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VOL. 4 No. 5

"Purposely, the twenty-something boys, who have never known a sex life without AIDS, fatalistically expose themselves to HIV as a test of ritual manhood."

—Jack Fritscher, Mapplethorpe:
Assault with a Deadly Camera, 1994.

"Deliver me from blood gatherers, O God, Thou art the God of my health."

—Book of Common Prayer

The convertible (one way only!) tattoos signal an unsettling phenomenon that is only now beginning to be acknowledged. An astonishing number of young gay men whose sexual activity began only after the implementation of the "Safe Sex" and "AIDS Education" programs of the 80s and 90s, are seroconverting – testing positive for antibodies, widely believed to indicate risk of AIDS. One estimate has it that one in three twenty-year old gay men will be HIV-diagnosed or dead of AIDS by the age of thirty. According to the psychologist Walt Odets, many of them accept AIDS not only as a possibility for themselves, but "as a destiny about which they can do very little."

A pair of recently published books, Odets’ own In the Shadow of the Epidemic: Being HIV Negative in the Age of AIDS1 and William I. Johnston’s HIV Negative: How the Uninfected Are Affected by AIDS2 explore this new insouciance about seroconversion and offer some disturbing insights into contemporary attitudes. Odets is a clinical psychologist and psychotherapist; Johnston is the facilitator of a discussion group for gay, antibody-negative men. Working independently, they have amassed considerable evidence of what Odets describes as "a psychological epidemic among uninfected gay men."

Now in its fifteenth year, the protracted AIDS crisis has had an impact on everyone in the gay community, diagnosed and undiagnosed alike. Odets writes that he sees "innumerable examples of psychological problems among gay men that seven years ago would have been unusual and noteworthy, but are now so common that they pass almost without comment." Many gay men are afraid to become close to anyone, as either lover or friend, for fear any intimate involvement will be terminated by early death. As one man put it, "I’ve never thought about having a relationship for more than a couple of years, because I’ve never dated anyone who was going to live longer than that."

Odets’ and Johnston’s books are the latest additions to a growing body of literature documenting the complex varieties of "survivor guilt" now experienced by increasing numbers of gay men. Both authors discuss the finding that in today’s breezy, out-of-the-closet gay ghetto, antibody-negative men tend to be profoundly clinically depressed, anxious, disoriented, hypochondriacal, uncertain about the future, sexually dysfunctional, deeply demoralised and psychically numb. Many abuse alcohol or drugs, and their physicians prescribe them millions of dollars worth of tranquillisers, sleeping pills, anti-depressants and sedatives every year. More and more undiagnosed men, Odets finds, now "live in nearly every detail like a dying man – disoriented, piecemeal, and with no assumption of a future."

From his years of intensive talks with friends, patients and clients, Odets concludes that this widespread, endemic depression has its origins not only in the current health crisis, but also in "a destructive mix of old developmental problems" that have usually begun in childhood. Substance abuse is often chronic, reflecting mood disorders, loneliness and stress; in this, antibody-negative gay men probably differ little from their antibody-positive brothers. We may now be starting to recognize longstanding patterns of psychoimmune disturbance in a second generation of gay men – a generation that has come to sexual awareness during the AIDS era.

A few years ago, when conservative commentator William F. Buckley, Jr. suggested that PWAs should all be forcibly tattooed (on the arm and/or the buttocks) for instant recognition, there was widespread disgust at the idea and embarrassment that the apparently urbane Buckley would suggest it. Now, such tattooing is available on a voluntary basis and there is no lack of takers. After a decade of propaganda about Safe Sex, a sizeable cohort of young men, becomes eligible every year for HIV+ tattoos. Bill Buckley’s American Auschwitz Theme Park is almost here, and no boxcars will be required.

