denial = death
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The Advocate  Sept 26, 2000  by Gabriel Rotello

 We've all heard about AIDS "denialists," those loopy flat-earthers who argue--against mountainous evidence--that HIV doesn't cause AIDS. But in the gay world there's a much scarier new group of denialists: the folks who argue that prevention is working, HIV transmission is under control, and any evidence to the contrary is a big, nasty homophobic lie.

 This came into focus recently when a story hit the national front pages announcing the most frightening new study of AIDS transmission in years. It showed that HIV infections among gay men at San Francisco's anonymous testing sites have nearly tripled in recent years, from about 1.3% per year in 1997 to an astonishing 3.7% per year in 1999, which would lead to a 37% level of infection in ten years. One researcher called it a "sub-Saharan level" of transmission, but it's actually higher than almost any in subSaharan Africa. And researchers later released data indicating that this year's rates may be far worse, up to 6% or 7%.

 This is not just tragic but mathematically astonishing, because from a strictly biological standpoint, new infections among gay men ought to be plummeting, not skyrocketing. Starting three years ago, large numbers of HIV-positive gay men began taking therapies that drive down their viral loads and make them far less infectious. Researchers say that when the number of highly infectious gay men began to drop, the number of new infections should have plunged too. It was literally our golden opportunity to put the fire of the epidemic out. Unless, of course, unsafe sex shot up so far that it offset the drop in infectious men.

 That is now happening, according to almost every researcher in the business. As a result, gay men appear to be squandering one of our greatest opportunities since the birth of AIDS--the opportunity to bring new infections down below the epidemic's tipping point by simply maintaining safer sex while the number of infections men declines.

 But just as insidious as that behavioral and biological failure is another, deeper moral failure: the failure of gay and AIDS leaders and the gay press to sound the alarm or even believe the disaster is happening at all.

 After the San Francisco story broke, for example, gay publications from California to Boston and activism from left to right didn't bemoan the statistics. They attacked the scientists who conducted the study, accusing them of making AIDS seem worse so that San Francisco wouldn't lose federal funds. (The head researcher's family even received dozens of harassing latenight calls at home from angry "activists.") In general, as scientific news accumulates about rising new HIV rates among gay men--including the transmission of horrible drug-resistant strains--you'd barely know it from reading the gay press or listening to gay leaders. AIDS, we're told, is over. Yesterday's nightmare.

 It would be easy to see this as normal human denial, to say that some of us genuinely believe we need to get past a "crisis" mentality about AIDS, that some are simply honest skeptics about research, that some deeply believe in a media conspiracy to "demonize" gay sex, and that all these denials--as dangerous and myopic as they are--are understandable, excusable, all too human.

 But in the year 2000, the 20th year of AIDS, the collective failure of our leaders, our journalists, our activists to alert us to what is happening is more than just garden-variety denial. In the face of AIDS history, of the fact that we have been here before, denied before, then died by the hundreds of thousands in large part because of our denial--this denial is a breathtaking moral failure. An evil betrayal of the next gay generation. An evil capitulation to weakness. It is evil, pure and simple.

 The researchers who are bringing us this bad news are the messengers, not the message. Disbelieve them if you will. Dis them if you must. But if you do, be prepared to condemn and consign the next generation of gay kids to die on the same massive scale as the last. Because the virus called HIV does not care about denial. Denial is its daily bread.

     

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