N
No One
Guest
The prestigious Journal of the American Public Health Association has
devoted a substantial portion of its latest edition (June 2003, Vol.
93, No. 6) to the risks associated with homosexual practices.
The following statement is one of several that glare at readers from
the journal's cover:
"I gave my lover everything including HIV. I didn't mean to. We
made a mistake. Maybe deep down we felt it would be better if we both
had it..."
The journal contents read like a litany of bad news, one article
following another. Consider the following: Mary E. Northbridge, Ph.D.,
MPH, Editor-in-chief, writes,
"Having struggled to come to terms with the catastrophic HIV
epidemic among MSM [MSM is the new politically correct term for
homosexual men i.e., Men who have Sex with Men] in the 1980s by
addressing the pointed issues of sexuality and heterosexism, are we
set to backslide a mere 20 years later as HIV incidence rates move
steadily upward, especially among MSM?" ("HIV Returns," Editor's
Choice section, page 860)
Michael Gross's editorial, "When Plagues Don't End," (pages 861-862)
focuses on the resurgence of HIV/AIDS among homosexual men in the
United States. The highest rates of HIV transmission are among African-
American and Hispanic men who self-identify as gay.
Those rates are devastating. Gross notes, "To prevent HIV
transmission, we have little more today than we had two decades ago,
when it became clear that the virus causing AIDS is sexually
transmitted: behavioral interventions."
After emphasizing the need for new biomedical technologies and
effective translation and dissemination of behavioral approaches, he
concludes with, "Perhaps most important, somehow we need to immunize
prevention science, programs, and policies against stigma, political
opportunism, and sanctimony."
In his article on "Black Men Who Have Sex With Men and the HIV
Epidemic: Next Steps for Public Health," David J. Malebranche,
addresses risk assessment and risk reduction. Malebranche references a
recent six-site, US metropolitan area study that concluded that 93% of
African American Men who were HIV infected felt that they were at low
risk for HIV and did not know they had contracted the virus.
Malebranche's study contradicts the view that coming out of the closet
or disclosing one's homosexuality is associated with improved mental
health, responsible behavior, and lower rates of HIV infection. To the
contrary, African-American men who disclose their homosexuality have a
higher HIV prevalence than those who do not choose to do so (24%
versus 14%). They also engaged in more unprotected anal sex (41%
versus 32%) than those who do not disclose.
As Malebranche searches for reasons and conclusions, he--like most
politically correct writers--inevitably lays the blame upon society,
stating "....racial and sexual prejudice may impair delivery of
services, helping to perpetuate rather than ameliorate the HIV
epidemic." (Editorial section, pages 862-865).
Vincent M.B. Silenzio advocates an "Anthropological Assessment for
Culturally Appropriate Interventions Targeting Men Who Have Sex with
Men." He considers the public-health education approach to be
inadequate because it fails "to sufficiently take socio-cultural
factors into account." Silenzio concluded that
"same-sex desire, attraction, sexual behavior, and identity are
dynamic historical processes profoundly influenced by culture. Public
health practitioners, advocates, and others need to be sensitive and
open to how target populations of MSM frame these issues and
experience these phenomena.
Culturally sensitive and appropriate interventions for MSM should
ideally be based in ethnographic data specific to the population of
interest in order to be effective. Using the comparative lenses of
anthropology and cultural studies, we may begin to appreciate the
needs of MSM and other sexual minority populations in fundamentally
different ways."
(Commentary section, pages 867-871).
The title of Michael Gross's second article comes as an ominous
warning: "The Second Wave Will Drown Us." Citing a Centers for Disease
Control statistic of a 14% increase of HIV-AIDS among homosexual men
in the United States between 1999 and 2001, he provided data from
California and New York (two states that were excluded from the CDC
report!), which includes unprecedented outbreaks of syphilis and
alarming rates of rectal gonorrhea.
As Gross searches for explanations, he theorizes that the blame lies
with several factors: the difficulty of condom use, changes in milieus
where HIV is spread, slow development of biomedical interventions, the
separation of prevention and treatment, and moralism--declaring that
homophobia "exacerbates rather than alleviates the threat."
Gross concludes that "behavioral interventions to promote condom use-
the only strategy currently available to stem the MSM epidemic-are
failing."
