AIDS and silence: The stigma is killing us

December 1 is World AIDS Day

We have a problem in the gay men’s community. Our silence about the epidemic slowly eating us away is killing us. As much as this might sound like it is some ancient diatribe written in the ’80s, sadly it remains the reality today.

HIV has not gone away, and, in fact, there is an increase in the reported cases of men who have sex with men in Michigan. We can blame a lot of things, but before we look very far, we have to blame ourselves.

Yes, the Bush administration’s fixation on abstinence-only education has hurt us. Gay sex has not been figured into that formula, so our lives were ignored. That does not mean we did not have a responsibility to teach each other how to be safe.

In the early ’90s when I came out, you could not go to a gay-related event or bar without finding a big bowl full of free condoms. I have been to dozens of queer events, including Creating Change, in the last year, and the free condoms seem to be gone. If we aren’t putting them out there at our events, we are pretending that the epidemic is gone.

Barebacking or raw sex — sex without condoms — is real. It is happening. Maybe it’s a backlash against the condom messaging that was hammered home in the ’90s. Maybe it’s because barebacking feels good. Maybe its because people are getting tweaked out on meth and screwing their brains out. But until we talk about it, it will continue. I am not saying barebacking has to end. I am saying we need to give people the tools to talk about engaging in it in a safer manner. And that means conceding it is real.

It also means being real about our options. Abstinence is the only 100-percent sure-fire way to make sure you don’t get infected. But it’s also an irrational expectation to place on a community that is told on one hand that it should abstain and on the other that its relationships don’t matter so don’t ask the state to recognize you. Sometimes, consciously or not, the gay community replaces intimacy with sex. All kinds of people replace intimacy with sex. It’s part of human nature.

Condoms are certainly an effective option, but realistically, they are not being used regularly or consistently. That’s why we are seeing increased rates of HIV and other STIs in the gay men’s community.

There are other options. Post-Exposure Prophylaxis or PEP; and Pre-Exposure Prophylaxis, or PrEP; work. PEP is the long-held secret of the medical community and is used when a health care worker is exposed to HIV. Promptly the person is put on a course of anti-HIV medications. The course is 30 days. It has also been shown to prevent infection if taken within 72 hours of exposure through sex. PrEP is used as a long-term option by some and requires the use of anti-retrovirals before and after exposures. It has been shown effective in studies.

But we don’t talk about PEP and PrEP as real options for HIV prevention. Why aren’t gay men being given PEP options through HIV education and prevention outreach efforts? Why aren’t doctors with HIV-positive patients discussing with those patient’s partners the PrEP option? Do most doctors even know about these options? Do HIV educators?

And finally we have to get real about how HIV is impacting all of us, infected and uninfected. Rejecting a guy merely because he is HIV positive sends the message that he should not disclose his status again. Not getting tested and trusting your partner to be honest with you is not safe, it’s reckless. And choosing partners who claim to be HIV negative but can not name the date time and place they were last tested is not reducing your risk, it’s burying your head in the sand. Our ignorance is killing us and we are aiding it by pretending we are not ignorant.

If you have not been tested for HIV, you are hurting the community. If you are not talking about HIV with your partner, you are hurting the community. If you are gossiping about someone and labeling them as HIV positive to ostracize them, you are making HIV a bigger, nastier monster than it already is. If you are rejecting some one who is HIV positive, you are damaging yourself.

A version of this commentary ran in Between the Lines newspaper, Michigan’s gay and lesbian news weekly.