Viewpoint
We have a problem in the gay men's community. Our silence about the epidemic slowly eating us away is killing us. As much as this might sound like it is some ancient diatribe written during the height of the deaths of gay men in droves in the 80s, sadly it is the reality today, right now, right here.
HIV has not gone away, and in fact, there is an increase in the reported cases of men who have sex with men in Michigan. We can blame a lot of things, but before we look very far, we have to blame ourselves.
Yes, the Bush administration's near psychotic fixation on abstinence-only education has hurt us. Gay sex is not figured in that formula, and so our lives were ignored. That does not mean we did not have a responsibility to teach each other how to be safe.
In the early 90s when I came out, you could not go to a gay-related event or bar without finding a big bowl full of free condoms. I have been to dozens of queer events, including Creating Change in the last year, and I have not seen a single bowl of condoms. If we aren't putting them out there at our own events, we are pretending that the epidemic is gone.
Barebacking or raw sex is real. It is happening. Maybe it's a backlash to the hammering home of condom messaging in the 90s. Maybe it's because barebacking feels good. Maybe it's because people are getting tweaked out on meth and screwing their brains out. But you know what? Until we TALK about it, it will continue. I am not saying barebacking has to end. I am saying we need to give people the tools to talk about engaging in it in a safer manner. And that means conceding it is real and it's a real desire.
It also means getting off our asses and being real about options. Abstinence is the only 100 percent sure fire way to make sure you don't get infected. But it's also an irrational expectation to place on a community that is told on one hand abstain, but on the other, your relationships don't matter so don't ask the state to marry you and recognize you. Sometimes, consciously or not, the gay community replaces intimacy with sex. Hell people replace intimacy with sex. It's part of human nature.
Condoms are certainly an effective option, but realistically, they are not being used regularly or consistently. That's why we are seeing increased rates of HIV and other STIs in the gay men's community. So what else can we do?
Be honest. There ARE other options. Post Exposure Propholaxsis or PEP; and Pre Exposure Propholaxsis, or PrEP; work. PEP is the long held secret of the medical community and used when a health care worker is exposed to HIV. Promptly the person is put on a course of anti-HIV medications. The course is 30 days. It has also been shown to prevent infection if taken within 72 hours of exposure through sex. PrEP is used as a long term option by some and requires the use of anti-retrovirals before and after exposures. It has been shown effective in studies.
But we don't talk about PEP and PrEP as real options for HIV prevention because… well I am not sure why. But why aren't gay men being given PEP options through HIV education and prevention outreach efforts? Why aren't doctors with HIV positive patients discussing with those patient's partners the PrEP option? Do most doctors even know about these options? Do HIV educators?
And finally we have to get real about how HIV is impacting all of us, infected and uninfected. Rejecting a guy merely because he is HIV positive sends the message that he should not disclose his status again. Not getting tested and trusting your partner to be honest with you is not safe, it's wreckless. And choosing partners who claim to be HIV negative, but can not name the date time and place they were last tested is not reducing your risk, it's burying your head in the sand and pretending the tidal wave is not coming. It is time, it is beyond time, that we get off our asses and stop pretending that everything is OK. Our ignorance is killing us and we are aiding it by pretending we are not ignorant.
If you have not been tested for HIV, you are hurting the community. If you are not talking about HIV with your partner, you are hurting the community. If you are gossiping about someone and labeling them as HIV positive to ostracize them, you are making HIV a bigger, nastier monster than it already is. If you are rejecting someone who is HIV positive, you are damaging yourself.
So yes, Matt Foreman, former executive director of NGLTF is right. HIV is a gay disease. The question is, are you willing to own up to that reality and do something about it?
