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One
of my best friends was recently diagnosed with HIV. Since
college, he’s been on an unending sex conquest, hooking up
with countless guys he meets online to engage in risky activities.
My concern is that he doesn’t seem fazed by his HIV diagnosis
and he says he has no intention of giving up his online sex
crusades. I worry about his mental and physical health, but
also about his seeming willingness to infect others just to
satisfy his sexual appetite. I’m pretty sure he doesn’t disclose
his HIV status to potential partners, and barebacking is what
got him into this mess in the first place.
I don’t know what to do. He’s a pretty clean cut, attractive,
A&F wearing, young guy, which doesn’t match the stereotype
that many in the homosexual community have about HIV-positive
guys. So what am I obligated as a friend to do? Should I tell
the group of friends we share, even though they are straight
and are not connected to the pool of people he is sleeping
with? Should we arrange a time to get together for some sort
of intervention? I want to be a good friend, but I don’t want
to just stand by and watch him continue to hurt himself and
possibly others. Any advice is appreciated.
—Help
Me Do the Right Thing
Would
you be friends with a guy who went out at night and mugged
little old ladies? Or a guy who beat his girlfriend? Or a
guy who ran around raping people? Of course not, HMDTRT, because
you’re an ethical guy and ethical guys don’t hang out with
violent, abusive assholes. So why on earth are you wasting
your time with this guy? Knowingly exposing other people to
a potentially fatal disease is an act of violence, HMDTRT,
and there’s just no excuse for it. Your college buddy obviously
doesn’t care about his own health any more than he cares about
the health of his sex partners. And you know what? If you
were an attractive, naive stranger he met on a Web site, he’d
be more than willing to imperil your health to satisfy his
own selfish sexual appetite.
So here’s what to do, HMDTRT: You’re going to drop this guy.
You’re going to refuse to have anything to do with him anymore
and you’re going to tell him why. And if anyone in your circle
of friends asks why you aren’t friends with this asshole anymore,
you’re going to tell him or her the truth. Will you be violating
your college buddy’s privacy? I suppose so, kiddo, but someone
who violates other people so casually isn’t in a good position
to complain about having his precious privacy violated.
Speaking of new HIV infections, an apparently deadly strain
of the virus that causes AIDS surfaced in New York City last
week just in time for Valentine’s Day. This new strain
doesn’t respond to the anti-retroviral meds that hold most
infected people’s HIV infections in check and, even more worrisome,
it appears to induce a rapid progression to full-blown AIDS.
The new HIV strain was discovered in a New York City man who
told health officials he has had sex with hundreds of men
in recent weeks while using crystal methamphetamine. Nice.
The news about what could be a deadly new stage in the AIDS
epidemic broke less than a week after public health officials
began warning gay men about a rare form of chlamydia known
as lymphogranuloma venereum, or LGV, that’s spreading among
gay men. Symptoms of LGV include a painful, bloody rectal
infection, genital ulcers, and exploding lymph nodes in the
groin. Six cases of LGV have been confirmed in the United
States, all among gay men, and most of the men infected with
LGV reported having multiple sex partners and engaging in
unprotected anal sex.
For some, the HIV/LGV one-two punch was the last straw: “Gays
Debate Radical Steps to Curb Unsafe Sex” read the headline
on the front page of The New York Times on Feb.
15. And the radical step that’s being contemplated? Partner
notification, or tracking down, testing, and treating the
sexual partners of people who have been newly diagnosed with
HIV. As radical notions go, partner notification is about
as radical as suggesting that surgeons wash their hands before
they operate. Public health officials have used partner notification
to combat other sexually transmitted infections for decades
and it’s past time that they started using it to combat HIV
too.
If people are looking for a truly radical step—something that
might actually curb unsafe sex—I’ve got a suggestion. But
first some context: When extremely promiscuous gay men assess
the risks and benefits of unprotected sex, most assume that
if they get infected, or if they infect someone, that an AIDS
organization or state health agency will pay for the AIDS
meds they or their sex partners are going to need to keep
themselves alive. It seems to me that one sure-fire way to
curb unsafe sex would be to put the cost of AIDS meds into
the equation. I’m not suggesting that people who can’t afford
AIDS meds be denied them—God forbid. No, my radical plan to
curb unsafe sex among gay men is modeled on a successful program
that encourages sexual responsibility among straight men:
child-support payments. A straight man knows that if he knocks
a woman up, he’s on the hook for child-support payments for
18 years. He’s free to have as much sex as he likes and as
many children as he cares to, but he knows in the back of
his mind that his quality of life will suffer if he’s irresponsible.
So why not drug-support payments? If the state can go after
deadbeat dads and make them pay child support why can’t it
go after deadbeat infectors and make them pay drug support?
Now that would be radical. Infect someone with HIV out of
malice or negligence and the state will come after you for
half the cost of the meds the person you infected is going
to need. (The man you infected is 50 percent responsible for
his own infection.) Once a few dozen men in New York City,
San Francisco, Toronto, Los Angeles, Chicago, Miami, and Vancouver
are having their wages docked for drug-support payments, other
gay men will be a lot more careful about not spreading HIV.
Trojan won’t be able to make condoms fast enough.
“I
don’t think there’s anything inherently illegal about it,”
said Jon Givner, director of the HIV Project at Lambda Legal
Defense and Education Fund when I called to bounce the idea
off of him. “It’s just a matter of whether you think it’s
good public health policy.” Jon doesn’t.
“I don’t want to play the role of the apologist for irresponsible
behavior [but] whatever public health policies we develop
should not be based on blaming the person with HIV first.”
Ana Oliveira, the executive director of Gay Men’s Health Crisis,
was more receptive to the idea. “We find ourselves at a time
where the idea of holding people accountable, of building
consequences into behavior choices, may be needed to help
change the paradigm,” Oliveira said. “We certainly appreciate
the element of justice in your idea. It could act as a deterrent,
and that would be helpful. The difficulty is that it would
be impractical to implement. It would require some kind of
a determination process and the pitfall would be a lot of
he said/he said situations.”
Still, Oliveira thinks everything should be on the table right
now, as do many other frustrated public health officials and
HIV-prevention educators. So I’m tossing my idea out there.
Anyone else care to comment?
mail@savagelove.net
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