The plague is over, lets party.
June 2, 2008 3:26 AM   Subscribe

The plague is over, lets party. Article by Elizabeth Pisani describing the troubling consequences of a gay scene in a world where HIV is treatable and AIDS is avoidable.
posted by seanyboy (45 comments total) 4 users marked this as a favorite

 
Gay plague. Only homosexuals are promiscuous.

Oh yeah, this will go well.
posted by DU at 4:23 AM on June 2, 2008 [1 favorite]


No no no, not promiscuous they just have more sex then straight people. High five! So if you happen to be a half black half asian homosexual you can run fast, do your own taxes, and you're always getting laid.
posted by nola at 4:32 AM on June 2, 2008 [10 favorites]


So if you happen to be a half black half asian homosexual you can run fast, do your own taxes, and you're always getting laid.

Sadly, you're also a car thief who can't drive, but you have lots of fun in the back seat.

Tip your waitress. We'll be here all week.
posted by jonmc at 4:35 AM on June 2, 2008 [9 favorites]


Just as long as we're all agreed that disco is still dead.
posted by Civil_Disobedient at 4:50 AM on June 2, 2008


I don't get why the editors decided HIV is still an acronym while, apparently, "Aids" is not. (There are other editing mistakes/oddities, which does not inspire confidence in the article's authority.)

Also, I don't get the totally plucked-from-thin-air guesstimate in the first paragraph that 25% of the men in the bar the writer speaks of are infected. She didn't explain at all how she arrived at that figure.
posted by loiseau at 5:03 AM on June 2, 2008 [2 favorites]


"Tom, I want to nibble your biltong."

That's a new one for the Grand List of Manly Synonyms. I've gotta get out more...
posted by Kinbote at 5:04 AM on June 2, 2008


DU: I'm not judging here, and the "gay plague" implications are worrying, but I don't think the article is anti-homosexual as much is it is pro-safe sex. There's a bunch of stuff in the article explaining why this issue is more important to the gay community. Specifically, this quote ...
In 2006, 2,640 gay men were diagnosed with HIV—making up nearly two thirds of the total diagnoses of HIV infections that were acquired in Britain.
posted by seanyboy at 5:15 AM on June 2, 2008


For all you non-South Africans out there: Biltong is dried meat.
posted by PenDevil at 5:29 AM on June 2, 2008


I don't get why the editors decided HIV is still an acronym while, apparently, "Aids" is not.

This is a pretty standard house style: if it's four letters long or longer and pronounceable, it gets title-cased. I find it visually jarring, but this publication is far from the only one doing it.

I guess I'll go RTFA now...
posted by rtha at 5:50 AM on June 2, 2008 [1 favorite]


The very next day, another friend, a journalist, told me a similar tale. "Of course you use condoms, mostly. But if you're fucking four guys in an afternoon, there's usually one you want to mark out as special, and not using condoms is a way of telling someone they are special." Who qualifies as special? "Oh, usually the guy who's name you can remember."

This says WAY more about her friends than it does about the gay community at large.

Also, I love that she put "dick size" in quotes.

This is one of those articles that has a really good point, but is nothing new and is written by someone who doesn't have a particularly keen grasp on the subject.
posted by [NOT HERMITOSIS-IST] at 6:05 AM on June 2, 2008 [4 favorites]


I guess I'll go RTFA now...
posted by rtha


Heh.
posted by jonmc at 6:12 AM on June 2, 2008


Aids isn't an acronym because the acronym from Acquired Immunodeficiency Syndrome would be AIS. It's a contraction. IANAGrammarian.
posted by alasdair at 6:19 AM on June 2, 2008


The pharmaceutical industry ...aggressively promotes antiretroviral drugs directly to consumers—the good-looking men in these ads show off their pecs while abseiling down a canyon against the sunset. It makes HIV look almost desirable—certainly not something you'd give up sex to prevent.

All the hot guys have AIDS. It's just the fashion today.
posted by Goofyy at 6:20 AM on June 2, 2008


I think this article has got things about right. It's important to be honest about HIV, even if this undermines the shock tactics used to raise awareness about the disease.

(As for the question of capitalisation in the acronyms HIV and Aids, this is common practice. As the Guardian style guide says, "Use all capitals if an abbreviation is pronounced as the individual letters: BBC, VAT etc; if it is an acronym (pronounced as a word) spell out with initial capital, eg Nasa, Nato, unless it can be considered to have entered the language as an everyday word, such as awol, laser and, more recently, asbo, pin number and sim card.")
posted by creeky at 6:40 AM on June 2, 2008


Also, I love that she put "dick size" in quotes.

