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"AIDS is still very much a crisis, and saying otherwise is dangerous to Black and brown communities across the country."
In a New York Times op-ed published on Tuesday, a historian named Patrick William Kelly wondered whether the advent of PrEP, the once-daily pill that prevents HIV transmission, has brought about “the end of safe gay sex,” as his piece’s title held. “AIDS is no longer a crisis, at least in the United States,” he wrote, “and that is a phenomenal public-health success story. But it also means that an entire generation of gay men has no memory or interest in the devastation it wrought.”
Kelly’s piece was riddled with inaccuracies, reaches and problematic assumptions, but that statement in particular — that AIDS is no longer a crisis — is borderline offensive. As a Black queer man who not only lives with the virus but has done years of work within the HIV/AIDS space, including testing, counseling, and writing more than 200 articles about the epidemic, I can emphatically say that AIDS is still very much a crisis, and saying otherwise is dangerous to Black and brown communities across the country, where HIV rates remain at epidemic levels.
Over two years ago, CDC researchers first revealed the shocking extent of that epidemic: a new analysis had found that at then-current diagnosis rates, about half of all Black men who have sex with men (MSM) and a quarter of Latino MSM in America would become HIV-positive during their lifetime. If we allow false truths like those in Kelly’s op-ed to propagate, the HIV crisis among Black and brown queer people won’t be stemmed anytime soon.
The article starts off by discussing a study of 17,000 gay and bisexual Australian men released this month, which indicated that PrEP use had risen among HIV-negative men from 2 percent to 24 percent from 2014 to 2017, condom use dipped from 46 percent to 31 percent. Yet the article never discusses the reasons these men stopped using condoms, including whether they entered monogamous relationships, or serodiscordant relationships where one person used ART while the other used PrEP — two valid reasons for why condom usage could have decreased. The piece later cites a 2016 UCLA study that found PrEP users were up to “25.3 times more likely to acquire gonorrhea and a shocking 44.6 times more likely to develop a syphilis infection,” but then notes that other studies failed to find a statistically significant rise in STI rates among PrEP users, contradicting itself.
Indeed, in responding to Kelly’s article, critics have noted that it makes all too much sense that PrEP users might display higher STI rates, given that clinical guidelines for prescribing PrEP hold that users should be tested for all sexually transmitted diseases and infections every three months. At this more frequent rate of testing, it only follows that STIs will be diagnosed and treated more often among PrEP users, meaning clinicians can treat these infections (which often don’t display symptoms) more frequently, thus decreasing the risk that they’ll be passed along. Activists like the inimitable Peter Staley and others took to Twitter to point out these and other flaws in Kelly’s work, including misinterpretations of historical HIV/AIDS transmission rate data.
1. Let’s break-down why @prose4321’s “I’m an AIDS historian!” rant is one of the worst (and most dangerous) AIDS op-eds ever to appear in the NYT. I hope we direct most of our anger at the Times, which doubled down on its history of promoting gays who scold gays. pic.twitter.com/dWTN3PcpJs— Peter Staley (@peterstaley) June 27, 2018
Yet beyond the op-ed’s dangerous assumptions and misinterpretations, the article states that declining condom usage correlates with a “historical amnesia” about safe sex and the HIV/AIDS epidemic among the gay and queer community. It’s a statement that could only be made by someone who isn’t affected by the epidemic — which, again, is still very much ongoing — in the ways that black and brown people continue to be. There is no amnesia for us. Now, that isn’t to say that fear of HIV hasn’t declined in America; as modern science has produced medicines that allow people with HIV to live with a normal life expectancy and quality of life, and as medication schemes like PrEP and TasP have changed lives, that fear is certainly less prominent. Yet to say that we have forgotten how the virus has decimated our community is simply untrue, and disrespectful to the numerous Black-led agencies who continue doing work in communities most affected by HIV/AIDs, ones that the government has let down.
Indeed, Kelly himself displays the most historical amnesia here. “The very idea of ‘safe sex’ emerged from the gay community in the early 1980s,” he writes. But abstinence and the promotion of safe sex has been the focus of American K-12 sexual education since its advent in 1919, and in many parts of the south, abstinence is still taught as the only form of safe sex.
“If a hyper-resistant strand of another life-threatening S.T.I. develops, we will rue the day that we forgot the searing legacies of our past,” Kelly writes near his piece’s end. It’s an incredibly dangerous statement. Fear is a tactic that has been used to oppress the queer community for hundreds of years. We have not forgotten about the devastation caused by HIV, because it is still all too present for many of us. But you can’t fearmonger people into using condoms, especially those from marginalized communities. Fearmongering leads to criminalization; an analysis by the Center for HIV Law and Policy found that as of last August, laws criminalizing HIV transmission still stand in 34 states, two territories and within the Federal Government. These laws are based in the fact that HIV was once considered a “death sentence,” and ruin the lives of innocent people, who are often unaware they have HIV in the first place. One should never, ever say that HIV or incurable diseases are karmatic retribution based on decisions one makes in the bedroom. This kind of rhetoric only leads to more disease-based criminalization, more stigmatization, and more fear.
It’s more than okay to promote safer sex and condom usage, and we definitely should be, given how HIV is still ravaging our country. But that can’t come at the expense of facts, fear, and the longing to paint HIV as anything less than a “crisis,” simply because one’s community has less investment in the epidemic than others. It is our duty to protect our community from the homophobic tactics that were used to dictate our sexual practices for so many years. The radical sense of community was never lost with the AIDS epidemic — the proof is in the fact that many of us are still fighting a war that articles like this seem to think we have already won.
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