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May 7, 2008

Killer Gay Sex!

by Tony Valenzuela

Barebacking Redux

A red screen flashes a statistic: 25 percent of men with HIV don’t even know they’re positive. “Come over here. We need to talk,” says a gravelly voice that you recognize immediately as the no-nonsense tone of Whoopi Goldberg.  She appears in her famous shaded spectacles and an incredulous posture. “You think barebacking is cool? Are you kidding me?” she exclaims standing in front of a red, in-studio backdrop covered with various-size words and phrases such as healthy, honesty and self-respect.  She continues, “We can stop HIV transmission. A condom says, ‘I love myself.’ Talking about HIV says, ‘I respect you.’ Love and respect, baby.  That’s cool.”  Whoopi along with Susan Sarandon, Rosie Perez and Amanda Peet each deliver two different 30-second public service announcements that ran in New York City in 2006 with overlapping messages about HIV, unprotected sex, crystal meth and self-love.  For example, Rosie Perez asks us, “Condom? No Condom? Is that a question?”

In fact, it is among the most germane questions concerning gay men’s health whose elusive answer has mountains of research dedicated to it even if here the question is asked glibly by a straight celebrity.  On an online gay men’s health discussion group to which I belong, these ads were fiercely debated.  One man posted, “Well, I know a few of them in fact have barebacked and have the progeny to prove it.  So it is especially irritating that there seems to be no room for gay men to make a thoughtful decision not to use condoms...Whoopi has unsafe sex and she gets a baby shower.  I do it and I am a psychopath.”  And herein lies the problem: No such words as thoughtful and unprotected dare enter the U.S. HIV prevention lexicon in the same sentence.  This man’s reaction illustrates the crux of the protracted debate activists have had for a decade over sex and HIV that the New York Patient brought, once again, to a boiling point.

Over the years, the dialogue around unprotected sex has evolved as researchers have made it a favorite subject of study, so that what was initially seen as fringe behavior has been largely reframed as a problem, albeit a common one, of mental health.  This work has produced a constellation of psychological syndromes, afflictions, deficits or social miasma to explain sex without condoms: low self-esteem, survivor’s guilt, loneliness, drugs, alcohol, lust, condom fatigue, AIDS fatigue, depression, sex addiction, poverty, slipping up, homophobia, internalized homophobia, racism, invincibility, complacency, because it feels better, childhood sexual abuse, self-destructiveness, sexual compulsiveness, denial, lack of education, resignation, love and the list goes on.  Yet the primary reasons both HIV-positive and HIV-negative gay men give for having unprotected sex is to feel greater physical pleasure and to feel more emotionally connected with their partners—the same reasons straight people bareback.  Far less frequently men cite a dislike of condoms, being high on drugs or alcohol or to do something taboo.  Despite the formidable challenges gay men face in their lives, more often than not we embody a tremendous range of responses, strategies and successes.  At the end of the day this is our story, not the list of deficiencies that have reduced us to a pre-Stonewall, pre-feminist notion of the patient under the omniscient gaze of the doctor.

I won’t resolve here the different points of view over barebacking, intentional unprotected sex, natural sex, raw sex—whatever you want to call it.  I don’t believe there is a resolution.  It is a subject deeply entangled in the normalizing politics of gay assimilation, in personal histories of grief and fear, in individuals’ boundaries of safety, in their sexual ethics and sense of morality that is formed by the minutiae of experience, politics, culture, emotion, that make us who we are.

To say the least, it is challenging to speak sensibly about gay sex, especially in the United States, when one is up against powerful institutions—health, media, politics – invested in determining all risk as pathological, gay men as damaged, disease as crisis, and HIV as it used to be—a virtual death sentence—instead of what it has become for people on antiretroviral meds: a chronic disease that must be managed with regular quality health care, individualized treatment and a broad range of physical, mental and, for some, spiritual health practices to help them live as close to a normal life span as possible. 

People still die of AIDS.  The treatments can and often do cause mild to moderate (and less often, severe) side effects, and scientists are now identifying long-term health consequences, such as increased risk for liver and cardiovascular disease.  Some activists and public health officials are convinced gay men don’t know this or have forgotten or are in denial or don’t care, and the proof is their continued risk taking, in increased HIV infections, drug use, depression, loneliness, (insert here long list of deficits from above).  This loop starts with sexual risk and doesn’t usually but sometimes does result in new HIV infections that are used to justify the pathologizing of gay sex, the deficits approach to our health, the use of disease as terror to curb the risk taking that doesn’t usually but sometimes … and on and on.

I suggest a way out of this all too familiar vicious circle, besides the obvious demands for universal health care and fighting poverty (two social justice issues that would do more for reducing HIV infections than all behavioral interventions combined): We must stop using HIV as the primary gauge to measure the gay well and unwell.  There are other health challenges, like drug abuse, mental health, obesity and smoking, that are also harming gay men and lesbians.  If HIV continues to be the barometer by which we assess the wellness of gay men—instead of one among many physical, mental and spiritual health concerns—then we are destined for generations of failed gay and bisexual men, because risk will not diminish as the consequences of it do.

During one of the last times I saw the New York Patient, late in 2007, he took me to see his painting that hangs at GMHC.  “I realized something,” he told me on our way there.  “I was looking at all the drawings and paintings I’ve done since I joined the art workshop.  I used to sign my paintings with my name followed by the initials SV for supervirus.  I stopped doing this in the middle of last year and didn’t even realize it.” 

The supervirus has been put to rest. 

We’ve stayed in touch by phone, grabbing lunch when I’m in New York or sometimes by quick e-mails to tell me how he’s doing. “I have visited three high schools this year on HIV prevention talks!!!” he wrote recently.  “It feels GREAT talking to these young students, especially since they are such a high target of newly diagnosed these days.”  He’s been dating here and there, he told me, and his health has been good.  He has been off the Fuzeon injections for a few months, and the Isentress appears to be working.  His injection-site sores have all but gone away, leaving a few scars on his legs and stomach.  His last CD4 count was 292, and his viral load remains undetectable.  “I’m getting closer to feeling as well as before HIV,” he told me during one recent phone conversation.  “I’m slowly getting my life back.  Hopefully I’ll get back to work sometime soon.”

Considering all he’s been through—all we’ve been through—this is news worth celebrating.

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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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