Well, it is presumably a quote from the website, rather than how the journalist would normally describe penis size in an article.

This is one of those articles that has a really good point, but is nothing new and is written by someone who doesn't have a particularly keen grasp on the subject.

That was my reaction. She's describing what is probably a very real phenomenon (or at least, a phenomenon that has been written about a lot already), but doesn't bring very much to the discussion.

I'm really glad that (except on college campuses and that "can you guess" website that was a FPP recently) you don't see the "we are all at risk"-style education campaigns so much anymore. Those always irritated me, because while the political point is a good one (we are all in the same basket, and we should care about people as people, rather than apply prejudices based on their risk category), the truth has always been that your risk of HIV exposure shifts dramatically depending on the demographics of who you are sleeping with. Pretending that everyone is equally at risk is a denial of fact in support of ideology, and I suspect that it is not an effective public health approach, compared to narrowly targeted outreach programs.
posted by Forktine at 6:49 AM on June 2, 2008


The continued sub-cultural resistance to contact tracking is a disheartening failure of AIDS activism. When you politicize one of the best epidemiological techniques of disease control, and offer nothing of scientific equivalence to replace it, you've done everyone on the planet a disservice in helping an infectious disease to spread, regardless of what that disease is.
posted by paulsc at 7:41 AM on June 2, 2008


I am shocked, shocked to learn that a bunch of drunken gay men in a sleazy bar have multiple sex partners, use "love drugs," and are careless about HIV status. This is why gay marriage must never be legalized -- once these guys figure out that matrimony is not an endless Tina-crazed bareback fuckfest, they'll surely get bored and feel nostalgic about "Fisting Night" at the Cock Pit.

Perhaps this journalist can next decamp to Beverly Hills, where she will discover a population of women who ruin their lives and health with fad diets, eating disorders, trendy religions, and egregious cosmetic surgery.
posted by digaman at 7:42 AM on June 2, 2008 [6 favorites]


This is one of those articles that has a really good point, but is nothing new and is written by someone who doesn't have a particularly keen grasp on the subject

Having worked in HIV for over a decade in developing countries, ....

Riiiight..
posted by c13 at 7:47 AM on June 2, 2008 [3 favorites]


I'm not judging here, and the "gay plague" implications are worrying, but I don't think the article is anti-homosexual as much is it is pro-safe sex. There's a bunch of stuff in the article explaining why this issue is more important to the gay community....

True. On the other hand, here's a nice tidbit from the article:

48 per cent of gay men in Britain still use condoms all the time, which is more than can be said for straight men

I'll admit I was startled by the statistic — and then a little ashamed at being startled. For the past few years at least, there have been these articles coming out portraying gay life as non-stop bareback action. I know better, but apparently I still bought into it, enough so that I was surprised to hear gay men were using condoms more often than straight ones.

So that's the harm that an article like this does. I'm bi myself, for chrissakes, and yet I've still been tricked into an unfairly and inaccurately negative view of homosexuality by this sort of reporting. Imagine the effect it has on people whose only insight into homosexuality is through the Guardian.
posted by nebulawindphone at 7:54 AM on June 2, 2008 [2 favorites]


The subject she doesn't have a keen grasp of is gay men, about whom she keeps making flat generalizations about their alleged sex and drug habits. Considering the milieu she's writing about, this is like going to Fort Lauderdale during spring break and writing about what "straight people" do.

But those surveys, those surveys!

What do want to bet that those figures came from self-reported behavior of gay men who end up in STD clinics and whatnot? Or do you think the researchers cold-called the general population of London, then asked, "Are you gay?", and followed up with "How many anal sex partners have you had in the past month?"
posted by digaman at 7:56 AM on June 2, 2008 [1 favorite]


...is through the Guardian.

Apparently I've also been fed the unfair and inaccurately negative view that Britain only has one print publication. Dunno where that one came from.

posted by nebulawindphone at 8:03 AM on June 2, 2008


an endless Tina-crazed bareback fuckfest

Y'know, this is more telling than anything in the article. Meth is bad, mmmkay?
posted by WolfDaddy at 8:03 AM on June 2, 2008


The subject she doesn't have a keen grasp of is gay men, about whom she keeps making flat generalizations about their alleged sex and drug habits. Considering the milieu she's writing about, this is like going to Fort Lauderdale during spring break and writing about what "straight people" do.

But we're not looking at all gay men in London. We're looking at guys in a pick-up bar at 1am on Friday night; I'm probably the only person here who will leave without being propositioned.

