I actually think about what I’ll write for World AIDS Day for most of the month of November. Too bad I don’t write a few sentences a day, or I’d have a full post by the time December 1st tools around, though no telling how coherent the post would be. I often feel pressured to write something deeply moving, personal and profound about al of the friends I’ve lost. Truly, that would be fitting, but a daunting task to be sure. When I stop and think about it, I’m sure there are tens of hundreds if not multiple thousands of friends who have died, and most of the time, I’m left with this deep bottomless sadness. I don’t know how to conjure up words for that. Except to say that the world I live in today is fundamentally different because of the absence of even one of these many many persons, let along the summary of all of them. I can’t be the only person to feel this way. At the same time, I’m aware that for different people of different ages, the pandemic of AIDS and what HIV means may be different. I often think about a young acquaintance I have who converted t positive just in the past few years. He seems to live his life as if it were not really any different from the days before he was positive. For him, AIDS isn’t this great killer, but just a chronic condition or annoyance like the common cold. Has HIV become- or will it- as common and mundane as a cold?

HIV prevention talk abounds as it has since the very beginning of the onslaught of the devastation. And with every decade it seems, there is talk about “rethinking prevention.” Logo has been showing a series of “commercials” with Avenue Q (or Q-like) puppets. Yet HIV rates continue to rise. Why is that? What’s gong wrong? You would think with so much information and so many ways to publicize it, we could decrease infection rates, and bring this disease under control.

If World AIDS Day means anything at all, it provides a perfect opportunity to decide to cut through the bull shit and start a dialogue about what’s wrong with the current HIV prevention strategies.

This Logo offering shared here is especially bothering to me. I think it is proof positive of everything that is wrong with HIV prevention:

[youtube]http://www.youtube.com/watch?v=RhfR9CeBjAI[/youtube]

I’ve pulled my copy of Susan Sontag down off the bookshelf, but I’m not sure I have the emotional energy to dig into it. Seems we payed her remarkable words no heed at all as we seek to fix HIV by the same status quo cultural morays that allowed the epidemic to explode in the first place. HIV isn’t about cheating and being committed to the one you love isn’t the answer . But I don’t mean this post to be all about a short commercial, so I’ll talk more directly about it in another post. Here are six thoughts that each deserve to be a topic of conversation. Over the course of the month of December, I’ll write about each one at further length and then link those posts back to this one.

The AIDS elephant on the living room: Six topics for discussion.

• Sex is not bad- even gay sex, and sex doesn’t cause AIDS

This idea is so not new, yet what is missing is the honest revelation that we, at least those within the LGBTQ community, have lost this battle. Too many, including most within the HIV prevention community have bought into the lies and self-hatred that sex is bad and gay sex causes AIDS. Stop and ask yourself- when was the last time anyone associated with HIV prevention told you emphatically that sex is good so go have at it with joy and abandon! Even in the linked commercial, the two puppets are encouraged to “make out” but only after their get married. Even here, the archaic notion that sex belongs only within marriage is predominant.

Globally gay sex is not the primary way that the HIV virus is spread, yet those who are anti-gay as well as those others maintain that AIDS is God’s punishment because of the acceptance of homosexuality.

If we don’t stop treating sex as bad or as if it only belongs within a marriage, we will never stop HIV rates from rising.

• Unprotected sex is fun and meaningful!

There, I said it. I told the truth, and I can hear the gasps already. Yes, condoms stop transmission, and stopping transmission is important, but if we don’t stop and admit that unprotected sex is fun and essential to healthy intimacy, we will never stop the rise of HIV transmission. The outdated and failed thinking has been that because condoms stop transmission, let’s just forget about having great sex, and force everyone into having less-satisfactory sex with protection. But if we are honest, we will begin to admit that people have lots of unprotected sex, because having sex doesn’t fit into some nice neat paradigm of using protection. Sex is passion-filled, and spontaneous, and often lacks having all the right accoutrements at arms length. It is easy to carry a condom with you, but without lube, it ain’t worth much. And lube often means needing a towel handy and I think you can  relate.

