Plus: Faulting Ferraro and Backing Obama
I always felt a strong empathy for women and their fight for equality.
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By Dr. Perry N. Halkitis
Friday, September 28, 2007
The New York City Department of Health and Mental Hygiene this month released a report that indicated a surge in new HIV infections among gay men (also referred to as “men who have sex with men,” or MSM) younger than 30. For many of us who work in this field, the announcement was no surprise. There is no doubt that this pattern in new infections among young MSM is not only very real but also puzzling and troublesome. Twenty-six years into the epidemic, MSM in the United States continue to constitute the majority of those infected with the virus despite millions of dollars in education and prevention aimed at reducing HIV transmission.
Our own research at New York University documents the continual struggle with safer sex even among those who lead otherwise “healthy” lives. Numerous explanations have been offered by academics like myself about the continued and perhaps growing struggle with AIDS: optimism in light of HIV treatment advances, decreases in funding to AIDS service organizations, the higher rates of depression in our population, the emergence of a new generation of gay men who did not witness the devastation that AIDS caused in the 1980s, the lack of effective prevention messages and increased promiscuity enhanced by the recreational use drugs such as crystal meth. These issues all conspire to create a general malaise toward the disease and safer sex strategies.
No one of these factors alone can simply be responsible for where we are today; more likely, these all work synergistically to create a state of complacency and risk and thus perpetuate HIV in our lives. For those of us who lived through and witnessed that ravages that AIDS has wrought on our community, there is a level of disbelief that anyone would place him or herself at risk of this infection.
BUT THIS IS NOT A time to point fingers, slam the gay community as irresponsible, or demand that everyone be tested without appropriate guidance and counseling. Rather, we need to reconsider the strategies that we use to work with gay men around this disease.
We wonder why young gay men are not afraid of the virus, and we claim that their limited understanding of history precludes them from truly appreciating their lives. We are told that we should learn from history so to not repeat the mistakes of the past. This wisdom sadly is lacking not only with regard to the HIV epidemic but also with many of the world’s social conditions. Perhaps it is too much to ask young men coming in to their own beings and sexuality to immerse themselves in the horrors of the past. Perhaps instead as educators and researchers we need to immerse ourselves in their realities of 2007 instead of asking them to immerse themselves in the realities of 1985 and accordingly tailor their lives.
IN THIS REGARD, WE need a paradigm shift, in the manner with which we conduct HIV prevention work. Too often we rely on the tired slogans of the past to advocate for safe sex. But these models no longer work for a generation bombarded with conflicting messages. We need more sophisticated public health campaigns that address safe sex and condom use to which the new generation can relate.
In creating a paradigm shift, we must be informed and guided by the words and actions of this new generation. We need to work with them and help them guide us in developing strategies.
One approach which holds promise is integrating HIV education and prevention efforts within an umbrella of gay men’s health. HIV is only one of the issues with which many gay men struggle. They also confront depression, drug use, stigma and all the other biophysical phenomena that emergent adult men face. All of these elements overlap and affect each other. A better approach to HIV prevention might be one that addressees these and other health and mental health elements together. This is one message that seems to resonate with young men, and thus one worth further examination.
To my peers, I strongly suggest this plan: Let’s meet these young gay men where they are in their lives, and with them develop strategies for confronting HIV, be it this holistic approach to gay men’s health or any other prevention strategy they deem meaningful, appropriate, relevant and helpful.
When I was 18, the men who should have guided me were all dying. Today, the survivors, my peers and I, are very much alive (despite being weary from 26 years of living with this disease), and as such we are not only responsible but also obligated to help this new emerging generation of gay men find their own voice, develop their own wisdoms, and create their own strategies that will help us more effectively address the HIV epidemic in their lives.
Perry N. Halkitis, PhD is a Professor of Applied Psychology, the Director of Research and the Director of the Center for Health, Identity, Behavior & Prevention Studies at the Steinhardt School of Culture, Education, and Human Development at New York University.
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