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Wednesday, January 2, 2008

HIV Infection Rates Rising Among Young Gay Men

posted by on January 2 at 9:04 AM

It seems like we read the same story about HIV infections every few years: more young people are getting infected, what does it mean, what do we do, etc.. From today’s NYT:

For years he had numbed his pain and fear with drugs, alcohol and anonymous sex. But in a flash of clarity one day, when the crystal meth was wearing off, Javier Arriola dragged himself to a clinic to get an H.I.V. test, years after he stopped using condoms.

He knew the answer before he received the results, but it was far worse than he thought: At age 29, he had full-blown AIDS.

He had planned to have a party for his 30th birthday. Instead he was thinking of hanging himself in his apartment in Hell’s Kitchen.

What’s to blame for the rising infection rates among young gay men?

So far, they say, the significant factors feeding the trend appear to be higher rates of drug use among younger men, which can fuel dangerous sex practices, optimism among them that AIDS can be readily treated, and a growing stigma about H.I.V. among gays that keeps some men from revealing that they are infected.

And what do we do? The story tells us that new HIV prevention education campaigns targeting young gay men are planned. Of course. It’s the same course of action taken—or recommended—the last four or five times this story was written. But so long as gay health educators refuse to level with gay men—there’s no “moderating” your meth use; you can suck too much cock; anal sex isn’t a first-date activity and having anal sex with hordes of anonymous partners, even with condoms, is sure-fire way of contracting HIV—these new campaigns won’t have much of an impact.

And so we’ll be reading this story again in a couple of years, yet another story about HIV infection that makes tragic heroes of guys like Javier Arriola and goes on to suggest that straight talk about HIV infection is part of the problem, not part of the solution. Take this example:

Kyle, who found out that he had the virus two years ago, at the age of 23, said he had grown weary of what he called “pity dates,” men who agreed to go out with him after he revealed he was infected, but had no intention of pursuing a relationship…. “They blame you and want nothing to do with you; they put you at the end of the line,” said Kyle, who spoke on the condition that his last name not be used because he said he believed his condition would hurt him professionally. “The older generation sees AIDS as a tragedy, the younger generation sees it as self-destructive behavior.”

He said he was infected by someone who did not reveal that he had the virus until after they had unprotected sex.

I feel great sympathy for Kyle. But his infection at 23 is tragic and it was the result of self-destructive behavior that Kyle chose to engage in.

And Kyle? The person with whom you having unprotected sex, the one who didn’t reveal his status to you, couldn’t have had unprotected sex with you if you weren’t willing to have unprotected sex with him.

RSS icon Comments

1

Dan, when you say having anal sex with hordes of anonymous partners, even with condoms, is a sure-fire way to get infected, are you saying that condoms don't work or don't work everytime? Of course, I know they break and stuff, but if used properly....well, you know what the gay establishment and the manufacturers have been saying. Just wondering if you are saying something different.

Posted by Justy | January 2, 2008 9:11 AM
2

Back when I was young and coming out in the early 1990's it was an accepted rule NOT to fuck everything that moved (even with a rubber since they are not 100% effective) but then we also knew that HIV at the time was a death warrant.

What we are seeing is the result of HIV being seen as a "treatable" long term condition vs a quick road to death. Young queers think that if they are infected they just have to take pills. And that is the extent of it.

Posted by Cato the Younger Younger | January 2, 2008 9:17 AM
3

I am. Condom use with a regular, responsible, and responsible-to-you partner who is HIV positive has been shown to be highly unlikely to result in HIV infection. But random encounters with numerous partners, particularly anonymous partners, is much less safe even with condoms.

If you're having tons of anonymous sex with tons of people, your odds of a breakage, leakage, or a condom "accidentally" falling off are that much higher. So many more rolls of the dice, you know? And when you're having sex with anonymous partners you're having sex with people who don't care about you and feel no sense of responsibility to you. It's a bad mix.

Posted by Dan Savage | January 2, 2008 9:18 AM
4

I'm 28 and grew up with HIV sex education that even incorporated gay sex in the lesson plans, however I was completely naive as to the reality of it. I didn't know anyone who was HIV positive until I was 23; five years after I became sexually active. Even worse, I didn't know there was a generation of gay men who watched most of their friends die from AIDS in the 80's and 90's. The education is totally sugar coated. I was lucky enough to make it through my young twenties without contracting anything. There were even older men that convinced me to have unprotected anal sex when I was just barely out of high school. They acted like it was no big deal. These guys are to blame as well. They prey on young, unsuspecting gays who are just hoping to finally fit in.

