Many people have probably seen the video channel, It Gets Better, started by Dan Savage in response to the suicides of Billy Walsh and other gay teens. It Gets Better tells an important message to young gay teens; that as bad as it seems now, as lonely and isolating as high school and even college can be, it does in fact get better. As a gay teen (although just barely, turning 20 this March) I can appreciate the necessity of the It Gets Better project. I am sure the project has helped countless teens when it seemed like there was nowhere else to turn.
The It Gets Better project has been a runaway success and I am sure it has been effective in preventing teen suicides. It also got me thinking about how we could use similar projects to address other problems that effect gay youth. One problem that has been inexcusably ignored for the past two decades is the HIV epidemic in young gay men. The rate of new HIV infections in young gay men has been increasing every year since about 1992. In 2006, the number of new HIV infections in just young gay men (ages 13-29) exceeded 10,000. Unfortunately, the situation is not getting any better, and by 2008, the CDC reported that the number of new HIV infections in young gay men was increasing by 12% a year.
The suicides of gay teens received a lot of press in 2010 and for good reason. Each one of these suicides is tragedy and totally unnecessary. I am proud to say that the gay community, my community, responded quickly and effectively. But why doesn’t anyone seem to care about gay teens getting HIV? After all, it is much more likely that a gay teen will get HIV then he will commit suicide (the total numbers of suicides in all young people was 4,559 in 2004). I am not trying to minimize suicide prevention or reducing homophobia–these are noble and essential goals–but I just wish that the community and the press would also give some importance to preventing young gay men from getting HIV.
Some of the little attention that is given to HIV in young gay guys consists of fear-based PR campaigns that are probably as ineffective as they are unpleasant. The recent HIV prevention campaign launched by the NYC Department of Health called “It’s Never Just HIV” is typical, video below. The point of this campaign is to demonstrate that HIV infection has many negative side effects (osteoporosis, anal cancer etc.) and therefore getting HIV is bad. This seems pretty obvious. I would say that most people know that HIV/AIDS is bad for your health. It would be like an anti-suicide ad telling people “don’t commit suicide, dying sucks” or teen pregnancy prevention campaign saying “don’t get pregnant”.
What people don’t know (and need to know) is how to avoid getting HIV while still being able to have a normal sex life.
This brings me to the “use a condom every time” message that is present in this campaign and most others. In a perfect world, this would be a very effective message, but in the real world, it might be more harmful then good (hear me out). The main problem is that this message is a vast oversimplification of the truth. In reality, there is a huge difference in the probability of getting HIV from unprotected oral sex, then say unprotected anal sex (unprotected anal sex is probably 100 to a 1000 times more likely to transmit HIV then unprotected oral sex). Treating all sexual acts like they pose the same risk to HIV transmission is simply not true. The problem with this dishonest, “one size fits all” approach is that while it exaggerates the risk of certain sexual acts (e.g. oral sex), it also understates the risk of truly high risk sex acts (e.g. unprotected anal sex).
It reminds me of realization that me and many of my friends made after smoking our first (marijuana) joint in high school. Our whole lives we had been told “Don’t do Drugs”, and that doing any drug will ruin our lives, destroy our brains etc. etc. Yet after we took the plunge and got stoned, nothing that major actually occurred. We didn’t drop out of school, we didn’t go crazy, we just ate a disgusting amount of potato chips and laughed at South Park. So after that, we (stupidly) concluded that all the stuff that health class taught us was lies. Of course, some of it was true, some drugs are really dangerous, and have a high probability of negatively impacting our lives. We just did not know which parts were true and which parts were lies. But that’s the problem with half truths, it’s hard to tell which half is true and which half is false. Wouldn’t it have been better if the teachers had just been honest with us; saying if you’re going to do drugs, weed is not that dangerous, but heroin, crack etc. is actually incredibly dangerous and can ruin your life.
That is how I view sexual practices. Unprotected oral sex is like pot, a low risk activity, and unprotected anal sex is like crack or heroin, something that you never do (unless you are in a committed monogamous relationship). And, to be honest, I have never engaged in protected oral sex nor have I ever met anyone who has (who wants to eat a Popsicle with the wrapper on?) yet at the same time, I have never had unprotected anal sex and won’t, unless I am .
In every activity we do, there is some element of risk. Waking up, crossing an intersection, driving to work, all of these activities are surprisingly dangerous. We learn from a young age, however, that in order to live, we must take risk. When possible, we try to minimize risk, but we know that we will never eliminate it.