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Old 02-11-2005, 10:57 PM   #1
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We've identified this strain of HIV that is difficult or impossible to treat

NYC Health Officials Find New, Virulent HIV Strain (Update7)
Feb. 11 (Bloomberg) -- New York City doctors have discovered a man with a previously unseen strain of HIV that is resistant to three of the four types of anti-viral drugs that combat the disease, and progresses from infection to full-blown AIDS in two or three months, the health department said.

``We've identified this strain of HIV that is difficult or impossible to treat and which appears to progress rapidly to AIDS,'' said New York City Health Commissioner Thomas Frieden. ``We have not seen a case like this before. It holds the potential for a very serious public health problem.''

The case was diagnosed in a New Yorker in his mid-40s who reported multiple male sex partners and unprotected anal sex -- often while using the drug crystal methamphetamine.

``It is likely there are others infected with this strain and this individual has infected others,'' Frieden said. The case is ``extremely concerning and a wake-up call,'' he said.

Antonio Urbina, medical director of HIV education and training at St. Vincent's Catholic Medical Center, site of one of Manhattan's largest AIDS clinics, said the patient's use of crystal methamphetamine shows that the drug ``continues to play a significant role in facilitating the transmission of HIV.'' The drug reduces peoples' inhibitions and their likelihood of using condoms or other forms of safe sex, he said.

`Alarming'

While drug resistance is increasingly common among patients who have been treated for HIV, cases of three-class antiretroviral-resistant HIV -- or 3-DCR HIV -- in newly diagnosed, previously untreated patients are extremely rare, and the combination of this pattern of drug resistance and rapid progression to AIDS may not have been seen previously, the health department said in a news release.

The strain found in New York was ``highly unusual,'' said Ronald Valdiserri, 53, deputy director of the National Center for HIV, Sexually Transmitted Diseases and Tuberculosis at the U.S. Centers for Disease Control and Prevention, in an interview.

``We're talking about a single case, but clearly the fact that we are dealing with such broad resistance of drugs and the rapid clinical progression is quite alarming,'' Valdiserri said.

U.S. health officials intend to contact clinics across the country to set up a surveillance system for the HIV strain, he said. City officials are working to identify, contact and counsel the patient's sex partners, Frieden said.


http://www.bloomberg.com/apps/news?p...d=azBO_AumTJhs
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Old 02-12-2005, 06:12 AM   #2
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Of course, it is disappointing that it exists, but I will say this: strains with higher virulence tend to be "too successful." In other words, by the fact that this strain progresses to AIDS much much faster than previous strains means that fewer people should be infected.

But I know how much of a skeptic I've been when it comes to diagnosing AIDS. The man is a crystal meth addict. HIV/AIDS or not, his immune system is destroyed. How much of this is actual HIV/AIDS virulence, and how much of it is crystal meth? This is what I find to be completely disingenuous about HIV/AIDS diagnoses. Here we have a guy who completely destroyed his immune system with crystal meth--and HIV/AIDS is now the worst of his problems? Please.

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Old 02-12-2005, 12:08 PM   #3
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This is very sad I was always afraid of this but surprised it took so long, most diseases do mutate to survive like the flu does every year I hope all forms can be cured soon.
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Old 02-12-2005, 12:18 PM   #4
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I have a friend in rehab as we speak from meth addiction. It's a devastating drug, with one of the highest relapse rates of any drug. I've read 92-94%.
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Old 02-12-2005, 03:12 PM   #5
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crystal meth is absolutley terrifying. i wish your friend good luck, joyfulgirl.
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Old 02-15-2005, 05:50 AM   #6
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http://www.nytimes.com/2005/02/15/he...rint&position=

"After all the thousands of AIDS deaths and all the years of "Safe Sex Is Hot Sex" prevention messages, it has come down to this: many gay men who know the rules of engagement in the age of AIDS are not using condoms. As news of a potentially virulent strain of H.I.V. settles in, gay activists and AIDS prevention workers say they are dismayed and angry that the 25-year-old battle against the disease might have to begin all over again.

While many are calling for a renewed commitment to prevention efforts and free condoms, some veterans of the war on AIDS are advocating an entirely new approach to the spread of unsafe sex, much of which is fueled by a surge in methamphetamine abuse. They want to track down those who knowingly engage in risky behavior and try to stop them before they can infect others."
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Old 02-15-2005, 06:45 AM   #7
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Originally posted by MrsSpringsteen
http://www.nytimes.com/2005/02/15/he...rint&position=

"After all the thousands of AIDS deaths and all the years of "Safe Sex Is Hot Sex" prevention messages, it has come down to this: many gay men who know the rules of engagement in the age of AIDS are not using condoms. As news of a potentially virulent strain of H.I.V. settles in, gay activists and AIDS prevention workers say they are dismayed and angry that the 25-year-old battle against the disease might have to begin all over again.

