Fear of AIDS lost on the younger generation

By Tanya Bricking
Advertiser Staff Writer

And as a result of a more lax attitude about safer sex, people under 25 account for half of all new HIV infections in the United States, according to a 2002 fact sheet from the Centers for Disease Control. Illustration by Greg Taylor • The Honolulu Advertiser Testing for HIV is free, confidential The first step in preventing sexually transmitted diseases is knowing whether you have one. Free and confidential HIV testing is available. Some clinics also offer free STD testing. For information: On O'ahu: Call the state Department of Health's Diamond Head Clinic at 733-9280. On the Big Island: Call the Big Island AIDS Project at (808) 981-2428, the West Hawai'i AIDS Foundation at (808) 331-8177, the Department of Health at (808) 974-4247, Hamakua Health Center at (808) 775 9133 or the Salvation Army Kona Community Clinic at (808) 326-5629. On Kaua'i: Call Malama Pono at (808) 246-9577. On Lana'i: Call Lana'i Community Hospital at (808) 565-6411 and ask for Jan. On Maui: Call the Department of Health at (808) 984-2129 or the Maui AIDS Foundation at (808) 242-4900. On Moloka'i: Call the Maui AIDS Foundation's Moloka'i branch at (808) 553-9086. AIDSWalk Honolulu's 12th annual AIDSWalk, a 5K walk around Kapi'olani Park, takes place Saturday to celebrate the lives of those lost to AIDS as well as people living with the disease. The walk raises money for the Life Foundation, Hawai'i's oldest and largest AIDS program. For a team packet and registration material, call 521-2437, or by e-mail.

They talked about stories in the news lately that have cast gay men in a negative light, placing a spotlight on people who are blasé about being infected with HIV or those who cruise Internet chat rooms looking for partners to engage in risky sexual behavior.

Those stories don't reflect the behavior of older gay men, the trio of observers said as they watched others mingle at the bar. At the same time, they wondered aloud whether a diligence about condom use and fear of AIDS are aging attitudes that have become lost on the younger generation.

On the other side of the bar, 24-year-old Brett Stout knew exactly what the men were talking about.

In the early days of AIDS, whether to have sex without a condom was considered by many to be a life-or-death choice. But as life-extending drugs are becoming more widely available, the healthy-looking face of basketball hall-of-famer Magic Johnson has replaced close-to-death images as the picture of what HIV infection can mean.

In the 20 years since AIDS entered Americans' vocabulary, young people's attitudes about HIV infection have changed.

And as a result of a more lax attitude about safer sex, people under 25 account for half of all new HIV infections in the United States, according to a 2002 fact sheet from the Centers for Disease Control.

In Hawai'i, 134 new AIDS cases were reported last year, bringing the total to 1,204 reported cases of people here living with AIDS.

AIDS educators say gay men 15 to 24 years old make up the demographic of those most likely to be infected with HIV. Since Hawai'i began compiling HIV data in 2001, the health department has recorded 503 HIV cases, but the numbers are incomplete because of a reporting delay.

"The older generation definitely still has the fear of being infected, much more than the younger generation," said Stout, a Hawai'i resident and former Marine who grew up in Iowa. "Younger people would never associate someone who would walk in the bar wearing beautiful clothes as someone who's HIV-positive."

Changing attitudes

Richard Barton is one of those people who has HIV and has outlived many of his friends.

Since 42-year-old Barton was diagnosed 20 years ago in San Francisco, some people have forgotten the horrors of the AIDS deaths of the 1980s, he said, because not as many people are dying.

Younger gay men were not part of the generation that saw the devastation AIDS wrought on gay Americans who are close to Barton's age. Today, HIV and AIDS are seen as something more treatable, he said, making unprotected sex seem less of a risk.

Barton, director of client services for the Life Foundation, a Honolulu agency that helps people with HIV and AIDS, has dedicated much of his life to working to prevent the spread of HIV and AIDS. He worries about the cavalier attitude some people take toward the disease and thinks about how to keep people from abandoning safer sex practices.

But young gay men say changing attitudes will be a tough challenge.

"I think it's going to have to be an epidemic for people to really wake up," said Brandon Morris, 25, promotions director for Hula's. "That's just the way it is in America."

"Either that, or it's going to take a drastic mutation of the virus that causes death to happen very quickly," Stout added. "Unless the disease dramatically changes, I think most young people really believe there's going to be a cure."

Getting past the hype

The February issue of Rolling Stone magazine carried a story that took careless attitudes about risky sexual behavior to the extreme.

The focus of "Bug Chasers — The Men Who Long to Be HIV+" sounded like a thrill-seeking sexual adventure about a reckless subculture in the gay community that wanted to risk HIV infection because it was somehow erotically thrilling. It told the story through several men who talked about their near-suicidal experiences hooking up with "gift givers" willing to infect them.