One effect of the ubiquitous official warnings about "risk behavior" and "vectors of (AIDS) transmission", is that more and more gay men now believe their body fluids to be dangerous, and "define certain behaviors, such as anal sex or oral sex, as unsafe in and of themselves, without regard to whether one of the people involved had HIV...It is common," writes Odets, "for gay men now to say that anal sex is ‘unsafe’ even when practiced by two antibody-negative people." William S. Burroughs is fond of quoting one survey that found most people believe you can get AIDS from anal intercourse, whether or not HIV is present.

Anxieties about gayness, about sexuality, and about intimacy, now frequently express themselves as fear of viral contamination, an ostensibly rational reason to avoid what has always been problematic. When HIV is identified with feared (and unconsciously desired) homosexual intimacy, the result is a powerful draw toward seroconversion. The undiagnosed men interviewed in both these books repeatedly express the view that antibody-positives live richer, more complex, more "authentic" lives, get more attention, are better able to take risks – including, significantly, the "risk of intimacy" – and that only with such risk-taking can life be meaningful and full.

This perceived link between antibody-positive status and emotional fulfillment is one of many factors now propelling gay men toward seroconversion. These pressures emanate from the AIDS Establishment’s group assumptions about gay men, assumptions which are more and more clearly reflected in the ghettoized gay community itself. And it is the power and diversity of the pressures to seroconvert that constitute the central, disturbing message of both these books.

After the Reagan administration pronounced in 1984 that HIV was the sole cause of AIDS, lucrative patents on HIV-antibody tests were granted to leading AIDS researchers and an aggressive international promotion campaign for HIV-antibody testing began. At first, most gay and AIDS advocacy groups considered testing to be dangerous and oppressive. In the mid-80s, people entering the "Test Sites" (a term eerily reminiscent of "nuclear test sites") often had to make their way through lines of vocal gay demonstrators. Governments and pharmaceutical companies then directed a light dusting of money to selected recipients and the protests died down. Soon a broad consensus developed that testing was a virtue, a civic duty, and the smart thing to do.

Testing positive, in the current wisdom, leads to "early intervention," by which is meant the prescription or administration of large quantities of pharmaceutical products – the so-called "antivirals" and so on – principally nucleoside analogues whose devastating "side-effects" often replicate AIDS symptoms. Whether subsequent illnesses are caused by the inevitable "progress" of the virus, or by a self-fulfilling prophecy is debatable.

The quotations and first-person accounts by antibody-negative men in these studies suggest that while an antibody-positive test result was originally looked upon as a calamity, this is no longer always the case. This is partly because some PWAs are learning how to take care of themselves and are living longer, and partly because a growing number of gay men see an HIV+ diagnosis and AIDS not as something that can or should be avoided, but as, in Johnston’s words, something "fundamentally linked to gay identity". Certainly it has been represented to them that way. Heterosexuals and lesbians are told, "AIDS doesn’t discriminate!" But gay men have come to perceive it as an inextricable part of their "community," their "identity," and their future. One female-to-male transsexual told his therapist that his transformation to a gay man would only be complete when he had contracted HIV! I have heard gay men repeat the homophobic joke:

"GAY stands for Got AIDS Yet?".

In the 70s and early 80s a ghettoized consumerism (fast food, fast drugs, fast sex, quick-fix medicine) was packaged and sold as "the Gay Lifestyle". Now AIDS is increasingly presented as the new Gay Lifestyle. In the gay community of the 90s, everything revolves around AIDS.

This AIDS-centred vision of community life has even made its encroachments on lesbian society. In 1994, after the founder of the British organization for lesbians with HIV, Positive Strength, revealed that her claim to seropositive status was false, AIDS activist Simon Watney spoke of "an imaginary epidemic (of) fantasy AIDS" among British lesbians. Lesbian writer Robin Gorna wrote that "although there are many gay men who also lie about their HIV status, it seems that some lesbians feel unable to articulate their own issues alongside the horror of AIDS. If you are a young dyke, your identity is all tied up with AIDS, yet it’s not your stuff." She added that there was no evidence to suggest lesbian sex poses any significant AIDS risk: lesbians with AIDS, she said, tend to contract it from drug use and/or sex with men, which she described as "still a taboo subject in the lesbian community."3 In all the fracas about how many lesbians get AIDS, Gorna’s remark that many gay men lie about having HIV seems to have been overlooked.

