By Charles Kaiser
From The New York Times, Op-Ed page, November 30, 1992
After many years of extraordinary progress, lesbians and gays are marching on the edge of an abyss. If we alter our habits, we may enter the greatest period of freedom and accomplishment in our history. But if we refuse to change we will perish.
Ever since the mid-80's -- after unprotected anal intercourse was identified as the primary means of H.I.V. transmission among gay men -- hundreds of thousands of us have modified our sexual behavior to curb the spread of this epidemic. But thousands of others are still gambling with their lives and losing.
The youngest men have never been educated effectively, largely because of the Government's refusal to support the explicit sex education that is necessary.
According to the House Select Committee on Children, Youth and Families, at least 40,000 adolescents are newly infected with H.I.V. every year. A new national study, by the Medical College of Wisconsin, found that 31 percent of the gay men surveyed outside big cities still engage in high-risk behavior. And in San Francisco, the public health department estimates that 14.3 percent of the gay and bisexual men under 24 are already H.I.V.-positive. "Denial of the problem at the Federal level .. . . is a national disgrace," the House committee concluded. Fortunately, Bill Clinton has already urged the earliest possible education about how AIDS is transmitted.
This onslaught on youth is predictable, since nearly every 18-year-old considers himself immortal and invulnerable. Far more surprising is an ominous new trend among gay men in their 30's and early 40's that has nothing to do with sex education. Many who managed to remain H.I.V.-negative after 20 years of sexual activity are practicing unsafe sex and becoming infected for the first time.
Eric Rofes, executive director of the Shanti Project in San Francisco, which provides services for people with AIDS, is alarmed because he has "many friends" between 29 and 42 who are "not crazy and not drug users" who have become infected in the last year. Mr. Rofes was particularly horrified by a conversation with a friend who told him that the least stressful condition "for a gay man in San Francisco today is to be newly infected with H.I.V." The friend said: "I'm not going to have to live through 50 years of burying dead people. I've got another 10 or 15 years to go. Nothing's going to hit me for the next six years, and I don't have to worry about getting infected anymore."
For many, it may be easier to condemn this behavior than to understand it. But therapists argue that it is extremely naive to assume that just because information about safer sex is available, intelligent men will automatically behave safely.
"Sex is a complicated issue emotionally, so I don't know why we would expect that people would be common-sensical or rational about it," said Walt Odets, a clinical psychologist in Berkeley, Calif., a pioneer in the study of H.I.V.-negative gay men. "A lot of forces in the gay community have conspired to deny the phenomenon," he continued. When he first discussed his findings with AIDS activists in San Francisco, they told him to remain silent. "They said: 'You're talking about things you shouldn't be talking about. You're going to damage the reputation of the gay community, which has won a hard-fought reputation for responsibility.' " When Mr. Odets said that they knew what he said was true, the activists replied that there's a difference between knowing it and talking about it publicly.
Mr. Rofes said: "It's easy to get H.I.V. You can get it by having fun. To avoid it you have to be committed to an identity of being a survivor." Many gay men over 35 have suffered the pain of losing from a dozen to 100 friends. Mr. Odets and Mr. Rofes believe these men suffer from survivor's guilt, cumulative grief and an identity crisis created by the connection between gay identity and H.I.V. infection. "In the 90's, gay male identity has been merged with H.I.V." in the minds of most Americans, said Mr. Rofes. "Gay equals AIDS. That is true in our community as well."
Modern gay culture is only two decades old. We still have grave problems of self-esteem, and many of us remain terrified of growing older alone. To some, suicide is a constant temptation. Mr. Rofes thinks new support groups for H.I.V.-negative men are essential to give us the courage to grow up. Activism aimed at Federal failures will always be essential, but today the most effective thing we can do to the prevent the spread of this infection is to focus responsibility for our health on ourselves.
Until now, openly gay men and lesbians have often had to define ourselves through extremism; the virulence of our enemies left us no other choice. But in 1992 we also need to embrace less fashionable virtues, including maturity and restraint. Gay men have displayed unlimited energy and enormous discipline in the pursuit of pleasure from our bodies. For the second stage of the gay revolution to succeed, we must now learn to do the same thing with our minds.
Charles Kaiser is writing a history of gay life in New York City since 1940. This is adapted from an article in QW magazine.
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