In an era when much of the focus on AIDS is international, where evangelicals rush to minister to AIDS-infected people in Africa and pressure President Bush to allocate more funding toward the global epidemic, word on the home front is mixed.
Yes, Ryan White funding will most certainly be renewed as the president promised in his State of the Union address. But efforts to convince gay men to guard their health by using condoms and practice safer sex continues to bedevil the public health community.
In mid-February, the New York Times reported that a New Yorker in his mid-40s contracted a rare strain of HIV "resistant to virtually all anti-retroviral drugs," one that appears to lead to the rapid onset of AIDS. Apparently, the man engaged in unprotected sex with more than 100 people on multiple occasions while under the influence of crystal mentham-phetamine. The drug is a stimulant that sharply reduces inhibitions and increases pleasure seeking, encouraging "marathon" sexual activity that can lead to the spread of HIV.
City public health officials called a press conference to publicize their findings and began seeking partners of the infected man to determine whether the unusual strain is present in their blood. The investigation could take several months to complete.
A reminder
I read that news report with sadness and fear. Sadness because it reminded me how many years had passed since I first heard of AIDS, then called GRID (Gay Related Immune Disease) in June 1981, on my 18th birthday. Now I'm 41, and AIDS continues haunting my community, exacerbated by drug usage and indulgent behavior. When will the recklessness and self-disregard stop?
In many ways, the emergence in 1996 of anti-retroviral cocktails, making AIDS more a treatable, chronic condition, encouraged our current complacency. Men, tired of using condoms and burned out from the epidemic, feel like they can live longer, more normalized lives if they become infected. Little attention is paid to the cocktail's serious side effects, such as diarrhea, neuropathy and accumulations of fatty tissue on the stomach and shoulder blades (the hump, as it is called).
The daily cocktail regimen becomes a requirement for staying alive, and missing a dose can create immunity to the drug. A life of pill taking becomes the norm.
The Internet
A second development leading to an increase in risky behavior among gay men is the popularity of "hooking up" on the Internet. While the variety and number of men one can meet opens up significant dating opportunities, the Internet is also a portal for anonymous sex.
The acronym PNP, "party and play," on someone's personal profile offers an invitation for men to meet and engage sexually with other men who enjoy using crystal meth or other drugs. Many of the social mores demonstrated in a face to face meeting are expendable when hiding behind a username and computer screen.
Should Seattle be concerned about what happens in New York? Many in the media and gay community viewed the February announcement as a slight overreaction.
Fred Swanson, executive director of Gay City Health Project, reiterates that multi-drug resistant viruses have existed for a long time and are transmittable. The New York case is a reminder that people must continue to practice safer sex. For those who test positive for HIV at Gay City's Wellness Center, Swanson reports, crystal meth use is often a factor in their sero-conversion. Gay City sponsored a forum on the dangers of crystal use in November and is preparing to launch an educational media campaign on the drug.
Dr. Bob Wood, of Seattle & King County Public Health, reports that over the past year, 3 percent of newly infected men in King County have a multi-drug resistant strain of the virus. An even smaller percentage of men (.5 to 1 percent) who become infected come down with AIDS in the first year are rapid progressors.
While the threat in Seattle is small (three in 10,000 would fit into the multi-drug resistant and rapid-progress category), Wood believes that scientists in New York did the right thing by issuing an alert. The news warned doctors about the existence of a "super" virus and made the case for collecting surveillance for drug resistance and monitoring of people through the course of their disease.
Why?
The bigger question is why are we still facing the onslaught of more HIV infection and deaths 25 years into the epidemic? One can blame irresponsible behaviors fueled by the anonymity of the Internet and sex clubs. Or the freewheeling drinking and drugging so prevalent in our community. Or AIDS burnout and the very human slip ups that occur when one is in the moment, enjoying the closeness of sexual intimacy.
After a week that saw three evangelical Christians found guilty for attacking Micah Painter last summer for walking "like a girl," and concurrently witnessed Senate Republicans in the state Legislature again thwart equal protection legislation for gay people, I'm more aware than ever of the fits and starts in social progress when it comes to gay equality. Slowly communities outside of Capitol Hill are beginning to understand the perils of gay people coming out and living openly.
But we still have unfinished business educating our families, friends, and even ourselves about the harmful effects of homophobia in U.S. culture, including our religious communities. We cannot expect others to treat us with respect and dignity if we don't show the same decency toward each other.
Let's make gay rights a culture of life, not a culture of death, issue.
Freelance writer Jack Hilovsky lives on Capitol Hill and can be reached at editor@capitolhilltimes.com.
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