In a new generation of gays, fatalism and ignorance supplant facts, fear

January 03, 1994|By Holly Selby | Holly Selby,Staff Writer

On a Baltimore street corner, an outreach worker listens to gay youths scoff that AIDS is "an old man's disease."

Across town, a young male homosexual tells his doctor he is resigned to being at risk for the virus but plans to continue being active sexually.

And, at an AIDS clinic, a teen-ager tests positive for HIV and admits he has traded sex with men for drugs. The teen explains to a social worker that he didn't believe he was gay -- so he never expected to be infected.

Disdain, fatalism and ignorance about AIDS. That's what many health professionals hear from the newest generation of gay males.

Since the epidemic began, public health officials have pointed to the gay community as an example of information being translated into action; its members rallied to spread the safe sex message -- and successfully lowered infection rates.

But health workers say the latest generation of gay men is not heeding AIDS-prevention lessons and is placing itself at increasingly high risk of infection with the virus that causes the fatal condition.

Recent studies indicate that rates of HIV infection among gay men under 25 in San Francisco are on the rise. The studies were conducted by the University of California and the San Francisco health department.

The rate of HIV infections had dropped among gay San Franciscansfrom 18 new infections per 100 men in 1982 to less than one new infection per 100 men by 1985. Now in San Francisco, for every 100 men under age 25, there are four new HIV infections per year, according to the data.

"What this means is that prevention efforts done in a community aren't permanent: You can't do a large campaign, get an unprecedented decline in risky behaviors, declare victory and leave the field," says Ron Stall, a behavioral epidemiologist at the University of California at San Francisco.

Statistics on how many young gay males are newly infected with HIV in Baltimore are not available; though AIDS cases are reported in Maryland, positive tests for HIV infection are not, according to the state AIDS Administration.

And some doctors say the new data simply illustrate what they have suspected all along: That AIDS prevention efforts haven't really changed the sexual behavior of young people -- whether heterosexual or homosexual.

"Young people generally think they are bulletproof regardless of sexual orientation," says Dr. Alfred Saah, an epidemiologist at the School of Hygiene and Public Health at Johns Hopkins University. "Young gay men under 25 aren't all of a sudden participating in more risky behavior; they've done it all along."

Kenn Hill, a member of BE MORE Maryland, an African-American outreach organization, frequents bars, bookstores and street corners spreading the word to gay men -- use condoms, practice safe sex. His efforts are part of an outreach program run by the Baltimore Urban League and the Gay and Lesbian Community Center of Baltimore that targets African-Americans.

Over and over, when talking to gay youths, he gets the same response: "They think they're immortal," he says. "They think, 'Those people who had AIDS in the '80s, they're all dead.' Or, they think, 'Safe sex? Not me. I'm not going to get AIDS.' "

Fear decreasing

But clinic workers and AIDS activists, while concurring that youthful feelings of invincibility contribute to high-risk behavior, also say that the reasons young gay men place themselves at risk are often complicated and deeply emotional.

As the epidemic continues into its second decade, some activists worry that the fear of AIDS among this new generation is decreasing.

"In the '80s, a friend would cough and die two weeks later. AIDS isn't like that anymore; there are life-prolonging drugs now," says Timothy Hartlove, a 23-year-old insurance agent who is gay. "We aren't living that death experience. We haven't seen the annihilation of our population that the 30- to 40-year-olds have."

Among younger gay circles, attitudes toward AIDS have changed, says Garey Lambert of AIDS Action Baltimore. Before, "there was panic in the gay community. If you got AIDS in 1985, that was an immediate death sentence. Now this is a disease that is sort of an accepted fact of life."

And as the demographics of the epidemic change -- from a disease that affected mostly gay men to one that is spreading most rapidly among intravenous drug users and women -- some younger homosexuals rationalize that AIDS is no longer a "gay disease."

"They say, 'gays aren't getting it anymore. It's in the IV community. It's in women,' " Mr. Hartlove says.

Drug and alcohol abuse also blinds youths to risks. "Gay life is centered around bars, and bars mean alcohol, and you can't forget the factor of getting drunk," he says.

Emotional issues

Complex issues of self-esteem and sexuality also come into play just as many young men are beginning to experiment sexually.

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