Walt Odets draws our attention to the attitude, widespread in the gay community, that only PWAs and antibody-positives have a right to express strong feelings. He recalls that when he voiced his concerns about the emotional well-being of antibody-negative gay men, he found it was considered inappropriate for antibody-negatives to "experience feelings about their own lives worthy of discussion or worthy of the concern and attention of others." The feelings of those regarded as "uninfected" are widely felt to be "selfish, inappropriate, or simply ridiculous." Often, antibody-negatives are even seen as The Enemy; one man, on the steering committee of a "mental health" conference, when told of an antibody-negative discussion group, retorted, "That’s like Germans getting together...to congratulate themselves on not being Jewish!"

Society has never made the well-being of gay men a priority. On the other hand, if you have AIDS or are antibody-diagnosed, a range of social services, support groups, medical benefits and other perks becomes immediately available. Suddenly, attention is paid. Variations of the same phrase crop up again and again in the sentimental AIDS literature: "I never knew how much I was loved until I got AIDS." It makes a great ad slogan, if AIDS is what you’re selling.

In the urban gay ghettos of the 80s and 90s, a whole AIDS Culture has emerged – an "AIDS Community" based on an ever-shifting melange of medical and subcultural assumptions. This new blood brotherhood is beginning to form a kind of Inner Order within the exoteric conglomeration of the lesbian and gay scene, and a growing number of glossy magazines now devote themselves to the perks and pleasures of the Positive Lifestyle. And one "comes out" into this Lifestyle in one way only: by seroconverting. Seroconversion is the ritual that all who would join the cult must endure. Those who have lost friends, or, especially, one or more lovers, to AIDS may claim honorary membership. The cult’s unofficial badge of honor is a looped red ribbon, usually pinned to the chest, or rather to the coat. Originally a fund-raising favor, the "red ribbon" is now commercially available in many stylish designer forms: one can choose from ceramic, dyed leather, or 24-carat gold encrusted with red stones. Elizabeth Taylor is one of the few who can afford a diamond and ruby "ribbon". Of course, fashion is fickle and the red ribbon is already coming to be regarded as somewhat passé, not to say kitsch.

Under the pressure of protracted crisis, the transformation of signals, policies and identities has been relentless. In the 80s and early 90s, the figure of the AIDS activist, the seething ACT-UP clone, body pumped under the white political T-shirt, head shaved, concentration- camp style, became, for a while, a symbol of erotic resonance, a sexual icon. Having exhausted itself in unfocused anger, the fashion is less popular now than it was.

The ongoing roster of AIDS dead (lots of blank space left on that memorial, how thoughtful) constitutes the raison d’etre of this new, prototypically postmodern, community. Obituaries and funerals are its social glue; its chief dramatic form is the memorial service. Every two weeks, when the new issue of Xtra! comes out, everyone turns to the obituaries first. The Toronto version of this Canadian gay newspaper combine (for it has cloned itself) publishes an annual roster of AIDS dead, under the banner headline "Proud Lives." Deaths from non-AIDS-related causes are relegated to a separate, less prominent, section bearing the mundane and rather dismissive tag, "Other Losses." antibody-positive decedents are sometimes placed in the "Proud Lives" section, even if they committed suicide or fell off a mountain. If you’re positive, there’s only one way to die, and we’re going to hold you to it.

The overshadowing of all other gay issues by the AIDS agenda (first pointed out by Darrell Yates Rist) and the frequent dismissal of the concerns of the undiagnosed, have understandably generated widespread feelings of "disenfranchisement" among uninfected gay men. These feelings are reinforced when the undiagnosed are told to behave as if they were infected: "Be good. Have Safe Sex" – even if they are in a monogamous relationship with an "uninfected" partner! Walt Odets suggests that these injunctions have been ineffective in promoting safety and psychologically disastrous.