While many are calling for a renewed commitment to prevention efforts and free condoms, some veterans of the war on AIDS are advocating an entirely new approach to the spread of unsafe sex, much of which is fueled by a surge in methamphetamine abuse. They want to track down those who knowingly engage in risky behavior and try to stop them before they can infect others."


i agree with this.

while i don't think any kind of behavior causes someone to "deserve" getting HIV, i do think this kind of behavior -- meth abuse, anonymous unprotected sex with multiple (in this case, hundreds) partners -- is so astonishingly stupid, so callous, and has such a disregard and disrespect for the self or for others, that it's hard to feel total sympathy for the guy. honestly -- i have no idea why any gay man, anywhere, would ever engage in unprotected sex outside the context of a commited relationship where trust and full disclosure are the norm. it's stupid beyond words, and it may take a grass-roots gay movement to adequately address the linkage between the slight increase in HIV diagnosis we've seen (though much of that is probably due to better and more widespread testing), and the clear increases we've seen in less deadly but still unpleasant diseases like syphilus, chylmidia, and gonnorehia.

at the end of the day, these people are drug addicts, completely out of their fucking skulls, and had they not been high on a drug that (i'm told) increases sex drive to almost inhuman levels, such behavior would not go on. and it also behooves me to say, that in my experience, and on an anecdotal level, the most consistent practicioners of safe sex are gay men who are educated, aware of the risks, and do not use drugs. in my experience, it is straight couples who will tend to give into the urge and have intercourse even when condoms are not available, whereas i would never, ever have intercourse without a condom (dated someone for nearly a year, and we always used condoms ... fear of a slow, horrible death will do that to you!). however, we are seeing a sub-group of gay men who are highly addicted to drugs, and apparently feel as if they have little to loose, and constitute a clear and present danger to the gay community as a whole. something must be done, from the insdie out, to address this problem.

it's disheartening, and after the huge strides in social acceptance that have been made by gays and lesbians over the past 10 years. but again, it's a minority within a minority that are responsible for such behavior.

while the immediate measure is to ratchet up safe-sex messages -- i have straight female friends who, ever weekend, spend a few hours in gay bars where drug use is known to go on, and they pass out free condoms and lube -- and also to address the root causes of drug use and unsafe sex. frankly, many gay men are very self-destructive, and much of this, while not an excuse for such abhorrent behavior, comes from deeply internalized self-loathing and a lurking desire not to live past 40. the idea that there's not much to the life of a young gay man past the party circuit, because there's no discernable path for him to follow. what do gay men do when they get old? you'd have to know an old gay man to know that, and not everyone does. this is why, when i was asked who my gay heroes are, i pointed towards gay men over 40 who are happy, healthy and successful. to me, the ability to resist the temptation not to lose oneself in feel-good but self-destructive activities, and to literally create self-worth where none is given to you by society -- that is heroic.

this is a problem; crystal meth is to the gay community what crack was to the inner-cities of America in the late 1980s. no, not in overt violence, but in self-destruction, human toll, psychological damage, and the slow death of a minority group.
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Old 02-15-2005, 07:02 AM   #8
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Quote:
Originally posted by Irvine511
this is a problem; crystal meth is to the gay community what crack was to the inner-cities of America in the late 1980s. no, not in overt violence, but in self-destruction, human toll, psychological damage, and the slow death of a minority group.
Even without crystal meth, between politicians who use popular hatred of us to win elections and the general public that just maintains widespread ignorance of us, I say this: we're already surrounded by death, whether it is on a literal or metaphorical level.

So, certainly, I can understand why people would succumb to drug abuse. Reality just plain sucks, and it will never get better. At least not in my lifetime.

If I weren't so principled, I probably would be a drug addict myself. Anything to escape this homophobic hell hole we call "Earth."

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Old 02-15-2005, 07:35 AM   #9
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aw, melon. it's okay, brother. baby steps. good progress is made every single day. and, hey, at least we don't get beheaded like in some other countries.

though you make a good point about druge use. i remember being told that there's a good percentage of gay men who are essentially functional alcoholics. since their social lives revolve around a bar, and the fact that many feel very trapped by their sexuality and societies rejection of it, alcohol and drugs provide that needed escape from a sometimes crushing reality. also many men, when they're not out, can only lower their inhibitions and internalized homophobia with the assistance of substances. i've felt this. i remember a long period of depression after coming out, and substance use/abuse was part of it.

so i hear you, but i also think we need to realize that there's never, ever been a better time to be gay.
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Old 02-15-2005, 07:39 AM   #10
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okay, this is a *really* long article, but well worth the read if anyone is interested in one of the most important pieces of journalism to come out of the AIDS crisis, and it remains relevant today as we try to piece together an understanding of the impulse twoards self-destruction that many gay men, especially those in our most vulnerable social groups, feel:



Gay Life, Gay Death.
The siege of a subculture - written as the plague was cresting in 1990.

In the living room of a friend of mine, there's a coffee table crammed with photographs. One stands out: four young men in tuxes taken three years ago. They're all grinning, in classic college-buddy group-shot mode. Of the four, two are now dead. One died two years ago, the second in early November, when Kaposi's Sarcoma (KS), the cancerous lesions common to people with AIDS, entered his lungs. Tom, the third of the tuxes, was diagnosed with the AIDS virus (HIV) five years ago. He found out his status soon after burying his lover of four years, who also died of AIDS.

