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Gay Men are Neither Dumb nor Self-Destructive |
By Eric Rofes From the mid-1980s forward, those trying to control the spread of HIV through gay male communities counted on a variety of "facts" about AIDS to shift gay men's sexual practices. Because we knew few gay men who survived more than a year or two after diagnosis, we discussed HIV infection as lethal and considered each friend who tested positive as facing a death sentence.
HIV prevention among gay men was acclaimed internationally because it quickly and skillfully funneled nascent epidemiological data, confusing and often contradictory biomedical findings, and complicated sociocultural trends into campaigns tailored to the cultural norms of various gay male populations. We knew gay men were not dumb, and we counted on their resilience and commitment to survival. Sure hindsight suggests instances where our judgments erred or community civil wars got the best of us, but for a period of ten years, rectal gonorrhea rates, surveys of sexual practices, and HIV infection trends within gay male populations suggest that basing our prevention efforts on the "facts" as they existed in the social worlds of gay men brought us tremendous success. Fast forward to the present moment and many of our leading AIDS organizations ask gay men to believe that we are in the same crisis moment we entered in 1985. They demand that the "facts" of the 1980s should guide our sex practices today. And they attempt to pull off an odd turn in the treatment arena: throwing a pep rally for HIV-positive men presenting optimistic visions of current and future pharmaceuticals, while marshaling horror stories for HIV-negative men about side effects and supposedly high-rates of treatment failure. Theoretically, the "facts" of the mid-1980s could have had staying power which lasted an entire century. The pages of weekly gay papers still could be filled with obituaries; but they are not. Everyone we know who tested HIV-positive in the 80s could be dead; but they are not. We now believe many of these long-term non-progressors will never develop HIV-related illnesses. Half of the gay men who populate bars, bathhouses, e-mail chat rooms, and gay dating service lists still could be infected. But that figure is under 15% in most urban centers and in the high-impact cities of the 1980s-San Francisco and New York-currently fewer than 25% of the gay men are HIV-positive. Contrary to what today's HIV prevention leaders seem to believe, gay men are not ignorant or unsophisticated and young gay men cannot accurately be characterized as irresponsible, reckless, or lazy. We are not mindless sheep, willing to ignore very real changes in the way HIV affects our friends and neighbors. We are also not lacking in self-esteem or filled with internalized homophobia that triggers us to self-destruct. Nor are we naïve or delusional and believe we are invulnerable to harm or disease. If prevention efforts are less effective today than they were a decade ago, it may be because much of contemporary gay male HIV prevention work refuses to accept fully the altered social, biomedical, and cultural realities in which today's gay men operate. And those few programs which have moved into the 1990s, have failed to re-conceptualize and re-envision what an authentically new generation of HIV prevention might look like. Many find it difficult to imagine that there are models of public health work which are not dependent on creating a community mindset of crisis, or relying on terror, panic, shame and guilt as primary tools. Thus we find ourselves in a situation where many gay men are engaging in sexual practices which are heavily informed by the "facts" of the late-1990s: most of the men we sex with are not likely to be HIV-positive; many of the positive men have diminished levels of HIV in their semen; while still awful and life-threatening, becoming infected with HIV no longer is assurance of imminent decline or tantamount to a death sentence for most gay men. HIV-positive men are further informed by the fact that highly-respected medical researchers continue to disagree about the possibility of reinfection with more dangerous strains of HIV. Even the National Institutes of Health have told us that the statistical risk from a single act of unprotected sex is much less than the 50:50 ratio many of us believed it was in the 1980s. Daniel Zingale, executive director of AIDS Action, the DC-based political arm of what's left of the AIDS movement, has been much in the media lately discussing what he believes is a huge shift in gay men's sex practices.