He notes an emerging visible subculture of "barebacking" (anal
intercourse without condoms among homosexual men). He blames
homophobia, which "inhibits prevention at all levels, not least the
broader culture, which delivers anti-gay messages, institutionalizes
homophobia through structural mechanisms, such as laws that regulate
intimate sexual behavior, and lags in support of sensitive and honest
prevention for gay and bisexual youth, young adults and older men."
Gross's article concludes with a moralistic monologue which includes
the following statements:
"...prevention efforts fall prey to political opportunism,
misplaced moralism, stigmatization, and homophobia."
"...distraught parents still evict gay youths, propelling them
into lives of inner-city scavenging and vulnerability to
exploitation."
"Most schools continue to refrain from even the meekest
adaptation to gay adolescents' needs for safety and mutual
affiliation, much less the authentic respect that might nourish self-
respect. In turn, whatever normalization school and after-school
settings might be providing for concurrent emotional and sexual
maturation among heterosexual adolescents is denied to most of their
gay counterparts, who instead are apt to retreat into furtiveness,
shame, or precocious pairings with older partners."
Gross ends with a tirade against the government--from an attack on
former Congressman Tom Coburn for his position on condoms, to
criticism of Congressman Mark Souder's concerns about programs such as
Stop AIDS because of the misuse of funds (which has been shown to have
indeed occurred) to complaints about the Defense of Marriage Act
(DOMA) and schools' emphasis on abstinence-only-until marriage
programs.
Gross offers an interesting comparison:
"On the same day that seven astronauts and fragments of the
vehicle that failed them plummeted to the fields and woods of East
Texas, six times that many US MSM became infected. Maybe the number
was higher, since it occurred on a weekend; perhaps lower if news of
the catastrophe interrupted libidinous pursuits. ...
"On the basis of CDC estimates of the lifetime expenditures for
treating a single case of HIV infection, MSM infections acquired that
single day will cost $6.5 million. The cost in human potential need
not enter the calculus even for a voodoo economist, unless so muddled
by moral outrage that he thinks sex between men is indeed something to
'die for'." (Going Public section, pages 872-881).
devoted a substantial portion of its latest edition (June 2003, Vol.
93, No. 6) to the risks associated with homosexual practices.
The following statement is one of several that glare at readers from
the journal's cover:
"I gave my lover everything including HIV. I didn't mean to. We
made a mistake. Maybe deep down we felt it would be better if we both
had it..."
The journal contents read like a litany of bad news, one article
following another. Consider the following: Mary E. Northbridge, Ph.D.,
MPH, Editor-in-chief, writes,
"Having struggled to come to terms with the catastrophic HIV
epidemic among MSM [MSM is the new politically correct term for
homosexual men i.e., Men who have Sex with Men] in the 1980s by
addressing the pointed issues of sexuality and heterosexism, are we
set to backslide a mere 20 years later as HIV incidence rates move
steadily upward, especially among MSM?" ("HIV Returns," Editor's
Choice section, page 860)
Michael Gross's editorial, "When Plagues Don't End," (pages 861-862)
focuses on the resurgence of HIV/AIDS among homosexual men in the
United States. The highest rates of HIV transmission are among African-
American and Hispanic men who self-identify as gay.
Those rates are devastating. Gross notes, "To prevent HIV
transmission, we have little more today than we had two decades ago,
when it became clear that the virus causing AIDS is sexually
transmitted: behavioral interventions."
After emphasizing the need for new biomedical technologies and
effective translation and dissemination of behavioral approaches, he
concludes with, "Perhaps most important, somehow we need to immunize
prevention science, programs, and policies against stigma, political
opportunism, and sanctimony."
In his article on "Black Men Who Have Sex With Men and the HIV
Epidemic: Next Steps for Public Health," David J. Malebranche,
addresses risk assessment and risk reduction. Malebranche references a
recent six-site, US metropolitan area study that concluded that 93% of
African American Men who were HIV infected felt that they were at low
risk for HIV and did not know they had contracted the virus.