Three years ago, despite treatment with the anti-viral drug AZT, Tom came down with his first major AIDS-related infection. His skin is now covered with KS. Because of an intestinal infection that doesn't enable him to digest food, an intravenous drip is connected to his heart and feeds him fourteen hours a day. His immune system is so weak that the plastic line keeps getting infected, so he has to go into the hospital from time to time to have it replaced. His lover of the past five years, Steve, the fourth tux, is HIV-negative, and is preparing for a new life on his own. Five in their close circle of friends have died in the past month alone.

This kind of familiarity with death is unique in modern times. With the advent of effective hygiene and medicine, death has long since ceased to be common among young people. If anything, death has grown more distant for the majority, a tragedy occurring either very occasionally in the otherwise healthy or among the old and frail, who are safely hospitalized beyond our immediate awareness and responsibility.

But for gay men in America in 1990, none of this applies anymore. Death is less an event than an environment. One hundred thousand people have now died of AIDS. This year almost as many have died as died in all the previous years put together. Ten times as many will die as have died. More young men have lost their lives to AIDS than died in the entire Vietnam War. Forty percent of these deaths have been among i.v. drug-users and others of both sexes. (Nothing here is designed to diminish their predicament.) But 60 percent have been among gay men. While the outside world thinks the worst is over, 800,000 people, on the lowest estimates, now face the hard task of actually dying.

This fact is transforming life for an entire section of America. Largely invisible and almost incomprehensible to outsiders, gay men and their families now live lives alien to modernity's rhythms. Death is ubiquitous. Friends and lovers die with random, rapid consistency. Time horizons shorten. Death is mentionable again. Indeed, it is unavoidable. Gay men now live essentially as medievals among moderns: habituated to mortality in a world of health, besieged by death in the midst of oblivious life. The gay cities within cities in America are in this sense medieval communities. The dying coexist with the living, and the dead clutter the address books of the dying as bones once festooned the charnel houses of medieval city-dwellers.

There is a further twist. Gay men must not only live as medievals among moderns, but also live as moderns, still wedded to the contemporary alienation from mortality, yet forced into encounters with extinction that the broader culture finds strange, distasteful. This dichotomy-modern and medieval, living and dying-is creating divisions among and within gay men too, divisions as hard to acknowledge publicly as they are privately unavoidable.

It is a commonplace that AIDS has united the gay "community" in newfound fraternity. But this is at best a half-truth. There are, of course, countless stories of reconciliation and courage in the face of the virus. Nothing here is meant to slight the truth of those experiences. But AIDS has also unmistakably widened the rifts among gay men. There are those with the virus, and those who are free of it. There are those who know many who have died, and those who do not. There are those who are dying and those who are not. In this crucible of solidarity, the divisions already in gay society are being cruelly exposed. Socially, racially, politically, AIDS is quietly tearing the gay world apart.

I.
Phil Zwickler is a fiery, stocky, fast-talking former filmmaker who has AIDS. He now runs a newsletter for people with AIDS and recently made a gripping short film called Fear of Disclosure, about relationships between people who test positive for HIV and people who test negative. I met him in his small, ramshackle office in downtown Manhattan. His lover, Jimmy, died a few years ago. Zwickler was barred from the funeral by Jimmy's family, and lived with the fear that he would die too and the guilt that he may actually have infected a man he loved. All this I learned within minutes, a function of the candor many people with AIDS display. After a few minutes of questioning, Zwickler's candor grew. "I'm angry at you," he said. "I know you won't have sex with me, not because of what I look like, not because of who I am, but because of a virus in my blood."

Perhaps the commonest misconception about the impact of AIDS among gay men is that it is restricted to the sick and the dying. In fact, its impact may be just as powerful among the well and the living. The vast majority of HIV-positive men are healthy and asymptomatic. And no HIV-negative gay man has lived without the risk and fear of HIV infection. Gay life and gay death are not separate issues, meeting occasionally at the bedside or the grave. They are wedded to each other.

The points of contact generate friction, of which Zwickler's passion is a sign. The divide between healthy HIV-positive men and healthy HIV-negative men has not yet been broached in the mainstream gay press. But it's evident in the personal columns: "HIV+ seeks same"; "Fun bright, passionate GWM, 41, 5'8", 148, HIV-, wants to meet similar quality men"; GWM, 40, 6' 200lbs, looking to meet younger GWM 20-29 for a lasting monogamous relationship. Disease-free as I am." This subtle, pervasive segregation among gay men is a growing feature of gay life. It has its roots in fear, although, paradoxically, not so much the fear of actually contracting HIV anymore. It's quite clear now that the virus is extremely hard to catch. Most gay men assume that kissing, oral sex, and anal sex with a condom are permissibly safe activities. So the phobia of sex with someone who is HIV-positive has an element of the irrational about it, as far as medical risk is concerned. "Fear" merges with stigmatization of the sick."They're the biggest hypocrites in the world," a positive man told me of wary negatives. "They hide behind this knowledge of safe sex and go to bed with anybody. But as soon as they find out you're positive, they drop you like a stone. "

There is also simply the gulf of experience between those with the virus and those free of it. Coming to terms with being HIV-positive is, for many, a transforming experience, and it becomes difficult to form relationships with people whose lives are untouched. "Ultimately," an HIV-negative who'd had a failed relationship with an HIV-positive told me, "that person is having an experience you're not having, and you'll never know him, however hard you try." Another HIV-positive with an HIV-negative lover spoke of the broader difference in attitudes the virus generated. Daily, petty squabbles, which obsessed his lover, seemed irrelevant to him: "I once screamed at my boyfriend, There are times when I wish you were positive, because none of these things would mean anything to you at all.' "

This dynamic of mistrust, fear, and stigmatization has further complications. One man whose lover became ill with AIDS told me he found it hard to take the HIV-test, not just because of his own fear of death, but because of the barriers it might have erected between them. He waited until his lover died, and discovered that he was negative. With that, he also saw the real reason for his earlier avoidance: "At the back of my mind, I guess I was afraid that I might have given it to him. That I might have killed him."

