On the eve of World AIDS Day, The New Yorker has an excellent short article by Michael Specter: What Young Gay Men Don’t Know About AIDS. Excerpt:
Outrage and new medicines largely overcame denial and hatred. In the years that followed, the epidemic seemed to go away—though of course it never did, here or anywhere else. (By the end of this year, AIDS will have killed nearly forty million people—most of them in Africa.)
And this week, in a powerful story in the Times, Donald McNeil pointed out that those most wretched days could return. “Federal health officials are reporting a sharp increase in unprotected sex among gay Americans,’’ he wrote, “a development that makes it harder to fight the AIDS epidemic.”
That is a genteel way to put it. Thomas R. Frieden, the director of the Centers for Disease Control and Prevention, was a bit more frank. “Unprotected anal intercourse is in a league of its own as far as risk is concerned,’’ he said. Three decades of data demonstrate the truth of that statement. If unprotected anal intercourse is rising among gay men—a trend noted not just in America but in much of the Western world—the rates of HIV infection will surely follow.
Why is this happening? Put at least some of it down to human nature. Why do people refuse to vaccinate their children against measles or whooping cough? In many cases, because they have never seen measles and have no idea what it might do. (For perspective, more than a hundred and fifty thousand people died of measles in the developing world last year.)
HIV is far more dangerous than measles, but also much more complicated. HIV is tied up with sex, a basic human need, but also with desire, shame, discrimination, and fear. What twenty-year-old man, enjoying his first moments of sexual adventure, is going to be scared because, ten years before he was born, people like me saw gay men writhe and vomit and die on the streets where he now stands?
For a while, in the nineties, gay men were scared, and the statistics showed it. They used condoms regularly, and tested themselves to see if they were infected. Many still do, but others began to weary long ago of the sexual and emotional straitjacket. A drug like crystal meth (which erases inhibitions and greatly enhances sexual pleasure), while addictive and attractive, also presented an obvious and immediate drawback: it caused a condition known as “crystal dick”—no erection, no sex. Then people began to combine crystal with Viagra, and a new surge of infections began.