Within the urban gay community, the undiagnosed now constitute what William Johnston calls a "psychic minority" – one that appears increasingly eager to Think Positive and join the psychic majority, the AIDS/HIV Community. Though it would have been inconceivable only a few years ago, a positive HIV-antibody test result, or even an AIDS diagnosis, now frequently results in a decrease in anxiety! The acute stress of the testing ritual is released by a positive result. Now, at least I know the worst – and I’ll never have to be tested again! (Negatives are encouraged to come back.) The director of one health service agency reports that individual "crisis responses requiring urgent counseling" were generated by negative test results at a three-to-one margin over positive ones!

Scattered through these two books are various responses to being told of a negative test result: "All my friends are positive – how can I relate to them?" "Everyone’s going to be very angry at me." "I feel like I’m being left out of the great event of our time." "I hoped I would be positive so it would give me an excuse to go back out and drink and drug." "I feel as if I won’t really have come out until I’m HIV-positive." "It’s a lot simpler to think about AIDS than about being gay." "Guys who get AIDS get a lot more attention." And, my own favorite: "Shit! I’m going to have to go to work tomorrow after all." Every two weeks, when the new issue of Xtra! comes out, everyone turns to the obituaries first.

One gay man told me recently that when he revealed to an acquaintance that he was antibody-negative, he received the sneering (presumably rhetorical) reply, "How come? Didn’t anyone want your tired old ass?" A gay student, who was relieved at his negative test results, nevertheless made a wryly revealing comment about the whole process and everyone’s attitudes to it: "For once," he said, "I was glad I failed a test."

One contributor to William Johnston’s book describes a gay man who eventually seroconverted after many attempts: he "had a beatific glow on his face when he found out he was positive. He had been expecting this for so long, and finally the desired outcome was achieved." (His lover, he feared, was about to "dump" him if he remained stubbornly negative.) This new attitude – utterly unforeseen by either the pundits of AIDS Education or its consumers – leads Odets to ask whether counselors "unconsciously suggest that a positive test result is more ’important’ than a negative (one)?" The language used suggests they do; certainly they focus almost exclusively on preparing their clients for "positive" results.

The man with the beatific glow is one of a growing group of gay men who see their "progress" (this is the official term4) to seroconversion and on to AIDS as somehow desirable or inevitable. For the burgeoning cohort of seroconverts, the assumption of antibody-positive identity represents an all-important rite of passage in their lives as gay men. A beatific glow is a characteristic feature of religious conversion experiences, and in many ways, these men resemble the freshly inducted members of a cult.

There is a growing perception that for a gay man today to be HIV-positive is, well, positive. Connotations as fundamental as those suggested by the words "positive" and "negative" are deeply imbedded in our interpretations of the terminology we use. People do not easily transpose black and white, or accept a positive result as negative. Nor can the frequent use of the word "status" be considered inconsequential; we are lectured about our antibody "status", the subliminal suggestion being that testing positive, becoming "Body Positive," and adopting a "positive attitude" involves gaining a positive status, becoming worthy of concern.5 The phenomena of the courageous, positive seroconvert and his neurotic, negative twin have evolved out of the bizarre, dogmatic logic of HIV fundamentalism – what Walt Odets calls the contradictions, inconsistencies and anomalies" of AIDS.

Odets writes that "a return to unprotected sex among gay men after about 1988 is now widely recognized." Why in 1988, four years after the announcement of HIV as the cause of AIDS? My own experience from periodic visits to New York City, an AIDS epicentre, is that the years 1987-88 constituted the height of what the novelist Andrew Holleran has succinctly called "The Fear". Christopher Street was emptier than it has ever been and many gay men were afraid even to kiss. Protracted, inhibited grief and paralyzing terror seemed, even to a visitor, to be causing all sorts of neuroses and a kind of mass mental breakdown. If the "return to unprotected sex" began in the late 80s as Odets believes, it may well have begun as a reactive symptom of that breakdown – an heroic defiance of fear by stoically embracing what was believed to be inevitable.