The danger of mutual transmission is a constant source of friction, and there is no escape from it. Even an HIV-positive man can be made sicker by re-infection with the virus, whether from his own lover or from someone else. The result is a curious turn of fate. Far from bringing couples closer together or encouraging monogamy, AIDS has actually pushed people apart. It has made intimacy harder, trust less tangible, selfishness more acceptable. It may not be what some have called "sexual apartheid," but it does amount to a kind of sexual and emotional zoning, an invisible wall between men who are themselves walled off from an outside world.

The effects of this can be seen everywhere in gay life, from the cult of the healthy body in body-building to the nervous inquiries on the second date about health. The divisions between HIV-positives and negatives are also reflected in politics. Queer Nation," a radical offshoot of ACT-UP, the AIDS Coalition To Unleash Power, concentrates on countering homophobia with a range of actions from kiss-ins to marches urging gays to bash back against anti-gay violence. To outsiders they seem just one more gang of gay activists. Among some AIDS activists, however, they're known as "ACT-UP for Negatives," people for whom the fight against AIDS is not so personal and therefore not so desperate. San Francisco's ACT-UP recently split between a faction focused entirely on AIDS and another more concerned with other gay issues. Behind the split lay positive-negative tensions. Alongside the usual rifts in any activist group between radicals and moderates, assimilationists and separatists, in today's gay politics there's the added factor of who has HIV and who doesn't.

These tensions inevitably lead to a raising up of the drawbridge of emotional commitment, to a retreat in the face of fear. In some ways safe sex is the apotheosis of this self-isolation. Safe sex can be the outcome of a life in which certain risks-of love, commitment, selflessness-are less likely to be taken. It's revealing that, according to safe sex counselors at Gay Men's Health Crisis (GMHC), the premier AIDS-care organization in New York, the most common "relapsers" from safe sex are not promiscuous, anonymous experimenters, but couples in long-standing, healthy, monogamous relationships. By protecting themselves against the virus, gay men also find themselves protected against intimacy.

This has led not to an abandonment of sex, but to a revival of it. As sex has become not merely physically but emotionally safer, it's become more popular. The back rooms, bath houses, and compulsive anonymous sex of a decade or so ago may have gone. But so too has the terrified celibacy of the first stage of the epidemic. "Sex is completely glorified and accepted. A 70s culture has come back," a young gay journalist told me.

The club scene has also experienced a revival. Two of the more popular New York bars these days are The Men's Room and Sod-O-Mee. The former is a pounding cavern, with sixty-foot ceilings, slides of nude men on the walls, and go-go boys, steroid-pumped to bursting, gyrating on boxes amid hundreds of mainly shirt-less men. The latter looks like any small dance club, with one difference. Above the dance floor there's a giant video screen showing pornography as the somewhat conventional crowd below bops to Madonna. All along the bar, video screens show the same genital images. Go-go boys in cellophane jockstraps sway in front of them. It's a symbol of a new sexuality: sensual, garish, safe, for the first time a full reflection of the phrase "mutual masturbation," in which emotions, as well as bodily fluids, are kept carefully apart.

The new sexuality, however, offers only the chimera of relief In willful nostalgia, the old Saint club, a legendary gay bar in the East Village that has long since ceased regular business, has been revived. In its heyday it was the focus of 1970s erotica. The old building is now defunct, but the glamorous crowd rents out other clubs to re-create the experience. And, indeed, it feels almost the same: throbbing disco music, near-perfect torsos, omnipresent drugs, and anonymous groping in the dark corners. But the fragility of the forgetting is apparent. The Halloween costume party was held this year at Studio 54, a sacred relic of an era gone by. An HIV-positive man showed up, scantily clad, erotically beckoning, his skin revealing the telltale signs of Kaposi's Sarcoma. He came as a court jester.

II.
Salem United Methodist Church is in the heart of Harlem on 129th Street and Seventh Avenue. One evening last October it was the site of a "Service of Love, Remembrance, and Hope" for people with AIDS. The high point of the "Harlem Week of Prayer for AIDS," it involved several local pastors. Perhaps because of the rain outside, it was a small congregation, with almost as many people up front as in the pews. The music was from the Addict Rehabilitation Gospel Choir, the first hymn: "On Christ, the solid rock, I stand; All other ground is sinking sand, all other ground is sinking sand."

We were called to prayer. The readings were read. A few people paid tribute to those who had died of AIDS. A young man in African garb recited a poem, calling upon all those black men who had died of AIDS to return to the fold of black history: Jesus is calling, for you and for me. Death is coming for you and for me. Come home, all you who are weary. Come home." A large woman shuffled for-ward, dressed in a checked cardigan and a flattened black felt hat: "In my little corner of the world," she said, "I saw my son slip away. But I looked to the hills whence cometh my strength. And we kept the faith." Tentative amens echoed through the building.

