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AIDS=Homophobia


From the archives of The Memory Hole

HIV=AIDS Controversy: Lost & Found Dept.

Dennis S. McKown, co-founder of HEAL San Francisco, has rescued a very compelling letter taking the position apparently rather unpopular among a number of AIDS dissidents that HIV and AIDS are species of homophobia. The gnomes at TMH are most grateful for his efforts and are pleased to be able to reproduce it here along with The New York Times article it references.


Dear Fred and Everyone:

I mentioned in my last posting that I was removed from Joe Finocchiaro's Reappraising AIDS list last December due to a letter I posted written by Dave Pasquarelli from ACT UP San Francisco. I found that letter and am forwarding it for anyone who is interested in reading it. It is worth reading again. The letter is in response to an article published in the New York Times dated Tuesday, November 24, 1998 which I include also.

Dennis ------------------------------------

The following was sent with permission of Dave Pasquarelli of ACT UP, SF and HEAL, SF.

Fred Cline, S.F.

Dear Fred,

Thank you for forwarding this shocking article. It struck me while reading it how truly vulnerable gay men in particular are on so many levels when it comes to the misidentification and promulgation, deliberate or inadvertent, of an "HIV-positive" test result.

Recently, I have been receiving snippets of a rather unpleasant back-and-forth on the Reappraising AIDS list regarding the issue of "homophobia"—it's relevance to the AIDS dissident movement, it's meaning (or meaninglessness to some) as a word, and the feelings among those who are non-gay on the list when it the word is used.

Homophobia, plain and simple, is the irrational hatred of gay men and lesbians. It may manifest itself overtly as with fag-bashings or it may be verbal with the taunts and insults that gays and lesbians must endure almost daily if we choose to be as open about our sexuality as straight people are about being heterosexual. Most insidious however is that the hatred of homosexuals is cultural and institutionalized—we are either ignored, mocked or demonized in the media or through distracting entertainment outlets that shape our society. We are often characterized as uppity, flaky, hedonistic or lacking any sort of moral capacity in discussions where the participants are primarily non-gay. And scariest of all, since the advent of AIDS—which has preyed on the lack of political power secured by gay men and lesbians—we have been identified as the dying victim as well as the evil and feared transmitter of death itself.

How much more can we as a gay community, collectively and individually, physically and psychologically endure from dominant heterosexual society? We have been poked, prodded, pumped full of pills, dissected, and culturally put on display so our worst sexual characterizations can be generalized to all and then scrutinized under the disapproving microscope of America's puritanical biases. In the church of AIDS, gay men have clearly occupied the role of human sacrifice.

Yes, as dissidents we all understand that HIV is a sham and that AIDS is a farce. Yet articles like the one below from the New York Times continue to reinforce the public perception that gay men are vicious sexual predators and dangerous carriers of deadly HIV. The inevitable result of this sort of propagandistic vilification is that one way or another the gay public health menace must be destroyed for the safety of the human race—either by the present psycho/poisoning scheme or by more drastic measures quite possibly looming on the horizon.

Those dissidents who are non-gay must realize that they have the luxury of retreating whenever they desire into a dominant heterosexual society of privilege and power—one that is largely unaffected by AIDS. The CDC-sponsored HIV war has destroyed our gay culture. AIDS is everywhere and inescapable in our gay world. And HIV proponents work daily in our gay lives to make sure gay independence and gay dignity is never again allowed to flourish. It's sick and it's surreal and it's our government-sponsored gay reality.

Make no mistake about it—AIDS IS HOMOPHOBIA on a most sinister level. It is literally the mass destruction of homosexual lives and the homosexual community blessed by a thoroughly brainwashed, co-opted and powerless gay political infrastructure. This situation has persisted for twenty years on our cultural landscape—seemingly without much notice or alarm among non-gay Americans who themselves may even proclaim no personal animosity towards those who are homosexual.

It seems to me that rather than dismiss the concept of homophobia as "irrelevant" on any level to AIDS dissidents, the movement must acknowledge, thoroughly understand, and work through what it means to be gay in a society that hates gays and collectively wills them to die of AIDS. Rather than add to the abuse that gay men are forced to face, non-gay AIDS dissidents need to admit that AIDS=HOMOPHOBIA and focus on delicately and methodically changing the perceptions of our rank-and-file gay brothers and sisters so that they understand what has been done to them. The dissident movement has the opportunity to unlock the emotional underpinnings (victimization, bitterness, self-loathing, fear...) that keeps the gay community trapped into believing in HIV and therefore gives AIDS power and keeps it alive. The key here is extreme sensitivity, putting ego and blame aside, and relinquishing some of the power and privilege that comes with being heterosexual in a heterosexually dominated society.

HIV and AIDS will never go away unless the gay community and its leaders stand up and vocally reject the brainwashing scheme in its entirety. And the gay community and its leaders will never reject HIV and AIDS if they don't sense that those at the zenith of promoting the admittedly startling concept that AIDS is not a viral condition UNDERSTAND what it really means to be gay and what AIDS has done to them personally and culturally.

The beginnings of that type of cross-cultural understanding between gay and non-gay dissidents needs to start now. Only then can we move beyond the bitchiness of the blame game and convince the gay rank-and-file and its presently misguided leadership that HIV and AIDS must be publicly deconstructed for our future and the future of generations to come.

Thanks again for the information that you pass on. I believe that despite differences in our life experiences it is critical that we all be given the opportunity, respect and forum to share our thoughts and ideas on how to end the HIV tragedy.

