February 23, 2005

"Radical" AIDS strategy?

Public Health 101 Finally Considered for AIDS: "Gays Debate Radical Steps to Curb Unsafe Sex" claims the NYT:

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.

It is a radical idea, born of desperation, that has been gaining ground in recent months as a growing number of gay men become infected despite warnings about unsafe sex...


Although gay advocates and health care workers are just beginning to talk about how this might be done, it could involve showing up at places where impromptu sex parties happen and confronting the participants. Or it might mean infiltrating Web sites that promote gay hookups and thwarting liaisons involving crystal meth.

Other ideas include collaborating with health officials in tracking down the partners of those newly infected with H.I.V. At the very least, these advocates say, gay men must start taking responsibility for their own, before a resurgent epidemic draws government officials who could use even more aggressive tactics.

There is nothing "radical" about "tracking down the partners of those newly infected" -- that's how governments have handled syphilis for generations, which is one reason syphilis is so much less prevalent than HIV these days. Indeed, the NYT article eventually gets around to admitting that this is "radical" only in the sense that standard operating procedures was not applied to the AIDS epidemic due to the political clout of gays, who valued their own sexual pleasure over not killing other gays.

Whether such ideas gain acceptance, the fact that activists are even thinking about curbing gay sexual freedom is a huge shift.

In the early years of the AIDS epidemic, gay men protested attempts to close down bathhouses and strenuously opposed efforts by health officials to trace those infected with the virus. Until now, those advocates, driven by concerns about privacy and the stigma associated with the disease, have successfully fought off efforts to impose a traditional public-health model for tackling the spread of the virus...

Those frustrations were given voice in November by Larry Kramer, the playwright and activist who himself has AIDS, in a widely discussed speech at Cooper Union in which he criticized gay men for their behavior. "You are still murdering each other," he said then. "Please stop with all the generalizations and avoidance excuses gays have used since the beginning to ditch this responsibility for this fact."

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