I don't know. Seems to me, she's pretty aware of the milieu. What she's saying is that this milieu is very conducive to the spread of HIV. Is this somehow incorrect? Do you think the bugs differentiate between a homosexual slut and heterosexual one? She's also saying that gay marriage and/or monogamy help to reduce the risk. So? What does this have to do with the population of Beverly Hills?
As for the surveys, this is what's available. I'm sure the people in the health services would be most grateful if you could provide them with a better data. Until you can do it, all you have is an opinion. Besides, epidemiology does not deal with individuals or exceptions. It just can't. So the only thing it has is a broad brush.


Meth is bad, mmmkay?

No, meth is better than Ovaltine and Cod Fish oil combined, you rebellious rascal you.
posted by c13 at 8:30 AM on June 2, 2008 [1 favorite]


Gay plague. Only homosexuals are promiscuous.

no, but it's rather rare for promiscuous straight males to get it, the obvious exception being if they engage in sexual activity with high-risk groups like injecting drug users or prostitutes. straight women have a far higher risk of getting it and gay men are the prime target.
posted by krautland at 8:30 AM on June 2, 2008


Aids isn't an acronym because the acronym from Acquired Immunodeficiency Syndrome would be AIS. It's a contraction. IANAGrammarian.

Were it a contraction, it would be spelled A'I'd'S' and would reflect some actual used pronunciation. It's an abbreviation, just one not done in the conventional English style. The fact that "immuno" and "deficiency" are easily identifiable, analyzable components probably has something to do with the use of the four-letter abbreviation.
posted by Electrius at 8:45 AM on June 2, 2008


Also, I don't get the totally plucked-from-thin-air guesstimate in the first paragraph that 25% of the men in the bar the writer speaks of are infected. She didn't explain at all how she arrived at that figure.

I wrote a research paper a few years back on the HIV epidemic in California. I don't have the relevant sources in front of me (and google has failed me in this regard as well), so, if you're willing to take my word for it: roughly 20% of men-who-have-sex-with-men in California are HIV positive, according to multiple studies. Perhaps more alarmingly, the majority of them did not realize that they were infected.

My research into this area was one of the major factors that convinced me to stop fooling around with random hookups. 1-in-5 is just too dangerous for me to warrant anything but the most clear-headed caution.
posted by Avenger at 8:50 AM on June 2, 2008


AIDS can be described as "acquired immune deficiency syndrome" or "acquired immunodeficiency syndrome". Obviously the standard acronym comes from the first phrasing. The French call it SIDA, since they never get their words in the right order.
posted by w0mbat at 9:08 AM on June 2, 2008


c13, to echo digaman, the reason she doesn't seem to have too keen a grasp on the subject is that she presents this as news. I'm in NYC and not in London, but the very issues she pinpoints have been well established for a very long time, making this essay almost redundant. While technically she has a point, the way she presents it makes it sound like she's just now catching up with what gay and poz communities already know and discuss exhaustively.
posted by [NOT HERMITOSIS-IST] at 9:13 AM on June 2, 2008


f you're willing to take my word for it: roughly 20% of men-who-have-sex-with-men in California are HIV positive

Actually, I'm *not* willing to take your word for it. Because as I said before, those surveys depend on self-reporting by volunteers, and are usually drawn from highly specific populations in urban gay ghettos.
posted by digaman at 9:15 AM on June 2, 2008


"She" responds:

This article was commissioned by Prospect, a monthly current affairs magazine with a smallish circulation among politicians, intellectuals and other more or less "establishment" types in the UK. Of course it's not news to gay men in New York, San Francisco or London, or to anyone who reads the epidemiological literature, either. But it is not well known among the policy makers and others who read Prospect, for whom it was written.

Does the article imply that all gay men in London are engaged in a Tina-crazed fuck-fest? It certainly doesn't intend to. I was describing a sub-section of the scene in which most HIV transmission is likely to occur, precisely because risk behaviour is disproportionately high. Indeed as c13 points out, I say so.

Re the 25% figure: yes, it is plucked from thin air. Well, not quite from thin air. The Health Protection Agency triangulates data from several sources including case reporting, unlinked anonymous testing of blood samples, HIV prevalence at GUM clinics and self-reported prevalence in the annual Gay Mens Sex Survey. For a detailed description of methods, see the HPA MSM pages. As I believe I said in the article, some nine percent of all gay men in London are estimated to be living with HIV. I looked at self-reported HIV status among men who reported a recent casual sex partner as well as the age-distribution of infection, and adjusted my estimates for the men in the bar accordingly. You can find information about the Gay Mens Sex Survey sample frame, methodology and questionaires here, along with reports of the survey results. (I would normally reference all of these data in an article, but Prospect doesn't publish references).

