Sunday, June 3, 2007

More things that make my head ache

This one is a bit of a rant, but seems appropriate in relation to events in recent days - a frank discussion of the social effects of HIV/AIDS on the LGBT community, at least as I'm aware of them. This isn't a discussion of the tragic effects on individuals or survivors - it's a look at some anecdotally observed social phenomena that, frankly, trouble me...and likely to be a lengthy post if I do the context-setting properly - because to understand where we are, we have to understand where we came from.

The AIDS epidemic hit its' stride in the early 80's - and gutted an entire generation in an emerging community before the initial fires ebbed. In the early days, a diagnosis was an indication you were in the last stages of a terminal and untreatable illness with good odds of a rapid decline and passing.

Within a short time, an emerging culture of free-wheeling sex and liberation was a culture under siege amongst hostile forces. Friends would announce they were positive, and be gone in weeks or months...and initially, the medical establishment and public health agencies were largely indifferent because it was "just gays."

Safer (never safe) sex, condoms, dental dams, and changing sexual practices were the initial preventative response, and remain so to this day.

Later, AZT and its less hazardous successors emerged, eventually developing into a somewhat effective palliative known as the "cocktail" (Viruses are kind of like computers...they can only hold so much information. Each "drug-resistance part" of a virus takes up a certain amount of "information space" in the virus. By hitting the virus in a patient with enough *different* drugs, so the theory goes, the virus eventually runs out of storage space and gets nuked by whichever drug it wasn't able to store a "resistance pattern" for...)

After an initial honeymoon, fear became less effective as a marketing tool for safer practices in the face of the fact that HIV/AIDS was not the near-term horror of a death sentence that it once was. Sure, there were folks (fewer every year, as therapies improve) for whom the cocktail didn't work...but after living for years under the threat of HIV/AIDS without any hope, even slight hope was enough to leave many in the community a feeling of relief.

The dark side of that relief was that risky behavior became more acceptable. Unprotected sex between partners (after all, partners never cheat on each other, right?), more frequent "oops" moments of drunken passion (after all, it's not a death sentence anymore, is it?), and other faux pas of the epidemiological world - not least of which was the belief that once your were HIV+ you were sufficiently screwed that you had nothing to lose by discarding safer sexual practices altogether with other HIV+ partners.

This last failed to consider that like the common cold or the flu, HIV is a family of retroviruses - a group with many strains of differing virulence and intensity. There was still risk - and, oh, what risk. Not only would a person risk infection with a more virulent brand of HIV with a more rapid progression with exciting new forms of drug resistance - but face a whole range of ancillary bacterial and viral opportunities for adventure with a compromised immune system. As a bonus, I'm given to understand that different viral strains can interact to create hybrid super-strains.

Joy. Yet, it gets even better. Operating under the misguided belief that with the new "cocktail" palliative therapy (palliative=put things in a holding cycle or at least slowing down the decline; curative=actually get better) that HIV/AIDS was no worse than an especially annoying form of diabetes, more joined the "bare-backing" crowd. The fatalists ("as a gay man, I'm eventually doomed to infection anyway"), the sensualists ("but it FEELS so much better!"), the depressed, and the emotionally wounded joined the party.

At this point, recall that HIV/AIDS has a variable and substantial incubation period to detectability (i.e., the incubation period isn't short and varies from person to person) just to add to the potential fun. Folks honestly believing they are negative, yet are actually infectious (whether from not being tested or from not being detectable at point of test) out there fooling around in this new environment.

It's a viral particles wet dream. HIV/AIDS infections begin an upswing after a long decline.

About now things take a real turn for the south, with a new group emerging that simply makes my head ache. The "bug chasers" - boys who actively seek to become infected and those that help them achieve their goal. Whether fatalist, horribly misinformed, or just plain bugfuck nuts they lurch upon the scene...with predictable results.

Then this week we learn of guys who have not merely gone south, they've apparently gone stark raving bonkers - date rape with a viral twist. Quarantine seems the minimal response, and in my little circle of friends, substantially more...vigorous...responses hold a certain appeal.

The mind boggles. The mindset that would perpetrate this kind of vileness is beyond me - but I would argue so long as it walks the streets, none of us are safe.

2 comments:

Sabra said...

That was an education. I knew most of it, but not all.

In all honesty, the random sex thing is something that still catches me flat-footed. I did nothing at all during high school, got married less than two years later, so my sex life is a mild one among even my heterosexual friends.

And then on the other side I have my best friend, and his friends (many of whom were my acquaintances during high school)...I somehow doubt he even keeps track of sexual partners anymore, though thank God he has of late sworn off casual sex (which of course means only one or two partners a month instead of four or five or six in that same time frame). Some of the stories I've been told are outright depressing, and I have seen that anything short of HIV infection is simply shrugged off. Syphilis? Gonorrhea? No big deal, just a trip to the clinic.

Diamond Mair said...

I've been raising the question for YEARS about the various viruses becoming resistant to Acyclovir & other anti-virals - I've a tendency to cold sores, and recently started developing shingles .................. first treatment of choice is Valtrex - and I LOVE how quickly it works - but I worry that I'm contributing to it's causing the virus{es} to become "stronger" ................. I would really hate to see what has happened with antibiotics {drug resistant strains of TB, various STDs, etc.} happen with the antivirals, as they are SO critical to the treatment of HIV/AIDS ...................