Where Are We?
AIDS statistics are certainly not above being tortured, often until they scream, but it does seem that in 2002 in the USA gay men may well be re-emerging as the leading group at risk for new HIV infections! On first hearing of this many people are incredulous-“how could this be happening after so much suffering and death.” Incredible or not it does seem to be happening and a shocked response I think is merely reflective of a profound ignorance of the “gay community”. The gay community is not a static, homogeneous entity.
Many, in fact I suspect a majority, of the new gay male HIV infections are in men in their 20’s with a significant portion being under 25, if my personal clinical experience is any indicator here in Denver. Realize that these guys were in diapers when it all started. Also factor in the reality that nearly 100% of them were not brought-up in households where their homosexuality was recognized, nurtured and celebrated from an early age as the gift it is. Even in 2002 “coming out” usually only begins at best in the late teens with hormones raging and with no societal support, in fact quite the opposite. The up hill “coming out” battle in our culture for the emerging homosexual makes the average sperm look like big winner! I will expand on this issue further on and relate it to the problems with HIV prevention in the gay community today.
I am writing this piece as a personal position paper on the current state of HIV in the gay male community in Denver, Colorado, 2002. My hope is that it will at least stimulate discussion or at the very least a good chuckle for some and for that reason I am being at times intentionally provocative. If that seems too pompous how about just irritating?
I fully appreciate, or at least am aware, that the AIDS epidemic looks significantly different in other parts of the country and totally something else in other parts of the world. I do believe that to understand and begin to effectively address this terrible nightmare, particularly in other countries much more severely affected than ours, we need a thorough and radical (to the root) analysis of how and why this is occurring on such a scale and why it is hitting particular groups so hard. This analysis should then begin to inform our response. To get you going on this I highly recommend Paul Farmer’s outstanding book from 1999, Infections and Inequalities. Just a few words from the book: “HIV tracts along steep gradients of power. In many settings HIV risks are enhanced not so much by poverty in and of itself but by inequality. Increasingly, what people with AIDS share are not personal or psychological attributes. They do not share culture or language or a certain racial identity. They do not share sexual preference or an absolute income bracket. What they share, rather, is social position – the bottom rung of the ladder in inegalitarian societies.” (p.91)
So I am writing this as a white gay man who is HIV positive and has worked in the area of HIV health care for over 15 years and longer as an activist. I would love to pull this off being totally inclusive of the entire HIV affected world but I can not do that, so please allow me the space to concentrate only on my gay brothers and primarily those in Denver. I will make an attempt to address the very real problems and concerns of class bias and racism within the local gay community though, particularly as they relate and often hinder HIV prevention. Being middle class and white it is understandable that my view points in these areas may be suspect, hopefully though my observations can still be taken as points for further discussion and development by those directly affected. Work for many years with brothers of different class and color has taught me a lot I would like to think.
I am genuinely concerned with the health and well being of my gay brothers and our continued growth and development as a dynamic and vital people. I believe to the core of my soul that our unique, very valuable and often unactualized queer contributions to the larger society are being hindered by this plague. Whether they realize it or not the heterosexual majority needs a healthy gay male community full of piss and vinegar, not one constantly pre-occupied with sickness and death or perhaps even worse one trying constantly to blend into a homogenized America. I am of course alluding to much more than straight people being able to get their homes decorated, meals served and their hair done right!
My greatest fear is that we have reached an “acceptable” level of carnage from HIV in the gay community and it has become background buzz. The new therapies have definitely slowed the rate of death dramatically and probably lengthened an already long period of time from infection to death, but they have also created a very real false sense of security. As we have all learned dramatically in the past few months, it is hard for anyone to stay on “high alert” for long and to expect such a state to rule the hour for years around a pleasurable activity like sex is probably nothing short of ridiculous!
HIV, as it is present in the gay male world of Denver, is well entrenched, not going anywhere soon and probably actually increasing. My observations lead me to believe there is now a disproportionate amount of HIV among gay men of color and there has certainly been a class shift with many of the white folks getting infected quite poor and disenfranchised. This shift in demographics in the forms of class and race may account for much of the deafening silence on HIV from the established gay community itself these days. In 2002 much of the organized and activist homosexual world is white and middle or upper middle class. Whether we like it or not “social position” is a real factor in who has power in the gay world these days and the young gay Latino man with a crystal meth problem, working as a waiter or hair stylist does not have much influence.