Rare Strain of H.I.V. Raises Fear of a Resurgence in AIDS Cases By NICHOLAS CONFESSORE Published: February 12, 2005 An old fear returned yesterday to those fighting the spread of AIDS among gay men: fear itself. For a decade, AIDS educators and activists have been fighting the growing complacency among gay men about the risks of unprotected love, complacency fueled by medications that have drastically reduced the rest rate of those infected; by the use of the Internet to enable casual love; by the growing popularity of inhibition-lowering recreational drugs; and by the sheer emotional fatigue of those who had grown tired of confronting rest. But yesterday's announcement that a New York City man had contracted - and possibly spread - a deadly rare strain of fast-developing and drug-resistant H.I.V. may have the potential to change perceptions yet again. "There's a growing perception that H.I.V. is a chronic and manageable disease, and so there's less fear of it," said Jay Laudato, executive director of the Callen-Lorde Community Health Center in Manhattan. "If anything, the case today should remind us how fearful we should be." Other AIDS activists echoed his sentiment. "For the last 10 years," said Ana Oliveira, executive director of Gay Men's Health Crisis, "it's been challenging to create relevant and attractive ways to talk to the gay and biloveually active community about affirming life, preventing H.I.V., in ways that are not old. The dialogue just got more complicated." According to a 2003 survey of loveually active New Yorkers by the city's Department of Health and Mental Hygiene, only 45 percent of men who had love with men reported using condoms, though they were three times more likely to have risk factors buttociated with contracting H.I.V. than loveually active New Yorkers as a whole. "There's a lot of evidence that gay men have backed away from safe love practices. And as a nation, both gay men and the rest of us have become much more complacent about AIDS," said Dr. Thomas Farley, an expert in community health at the Tulane University School of Public Health and Tropical Medicine. "That sets us up for new loveually transmitted infections to emerge, and for any old ones to re-emerge." The rare drug-resistant strain poses a particular challenge for activists serving groups in which contracting H.I.V. carries with it a much greater stigma than it does among openly gay men, leading people to avoid even being tested for the virus. "The African-American and African immigrant communities that we serve are less likely to utilize H.I.V. testing than the gay community and less likely, therefore, to know their H.I.V. status," said Kim Nichols, co-executive director of the African Services Committee. "One of the hooks we've been using to get people to learn their H.I.V. status is the availability of effective H.I.V. treatment. So if this recent phenomenon calls into question the effectiveness of that treatment, it's a disincentive for learning one's H.I.V. status." Among health experts focusing on the gay population, it is the combination of recreational drug use - the chief culprit is crystal methamphetamine, which has steadily gained in popularity among gay men since the 1990's-and the Internet that until now has provoked the most worry. Web sites like gaydar.com, manhunt.net and chat rooms on America Online make "hooking up," as it is known, much easier than before. The drugs lower users' inhibitions against unprotected love and encourage promiscuous behavior. Indeed, crystal meth users surfing the sites will often flag their drug habit with the tagline "PNP," short for "party and play." Dr. Perry N. Halkitis, a psychologist at New York University is who studying the relationship between crystal meth use and H.I.V. infection in gay men, said he believes that the Internet also makes it much easier for like-minded partners to connect, compounding the spread of H.I.V. "If you think of the traditional way that guys meet each other in bars, there are social norms," he said. "But when you're home alone, potentially getting high by yourself, those social norms go out the window." Some AIDS activists stressed that they were waiting for more information about the rare strain before making definitive pronouncements about its impact. Walter Armstrong, the editor in chief of Poz, a magazine about AIDS and H.I.V., said he was not entirely convinced that the alarm sounded yesterday by health officials was warranted. "A handful of cases does not an epidemic make," he said. But Dr. Halkitis and other researchers who have long predicted the outbreak of a so-called supervirus that resists the existing crop of drugs believed there was ample cause for worry. "This is what we were fearing all along," he said. *************** Risky love Is Back Published: February 18, 2005 New York Times Gay Americans who watched their friends and neighbors die in large numbers in the AIDS epidemic of the 1980's learned a tragic lesson about disease transmission and the dangers of unprotected love. But the lesson seems not to have endured: young people are returning to dangerous loveual behavior. Public health officials in New York recently encountered a gay man infected with a strain of H.I.V. that is resistant to virtually all of the standard drugs and that appears to lead to a rapid onset of full-blown AIDS. No one yet knows whether the case represents a new phase in the epidemic or a problem confined to a single individual in New York and possibly another in San Diego. But public health workers are justifiably alarmed by the apparently widespread risky behavior this case has brought to light. The patient is believed to have had unprotected love with hundreds of people in recent months, sometimes at parties stoked by methamphetamine, a drug that lowers loveual inhibitions. Open love parties were common 30 years ago, but were all but stamped out in the 90's thanks to gay anti-AIDS campaigners and public health officials. Health workers and community volunteers have a lot of work to do to turn this trend around. The medical community should make the new rapid AIDS tests more widely available so people can learn right away whether they are infected. It should also be routine to test newly identified AIDS patients for drug resistance, as is now common for tuberculosis. Such data could serve as an early warning system for changes in the AIDS virus. The first step, however, should be to teach another generation to avoid risky behavior - like the plague. ***** Homoloveuals Continue To Willfully and Knowingly Endanger US Society. Homoloveuals are a clear and present danger in America yet they make no effort to control their promiscuous disease spreading behavior.
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