Unease With Disease

OK, the lecturer/father/disciplinarian in me is about to come out and it won't be pretty.

Well, the news isn't pretty. Updated analysis released last weekend by the Center for Disease Control found there were about 56,300 new HIV infections in 2006 (the most recent year for which data are available), about 40% higher than CDC's long-standing estimate of 40,000 for each of the last several years.

The caveat: According to CDC, the number of new infections likely was never as low as the previous estimate of 40,000 and has been relatively stable overall since the late 1990s. But there are disturbing trends among men of color. Blacks accounted for 45% of new infections while Hispanics accounted for 18%. Keep in mind the general population for both races is much lower.

I'm sure part of that is attributable to declining funds for public health and prevention, but let's face it - a very substantial part of that pie is risky behavior.

A scroll on Craig's List, Adam4Adam, Gay.com and a host of other sites confirms that too many of us are being deadly complacent. I'm so tired of seeing all these guys who want to bareback still. Barebacking?? I mean, really. I'd like to ask these guys if they'd want to try running across I-495 at 5:15 p.m. to see if they can dodge the cars.

Maybe that's just it. STDs just don't seem that scary anymore. When you see pristine, young faces on advertisements for HIV drugs, it's easy to think any virus or disease can be contained. Any bad result can be fixed with a shot or a pill and you can go back to what you were doing. The vision of a haggard, sunken-cheeked Tom Hanks languishing in his deathbed in Philadelphia seems antiquated now.

I have been amazed at how many sexual partners in my past were ready to make a move without condoms. Perhaps they just saw a (outwardly) healthy, professional man and automatically assumed I wouldn't be "the type" to do anything foolish or "have something"? If that's true then why do the knuckleheads turn around and then do something foolish? I’ve remained STD-free but I could have been lying about my status to them for all they know.

True confession: I’ve been lax (i.e. condomless) twice (outside of a monogamous relationship) and thus can be categorized as a temporary above-mentioned knucklehead. I chose to continue to be swept up by the moment. But I shouldn't have, out of principle, and I have never made that mistake since.

I have several people in my life who are HIV-positive. In three cases, I discovered a pattern of unsafe sex in their lives. I like to consider myself nonjudgmental but, admittedly, my initial feeling was deep disappointment in them. But I soon realized their lives have changed forever and no amount of lecturing from me can make them feel worse than when that nuclear bombshell of a discovery resonated inside their heads.

Part of the problem is a lack of education, considering I still come across some guys who assume a top can never get HIV, for example. The other pieces include a myth of infallibility ("I’m young, dammit, and can always win Russian roulette!") and this sense of inevitability of STDs, just like some of we African-Americans think we're fated to get diabetes, not realizing how much of that we control in diet and exercise.

Another thing is laziness. I didn’t consistently ask about STD status every time, so I got complacent even with the glove on. And some of us are so focused on HIV, we may be ignoring the consequences of other unprotected acts apart from penetration and other, more easily-transmitted diseases like syphilis and hepatitis.

If disturbing trends like these don’t make us ditch this ludicrous abstinence-only sex education habit the Bush administration is intent upon pushing, I don’t know what will. Sexual behavior is so complex that young and older adults need comprehensive education and real conversations about what is out there and how we can enjoy our sexuality in a healthy way.

OK, lecture’s over.