easily. Let's hope our AIDS community leaders, and each of us, will learn to speak up. Can we share a smoke and discuss it?
Mark S. King worked for AIDS non-profits until 1999. He can be reached at firstname.lastname@example.org.
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