HIV issues
29 07 2007There seems to be a distinct difference in how my generation and younger generations think about and deal with HIV issues.
My earliest memory of HIV and AIDS was when I was in 6th grade and we were in the school cafeteria for a “family life” assembly about sex and health. The year was either 1986 or 1987. 1986 was the year that the term “HIV” was adopted to describe the infection, rather than AIDS (and the even earlier GRID), and I remember an article being read to us in this assembly on that very subject. We still called it AIDS, anyway, and it would be a few years before I remember anyone really started regularly using the term HIV.
During my teen years, HIV/AIDS was more or less a death sentence. It was a “crisis.” Life expectancy was perceived to be short once diagnosed, and many movies and television shows were made that portrayed the illness as involving a lot of suffering and (physical and emotional) pain. It was also portrayed as an almost exclusively gay disease, although I think the statistics even back then didn’t actually support that assertion. “AIDS” was the worst think that could possibly happen to you back then, even worse than cancer. If someone was gay, it was assumed they might have AIDS. It was my greatest fear.
Today, HIV infection is quite different. The current projected life expectancy for someone infected with HIV is about 32 additional years after infection if treatment starts before CD4 T cells fall below 350 (2006 computer model project based on 2004 treatment guidelines). That projection does not even include any future advancements in treatment or cure. HIV is a manageable infection, and those infected can more or less count on being relatively healthy except for any drug side effects - which are still common. Many patients on new treatments remain “undetectable” and can even pass common HIV tests. The key to these new survival rates is access to continuous medical care and adherence to strict medication routines - which are not even as arduous as they used to be, sometimes just one pill per day. This is of course not applicable to developing countries, where HIV infection continues to often be a quick death sentence.
So, that’s he HIV that a younger generation knows, and I think that attitude can easily be seen in a resurgence of unsafe sexual practices. Years ago, unsafe sex was not as out in the open - but it doesn’t take long these days to see the multitude of online postings and profiles soliciting it, also apparently equally from those who are negative. Something that was once shunned by the industry itself, porn that doesn’t involve condoms is also quite popular and prevalent now. I think everyone is still more or less aware of the virtual holocaust that was experienced by an older gay generation, but faith in science and medicine seems to cancel out any fear of that happening now or again.
For the first time in my life I feel like safer sex is at risk of becoming the exception for most people, rather than the rule, and it scares me.
Pick up any gay pop culture magazine such as Instinct, Advocate or Genre, and you will probably see no less than 2 or 3 ads for HIV medication that feature reasonably attractive and active models. There is usually no overt discussion of the inevitable side effects of the medication, although it’s usually hidden somewhere on the page because I think they have to disclose it somewhere in the advertising for legal reasons. A couple of messages get relayed to readers: 1. This guy looks happy and healthy (and maybe hot, although I think they are trying to tone down this aspect now in most ads), and 2. There seems to be a lot of different (and effective) medications available to someone if they get infected. These aren’t necessarily bad messages to convey, either, because they are more or less accurate. What doesn’t get conveyed, and I don’t even really think the pharmaceutical companies should be required to convey them, are the social and body image implications of those side effects, and the insurance nightmare you may have to navigate in order to get these medications for an affordable cost. They’re also not gonna tell you that you might be stuck with a job you hate, for years, because you have to hold on to your health insurance!
It all still freaks me the hell out. I am in that older generation that, no matter what advancements are made by medical science, tends to mentally equate HIV with imminent death. I am well read, normally quite rational and intelligent, but still unable to get past this mental block and see the infection for what it really is today. And regardless of it’s status as being a controllable infection, there is no way I would want to risk taking on the expense, inconvenience, stigma, and medicinal side effects of this long term health condition. Many would agree with me, but I have a strong feeling that there are quickly growing numbers who are willing to risk it. Normally you might expect me to say that those who choose to take on those risks shouldn’t be judged, but I’m not going to say that. Their decisions directly impact the physical and social environment that I am required to live in, in a substantially negative way.
(Same thing to the smokers and the obese, and anyone who consciously contributes to any health crisis - I am paying part of those medical bills, although this is about a lot more than just the money.)
HIV isn’t the only thing that freaks me out, as most of my close friends know me as the opinionated hypo who carries Listerine spray and sanitizing gel wherever I go. I really am sort of crazy about “germs”…I spray Lysol on everything, and mop with bleach. All the soaps are antibacterial, and I run to the doctor for antibiotics after every cough. People who swim in my pool think it has a lot of chlorine in it, and they’re right. What does this fear of germs do to my sex life? You’ve probably guessed by now, it ruins it.
Well, this post is now at risk for becoming a term paper, so I think I’ll close it here. These are just some of the things that have been in my mind for the last few months, and I feel a little bit better after talking about them. As always, comments and debate are welcome, these are just my feelings at the moment.
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