HIV: A STORY YOU PROBABLY HAVEN’T HEARD BEFORE
a brief history of 34 years
A question.
Looking back over thirty four years, what are some of the many lessons we have learned from a plague that has affected the gay community on a scale similar to war time?
We have learned that people are going to continue having sex in the face of a crisis, even with great personal risk, or under threat of death. In fact, under these circumstances, many will have more sex than they would have in normal conditions.
We have also learned that shame, blame, and moralizing ridicule may be wonderful tools to aid in ones perception of personal superiority, however as a prevention method for a global pandemic, they actually do little to help. Many argue, myself included, that they may in fact make the problem worse, by helping to set up dynamics of entrenched and marginalized sub culture, where what eventually manifests as norms in response to unrelenting persecution, are examples of discordant personal and community responses to crisis.
Another lesson from the past quarter century of public health and epidemiological data? Abstinence is a rock solid theory on the prevention of HIV, but, like Communism, it just never really works out as planned.
I’m going to propose something radical.
If we expect a community or individual to respond appropriately in the time of extra ordinary circumstance, then it would be a logical extension that we offer that community or individual a standing in society that mandates equality. That is humanity 101, and is central to the human nature of moral individuals.
This point is so key in this crisis I cannot understand why we have not been dealing with it from the start. The gay community of the early eighties was a young and a culturally immature community. It was also less than five years out of the era which saw Anita Bryant and the Briggs initiative, teachers fired from their positions for being gay, landlords, employers, even stores, routinely deny service to gays and lesbians.
And then, July 1981 happens.
The time when cruel irony, being the bitch that she is, makes her entrance.
Bringing with her a new, fatal in all cases, very disfiguring gay cancer.
It hits hard, and it hits fast; targeting a community not accepted in most ways by a very fearful, hostile and intolerant greater society.
Add on a good fifteen years of unrelenting death.
Don’t add in a cure, because there was none.
But please, add in more death.
The dangling carrots of treatments and cures, followed by failures of same, rinse, repeat.
Add in grieving and more grieving, eventually experienced as a learned art.
Entire circles of friends — gone.
People having to face, often out of a life threatening necessity, what it is to be a true friend, and then without hesitation actively engage it. Or, what it is to support another fully and without condition. Or, perhaps it’s coming face to face with the truth of just how much pain one human being can endure.
Now at the same time, consider what was happening in the wider backdrop. Ongoing prevention attempts that were, at best, only marginally effective.
At worst, mind numbingly contradictory. An example:
“Talk About Status” at the same time as “Assume Everyone is Positive”.
The net effect? A population at risk hears “you need to engage in difficult discussions with ease to promote honest and effective dialogue, and then assume the worst no matter what you are told, because you probably can’t believe it anyway.”
Said to a hellishly never ending background refrain of “a condom every time.”
As human nature would dictate, in the midst of a crisis where people are scared and frustrated they may very well stop listening, especially when those same people feel they are not being heard.
Cut to 1996.
For the first time since this crisis began, people start to whisper about hope.
The whisper turns into an official announcement.
New medications.
And in what felt like overnight, people stop dying in massive number.
For the first time, real and viable treatment options.
But only for some. Mainly those who have the resources to afford it, the structure to sustain adherence, and the benefit of a healthy supportive network. Translated? Not many.
So because there is a real sense that the crisis has largely abated, and, like human beings are known to do, people react in very individual and very human ways.
Many say thank God, I can now forget this nightmare for a while.
Many see the beginning of an end they dream, hope, and pray for.
But here’s the thing.
At roughly the same that things got a little better, slowly, and in a different way, they also managed to get a little worse. For those lucky enough to be offered treatment, there was often something else that came along with that.
Something that for the longest time, no one could really place, let alone verbalize. It was most often referenced through random experiences of anger, feelings of helplessness, a general and non specific anxiety, social retreat and increasing isolation, “survivor guilt”, risky behaviors that often manifested sexually, substance use where often there had been none before, and a global sense of what the professionals now like to call “a lack of a future orientation”, expressed with a significantly decreased or flat affect.
Cut to the late 2000's.
Well, what do you know? We have a prevention crisis in the gay community!
Cruel Irony. Act II.
Rinse, repeat.
We also happen to have a serious crystal meth problem in the gay male community that in some studies has shown a correlation to seroconversion.
We have increasing numbers of disenfranchised youth, often with a history of severe abuse, often homeless, often involved in sex work, who both fear and distrust the systems meant to protect and treat them. Thus, a large segment of youth, particularly gay youth, are at high risk for HIV and unreachable by current interventions.