Posted by Rye | January 2, 2008 9:52 AM
5

@4, Yes, it makes a BIG difference to watch people die of AIDS and BTW, what ever happened to the AIDS Quilt?

Posted by Cato the Younger Younger | January 2, 2008 9:59 AM
6

Hey, Rye: I've gotten no end of shit over the years for telling young and newly out gay men to stay the hell away from older gay men -- they're not your "brothers." We don't tell teenage straight girls that straight men are their "brothers." We tell 'em to avoid 'em and that any significantly older straight man that pays attention to them probably has an ulterior motive.

But we're supposed to tell young gay men that older gay men are their brothers -- "gay and lesbian brothers and sister" -- and that once they're out and away from the bigots in their high schools and small towns, why, you're safe now!

Posted by Dan Savage | January 2, 2008 10:05 AM
7

@6 - You're right, we are taught to look up to our older gay counterparts. I had one guy try to convince me that HIV was a myth and that he was living proof since he never contracted it and he'd been having unprotected anal sex for years (I'm sure he never got tested for it either). But there are so many of those men out there, it's scary. I'm always fearful for the cute young gay boy who just moved to the city from some midwest small town. So oblivious to what's out there.

Posted by Rye | January 2, 2008 10:13 AM
8

Scary stuff. I just don't get it. I grew up in a small midwestern town not far from where Ryan White lived. He ended up attending school in the small town my Grandmother lived in at the time. So AIDS info was everywhere when I was little. And it scared the hoo-ha out of me. When I grew up and came out I wasn't super eager to throw caution to the wind and sleep with strangers. Tempting? Mabye a little. But the fear factor, for me, was a definite motivation to be more careful. Or maybe it's just my good Christian upbringing. j/k

Posted by Michigan Matt | January 2, 2008 10:18 AM
9

Dan, this was a very thoughtful and heart-felt post from you. I appreciate the sincerity. I've known a couple of those "cute young gay boy[s] who just moved to the city" -- in both cases they were quickly meth (and pill) users and miserable, and one of them is already HIV+. Somehow they were caught in this trap of thinking that their tragedy made them more attractive and more in touch with the gay community.

Posted by Katelyn | January 2, 2008 10:25 AM
10

@9 - I think young guys are just trying to fit in somewhere. What's sad is Meth use is more accepted in the gay community than being HIV positive.

Posted by Rye | January 2, 2008 10:28 AM
11

A more effective approach would be to promote *safer* sex practices—like mutual masturbation—that can be just as hot and fun (to me anyway) while reducing the chances of HIV infection to zero.

Posted by Original Andrew | January 2, 2008 10:34 AM
12

Yes, but it's important to note that while infection rates have risen amongst young gay men (30 and younger), overall infection rates have dropped

And Dan, I don't agree with your infection logic- a HIV+ steady means that your partner has HIV 100% of the time. An unknown would be 33% (which you can edge up to 50% if you want to assume they're a riskier group). Even after factoring in the greater risk an unknown may be willing to take with your health, I think your odds are still better with the unknown than a known HIV+ guy, as you can also get infected through breakage, cuts, etc. And anyone hooking with an unknown should always verify that a condom is on the person before getting fucked by them of course.

Posted by freshnycman | January 2, 2008 10:40 AM
13

it's so sad, but they're kids - what can you do? i did so many stupid things at that age - although most of those involved drugs, alcohol, and motor vehicles - but unprotected sex with strangers was considered certain death. jesus, that was only a decade ago. things change so quickly.

i can't speak for the younger generation [!!! that was me 5 years ago], but most fags i know [in SF] consider crystal users to be gutter trash. but then again my friends are turning positive left right and sideways, so maybe it's not as simple as blaming a drug.

Posted by brandon | January 2, 2008 10:45 AM
14

@12 - I completely disagree. I'd rather have sex with someone who I know is HIV+, is taking their meds to keep their viral load down and practices safe sex than gamble the unknown. Do you know how easy it is to contract HIV from someone who doesn't know they're positive and their viral load is out of control?

Posted by Rye | January 2, 2008 11:02 AM
15

Until the gay "community" changes it's norms...The rates wont's really change much...My friends act like i am a fundamental christian for suggesting anal (even with a condom) with a stranger is NOT worth it or when i suggest they date (regularly screw) one guy at a time...being slightly more conservitive sexually could save our community...I dunno, maybe i'm a homophobe?

Posted by never change | January 2, 2008 11:40 AM
16

@14, yes, if you insert the "keeping their count down", "practices safe sex", "responsible" adjectives, then yes, I'd agree that's safer. But not all steadies are all those thing, and not all strangers aren't...

