In the past quarter century, HIV/AIDS has made a dramatic shift in the way it manifests itself in the American psyche. Gone are the scary Time magazine cover stories and brooding black-and-white public service commercials; now we have U2s Bono, serenading infected orphans a few continents away (while asking the First World to contribute money for relief). So when a new Überstrain of the virusprogressing to full-blown AIDS in a matter of months and immune to 19 of the 20 drugs available for treatmentwas discovered in a New York City man, public health officials and the media took notice. Suddenly, AIDS was in our own backyard again.
This new strain, dubbed 3-DCR HIV, may be much ado about nothingan isolated case related to one particular persons immune systemor the start of a public health nightmare (researchers believe they have found a similar strain in a San Diego man). Regardless, the circumstances surrounding the mans infection offer an alarming glimpse into part of New Yorks gay subculture and its related advocacy groups.
To begin, the anonymous patient is a 40-something gay man who, according to a New York Times source briefed on the case, engaged in unprotected sex with hundreds (yes, thats hundreds with an s) of partners last fall and winter. Oh, and he was using crystal meth at the same time. This is not risky behavior; its downright self-destructive behavior that, sadly, is part of a trend in New York City.
Crystal methamphetamine is your nightmare Bad Drug. More addictive than heroin, the central nervous system stimulant brings users to euphoric, energetic, and confident highsif theyre lucky enough not to overdose (which could trigger a stroke, heart attack, or death). Crashing down from this high brings not only intense physical discomfort, such as nausea, but a severe emotional drain. Users are likely to develop depression, marked by feelings of irritability, and even psychosis (the Philadelphia Inquirer quotes a former user: the shadow people were everywhere). To escape from such emotional and physical distress, users thus clamor for more of the drug, and inevitably enter an upward (and downward) spiral of addiction.
The popularity of the drug (which began, surprisingly, in rural America) in the Big Apple seems to have settled primarily among gay menso says the New York City Department of Health and Mental Hygiene. And the Times offers up some anecdotal evidence: a recent survey of gay men found that 25 percent had tried crystal meth in the last few months. Indeed, theres no denying an element of the gay subculture in the city has taken a dangerous liking to the drug: some members of gay websites will tag themselves PNP (party and play)meaning sex with crystal meth. They even refer to the drug by cutsie nicknames, such as Tina and tweak. Tina, after all, will loosen any inhibitions they have and enable them to take part in marathon sex sessions with multiple people, many of them complete strangers. Thus, with the danger of HIV/AIDS (the Center for Disease Control and Prevention says HIV infections rose 11 percent among gay men from 2000 to 2003, while the rest of the populations infection rate remained virtually stable) and STDs (in the last five years, syphilis cases have increased a whopping 400 percent among gay men in New York City), these men are most certainly playing with fire.
So what do the ever-present HIV/AIDS/gay advocacy groups in the city have to say about such behavior? HIV Forum NYC has been aware of the problem for well over a year and has created its own subdivision, the Crystal Meth Working Group, to educate the gay population about the drug. Their latest ad campaign: Crystal Free and Sexy. As their website says, the goal of the [print ad] campaign is to elevate gay men in the community that do not use crystal meth and are sexy, have fun and live full lives. They may go to clubs or not. They may use drugs or not. The one thing they all have in common is that they do not use crystal meth and they are hot, cool and hip. (Nancy Reagan shouldve used this: The sexy say no to drugs.) In other words, your promiscuous, pot-smoking, gay boyfriend is cool, as long as hes not injecting some tweak.
At least HIV Forum NYC is condemning the use of the drug. Another group, Gay Mens Health Crisis, is another story. Their advisory, Crystal Meth: What You Need to Know, is both comical and sad in how it attempts to avoid judgment at all costs. After explaining why gay men take the drug, what happens (written in startlingly graphic terms) when the drug is taken during gay sex, and meths guaranteed dangers, GMHC then says, If you are going to use, you ought to use extreme caution and limit how much you take. . . . Dont assume you didnt get enough. The more you use the less burning you will feel in your nose and the less intense you may feel. If you dont feel it right away, wait. And, If you are injecting (slamming) crystal, they offer some more helpful tips: Use a new syringe and new equipment every time you inject. . . . Clean injection sites with alcohol pads before injecting. If alcohol pads are not available, clean the injection site with warm soap and water. And so on.
GMHC is saying, in other words, This stuff is bad, but if youre gonna do it, do it right. This is analogous to saying, Teenagers are going to drink beer no matter what we do. Might as well tell `em where to get the best fake ID. So afraid are they of being seen as judgmental, GMHC would rather inadvertently promote meth use than say to at-risk members, Dont touch this illegal substance.
The dangers of crystal meth aside, both advocacy groups remain silent on an even bigger factor in HIV infections: promiscuous sex. Had the New York City man with the superbug cut his number of partners down to, say, single digits, he might not be making headlines today. While abstinence is anathema to the advocacy groups, they can at least preach restraint and responsibility. But no: better to stay silent then to be seen as prudish or eveneek!socially conservative. (The New York Times, normally in thrall to PC orthodoxy on gay issues, has been comparatively sensible in its coverage of this problem.)
This is not to say that if a few HIV/AIDS/gay advocacy groups change their ad campaigns or the contents of their websites, New York City will be HIV-free. But personal responsibility will go much farther in the fight against AIDS than waiting around for a government-subsidized cure. It would behoove the advocacy groups to catch up with the rest of society and put a stigma, as scary as it might be for them, on the irresponsible behavior that leads to HIV/AIDS, other diseases, and broken lives. Such a stigma would lower the risk of another 1980s-style outbreak. Even the sexy would approve.