When New York City Health Commissioner Dr. Thomas Frieden announced the discovery of a new and more-virulent strain of HIV less than two weeks ago, he seemed to be confirming health officials’ worst fears about the disease. AIDS activists and public health workers have long feared the emergence of drug-resistant, fast-progressing forms of HIV.
The New York case, involving a gay man with a history of crystal methamphetamine use and unprotected sex, has focused attention on the interplay between drug abuse and unsafe sex in the gay community. Some AIDS-prevention workers and gay activists have begun to discuss more-radical interventions aimed at stopping unsafe sexual behavior before it results in infection. But focusing on risky behavior in the gay community misses the mark. AIDS is an equal-opportunity disease wreaking havoc across a wide variety of communities.
Talk of monitoring Internet chat rooms and thwarting sexual liaisons – as some gay activists have suggested – can only fuel the ugly stereotypes of promiscuous sex in the gay community. Risky behavior no doubt plays a part in the spread of HIV among gays, but the toxic mix of drug use and unsafe sex also affects black and Hispanic women, heterosexual men, intravenous drug users and every other group struggling with the AIDS epidemic. Efforts to promote safe sex and curb drug abuse are sorely needed, but they should not be confined to the gay community.
HIV has long since moved beyond the gay community to affect black and Hispanic women in epidemic proportions. In 2003, 85 percent of new HIV cases among women occurred in these groups. The reasons behind this growth go well beyond self-destructive behavior to include poverty, poor education and unemployment.
The jury is still out on whether health officials have a new AIDS crisis on their hands, but the public has already been served its wakeup call. New AIDS crisis or not, eradicating it in the United States will require a comprehensive preventive effort that reflects both the behavioral and deeper reasons behind the spread of HIV.
Concentrating on risky behavior in the gay community alone just won’t cut it.