Since the article rolled off the presses, Rolling Stone has been under attack by AIDS groups, who say the article paints an irresponsible picture of gay men, and doctors quoted in it who say their words were twisted.

In Hawai'i, HIV prevention leaders say they have not seen the "bug chasing" phenomenon surface here. The mere idea appalls people who have fought for years to break negative stereotyping of the gay community.

"It really demonized how bad it is to be HIV-positive," said Jayne Bopp, Barton's colleague, who works as director of HIV preventive services at the Life Foundation. "It perpetuates a stigma."

The magazine sensationalized and exaggerated how widespread the "bug chasing" subculture is, Barton said.

"I think people want to know how pervasive it really is," he said. "And I think the answer is nowhere near what the article suggests."

Rolling Stone quotes Dr. Bob Cabaj, a San Francisco psychiatrist, who says 25 percent of all newly-infected gay men in the United States (about 10,000 people a year) are either consciously or unconsciously seeking to get HIV. Cabaj now says he never made that claim.

At least one observer, however, says there probably is an element of "bug chasing" in Hawai'i, even if it's not labeled as such. It has raised enough attention to hit local Internet discussion boards, said Kenneth Miller, director of The Center, a Hawai'i outreach, counseling, referral and advocacy organization formerly known as the Gay & Lesbian Community Center.

"I suspect it's actually happening here," Miller said.

Regardless of whether it's happening in Hawai'i, he said, the only way to make something positive out of it is for AIDS service groups to focus on increasing awareness.

Otherwise, he said, "it's putting another black mark on the image of the gay community, of being irresponsible."

Shifting emphasis

But just how AIDS service organizations can reach out to young people is perplexing.

"We don't have an insight right now to the younger people, or know what message to them would get through," said Karen Carder, AIDS prevention outreach worker for the West Hawai'i AIDS Foundation.

On O'ahu, a group called IKON (Island Kane Ohana Network) is a young men's peer health project organized through the Life Foundation to address concerns of gay and bisexual men and boys 13 to 29 years old. Organizers launched the outreach group in 1999 because they saw a need to address the generational divide in the gay community.

On Neighbor Islands, where it's more rural than Honolulu, it's harder to have those kinds of support groups because young men are not as likely to "out" themselves at community meetings where everyone knows them and their families, said Dean Wong, director of HIV prevention and education services at the Maui AIDS Foundation.

Most youth outreach on Neighbor Islands is still done through high schools and individual school counselors, Wong said.

Simply raising money to support AIDS outreach programs is increasingly difficult, Barton said. With HIV and AIDS out of the national spotlight, fund-raising for the Life Foundation alone has decreased about $200,000 a year for the last couple of years.

Peter Whiticar, chief of the Sexually Transmitted Disease/AIDS branch of the state Department of Health, said people in general care about their health and want to "do the right thing" and keep HIV from spreading.

In the meantime, prevention workers are shifting their emphasis. This year, for the first time, Hawai'i AIDS service organizations have officially made people who are HIV-positive the priority when it comes to primary HIV prevention.

The idea used to be that it was too late to talk to HIV-positive clients about prevention, so the focus was on people who were not yet infected. The new theory is that helping HIV-positive clients deal with additional issues (such as drug abuse or mental problems) will reduce new cases, Bopp said.

No easy answer

No solution is simple, Barton said.

There was a time, when Barton was living as a gay man doing HIV prevention work in Colorado, when he dated a man who wanted to have unprotected sex, even though he knew Barton was HIV-positive. Barton rejected his offer and was angry. But he later learned the man's thinking was much more complex than some kind of thrill-seeking attitude. As Barton eventually discovered, his partner was depressed and trying to hold onto a past relationship with someone who was infected. The man was later regretful about his desire to be irresponsible.

"Anywhere you go in the country, you're going to find people who feel like their life is not worth living," Barton said. But defining those people as a reckless stereotype of the gay community is hardly fitting, he said, because there is an irresponsible subculture in every group.

Within the gay community, the problem is not so much reckless disregard for life as it is shifting attitudes about HIV infection that are putting the older and younger generations at odds.

Young gay men are more apt to say living with HIV is more of an inconvenience, Stout said.

"As the medicine gets better, people are living with HIV," he said, "and it's not as much of a death sentence."

The Showtime cable series "Queer As Folk" is one way the safer-sex message is still getting out to the younger generation, said Stout, executive director for the Honolulu Gay & Lesbian Cultural Foundation, which promotes Hawai'i's gay film festival each year.

"On the show, they always have condoms and they make condoms look sexy," he said.

If they could only translate that to reality, safer sex would mean more than small talk at a gay bar.

Tanya Bricking writes about relationships for The Advertiser. Reach her at tbricking@honoluluadvertiser.com or 525-8026.