Sincerely yours,

 

Dave Pasquarelli

==========

New York Times, Tuesday, November 24, 1998

Cases: Helping AIDS Patients Have Safe Sex By ABIGAIL ZUGER, M.D.

The patient was running late; he was due at work in 20 minutes and didn't have time to chat, but he did need the doctor's help with a couple of quick problems.

First on his list was an annoying burning and discharge after urination that he worried meant he had picked up a sexually transmitted infection from an incautious weekend sexual encounter.

And second, he needed refills on all his regular medications: the three he took for AIDS, his vitamins, and the testosterone and Viagra he took to normalize his sexual functioning.

By itself, none of his requests would have given the doctor much pause. Together, they packed a wallop.

Were the patient's symptoms evidence that he was not using condoms during sexual activities—activities that were enabled by the doctor's prescriptions, and were putting others at risk of H.I.V. infection? What were the doctor's responsibilities in this situation?

It was one of those moments that medical school seldom prepares doctors for, but that caring for people with H.I.V. infection is increasingly providing. As AIDS changes from an inevitably fatal condition to one people can live with for years, patients are struggling to readjust—and doctors are, too. The fast-paced tragedy and heroics of dealing with catastrophic illness are fading from their workdays, which are filling instead with the less dramatic but often far more difficult tasks of helping patients with a chronic but treatable illness craft normal lives.

And integrating sexual activity into those lives is probably the most complex job of all, for patients and doctors.

H.I.V. infection can affect sexual and reproductive health in a variety of ways.

Depression can limit sexual drive in both men and women; irregular menstruation is common in women, while in men blood testosterone levels may fall to levels far below normal, causing fatigue, weight loss and an inability to function sexually that may persist even on the powerful new AIDS drugs.

"Sexual dysfunction is very prevalent in H.I.V.-infected people," said Dr. Ellie E. Schoenbaum, director of AIDS research at Montefiore Medical Center in the Bronx. "All through the epidemic we've found that patients haven't had the active sex lives or rapid partner turnover we first expected."

In the early 1990's a series of studies showed that replacing testosterone in men with H.I.V. infection "transformed them," said Dr. Judith G. Rabkin, a professor of clinical psychology at Columbia University's College of Physicians and Surgeons who worked on some of the earliest studies. Men gained muscle mass and energy, shook off depression, and sexual desire and performance became more normal.

"Testosterone is an extremely popular and effective treatment," she said, one that is increasingly accepted by doctors for H.I.V.-infected men and is being studied for women with H.I.V. as well.

Important in her studies, Dr. Rabkin said, was the discovery that improving men's sexual functioning with testosterone unquestionably increased the likelihood that they would use condoms.

"Before taking testosterone, a lot of men didn't use condoms because they were afraid they would lose the erection," Dr. Rabkin said.

"That wasn't the case afterward.

So giving it to people can actually be a positive public health move." While Viagra is too new to have been studied extensively in H.I.V. infected men, it is also used by doctors to help patients with H.I.V. function more normally.

Against these straightforward medical facts, the behavioral facts are plain, too. Despite the "safe sex" and "use condoms" mantras that permeate AIDS counseling, in sexual matters, people with H.I.V. find it as difficult as anyone else to speak frankly to partners and to use condoms.

In a study published in February in the Archives of Internal Medicine, Dr. Michael D. Stein of Rhode Island Hospital in Providence found that 40 percent of the sexually active H.I.V.-infected people he surveyed had not told all their recent sexual partners of their infection.

More than half of them also did not use condoms regularly.

"Our hope is that as survival increases and optimism about the disease increases, there will be more truthful talk about sex among infected people and their partners," Dr. Stein said.

Who should initiate these conversations? Is it the infected person's responsibility to tell, or the partner's responsibility to ask? Both, said Dr. Ronald J. Bayer, a professor of public health at Columbia University who has written extensively on the topic of sexual ethics in H.I.V. infection.

Medical ethicists increasingly endorse a responsibility on the part of the infected person to protect uninfected partners, as well as a responsibility on the part of partners to protect themselves, he said.

But the sexual ethics of AIDS-complicated enough when only the participants are involved—become even more of a tangle when a third party hovers in the background, influencing the course of events with a prescription pad.

On the one hand, the doctor's primary allegiance is traditionally to the health and well-being of his or her own patient. Still, experts in medical ethics acknowledge the obligation to protect other people who may be injured by the patient. In recent years, the courts have emphasized this obligation, finding doctors liable for failing to warn others of potential harm at the hands of their violent patients or of patients with communicable diseases.

When a doctor is treating a patient known or suspected of being sexually reckless, then the doctor may well choose to withhold medications that enable sexual activity until the patient demonstrates more responsible behavior, said Nancy N. Dubler, a lawyer and ethicist who heads the division of bioethics at Montefiore Hospital and the Albert Einstein College of Medicine in the Bronx. But even this simple decision can be a terrible mistake if a patient who occasionally neglects to use condoms becomes completely unable or unwilling to use them as a result.

The patient was late for work and wanted his prescriptions. The doctor's next two patients were jittering in the waiting room.

A physician in this situation "has the absolute obligation to deliver a set of educational and moral warnings and information with the medication," Ms. Dubler said, telling the patient that his right to a normal and enjoyable sex life is balanced by "extraordinary obligations" to be candid with sexual partners and avoid putting them at risk.

"Look," the doctor said. "I know you're in a hurry, but I can't refill these medications until we have a discussion about why you forgot the condoms last weekend, and why we have to make sure it won't happen again."

And that is what they did.

✳ ✳ ✳