Public health does not even attempt to test these youth for HIV.
We also have a greater than ever before stigma problem within our own community, following a parallel track to the ever growing positive / negative divide.
We have a substantial increase in gay men over the age of forty testing positive. Think about that for a second. We have men who were there and made it through the first wave and are now becoming infected. That should be sign enough there is a lot more going on here than not making “safe choices”.
The terms bug chaser, gift giver and poz fetish become familiar terms to all involved in the HIV world. If you happen to be positive and interact in gay venues online, you are no doubt familiar with the weirdly surreal experience of a negative man asking you to “charge him up.”
The last sentence above can be seen as a very instructive example of the sexual objectification of a marginalized community.
And in light of all that and more, a collective What The Fuck is heard round the world!
So, here we are. Please ask yourself:
Is it not possible that the dynamics I describe so very briefly above, could have helped, in part, to create a less than optimal environment in which to self advocate for personal health? Or, a less verbose way of saying it; the past three and a half decades have been one hell of a twisted mind fuck for an entire community. It has known more loss, with an equal amount of non acknowledgment, than most people could ever conceive of.
Some may ask why the intense detailing? Because it shows (especially within elements of the gay community) that often the actions people counter with, are, in some ways, only adding to the problem. Our responses culturally, and in some cases our responses personally, are often making this situation worse.
Why, you ask? Is it ironic? Evil? Intentional? A flagrant disregard for a second chance at life?
Hardly! What we know now, and have known for a while, is that these responses should have been expected. They are straight out of the DSM-5! In so far as they form several of the identifying markers and clinical indicators of community acquired Post Traumatic Stress Disorder.
If I have completely lost you, look at it like this: the constellation of experience I describe above now has a clinical name.
More on that by LetsKickASS.org …
Because for a community of people whom studies have shown the majority to be socially isolated, finding it difficult to form close or intimate attachments, does it not stand to reason those attachments will be found wherever and however they can?
Reacting out of the range of what “should be done”, is an entirely normal, human response given the current context. These people have lived through the war. They have won the fight, because they are still here. They have a lot to say, a lot to teach, and a lot to give.
Which Brings Us To Today
Like it or not, in 2015 there is a critical mass of gay men who have lived through a nightmarish mind fuck for decades, and a lot more than a few of us, poz as well as neg, are finding it more than a little difficult to simply “get over it already”. Perhaps that is one of the reasons that no one really talks about this too much anymore. The unspoken expectation we hear in a hundred silent ways that says if we have stable housing and are compliment with our medications, then we should be good, appreciative gay boys and just be quiet already! What is very telling, however, is that on the rare occasions we feel safe enough to talk about this issue with each other, we talk for hours.
Perhaps that is the reason for distractions. Or, what some may call vice. Things like a large fetish interest in hot, intense sex, bareback especially. Often brief, but profound attempts at connection through the same. Like Snow Patrol says in Chasing Cars, “If I lay here, If I just lay here would you lie with me and just forget the world? Forget what we’re told, before we get too old, show me a garden that’s bursting into life”.
Even if that happens to be less than an hour by virtue of an anonymous hookup.
There’s also the issue of substances. Something that for gay men can be experienced in vastly different incarnations, degrees, and with multiple attributed meanings. Sure, some obvious examples standout, like those who seem willfully self destructive, playing a drawn out form of death by cop. Maybe it’s the ultimate kick of a sociopath; or, just as likely, it is someone who for whatever reason is profoundly lost and can’t understand why no one is offering to help him home.
For those who have been paying attention, layered, complex, and discordant are the current themes.
AUTHOR NOTES
While this analysis is specific to how HIV has affected the gay male community of North America and Europe, that is only a small and community specific picture of who is dealing with HIV today. Please realize that in 2015, HIV is affecting the following communities on a scale similar to how it affected gay men in the 1980’s. The HIV epidemic is not even close to over. These communities and individuals need your support. Please remember them when you think about, advocate for, and offer support to those living with HIV. They are sex workers, new immigrants, racialized minorities, trans men, trans women, victims of domestic abuse, homeless youth, first nations communities, incarcerated populations, and those marginalized due to poverty, substance issues, or mental health conditions.
Currently a researcher, educator, & writer, Allan G Rae (alto) left a twelve year career as a flight paramedic to obtain his MFA in creative writing. Stray dogs, Starbucks, & satire do not displease him. Follow him on Twitter below.