Don’t misunderstand me! Protected sex is essential to curb the transmission of HIV between gay men, but we have to stop pretending sex easily fits into a rigid scenario of protection. It may seem like the easy answer to promote all sex as protected sex, but it isn’t realistic, and the real answer to stopping HIV transmission will be more complex that the simple advice to wear protection.

• HIV isn’t an evil force out there about to infect everyone.

I know I’ve experienced this, and I’ve heard too many others express the same sentiment. It is easy to envision HIV as this malevolent force out there just awaiting to pounce on the bad people at every chance it can find.  You know- you just had a HIV test, and as you wait for the results, you wonder, did it finally get me?  This is a manifestation of my first point above- we have synthesized the notion that AIDS is God’s punishment, even if we don’t believe in God, by making AIDS this invisible force that seems to be everywhere.

But really it isn’t, and AIDS doesn’t have a brain, nor can it actively seek out new hosts. It is a retrovirus and does what a retrovirus does, simple as that. It isn’t like Santa and does’t know if you have been naughty or nice.  Sure, as a living organism, it seeks to remain alive and reproduce. But that is really a very different thing than a determined desire to infect everyone.

• People can not be easily divided into two groups: those who are positive and those who are negative.

On one level I understand why this lie is perpetrated by the Medical Establishment and the HIV community, but on a deeper level it is the worst lie that has been perpetuated.  The reality is that there are some people who seem to be immune to HIV as well as some HIV strains that are weaker and less dangerous than others. But the mantra, “know your status” doesn’t make room for those truths.

How many people are immune to HIV? We don’t know, and it isn’t clear anyone is really trying to figure it out. In fact, a quick review of the literature, suggests that the only use of this knowledge has been to seek out an understanding of the virus to help create new treatments, vaccines or cures.  Truly these efforts are important, but they don’t negate the fact that not everyone can get AIDS and no one is talking about that. Do you think Stephen Crohn may be alive today, if his condition (immune) had been treated as more than a way to seek out treatments? How many others live in fear of getting AIDS or whose lives remain devoid of real intimacy when they would not be at risk at all because they are immune?

• We need to stop blaming individuals and start confronting the cultural/structural/ systematic influences that perpetuate infection rates.

• We need to support people holding themselves accountable for their own actions, at least within the gay male community, while stopping the process of demonizing them and Othering them.

These two points are connected and may seem contradictory, but I don’t think they really are. Infection rates rise and fail to decrease enough because of systemic influences that are structural and so deeply embedded into our culture that they can not be stopped or changed quickly. The easy solution is to blame people who don’t conform their physical and intimate sexual lives to a difficult and less-than-satisfying idea of protected sex, only within a monogamous relationship. At the same time, we provide no support or accountability to help people understand the choices they make, including the ones which may place them at risk for HIV. And this is cultural! Consider the recent commercials for electronic cigarettes which suggest that using them is about taking back your freedom. When is using a very addictive drug, really a form of freedom? Structurally, our culture promotes those who refuse to honestly become accountable for the choices they make.

Consider the statistics for Alcohol related illness and deaths and HIV related illnesses and death if you want a perspective from which to consider this. Or take a look at deaths from texting while driving? Sure, a few statistics isn’t the whole story, but when you use this perspective to consider the efforts to demonize and stigmatize individuals?

Let’s talk!

I will expand upon these points over the next month, but please, don’t just pass this post by or quietly read my words, and forget them. If we are truly going to turn a corner in a fight against HIV/AIDS, we must stop attacking people, and especially men who have sex with men, and be willing to talk at length and deeply about the real factors that thwart ending the pandemic we call AIDS here in the US and globally.

So disagree with me, add another idea, or get willing to keep talking about this important subject everyday, not just on World AIDS Day.

Photo: License Some rights reserved by max_thinks_sees