The service was faintly unreal: a scattering of embarrassed people focusing on death as if it were still an occasional, tragic intervention in normal life. The point of the evening, it turned out, was to force the assembled pastors, who had done very little to acknowledge the scope of AIDS in their congregations, to listen to the Rev. James Forbes Jr., the pastor of Riverside Church.

His text was the parable of the Good Samaritan. His aim was to confront the pharisaism of today's christians toward those with AIDS. He spoke of a gay parishioner. "He asked me, as he lay there dying of AIDS, he said, What's God's attitude toward me? Don't tell me something just to cheer me up. Just tell me the truth.' " The church went silent. For the first time that evening, the subject of homosexuality--not AIDS, not i.v. drug use, not poverty--was addressed. "What he wanted to know was not whether God would forgive him, not even whether God would love him, but whether God would affirm him." Forbes turned to look at the pastors: "I wonder very much what you would have told him." After an awkward pause, he continued: "There is a part of the Church that can only deal with respectable problematics. But grace is able to deal with any problematic." People shifted in their seats. "We have to deal with sexuality. Why do we have to allow Oprah Winfrey to tell the truth before we do?" A handful of people walked out.

AIDS is now affecting black and Hispanic New Yorkers more than it is affecting whites. In 1986, according to New York's Health Systems Agency, 30 percent of AIDS cases were black and 23 percent Hispanic. Now that's 31 and 26 percent, respectively. By 1993 the percentages are forecast at 35 percent and 30 percent. Thirty-seven percent of black and Hispanic AIDS cases are due to gay transmission; and experts believe this is an underestimate, since many black and Hispanic men would sooner admit to being a junkie than to being gay.

This, perhaps, is the most alarming feature of black gay life. In addition to the familiar problems of urban minorities, poor black gay men also have to deal with extraordinary homophobia. In talking to minority men with AIDS, it was hard to avoid the impression that the level of denial is measurably greater, the pain more intense, the isolation more complete than among whites. Stories of hushed burials, of families collecting sons' bodies from hospitals and not allowing friends or lovers to pay tribute, of bashings and neglect are commonplace, and usually told by people who request anonymity. Even among elites-perhaps especially among elites-homophobia is intense. Of the fifty-nine board members of the Black Leadership Commission on AIDS, the core minority group in New York confronting the problem, only one, project director Gregory Broyles, is openly gay. He's had to fight hard to get the fact of homosexuality acknowledged at its meetings.

"By being black, I'm separated from the white gay community, and being gay, I'm separated from the African American community," is how Broyles puts the black gay predicament. The black press rarely deals with gay men with AIDS: recent issues of Emerge and Spin, guest-edited by Spike Lee, for example, focused on the threat to women and children. According to gay black men I interviewed, there is even a belief among many young blacks that only whites are gay, and therefore AIDS iS irrelevant to blacks. Lies about the cause of early deaths merely perpetuate this myth. The truth is, a generation of young black men is disappearing in a silence broken only by the occasional, sparsely attended church service.

Take Kevin, for example, although that's not his real name. He lives on a run-down street in the middle of Spanish Harlem, the only black man on the block. He hasn't seen any family members for nineteen years, most of his friends are white. Few neighbors know he has the disease, although some know he's gay. He has heard women whispering "faggot" on the street as he walks by. It's a term that can be more than psychologically wounding. A man with AIDS on Kevin's block got badly beaten up recently when his neighbors found out he had the disease.

The walls of Kevin's dilapidated apartment are lined with classical music tapes, the floors cluttered with dumbbells, a reminder of the days when he was a body-builder. Twirls of flypaper hang from the ceiling like garlands. Kevin got really sick two years ago. He found he couldn't make his second shift as a security guard because of acute chills. He ended up in the hospital with tuberculosis. Since then he's had pneumonia, herpes, and KS. As we talked he scratched the KS lesions repeatedly, and had recently taken to picking at them with needles to relieve the itching. Halfway through our conversation, he suddenly said, quite calmly: "I can't see your face. I can't see you. I've got these spots in front of my eyes. Strange little horizontal lines." He was probably in the early stages of going blind.

His isolation is triple: race, sexuality, disease. In his first stay in the hospital, for TB, the three had come together: "A doctor came in and said would I like to go to the tenth floor? I said no, and he said wouldn't you like to be with your own kind? And I never knew what that was.... So two doctors came in and they said to me like I was getting a Christmas present, they said, yes, you've got it. And I said, got what? And they said, you've got AIDS. I said how much longer have I got? And they said three years at the most." That was two years ago.

When black gay men are visible, and the real cause of their deaths acknowledged, the reaction is often vicious. "All we've ever had is the power of the dick, the power over women," one young black gay man told me. "So if one dick likes another dick, that's a problem. They think: this faggot is in my community. I can't have that." The younger generation seems to be getting more-not less-bigoted. Black role models, like Eddie Murphy, crack jokes about people with AIDS. Rap spews anti-gay venom across the airwaves. As the black family has disintegrated, the pressure on middle-class gay men to get married gets stronger. One man told me the worst comments he had ever had were from women, resentful of a "good man" refusing to have a family.