Just as the health crisis was about to be recognized, the poet and novelist George Whitmore wrote that we engaged in so many of our "rebellious" acts (dangerous sexual scenes, crawling around on all fours on the floor of the Mineshaft at four in the morning) to show that we could do these things "without flinching" – that we were not, after all, sissies. John Rechy endowed sexually promiscuous gay men with "heroic" qualities, calling them the shock troops of the sexual revolution. Is the same defensive need to prove one’s masculinity, one’s courage, and one’s "in group" status now helping to create the phenomenon of the seroconvert?

Survivor guilt often involves the feeling that one should not have survived – and even the hope that one will not survive. The urban gay lifestyle is designed for youth, and for those committed to that lifestyle, the loss of youth may seem more terrible than a fatal illness. Michelangelo Signorile wrote in a recent column that "far too many gay men say they actually fear growing old in a gay world that puts the young and buffed on a pedestal while treating the over-35 crowd like lepers." He tells of one young guy who has unsafe sex because "he doesn’t want to live to be 50. He doesn’t want to be another aging queen, being jeered at by people like himself." Another man said he felt so "beneath" the men he was attracted to that he’d "do anything" for them, including have unsafe sex.6

Walt Odets concludes that "for some, the self-destructive aspects of unprotected sex are important incentives to practice it. This," he emphasizes, "has nothing to do with complacency, nor will traditional AIDS education address it."

The AIDS System now entrenched in the urban gay ghettos has aggressively promoted HIV-antibody testing ("the AIDS test"), and most available AIDS Education has been oriented toward encouraging people – particularly gay men – to "get tested." Former presidential candidate Bruce Babbitt described the system as a "voodoo health policy" animated by the idea that "if we keep sticking needles into people and taking blood tests, the disease will go away." The apparent non sequitur only begins to make sense if, unconsciously, it is not so much the disease but the seropositives who are being wished away, with the AIDS System constructed as a wish-fulfillment around the group fantasy, and camouflaged as medical services.

"There are two ways to find out," read a slogan on the outside of an envelope one gay man received in the mail: "You can get tested. Or you can get sick." Even though AIDS was nowhere mentioned, he "knew right away what this cryptic message meant." It felt, he said, "like an assault." The letter was from Project Inform, a group that began as a dissident AIDS advocacy group and quickly devolved into what one commentator called a "power broker, coordinating sections of the AIDS industry with the appropriate government agencies." In a letter to the San Francisco gay paper the Sentinel, one reader described Project Inform as a "pharmaceutical pimp."

Extensive sections of Johnson’s HIV Negative are contributed by various "uninfected" gay men. And Odets’ book, the more analytic of the two, contains many briefer quotes drawn from the author’s extensive counselling experience. Among the remarks: "Negative men are like my family: they have no feelings." "What I know is that I am going to follow my heart, and I think it’s leading me to the (kind of) understanding that having HIV gives a person." "They will have a cure for it by the time we get it." Another remark I have heard repeatedly is "If I test positive, I can start taking care of myself."

There is a common feeling that to try to stay negative – to "struggle" to stay negative, as one man put it – is simply too difficult, too destructive of any joy in life. This is hardly surprising when the rules of "safe" behavior are at once so stringent and so slippery. Is oral sex safe? Is rimming with a dental dam OK and if it is, why should we want to do it? Should I worry about that sharp pizza crust that might cut my lip and let the virus in? Am I condemned to stay around and watch all my friends die?

In the shadow of such conundrums, becoming positive seems to some like a doorway to intimacy, light and love, and life with AIDS, for all its horrors, begins to appear more rewarding, or just simpler, than life without it. Whatever the respective merits of these questions, the mental soil in which they grow is fertile ground for a positive choice.

Ian Young was born in London. His involvement in the gay movement, as activist, writer and publisher, began in the 1960s. His books include the ground-breaking gay psychohistory The Stonewall Experiment, as well as poetry, literary anthologies, bibliography and history.

Director of a communications consultancy firm and a frequent contributor to the gay press, he lives in Toronto and Banff, Alberta.

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