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Can relationships fight rising HIV rates?
Can relationships fight rising HIV rates?
by Chris Crain - SGN Contributing Writer

Just in time for December 1 - World AIDS Day - there is bad news about rising HIV infection rates among Gay and Bisexual men, in the United States and beyond. Don't turn the page just yet. This isn't yet another alert about yet more "alarming" HIV rates or a dire warning about a "second wave" of infections.

They may not have come up with a vaccine to make us immune from HIV, but we're almost completely immune to these repeated cries of AIDS "wolf." Too many cogs in the AIDS, Inc. machine - from pharmaceutical companies, HIV organizations and politicians hording government AIDS dollars - have a self-interest in promoting "alarming" data on the epidemic. So we tune them out almost instinctively.

This time, however, is different. It's not one study; it's many, and they all show an undeniable increase in HIV infections among men who have sex with men:

o The rate of new infections among Gay men under 30 in New York City rose 33 percent from 2001 to 2006.

o As many as 1 in 22 Gay and Bi men in Florida is infected, with rates reaching 1 in 11 Gay white men in Fort Lauderdale, 1 in 13 Gay black men in Palm Beach and 1 in 12 Gay Latinos in Miami-Dade.

o New infections among Gay and Bi men in the U.K. are at record levels, with an estimated 1 in 20 infected nationwide and 1 in 10 in London.

o In Australia, HIV infection rates have risen by a third in the last decade, with 88 percent of transmissions occurring through Gay sex.

Then came the big one: a report this week in the Journal of the American Medical Association showing that overall, the number of Gay and Bisexual men in the U.S. with HIV or AIDS has risen 13 percent in just the last four years.

The authors of the JAMA report put a lot of the blame for that increase on the fact that most of us don't know our HIV status. One study cited in the report found some 77 percent of the Gay and Bi men infected with HIV were unaware they were positive; 91 percent of black Gay and Bi men did not know they were infected.

The report also pointed to another cause that anyone who's sexually active already knows intuitively: Sex without condoms has become more and more common, as rebounding rates of syphilis among Gay and Bi men also testify.

The reasons are also no mystery. Most sexually active Gay and Bisexual men weren't around for the darkest days of the AIDS epidemic, never cared for dying lovers and friends and didn't attend funeral after funeral for men cut down before they turned 30.

The drug cocktail has transformed AIDS into a treatable, if not curable, disease, and the conservative political climate has diverted too much funding into abstinence at the expense of safe sex prevention efforts.

The rising infection rates will undoubtedly result in calls for additional funding for HIV/AIDS prevention and treatment programs, and no doubt those additional dollars are needed. But the grab for cash ought to be coupled with a hard look at whether we're throwing good money after bad.

If anything, the data on rising HIV infections is an indictment of the way most agencies have tackled prevention among Gay and Bisexual men. The old ideas of the past, simply handing out condoms and such, are no longer working. It's time for new ideas and new energy.

It's long past time to trust Gay and Bisexual men with real information about the risk of exposure associated with particular sexual behavior. It's criminal that more than a quarter-century into this epidemic, public health officials still keep secret the data they have on how risky it is to give or receive oral and anal sex, with or without condoms.

It's not just about condoms. Gay men are already way out ahead of prevention efforts, adopting their own techniques like "sero-sorting" - that is, poz men having sex with only other poz men - to limit if not eliminate their exposure. We need to know what works and what doesn't.

The JAMA report also makes one policy argument that is long overdue. The authors called for "legal domestic partnerships as a way to promote stable, longer term [Gay male] relationships." The most effective curb against Gay male sexual promiscuity is to encourage committed relationships, and legal recognition is an important way of doing that.

Another is for public and private HIV agencies to help promote the alternative of dating and relationships over promiscuity; not in a preachy way, but by reminding us all how sex with love beats just plain sex any day.

Chris Crain is former editor of the Washington Blade and five other Gay publications and now edits He can be reached via his blog at

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