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May 7, 2008

Killer Gay Sex!

by Tony Valenzuela

Sexually Irresponsible Gay Men?

The New York Patient was terrified and weak when the news of his virus broke on February 11, 2005.  In an ominous press conference declaration, Thomas Frieden, MD, commissioner of the New York City Department of Health and Mental Hygiene, announced the discovery of a strain of HIV that was “difficult or impossible to treat” and that “potentially, no one” was immune.  At 46 years old, the Cuban-born man believed that he would die and bought a cemetery property in a family plot in Florida.  It was an arduous yearlong climb out of precarious health, six months before his viral load fell to undetectable levels or before he could leave a bedridden life to take short, exhausting walks in his Manhattan neighborhood.  Having plummeted to a dangerously low 28, his CD4 cells inched upward gradually until November 2006, when they climbed above 200 where they’ve remained since.

The health commissioner’s press conference incited terror of the return to the AIDS-as-death-sentence days of the ’80s and early ’90s so that the anomalous story of one man’s potent infection turned into a universalizing gay morality tale.  Activist Larry Kramer called the New York Patient a “total and utter asshole” in the New York Observer then suggested to Gay.com that “one thing is certain: We must make all efforts to de-eroticize anal sex.”  Historian Charles Kaiser went further, telling The New York Times, “A person who is HIV positive has no more right to unprotected intercourse than he has the right to put a bullet through another person’s head.”  And Michael Weinstein, president of the Los Angeles-based AIDS Healthcare Foundation, told the Advocate that the New York Patient was “indicative of a subculture of self-destruction and carelessness about our health.”  These are just a few examples of dozens like them where the crystal meth context of the New York Patient’s infection is incidental to pointed assumptions about gay sex: self-destruction, suicide and murder have been ascribed to sex between men long before meth crowded headlines.

The moral panic that ensued over the New York Patient’s personal sex life was one familiar to those of us who have observed, or participated in, these paroxysms of anger since the mid-1990s, when it became clear among researchers that gay and bisexual men would not, for reasons simple and complex, use a condom every time, even though they use them far more often than heterosexuals.  The trail of high-profile, high-drama explanations that have attempted to make sense of continued HIV infections often have more in common with folklore and tabloid journalism than with sound research.  For over a decade, activists have engaged in rancorous debates over barebacking, circuit parties, “gift givers” and “bug chasers”, men on the down low, resurgent syphilis and of course, crystal meth, to name a few, all highlighting the complacency at best or depravity at worst of gay men in the age of HIV—and all aired in deliciously lurid detail by a mainstream news media that survives on a steady diet of spectacle.  In other words, we had been through this before, over and over again.

The representation of the sexually irresponsible gay man as the driving force behind new HIV infections has been a recurring theme in both mainstream and gay media despite evidence to the contrary.  According to the Centers for Disease Control and Prevention (CDC) in 2005, the year the New York Patient learned he had AIDS, rates of HIV infections nationally among Latino men were up to three times higher than among white men.  Infection rates among African-American men were up to eight times higher than among white men.  No other group in the U.S. is affected by the HIV/AIDS epidemic as severely as black gay men.  Although African Americans represent only 13 percent of the U.S. population, they account for 49 percent of new HIV infections and 50 percent of new AIDS diagnoses.  In a June 2006 literature review from the American Journal of Public Health, researchers tested a dozen hypotheses as to why this might be among black gay men in particular, ranging from rates of unprotected sex and drug use to awareness of HIV status.  What researchers found was a powerful argument contradicting public health’s idée fixe that the epidemic rests on individual bad behavior.  Black gay men reported less risky sex on average than white gay men and similar rates of drug use.  But black men also got tested for HIV less frequently and were more likely than white gay men to be unaware of their HIV infection.  They had irregular access to good health care and higher rates of STDs – all proven risk factors for HIV transmission.  Perhaps most importantly, the sexual networks of black gay men tended to be other black men, increasing their chance of HIV infection among a population already challenged by high levels of HIV. 