Re how well I know the London scene: well, I've been living in Asia for most of the last decade, so not all that well. (If any of you are interested in the results of research in the emerging gay scenes or among transgeder sex workers in that part of the world, you could take a look at my book The Wisdom of Whores: Bureaucrats, Brothels and the Business of AIDS, which I believe comes out in the US this very day. The book also talks a bit about the issues raised by digaman -- how our survey results get skewed by who we ask, how we ask and even who does the asking, and by paulsc on the failures of AIDS activism.) I certainly can't disagree with NOT HERMITOSIS-IST that the article may say quite a bit about who I hang out with....

You're also welcome to comment on my other too liberal/too fascist/too scientific/too political discussions of sex, science and HIV at www.wisdomofwhores.com
posted by Elizabeth Pisani at 10:05 AM on June 2, 2008 [24 favorites]


Heh. Hiya, Elizabeth.
posted by cortex at 10:38 AM on June 2, 2008


c13, to echo digaman, the reason she doesn't seem to have too keen a grasp on the subject is that she presents this as news. I'm in NYC and not in London, but the very issues she pinpoints have been well established for a very long time, making this essay almost redundant. While technically she has a point, the way she presents it makes it sound like she's just now catching up with what gay and poz communities already know and discuss exhaustively.

Well, Elizabeth Pisani beat me to it, but to repeat: this article was probably not written for club-going gay men in London. Maybe it's not news to you and, other than the numbers, not that much of a news to me. But it's not always about us, is it now?
Frankly, I'm not sure what digaman is having a problem with. The data? Has it been shown that self-reported data is inaccurate? Always? By how much? Is there any better data available? Or that these guys don't know what they are doing (seems kinda strange, considering that they came up with the drugs and treatment protocols)?
Or is it how the gays in London clubs are portrayed?
posted by c13 at 12:28 PM on June 2, 2008


48 per cent of gay men in Britain still use condoms all the time, which is more than can be said for straight men

What's the % for straight men? I couldn't find it in the article.

"Tom, I want to nibble your biltong." (For all you non-South Africans out there: Biltong is dried meat.)

Nothing quite as sexy as a shrivelled up pepperoni stick, is there?
posted by msalt at 1:04 PM on June 2, 2008


Hi Elizabeth! I really appreciate your clarification. While I have a good idea of the sorts of dialogues about AIDS that are taking place in the cities with large gay populations, I admit that I don't really know what people think out there in the rest of the world, so I admit my response may have been unfairly dismissive.

I hope that you didn't take my crack about your friends in a disparaging way; for all I know, I may have slept with one of them myself.
posted by [NOT HERMITOSIS-IST] at 2:23 PM on June 2, 2008


Who knows, right? Ha ha ha, you tawdry scamp.
posted by Ambrosia Voyeur at 9:38 PM on June 2, 2008


no, but it's rather rare for promiscuous straight males to get it

In the West. It's worth emphasising that: HIV/Aids is a global disease, and while it predominantly affects gays men in the West, places like Africa have a whole other profile.

And yes, digaman, you come across as only being upset with this article because it doesn't accord with your political views, rather than because you've got any legitimate, sourced beef with its information. People (rightly) throw rocks at the Bush administration for wanting to warp science to its world view; I see no reason you should be allowed to do the same.
posted by rodgerd at 9:51 PM on June 2, 2008


I have a friend who does drugs and sexual health outreach on the gay club scene here in Liverpool, and she reports similar things to Pisani's article. One of her major sources of concern is the steadily increasing rate of STD infections among men who aren't HIV positive, which she seems to take as an indicator that the likelyhood of many of these men ending up positive is fairly strong.

On the other hand though, she reports that methamphetamine use is virtually non-existant here in the North West, and she's dubious about claims regarding the extent of its use in London. While there may well be a smallish group of international party-goers who have access to it by virtue of their extensive travel, her intelligence suggests that it's far from common-place, and that cocaine and ketamine are the dominant club drugs still.
posted by PeterMcDermott at 12:22 AM on June 3, 2008


msalt: 24.4% of straight men reported always using condoms according to the 2nd national survey of sexual attitudes and lifestyles (2000 -- it's the most recent data we have for the UK)

peter: your friend is right, coke, k and e dominate nationally. tina is greatly more common in london than elsewhere; it is still used by a small minotiry (<5%), but associated with far higher rates of partner change, syphilis and HIV infection. anecdotally, it approaches a norm only among escorts, but we don't have data from a big enough sample to confirm that.