Posted by freshnycman | January 2, 2008 12:03 PM
17

"What’s to blame for the rising infection rates among young gay men?"

It's no mystery: Ignorance (willful or imposed), idiocy (infection-friendly behavior), and misfortune.

The first two are completely within our control, and even misfortune can be mitigated. My father always told me that there are no accidents. By that he meant, "Think ahead" and "Act preventatively to avoid negative outcomes." It's not magic.

Thus, it's more correct to ask not "what" but "who" is to blame. And the answer is: Young gay men who behave ignorantly and idiotically, thus placing themselves almost completely under the influence of chance.

Posted by doctiloquus | January 2, 2008 12:07 PM
18

Hm. No HIV denialists have piped up yet. They must be at lunch.

Posted by spencer | January 2, 2008 12:10 PM
19

You can have a completely satisfying sex life, with bragging rights and epic tales to tell over Sunday brunch, and still stay HIV negative. I know this, because I've been gossiped about over many a brunch, and I've still HIV negative.

Know the rules, keep your wits, don't mix sex and drugs--it's not as hard as you think.

Posted by boomer in NYC | January 2, 2008 12:14 PM
20

Man, you think it's hard being a 'no sex on the first date' gay in Seattle? Try it in Denmark. I get RAILED by friends and acquaintances for mentioning that I think anal sex right away is a bad idea. 'Prude', 'lighten up', 'your only denying yourself', etc. I don't know what the infection rates here are, but people seem way more one-night-standy, even by gay standards.

No meth around, though, that's sorta nice...

Posted by Rottin' in Denmark | January 2, 2008 1:05 PM
21

Someone told me recently that getting HIV was like getting diabetes. He was told this by a health care provider that was couseling his friend about a possible exposure.

I told him I thought she was obviously fucking insane.

What is weird to me is that anytime I meet someone online for sex they are always trying to fuck without a condom. It's *not* something that I'm looking for or that I want, but it never fails. I just don't get it...

Posted by Caliente | January 2, 2008 2:52 PM
22

I blame the hormones in beef and other food additives which are causing today's young man to be hotter, leaner, harder and more hung than ever before.

How can anyone resist a six pack of abs followed by 8 inches of glorous schlong with two luscious scoops of ass for dessert?

i blame food science.

Posted by michael strangeways | January 2, 2008 3:03 PM
23

michael @22

I blame you being older for romanticizing young male looks

Posted by luke | January 2, 2008 3:31 PM
24

@10: Is that what those "bug chasers" are after? I've never understood what their motivation was. Do they think having HIV/AIDS will help them "fit in" with the gay community?
In all of the cases I've seen, it seems that "bug chasers" tend to be young gays. Maybe that's why cases of HIV/AIDS has been on the rise lately.

Posted by Anna | January 2, 2008 4:01 PM
25

I'm 44 years old, and was fairly promiscuous in my NYC adolescence, which I survived, thank G-d, disease-free. What I can add to this dialogue is my conviction that there are too many unexpressed needs that young gay men are trying to be met through sex: social acceptance, self-esteem, an escape from loneliness or boredom -- and that too many young gay men, while seemingly uninhibited about sex, are too inhibited about consciously acknowledging these needs to themselves and to others. Being vulnerable and candid has never been considered "hip" or "cool." Thus, the shaming involved about one's insecurities or fears or needs also compromises any honest attempt to broach a dialogue about one's personal safety.

Posted by Rick | January 2, 2008 4:30 PM
26

well said rick... couldn't agree more.

Posted by nice | January 2, 2008 4:44 PM
27

It stuns me that Dan's position on this issue is not the common wisdom. It seems so straightforward and not particularly controversial.

I guess the people who think it is controversial would also be into "teaching the controversy" if their politics were right rather than left.

Posted by Jim | January 2, 2008 5:28 PM
28

@25 -- It's called "filling the wrong hole."

Once you've held a sobbing partner every night, who went out and got some on the side and also came up HIV+, you never want to date again. You grieve for your (now ex-) partner's situation, you fear for yourself (neg here thank god) and you wonder if everyone out there isn't poz -- especially those nice boys from the interwebs who all want to "just put it in for a second" without a rubber.

I miss dating and being in love with a wonderful guy, but at the age of 44, I almost don't think it's even worth it to try and find someone who is neg and who won't go fucking around on the side.

One thing's for sure -- the interwebs ain't going to be seeing me looking for love (or a fuck) anymore. Too many freaks, liars and flakes. I deserve better.

I bet you do, too.

Posted by Jubilation T. Cornball | January 2, 2008 8:17 PM

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