In another notable study, this one from the September 2007 edition of the journal Sexually Transmitted Diseases, researchers at the University of Washington, Seattle, found through two large population-based surveys that gay men had similar rates of unprotected sex as heterosexuals but that the HIV epidemic among gay men in the U.S. remained strong because anal sex is more conducive to the transmission of HIV than vaginal sex.  Heterosexuals maintained the same sexual roles (male insertive and female receptive), while gay men often switched roles, giving HIV a greater likelihood for back-and-forth routes of transmission. 

What does it mean that the same levels of sexual risk in heterosexuals, in gay men in general, and in black gay men specifically, result in vastly different rates of HIV infections across these groups?  Structural dynamics far outweigh individual behavior in determining the American HIV epidemic.  And yet the meth “party ’n’ play” guy, the circuit boy, the so-called bug chaser, is almost always nameless, faceless but presumed to be a middle-class gay white urbanite with the skills and knowledge to keep himself HIV negative.  If the fear over new infections is what’s ostensibly behind this rapt concern, why is this “reckless” gay man paid so much attention when, by leaps, the brunt of HIV disease, the real number of men infected is above all else determined by a lack of access to health care and by poverty in the United States?  HIV continues to be misrecognized as a disease of gay debauchery, which would imply that gay men of color are many times more irresponsible than gay white men, who are many times more irresponsible than heterosexuals: That’s the cloaked assumption when HIV incidences are framed around sexual irresponsibility.  When writer Dan Savage proposes that the state come after those who infect others with HIV “out of malice or negligence” so that the state can recoup “drug-support payments—thousands of dollars a year for treatment to keep them alive, comparing drug costs to child support payments—he is unwittingly suggesting another layer of penalty to populations who are disproportionally at the punitive receiving end of the criminal justice system.

Am I saying reckless gay men don’t exist?  Of course not, but sexual irresponsibility is not a gays-only disorder. Nonetheless the burden of scrutiny and explanation weighs most heavily on gay men of all races.  Arguably most HIV infections are due to negligence, as are the myriad diseases caused by smoking and overeating.  We don’t base health care policy on merit.  Whatever tiny minority of people exists with a malicious intent to infect others with HIV, it’s a dangerous fallacy to pin the thrust of infections on a willful disregard for health.

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Search: Tony Valenzuela, barebacking, supervirus, Thomas Frieden, Larry Kramer, Michael Weinstein

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  comments 1 - 15 (of 16 total)     next > >>

Jesse, , 2008-07-07 15:43:21
Please...Tony V. has once again decided to come out of hiding to try and be a flavor of the month. Every couple of years critics like Valenzuela crawl out of the woodwork and complain about how much gay HIV prevention work sucks. But do any of them put in the hours/weeks worth of work to advocate for and actually create effective programming? How about helping to build up glbt health workers and advocates instead of incessantly harping about how much we suck?

Phillip Schwartz, , 2008-05-14 13:30:22
Than you for printing this story! I worked for 12 years as an HIV test counselor at a free clinic serving the GLBT community. Our client base was mainly unable to access health care elsewhere, many were non white and impoverished and many were also closeted. These circumstances put our clients at high risk for STD infection and HIV infection. I want to applaud Tony Valenzueala for publicly debunking some of the myths surrounding new HIV infections among men who have sex with men. Thank you.

Bruce, miami, 2008-05-14 13:03:36
First and formost i want to remind everyone that you do not have to be gay to catch HIV. I have been positive for 12 years and in my line of work on medical equipment been through treatment for being stuck with sharp objects 3 times. They power dose you with HIV mneds in an effort to prevent you catching the disease. I have a tattoo that i wanted many years ago.You can get this virus from many different paths today. Just protect yourself and those you love. Make them aware. Live Life and Love.