NOT HERMITOSIS-IST. oh lord, if i could be offended, i wouldn't be in this business.

re: accuracy of self-reported data. that's one for a discussion over a bottle of wine. or maybe a case.
posted by Elizabeth Pisani at 4:16 AM on June 3, 2008


no, but it's rather rare for promiscuous straight males to get it....straight women have a far higher risk of getting it and gay men are the prime target.

Erm, if it is indeed 'rather rare for promiscuous straight males to get it', how come 'straight women have a far higher risk of getting it'.

Who are they at risk of getting it from? The 'prime target' gay guys?
posted by freya_lamb at 10:00 AM on June 4, 2008


Freya_lamb, if I'm not mistaken, it's just physically easier for women to contract the virus through vaginal tearing, but it's harder for the virus to find its way into man engaged in PIV sex. And because anal sex is riskier gay men are even more easily infected.
posted by loiseau at 2:51 PM on June 4, 2008


Freya, HIV is transmitted through fluids--e.g. blood, ejaculate, breast milk, saliva (though it's my understanding the concentration is VERY low in saliva). That means your body has to absorb fluids that have HIV in them. Think of the walls of the colon, the vaginal, and the inner vulva--these are largely internal organs that offer very little protection against microtears and invading organisms). However, the penis is covered in skin. Unless that skin is ripped (and few men will have sex if their penis has scratches on it), or men manage to get fluids up through their urethra, the risk of HIV-loaded fluids getting inside is low in comparison. It's for the same reason that if an HIV-positive person were to bleed on your unbroken skin, it's pretty unlikely you'd catch HIV.
posted by schroedinger at 3:02 PM on June 4, 2008


Elizabeth Pisani interviewed on Fresh Air, if you're interested. Mostly about Sub-Saharan Africa. Very instructive to the uninformed likes of me.

I was surprised to hear from her accent that she comes from the West Country, though (Swindon?). I don't know why. I suppose I'm just a bigot.
posted by Grangousier at 5:12 AM on June 12, 2008


The Economist relied heavily on her book in a June 7th article (and mentioned that they reviewed it in May). In that article, they stated directly what is very rarely discussed so clearly:

It has been known for years that HIV is hard to pass on during normal heterosexual intercourse. Only one copulation in 500-1,000 with an infected individual will do so. The risk comes with certain behaviour (anal intercourse, which risks tearing the lining of the gut; and injecting drugs using dirty needles), certain professions (prostitutes of both sexes) and certain ways of life (multiple, simultaneous lovers, rather than serial polygamy). Aiming propaganda at heterosexual teenagers is (outside the special case of Africa) a waste of money. It is, however, often an easier course than tackling drugs, whores and buggery, which many politicians would prefer to pretend have no place in their countries.

I would add to their list of risks bad medical practices -- I have been in too many clinics in the developing world that routinely reuse needles (as did that clinic in Nevada recently, I believe), for example, to not suspect that misinformed or under-resourced medical workers are causing at least some of the problem. I'm also not sure that buggery, as they so delicately put it, is a "problem" that needs "tackling" -- adding a condom turns anal sex from very risky to only somewhat risky, for example, as does testing and choosing one's partners with care. Similarly, drugs and prostitution don't need to be disease vectors -- with easily available clean needles, and other not-as-common-as-they-should-be outreach programs, these things can at least be minimized as risks, though they will never be as safe as being a vegan celibate recluse.
posted by Forktine at 7:33 AM on June 12, 2008


Freya, HIV is transmitted through fluids--e.g. blood, ejaculate, breast milk, saliva (though it's my understanding the concentration is VERY low in saliva). That means your body has to absorb fluids that have HIV in them.

I totally understand how HIV is passed on, I'm just puzzling over the logic of the statement I quoted. If straight men are less likely to contract HIV, then subsequently the straight women with whom they are sleeping have a smaller pool of people by whom they can potentially be infected.

I'm now taking this statement to mean that women are much more likely to catch it if they have unprotected sex with an carrier than straight men are, as opposed to just being more exposed by having unprotected sex with higher risk partners generally.
posted by freya_lamb at 5:57 AM on June 15, 2008


Yeah, I think the statement does mean women are more likely to get it if they have sex with a carrier.

But it is also worth mentioning that straight women are not always sleeping with completely straight men, especially if the cultural background where they live is extremely homophobic. Theory goes that one of the reasons African-American women are dealing with such increasing rates of HIV is due to the "down-low" phenomena, where African-American men who lean bisexual or homosexual have sex (frequently unprotected) with other men, while maintaining sexual relationships with females to skirt any accusations of being into dudes.
posted by schroedinger at 9:37 AM on June 16, 2008


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