Reading these recent epidemiological reports through the crisis-tinted lenses of AIDS Inc., he apparently cannot imagine two men fucking without condoms as anything other than "a romanticizing of unsafe sex." AIDS Action recently issued a press release under the title "Unsafe Sex Spike Signals New Crisis" in an attempt to extend the emergency mentality of the 1980s into the new millennium. The recently released studies from the Centers for Disease Control upon which Zingale bases his hysteria and smug "We told you so" attitude may be cause for concern, but not in the narrow ways in which much of today's AIDS leadership is suggesting. The study of increased rates of rectal gonorrhea in San Francisco has been universally read as indicative of increasing new HIV infections among gay men, yet if most of these new cases are among already-infected men, our concerns might be more appropriately directed towards general sexually-transmitted disease prevention campaigns or more incisive community education concerning treatment-resistant strains of HIV. While many of the press reports about this rise of rectal gonorrhea jumped immediately to "this-is-a-return-to-the-1970s" rhetoric, almost all journalists failed to note that San Francisco's rate of rectal gonorrhea is still a tiny percentage of what it was before our education work of the 1980s. Likewise, the much ballyhooed report of upswings in gay men reporting unprotected anal sex (from 30% in 1994 to 39% in 1997) can only be understood as a "problem," if one maintains the AIDS absolutist position of the 1980s (good gay men use a condom every time). This shift could suggest many things, besides an upswing in new HIV infections trumpeted by AIDS Inc. Social scientists are aware that people's response to surveys is linked to current cultural norms. Hence the shift could signify the transformation in community discourse from a time when all gay men in the media represented themselves as having 100% safe sex to a time when some men have spoken openly about unprotected butt sex and when debates flare over barebacking subcultures. This makes it safer for surveyed gay men to "fess up" to such sexual activities. The shift could also suggest more gay men understand the lower level of HIV in gay communities, and sometimes choose to get fucked without condoms in circumstances where they do the mental calculus and assess that their risk may be minimal. I am not arguing that the sexual practices of gay men raise no significant and serious concerns around health or that the new treatments are a panacea. Instead, I believe the willful misreading of epidemiological data, the continued churning out of crisis-based press releases, and the escalating depiction of gay men-particularly young gay men-as dumb, self-destructive, and responsible for undercutting the assimilation-based, best-little-boy progress of the "responsible" gay community, have enormous consequences in terms of gay men's health, effective community organizing, and the declining credibility which gay men-especially young gay men-hold for our community institutions. Who's being lazy, irresponsible, and self-destructive here? Gay men in their 20s and 30s, or AIDS Inc.? It may be more convenient to pin current failures in prevention on the general gay populace, blaming young gay men and mischaracterizing all whose sex falls outside the narrow dictates of use-a-condom-every-time mantras, than take a fearless and searching look at the current state of prevention. Prevention efforts targeting gay men are sorely in need of re-visioning and re-direction. We don't need more brochures, more programs to improve our supposedly sagging self-esteem, or more sound bits and marketing messages: we need a multi-issue, multicultural gay men's health movement. By willfully misrepresenting gay men who organize their sex and relationships outside of the crisis-driven dictates of 1980s prevention, AIDS leaders cross an important line. They find it convenient to use all-too-willing mainstream media, amidst a political climate of homophobia and sexphobia, to divide gay men into good and bad. If they wonder why popular support for AIDS groups is plummeting among gay men, they need look no further than their own press releases, media statements, and prevention brochures. If you patronize and defame gay men, don't act shocked when we no longer support you. Instead of bringing together a savvy and creative brain-trust to generate a multi-issue, activist gay men's health movement, we point fingers at the bad boys (barebackers, circuit boys, and those lazy, self-centered young gay queers) and continue to see our AIDS work separate from the broader public health context in which gay men live our lives and have our sex. Instead of creating a new generation of HIV prevention rooted in the altered (and ever-changing) "facts" of HIV infection in 1999, we recycle the education models and supposedly common sense assumptions of the 1980s, making-at best-mild adjustments. While a chorus of AIDS leaders characterize young gay men as slackers, wantonly ignoring the wisdom of their elders, it might be more appropriate to turn the accusation of laziness, self-destructiveness, and irresponsibility back on today's AIDS leaders. At the same time we continue to enlarge the ever-widening gap between rank-and-file gay men and the institutions which many of us created, funded, and populated as volunteers. Until AIDS leadership ceases to patronize the common gay man by presenting us with "facts" which have little likeness to the realities of our lives or the findings of balanced biomedical research, or treat us with contempt, they ensure the further erosion of their funding and volunteer base in gay communities. Eric Rofes is the author of Dry Bones Breathe: Gay Men Creating Post-AIDS Identities and Cultures (Haworth, 1998), a professor of education, and a long-time community organizer. |