News of a potentially virulent strain of HIV invading and infecting a new generation of homosexual men should come as no surprise. After years of a growing laxness of gay men who were increasingly complacent about AIDS and engaging in risky behavior, fueled by Internet liaisons and inhibition-lowering drugs -- rather than behavior modification or lifestyle transformation -- AIDS workers are "dismayed," as The New York Times put it in a Feb. 15 story.
This isn't like the terrorist threat that faced the country prior to 9/11 in which government and the media largely ignored warning signs. Twenty years ago, Surgeon General C. Everett Koop sounded the alarm about what could happen if people didn't change their behavior by either remaining celibate, using condoms or altering their lifestyles. At the time, Dr. Koop said he doubted that a vaccine could be produced to cure HIV because of the virus's ability to mutate so frequently. He said he did not expect a cure to be found in this generation and perhaps for a very long time, if ever.
In a telephone conversation from Dartmouth College, where he teaches, Dr. Koop said that while "It is never too late to take steps to rein it in" and while we in America are "affluent enough to treat it," most of the rest of the world is not. AIDS cocktails must be taken on an exact time schedule, he said, "and in places like Botswana, no one has a watch." Plus, the new HIV strain is resistant to almost all anti-retroviral drugs.
Dr. Koop said one of the things he tried, but failed, to get government to do when he was surgeon general was to act on the number of sodomy cases in prison, which he said are widespread. Sodomy in prisons, he told me, "reaps its own reward. No one tells the wife or partner of a freed inmate that he is HIV positive and so he infects his family and they can infect others."
While data and interpretations of it vary as to whether homosexuals are any more promiscuous than heterosexuals, those who are at greatest risk for contracting and spreading this new virulent strain of HIV are promiscuous in the extreme. They hook up at "sex parties," engage in anal sex without using condoms and often use crystal methamphetamines to enhance their sexual experience in sex marathons with multiple partners.
In New York, some veterans of the war against AIDS are proposing a new approach to the spread of risky sex. They want to track down people who know they carry the virus, but have sex anyway, spreading the disease. Charles Kaiser, a historian and author of "The Gay Metropolis," told 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."
This attitude follows two decades during which telling anyone they should stop doing what they are doing because it harms them and others got them labeled "homophobic." Not many were able to stand up to such condemnations and so they mostly remained silent. People who refused to change their risky behavior blamed the Reagan administration for not "doing enough" to fight AIDS.
'Glory hole' facilities
"Safer sex" campaigns have been tried before -- at bath houses and "glory hole" facilities in San Francisco and similar places in New York and other cities. Initially the campaigns produced some admirable results as people became aware of the dangers they faced from "unsafe sex" and the jeopardy in which they placed uninfected "partners."
Soon, though, the messages were ignored and the risky behavior resumed. There have been some reports of "suicide missions" by uninfected men who knowingly have sex with HIV positive men, believing that to be infected gives them a certain societal status.
"Behavior remains the key," says Dr. Koop. After at least two decades during which we have been told that changing homosexual behavior is nearly impossible and conversion to celibacy or a heterosexual lifestyle is a sham that denies "who we are," getting people to listen to a message about behavior change will be increasingly difficult, like finding the miracle vaccine Dr. Koop doubts is around the corner.
Tribune Media Services