It's no surprise, then, that the AIDS activist groups are overwhelmingly white. What's odd is their silence about the homophobia affecting minorities. ACT-UP, while protesting the white Catholic Church's stance against safe sex education, has failed to attack black churches that follow the same policy. The Minority Task Force on AIDS (MTFA), the only black group fighting AIDS on the streets of Harlem, holds safe sex workshops in black churches, which are required by pastors not to mention anal sex, condoms, or homosexuality, unless specifically asked about them. According to activists I spoke with, many pastors in Harlem are themselves closeted gay men, who mask their own homosexuality by refusing to acknowledge it in their congregations. Yet ACT-UP has not "outed" these men or even protested their negligence. Such an act, activists explain off the record, would be racist.

A large part of the minority gay predicament is the result of whites' reluctance to face a problem that does not affect them. But just as problematic as white neglect is homophobia among healthy, heterosexual blacks. One black AIDS activist I spoke with lamented that, if the minority groups fighting AIDS were to disappear tomorrow, nobody but a few white people would care: "Our white allies drive us crazy, but they're still our allies, and our racial compatriots don't give two shits about us." Broyles of the Black Leadership Commission on AIDS complains that elected officials never see blacks lobbying on AIDS, and so it is hard to attract funding. Ronald Johnson, who runs MTFA, blames minority officials as well: "There's not one black or Hispanic legislator who has done a goddamned thing about AIDS in this city, state, or country. And that's disgusting."

MTFA's offices are a few connected rooms in a dilapidated apartment building on 115th Street. MTFA has a handful of staff, and doesn't even have the word AIDS written on its door, for fear of reprisal. The contrast with the gleaming, five-story office block of GMHC-with its designer logo and color-coded office suites-could not be more acute. According to Johnson, the plight of black gay men with AIDS is dire not simply because of all the other problems affecting the sick-crime, poverty, drugs-but because AIDS has not even begun to enter the collective consciousness. Changing behavior is virtually impossible when the very people at risk don't acknowledge that they are at risk. A bathhouse still operates in Harlem. Denial by gay men of their own homosexuality is the norm. Drug use is commonly related to sex: "For black gay men who are still struggling with guilt over their homosexuality, drugs help them get over that guilt hump in order to be able to have sex at all," Johnson explains.

The group most able to help-the educated black middle class-is made up of the very people, according to Johnson, least willing to confront the taboo of homosexuality. The Dinkins administration, he claims, is more comfortable dealing with Tim Sweeney, the white head of GMHC, than with Johnson, who is black: "I broke one of the unspoken rules of the black community: if you're a homosexual, keep it to yourself"

Among Hispanics, the situation is more acute. The rate of infection is growing fastest in this population, yet if anything, the denial is greater than among blacks. Homophobia is arguably more profound among Hispanics than other ethnic groups, but gay sex may be more common. According to gay Hispanic men I interviewed, anal sex is very prevalent among "straight" Hispanic men. One now openly gay man said he'd had far more sex with his straight male friends when he was in the closet than he's had since. The deep taboo, he argued, is not against sex between men as such, but against admitting it and forming relationships. This is exactly the toughest scenario for AIDS education: those most vulnerable to the disease are those least likely to admit they're vulnerable.

The gay Hispanic population in New York is concentrated in Queens and isolated from white gays. There are Hispanic clubs-Studio 88, La Escuelita, The Love Boat-and a Hispanic gay culture, which, according to the few Hispanic men prepared to talk about it, is more close-knit and monogamous than white gay life. This isolation makes access to help difficult, as does the immigrant experience: "Their families don't know, they don't have legal papers, they don't have good access to treatment" explained Luis, an HIV-positive Hispanic man in his 20s. "A lot don't speak English. And they're afraid that if they go to the hospital, they will get deported." He plans to tell his mother about his condition when she visits from the Dominican Republic this month: "It's kind of sad," he points out. "She said one day that if I ever got sick, she would die. The pain will be something like that. So you see how scary it is for me to tell her. Of course, she will not die. She will live.

Among the varieties of gay death, the minority experience is the least accessible. Often the first thing the broader society sees of it is an emaciated black or Hispanic man in a hospital, adamantly claiming he's an i.v. drug-user. And it's no accident that as the disease has shifted to these populations, it has become less visible. In the pew in front of me at the Salem service a thin young black man stood on his own. From time to time he left to go to the rest room. Throughout, he mopped his face and neck with small pieces of brown paper, and clutched his body with his arms, cradling himself into temporary comfort. I didn't know whether to talk to him. Those around looked through him, caught in that awkward gap between patronizing and addressing his pain.

After the final hymn, we talked. When his illness became intense, he was forced to live with his mother and give up work. He lived in the South Bronx but was still here at 11:30 p.m., because he wanted "to do something." And besides, he couldn't stand being trapped in bed any longer. He was in touch with GMHC, and was supposed to go to a clinical trial for a new experimental drug that day in New Jersey. He had felt too sick to go.

