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Having lived in SF at the height of the AIDS catastrophe, and seen vividly and at first hand and very close up in volunteer activities the devastation HIV causes, this story shatters my heart. One in five gay and bisexual men living in American cities are infected with HIV, with an overall infection rate of 19%.  From the story in Reuters:

Nearly one in five gay and bisexual men in 21 major U.S. cities are infected with HIV, and nearly half of them do not know it, U.S. health officials said on Thursday. Young men, and especially young black men, are least likely to know if they are infected with HIV, according to a study by the U.S. Centers for Disease Control and Prevention. “We need to reinvigorate our response to preventing HIV among gay and bisexual men,” Dr. Jonathan Mermin, director of CDC’s Division of HIV/AIDS Prevention, said in a telephone interview. “We can’t allow HIV to continue its devastating toll among gay and bisexual men, and in particular, among young black men.”

Researchers at the CDC studied 8,153 men who have sex with men in 21 U.S. cities. The men were taking part in the 2008 National HIV Behavioral Surveillance System, which looked at prevalence and awareness of the human immunodeficiency virus or HIV, the virus that causes AIDS. Overall, they found that 19 percent of gay men are infected

This is just awful.  It seems to me that this awful statistic proves the failure of the “safe sex” misnomer as a way of preventing infection.  (I’ve posted other entries pointing out that the rate of infection has remained stable over the course of the epidemic, about 40,000 new cases a year in the USA.)  The only truly safe sex is mutual monogamy with uninfected partners.  Using a condom is, hence, not “safe,” nor the newer moniker “safer,” sex. It isn’t even truly “protected” sex.  If we were totally candid, using condoms is, at best, “less safe sex,” in comparison with “unsafe” sex in which nothing is done to prevent infection.   Indeed, many people have become infected even though they used a condom.

But the safe sex meme stuck as a way to convince people to use condoms to reduce rates of infection.  But that approach—along with the thankful reality that HIV can be controlled for many years— may have also encouraged people not to alter their sexual practices.  In any event, it clearly hasn’t worked very well.   And if the drugs ever stop working, the consequences will be catastrophic.

Perhaps honesty—that sex with a condom is still risky, particularly while engaging certain sexual practices, would be more effective.  It would treat people as adults, and hopefully, could induce people to be more responsible and restrained in the risky behaviors.


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