The New H.I.V. Strain: Sullivan, Kaiser Sound Off

In June 1985, a centerpiece float in San Francisco’s Gay Freedom Day Parade bore a giant mock tombstone shrouded in garlands. Solemn volunteers walked down Castro Street, handing out fistfuls of free condoms. Not long before, the parade had been an extravaganza replete with drag queens and leather chaps, but AIDS had changed the mood, wrote Randy Shilts in And the Band Played On, his magisterial account of the first years of the epidemic. “There might have been a time Before, but it was no longer the moment that people longed for; it was gone, everyone understood now, and it would never come back. Life would forevermore be in this After.”

Or maybe not. Twenty years later, on Feb. 12, an article appeared on the front page of The New York Times, reporting that doctors had detected a “rare strain of H.I.V.” in a patient that seemed impervious to the drugs that have made AIDS manageable in recent year-and which, it seems, may have emboldened the unidentified man to engage in the kind of bathhouse-era sexual practices the disease was once thought to have made a thing of the past. To those who had lived through the era Before, and the first foggy newspaper reports of a mysterious “gay cancer,” there were eerie echoes. And in New York’s fractious gay community, the frightening discovery occasioned the revival of a debate about the demands of public health and the limits of personal freedom.

“It’s reawakened people to the need to find some new way to make people better,” said Charles Kaiser, a journalist and author of the book The Gay Metropolis.

No one is actually sure how to make people better-many have tried and failed, from John Calvin to Rudy Giuliani-but, in this case, ideas mooted include shutting down Web sites that cater to risky, anonymous sex, shuttering gay clubs and bathhouses that play venue to the same, and directly confronting those who choose to engage in such behaviors. This, in turn, has drawn howls of protest from some in the gay community, who warn that raising the alarm one more time-over a single, isolated case, no less-carries the danger of making those people most at risk inured and less willing to listen to education about the continuing AIDS threat.

“Fear mongering, coercion or even criminalization will not solve the problem of H.I.V. transmission,” said Bill Dobbs of United for Peace and Justice, a civil-libertarian group.

“You can never be scared too much,” shot back Larry Kramer, the acerbic, H.I.V.-positive playwright. “Fear is the only thing that seems to work in controlling people’s suicidal, murderous behavior.”

If this argument sounds familiar, that’s because it’s an old battle-one that seemed to have been settled, decisively, in favor of public health in the 1980′s, when officials in San Francisco and other cities shut down the fervid gay-bathhouse scene.

They did so over the objections of a vocal libertine lobby, which argued that the right to have sex anywhere, anytime, with anyone (or anyones), was intrinsic to the gay experience, that gay sex itself amounted to a political speech.

“Being gay has always been a revolutionary act,” Mr. Kaiser said. “Since we’ve rejected all convention, we don’t have to observe any rules when it comes to our bodies.” He added, “I think that is a disaster.”

Yet in recent years, with the advent of new anti-retroviral treatments, AIDS has come to seem a less imminent threat.

“This ordeal as a whole may be over,” H.I.V.-positive journalist Andrew Sullivan wrote in a 1996 New York Times Magazine article, provocatively entitled, “When Plagues End.” Since the introduction of the new drug therapies, and in particular since The Times declared an end to the epidemic, “we haven’t really done prevention,” said Walt Odets, a prominent psychologist and author of In the Shadow of the Epidemic: Being HIV-Negative in the Age of AIDS. And that, almost inevitably, has led to a slackening in vigilance, and a rise in risky behavior. A few years ago, the change in moral temperature seemed affirmed when it was revealed that Mr. Sullivan had placed a personal ad on a Web site advertising his desire to find partners for “bareback” sex. Mr. Sullivan disclosed his H.I.V. status in the ad, and passionately defended his right to have pleasurable, consensual sex. He subsequently called the episode “one of the most homophobic and H.I.V.-phobic witch hunts in recent times.” (Mr. Sullivan did not respond to several messages on Tuesday.) Yet the episode-unthinkable in the besieged era before anti-retrovirals-is one that comes up time and again in conversations with gay activists.

“Why should we allow Web sites that are exclusively for people who want to bareback like the one that Andrew Sullivan posted himself on a couple of a years ago?” Mr. Kaiser asked. “I just don’t see any inalienable right to spread a deadly disease.”

For more than a decade, public-health advocates have been warning of a resurgence of libertinism. (Mr. Kaiser, for instance, forwarded The Observer an editorial he’d written on the subject back in 1992.) This week’s alarm about a new, ultra-virulent H.I.V. strain, though perhaps premature, seemed to vindicate the fears that gay New Yorkers had learned nothing from the past.

The patient in whom the purported new strain was diagnosed reportedly met men online to arrange crystal-methamphetamine-fueled orgies; according to one report, he may have engaged in sex with hundreds of other men. The parallels to Gaetan Dugas, the promiscuous flight attendant who came to be known as “Patient Zero” to the epidemiologists trying to piece together AIDS’ emergence across America, were obvious-though it could be argued that Mr. Dugas’ behavior was more understandable, since he never knew the risks. “This guy is a total and utter asshole,” said Mr. Kramer, who in April will publish a book entitled The Tragedy of Today’s Gays. “What happens is, this is what people think gay people are like. Now we can’t move forward, we can’t get to our place in the sun, because of stupid assholes like this.”

On paper, the new strain sounds terrifying: It’s resistant to almost all anti-retrovirals, and it seems to have progressed from H.I.V. to full-blown AIDS in about a month, “an astonishingly quick assault by an infection that often goes unnoticed for a decade,” The Times said in its first day’s coverage. Yet one troubling case does not an epidemic make, and some see another agenda at work. ” The New York Times is starting prevention up, after it’s been dormant for eight or nine years,” Odets said-in other words, since around the time of Mr. Sullivan’s plague-ending opus. Mr. Odets said that since The Times mentioned his name in one of the 10 articles it had written over the course of three days on the subject, he’d been busy returning “a table full of messages”-a testament to the agenda-setting power of the newspaper of record. “The stuff that was in The Times on Saturday looked to me like a series of articles putting together a story about ‘The Gay Peril,’” Mr. Odets said.

“The tenor of these stories is markedly stentorian,” Mr. Dobbs said. “Go tell a heterosexual like Arthur Sulzberger that he can’t have penile-vaginal sex.”

Mr. Odets pointed to a what he said was a deeper problem. “Fear does not motivate people over long periods of time,” the psychologist said, whether or not Mr. Kramer believes otherwise. “Let me say something about Larry Kramer,” he continued. “It’s easy to be 65 years old and feel that sex can be reined in …. People like to ignore that part, older people especially: the fact that sex is immensely compelling for young males. You have to start there, and work from there.”

Mr. Odets pointed out that today’s gay elder statesmen-those who survived the 1980′s-were fortunate enough to come of age in the 1960′s and 1970′s, an era that, prejudices of the time notwithstanding, is now recalled as edenic: a rollicking experiment in sexual liberation, free of consequences and the spectacle of rolling tombstones. Younger generations have not had to bear the anguish of seeing friends and lovers die in droves, but they have always had to live with fear, because they came along After.

“Obviously it would be a better world-and it was a better world in the 1970′s-if this threat did not exist,” Mr. Kaiser said. “But life is unfair. It’s true that they missed out. And now they have to deal with the reality that is.”