PAC, Baltimore, 2008-05-14 01:01:54
This is the most pathetic rationalization of the self-inflicted self-destructive squalor so many Gay men choose to live in, now rebranded as defiant acts of pseudo-liberation. The loveless compulsiveness, the men who intentionally chase down HIV to fill the "hole" in their lives; why examine this sad nihilism when it can be glamorized and everything else blamed on the MOSPs (Mean Old Straight People)?

josewilsonmontoya, long island, 2008-05-13 23:33:16
great story about gay men have been treated over the past 25 years since the beginning of HIV. I think we should be more aware about all the messages out there that instead of helping us is hurting us. Good job

Gary, Jacksonville, FL, 2008-05-13 18:25:54
As for that couple in 2003, he’s not angry at them and says only, “They're very good people. I don't blame them. I blame crystal.” So much for responsibility for your own actions. I popped POZ too after a bad crystal habit. Guess who I blame? ME!! Being high is not an excuse to forgo protection. It's just stupid, which I was and so was he. Seems like he still can't come to terms with the life he created.

Kim Watson, New York, 2008-05-13 15:53:05
Re-inventing the wheel from HIV 101,STD,STI's is fantastic...I am 23years HIV positive,living with AIDS,but I am of trans-experience female,I am employed at one agency as the Navigator and Retention Care Specialist,I will always be your ally.....each one teach one. Kim,.

Johnny Guaylupo, brooklyn, NY, 2008-05-12 16:40:31
Hello, I thank you for bringing this back to life, this is the NAKED TRUTH and we should all know about it!~

Rod McCoy, Washington, DC, 2008-05-12 11:05:10
I'm an HIV educator, and I became infected in 2002. The question put to me was "How could you be come infected?" The truth is I enjoyed sex with condoms, but felt I couldn't share that with anyone. Demonizing unprotected sex (and the people who practice it) won't make HIV or AIDS go away. Honest and nonjudgmental messages about unprotected sex with REALISTIC strategies for reducing risk is what's needed. Especially since many naysayers have unprotected sex themselves! Thanks, Tony!

James, Minnesota, 2008-05-11 14:57:14
This article should be published in the TIMES magazine and on the front page of every newspaper in the country. Unless this information is given to the general public this disease will continue to be mis-represented.

David, Atlanta, 2008-05-10 11:33:12
I dont buy the author's argument that just because other groups are also sexually irresponsible, its ok for gay men to behave that way. Just like lung cancer from smoking, heart disease from overeating, HIV and other STDs come from promiscuity. The more cigarettes you smoke, the higher your risk for lung cancer. The more anonymous sex parters you have the more likely you will become infected. Sure, sex between consenting adults should be a right but promiscuity is hazardous to your health

Jim Pickett, Chicago, 2008-05-09 17:58:45
Fantastic piece! Would like to let readers know about IRMA - International Rectal Microbicide Advocates. Our global advocacy group supports the research and development of safe, effective and acceptable rectal microbicides that could provide extra protection with condoms, or some protection in the absence of condoms. They could be in lube or enema form, for example, and would be another prevention tool. There is vaginal research happening too! For more on IRMA www.rectalmicrobicides.org THX

agnes, new york, 2008-05-08 19:16:44
i am an hiv-negative woman in love and in a committed relationship with an hiv-positive man. his viral is very load is undetectable. we sometimes have unprotected vaginal sex--really just some strokes. i definitely feel stigmatized, particularly from other women, about that and have rarely told other folks because of it. people look at you like you're crazy. as if there is no way to reduce your risk or simply make an informed decision to take a risk once in a while and feel ok about it.

Sergio Sanchez, Los Angeles., 2008-05-08 19:14:18
I completely agree with you on every single point. I have been working on the HIV field for 14 years, always dealing with the impositions of CDC and OAPP contracts. They are so narrow that don't left any room to improve or for feed back from HIV poz people. I am too a long term survivor, and I am too a gay man claiming his right to have sex, love and the natural way. It is a choice among two people, not goverment has to be allow in it.

Thomas B. Bowie, Jr, Village of Rossie, Upstate New York, 2008-05-08 16:05:13
I am glad to hear Tony is alive and well. I was fortunate to bring his show to Hartford back in 2000. I was working then as a positive gay man bringing information to other positive men through one of the many HIV Prevention Programs offered under the Clinton Administration. Then all education that was honest stopped in the years of the Bush Administration. All the work done to that point was put aside as ASOs and CBOs ran for cover to continue funding under the new rules of Bush. Pray its over

comments 1 - 15 (of 16 total)     next > >>

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