Malebranche's study contradicts the view that coming out of the closet
or disclosing one's homosexuality is associated with improved mental
health, responsible behavior, and lower rates of HIV infection. To the
contrary, African-American men who disclose their homosexuality have a
higher HIV prevalence than those who do not choose to do so (24%
versus 14%). They also engaged in more unprotected anal sex (41%
versus 32%) than those who do not disclose.
As Malebranche searches for reasons and conclusions, he--like most
politically correct writers--inevitably lays the blame upon society,
stating "....racial and sexual prejudice may impair delivery of
services, helping to perpetuate rather than ameliorate the HIV
epidemic." (Editorial section, pages 862-865).
Vincent M.B. Silenzio advocates an "Anthropological Assessment for
Culturally Appropriate Interventions Targeting Men Who Have Sex with
Men." He considers the public-health education approach to be
inadequate because it fails "to sufficiently take socio-cultural
factors into account." Silenzio concluded that
"same-sex desire, attraction, sexual behavior, and identity are
dynamic historical processes profoundly influenced by culture. Public
health practitioners, advocates, and others need to be sensitive and
open to how target populations of MSM frame these issues and
experience these phenomena.
Culturally sensitive and appropriate interventions for MSM should
ideally be based in ethnographic data specific to the population of
interest in order to be effective. Using the comparative lenses of
anthropology and cultural studies, we may begin to appreciate the
needs of MSM and other sexual minority populations in fundamentally
different ways."
(Commentary section, pages 867-871).
The title of Michael Gross's second article comes as an ominous
warning: "The Second Wave Will Drown Us." Citing a Centers for Disease
Control statistic of a 14% increase of HIV-AIDS among homosexual men
in the United States between 1999 and 2001, he provided data from
California and New York (two states that were excluded from the CDC
report!), which includes unprecedented outbreaks of syphilis and
alarming rates of rectal gonorrhea.
As Gross searches for explanations, he theorizes that the blame lies
with several factors: the difficulty of condom use, changes in milieus
where HIV is spread, slow development of biomedical interventions, the
separation of prevention and treatment, and moralism--declaring that
homophobia "exacerbates rather than alleviates the threat."
Gross concludes that "behavioral interventions to promote condom use-
the only strategy currently available to stem the MSM epidemic-are
failing."
He notes an emerging visible subculture of "barebacking" (anal
intercourse without condoms among homosexual men). He blames
homophobia, which "inhibits prevention at all levels, not least the
broader culture, which delivers anti-gay messages, institutionalizes
homophobia through structural mechanisms, such as laws that regulate
intimate sexual behavior, and lags in support of sensitive and honest
prevention for gay and bisexual youth, young adults and older men."
Gross's article concludes with a moralistic monologue which includes
the following statements:
"...prevention efforts fall prey to political opportunism,
misplaced moralism, stigmatization, and homophobia."
"...distraught parents still evict gay youths, propelling them
into lives of inner-city scavenging and vulnerability to
exploitation."
"Most schools continue to refrain from even the meekest
adaptation to gay adolescents' needs for safety and mutual
affiliation, much less the authentic respect that might nourish self-
respect. In turn, whatever normalization school and after-school
settings might be providing for concurrent emotional and sexual
maturation among heterosexual adolescents is denied to most of their
gay counterparts, who instead are apt to retreat into furtiveness,
shame, or precocious pairings with older partners."
Gross ends with a tirade against the government--from an attack on
former Congressman Tom Coburn for his position on condoms, to
criticism of Congressman Mark Souder's concerns about programs such as
Stop AIDS because of the misuse of funds (which has been shown to have
indeed occurred) to complaints about the Defense of Marriage Act
(DOMA) and schools' emphasis on abstinence-only-until marriage
programs.
Gross offers an interesting comparison:
"On the same day that seven astronauts and fragments of the
vehicle that failed them plummeted to the fields and woods of East
Texas, six times that many US MSM became infected. Maybe the number
was higher, since it occurred on a weekend; perhaps lower if news of
the catastrophe interrupted libidinous pursuits. ...
"On the basis of CDC estimates of the lifetime expenditures for
treating a single case of HIV infection, MSM infections acquired that
single day will cost $6.5 million. The cost in human potential need
not enter the calculus even for a voodoo economist, unless so muddled
by moral outrage that he thinks sex between men is indeed something to
'die for'." (Going Public section, pages 872-881).