III.
So much has been written about ACT-UP that it's easy to overlook its most compelling characteristic. Perhaps a majority of its youthful members will be dead in a few years' time. They are, of course, not alone in this. About 30 percent of GMHC'S Staff, for example, is thought to be HIV-positive. But the combination of nearing death and political activism makes for a unique phenomenon. ACT-UP is not merely a brigade of gay rights activists. It is not even a countercultural crusade for the rights of others. It is a movement primarily designed to prevent the demise of its own.

Most are candid about this: "For me, it's therapy," a Wiry, HIV-positive former Wall Streeter told me. "I've always admitted that. But it's not the therapy of comfort. It's the therapy of seeing that change can happen. It's self-empowerment in its true form. It's a sense of power." He said this last word with the curious intensity of many ACT-UP members. They are high on power, a high intensified by the liberation of coming to terms with one's own mortality.

The high has a drawback. It generates what can only be called fanaticism. Artfully crafted slogans baldly sLate the message: "Silence = Death," "We Die. They Do Nothing." One poster shows a picture of New York's commissioner of health, Steven joseph. The slogan: "Deadlier than the virus." Designed by graphic artists and advertising executives, they have a sharpness that echoes the look of mass advertising and throws it back in the face of its complacent consumers. Stretched across the chests of men who would look at home in Soloflex ads, the logos come close to morbid camp. The result is a kind of designer revolt, an AIDS aesthetic. Halfway through an ACT-UP meeting shout goes up: "The merchandising has arrived!" and there's a rush to the T-shirt counter.

This aesthetic is allied to intelligence. The Treatment and Data Committee-a subgroup of ACT-Up-has helped revolutionize federal procedures for the testing of experimental drugs through scrutiny of the bureaucracy and science Of AIDS. It has engendered respect and admiration-as well as frustration-among scientists and bureaucrats. Its latest campaign is to make five major opportunistic infections treatable within eighteen months, by speeding up the drug-trials process. In stark contrast to the sometimes hair-raising antics of the rest of ACT-UP, T&D is coldly rational--and effective. T&D pressured Burroughs Wellcome to halve the price of AZT, the only effective (but flawed) treatment for HIV.

Still, there's something unsettling about ACT-UP that is not easily allayed by understanding its context or its success. The intelligence is sometimes distorted by the Manichaean vision of those confronting death. It's a matter of dogma to ACT-UP members, for example, that there's no moral difference between negligent complicity in the AIDS crisis and the act of murder. Yet there are clearly complex arguments about levels Of AIDS funding that won't fit into this framework. Cogent arguments also exist for "outing" powerful closeted gay men who are actively homophobic, but in the hands of Outweek, a new magazine closely allied to ACT-UP, outing has become a way of enforcing ideological conformity on illiberal lines. Articles in Outweek have backed taking away free speech from anyone alleged to be homophobic and have urged the use of violence against straight "oppressors." A recent cover featured a lesbian pointing a gun at the reader, with the headline: "Taking aim at bashers." Another proclaimed: "We Hate Straights." That some of this material is presented as camp merely heightens the ugliness of the message.

The ACT-UP meeting I attended in New York was held in a theater, the drama taking place as much in the auditorium as on stage. Unlike other radical groups, ACT-UP is, internally at least, democratic-sometimes painfully so. The meeting went on for hours, accommodating loquacious bores who were each allowed their say. There seemed no moral pressure on dissent, or even on tedium; merely ecstatic cheering to greet the elect.

The meeting's main agenda was a forthcoming day of action that would shut down the major traffic arteries in New York on December 10. Activists were going to raid the subways, lie down on bridges, clog the free-ways, descend into tunnels-all to press the case for socialized medicine. The objections from the floor were ones any sane activist would make: the demo would backfire, it would enrage commuters, alienate potential supporters. It might affect sick people, caught in traffic jams, even cause deaths. And the date clashed with another planned demonstration for national health care.

Little of this carried any weight. At the worry about the sick came a shout from the back: "We're sick." At the chance of deaths: "We're dying every day." A young woman spoke from the balcony: "This is a great action. This is my fantasy action." Someone yelled from the stage: "Desperate situations require desperate means. It's not going to get better. It's going to get worse. If Larry Kramer's sermons haven't moved you, move yourselves! "

Kramer, an HIV-positive playwright in his 50s, founded ACT-UP. Sitting on the stage in a large smock, he smiled quietly throughout, like an old, wise child. His presence among the largely young men and women was a little like that of a guru, except, unlike most gurus, his influence was not to moderate the passion around him, or to direct it to more contemplative ends. It was to intensify it. He began the meeting with a soft-spoken announcement that he wanted to set up a group to do target practice, to learn how to use guns against the police and gay-bashers. His point in the demo debate was to back the radicals. He mentioned last year's demo that broke up a mass at St. Patrick's Cathedral, and provoked a storm of hostility: "We couldn't have gotten worse publicity than the Church action, and that put us on the map.... Don't use the backlash argument as an excuse. They're not going to like us. They hate us anyway."

ACT-UP, as Kramer's brainchild, is not about rational persuasion. As the meeting overwhelmingly approved the action, it was clear it was not supported despite its possible drawbacks, but because of them. "Oh, of course it's a nightmare. That's what I like about it," remarked the man sitting next to me. ACT-UP members wish as much to express' a contradiction, to give vent to desperation, as to achieve any particular end. Their politics wills the rejection it courts. "They hate us anyway," as Kramer succinctly put it. In any other group of people, this would be called a death wish. But among the dying, a death wish is also a curious way of staying alive.

