It’s time to focus on the AIDS epidemic in the United States and not give all the attention to the infected in Third World countries
Now that World AIDS Day has come and gone, I’m sure that everyone who participated in it has a warm glow of satisfaction that they have helped make the world a better place.
I’m sorry people are still contacting HIV and dying of AIDS, but as a man long involved in AIDS issues I find myself having dyspeptic, even bitter thoughts about the whole thing.
I’m tired of the self-satisfied, sanctimonious politicians and celebrities who have come late to AIDS as an issue and profess concern about AIDS around the world but never bothered to say or do anything when AIDS was sweeping through the gay community in the U.S. in the 1980s and early 1990s.
It’s nice that a singer named Bono cares about AIDS among heterosexuals in Africa. But when it was gay men in the U.S., where was he? Or now? The same is even truer for many American celebrities who belatedly express concern about AIDS. Where were they then? particularly those who always tell gay reporters they are so grateful to their gay fans. What did they do to help keep some of those fans alive?
Bill Clinton is trying to burnish his legacy by getting cheap HIV drugs for the poor in Third World countries. Fine. But when he was president where was that “Manhattan Project on AIDS” gays urged on him? Where were the directives to the National Institutes of Health? Where were the tax write-offs for private AIDS and HIV drug research? Where were the AIDS public education campaigns in the U.S.? Even now he seems more interested in Third World countries than gays and minorities in the U.S.
President Bush, too, has made noises about AIDS in Africa, but said little or nothing about AIDS in the country he is president of where many of the infected are gay.
Where is the U.S. surgeon general? Is he or she being held in an undisclosed location? Years ago, when Everett Koop was surgeon general, a friend who had AIDS had an occasion to meet him. Explaining that he was gay and had AIDS, he thanked Koop for all he was doing to promote AIDS awareness and reduce stigma.
Koop replied soberly, “I am the surgeon general of all the people.” Is his successor the surgeon general of any of the people?
The Centers for Disease Control and Prevention got into the act by putting out the same boilerplate statistic of 40,000 new HIV infections a year that they have been issuing for more than a decade. Doesn’t it seem strange that the rate hasn’t changed despite all the CDC’s AIDS prevention programs and even though current AIDS drugs reduce viral loads, ostensibly reducing transmissibility? Face it: Their numbers are guesses. They’re making this stuff up.
Come to think of it, it’s been a while since I saw a safe-sex message. Are they still around? Do we know if they do any good? Maybe the only really effective safe sex message was watching friend after friend get sick and die. We’re not seeing much of that now. Draw your own conclusions.
Lest anyone think that focusing on AIDS in the U.S. is just about white people, recall that the fastest growing infection rates are among African-Americans and Latinos many gay, but a higher percentage of heterosexuals than among whites. Why?
The most efficient sexual transmission route for HIV is anal sex. The higher rates of HIV infection among gay and heterosexual blacks and Hispanics are likely due in part to their higher rates of anal sex. Black men reported rates of anal sex in their last sexual encounter 50 percent higher than whites; Mexican-American men reported rates 30 percent higher, and non-Mexican Hispanics reported rates three times that of whites. For many heterosexual minority males one advantage of anal sex is that it does not cause pregnancy so it can be done “raw” i.e., without a condom. Effective AIDS prevention among minority heterosexuals would stress using condoms even for anal sex. Don’t expect it.
No data exist on rates of oral and anal sex among Latino gays, but black gays reported a much greater desire for and frequency of anal sex than white gays.
Whatever the reason, the CDC should promote a harm reduction strategy, urging oral instead of anal sex among gays, since even uncondomized oral sex has a far lower rate of HIV transmission. It won’t.
Many of Paul Varnell’s previous columns are posted at the Independent Gay Forum at www.indegayforum.org.
E-mail is Pvarnell@aol.com
This article appeared in the Dallas Voice print edition, October 20, 2006.