It's no exaggeration to say that this wish, the experience of it, the feel of it, has changed a segment of gay life permanently. It has replaced strategies of pleading with those of demanding. It has substituted candor for apology. It has absorbed the momentum of the post-Stonewall gay sensibility and gone on the desperate offensive. But at the same time, ACT-UP has inevitably alienated a whole group of gay men-those whose own view of their sexuality is more opaque, whose politics is more complex, whose lives are not so transformed.

"Outing" is the most obvious feature of this rift, a declaration of war by some gay men upon others who are less committed in the struggle against death. Not so long ago the closet was sacred territory. No fellow gay would invade its sanctuary. Now every closeted gay man has to fear the animosity of his fellow gays as much as straights. This is a conscious strategy of intimidation, one that most ACT-UP members willingly celebrate. And when it isn't manifested in hate, it finds expression in scorn. "They're just being left behind, " one angry ACT-UP member told me of closeted and apolitical gay men. "They're just not relevant anymore."

By breaking the taboo against aggressively candid homosexuality and the greater taboo against aggressively candid death, ACT-UP has not only strained understanding between gays and straights. It has also torn apart the code of security among gays. In the long run this may turn out for the best, as more gay men acknowledge their sexuality and refuse to be patronized by society as a whole. But in the short run another threat has emerged to the rhythm and unity of gay life. And this one comes from within, and in the rhetoric of transfiguration.

IV.
There is a metaphor in Tolstoy's The Death of Ivan Ilych that sticks in the mind. At the very end of his life, Ivan struggles against death until finally becoming reconciled: "Suddenly some force struck him in the chest and side, making it still harder to breathe, and he fell through the hole and there at the bottom was a light. What had happened to him was like the sensation one sometimes experiences in a railway carriage when one thinks one is going backwards while one is really going forwards and suddenly becomes aware of the real direction."

Since almost the beginning of the AIDS crisis, gay men have had an acute sense of going backward. At first it seemed as if the worst would happen, but there was no massive public backlash, no branding, no quarantine. Then came the more difficult challenge of mass death, often unnoticed and almost always misunderstood. Gay lives quietly and increasingly attained a brutalizing concentration as the number of deaths mounted. As the crisis deepens, it's hard not to concur with one man with AIDS I met in New York: "How strong can we be? How much empowerment' does it take? How many support groups do I have to attend to talk about my 'feelings'? Sometimes I feel weak and afraid, and no one can help do anything about it. I hate it when that happens, but it does."

Denial is still there: denial of death, of the racial and viral barriers that exist among gay men, of the costs of cathartic political activity. And with this, an avoidance of the intimacy the crisis demands. At this point, perhaps, it is only fair to say that going backward is an understatement. There is no light beneath us in this hole. The hopeful idea that a community is being forged in the face of death is untrue, not because it is beyond the capacity of gay people, but because there is nothing as isolating as one's own extinction. There is, ultimately, no community of the dying. There are only the dying.

If there is an occasional sense that the railway carriage is actually going forward, it is perhaps in the strengthening of gay identity that has begun to be felt, the knowledge that a new, less ravaged generation of gay men will replace the one that is soon going to be missing, and that it will surely gain something from knowledge of the current horror. There is also the awareness that we have gained subtle, private strength from meeting death in this way. And there is the consolation that at least one myth about gay life, held by gays and straights alike, has finally been put to rest. It is an irony of the isolating nature of death that it is also curiously universalizing. Gay men die like straight men die. Loneliness, it turns out, is not the condition of being homosexual. It is the condition of being human.

December 17, 1990, The New Republic.
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Old 02-15-2005, 08:51 AM   #11
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Quote:
Originally posted by Irvine511

so i hear you, but i also think we need to realize that there's never, ever been a better time to be gay.
I'm glad you feel that way.

I hope you will both find the peace and happiness you deserve. It must be so tough not to feel so hurt and cynical, but please know that there are so many people who want good things for you. I know that's easy for me to say, but I want to believe that it's the truth.
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Old 02-15-2005, 03:01 PM   #12
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http://www.signonsandiego.com/news/m...-1n15aids.html

"An unidentified San Diego resident may be infected with the same rare, aggressive and highly drug-resistant strain of HIV found last week in a New York City man who has rapidly become ill with AIDS, health officials said yesterday.

"(The local person's) HIV has a similar molecular makeup as the patient in New York City," said Dr. Nancy Bowen, the San Diego County public health officer who held a press conference about the finding yesterday afternoon in San Diego. "
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Old 02-15-2005, 03:23 PM   #13
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Old 02-16-2005, 12:19 PM   #14
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HIV is scary. I can't believe what's happening.
It's unreal at times, this goddamned virus.
I hope that one day there'll be some sort of permanent cure.
The victims shall have my sympathy.
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Old 02-16-2005, 12:22 PM   #15
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Keep in mind this is ONE case. It hasn't been determined if it's nessacarily because this one individual is resistant to treatment or if there is a genuine threat of a newer, more agressive strain....
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