Reginald had a hard time going through this world – this world he didn’t survive, to echo a line from one of his poems.
I’m not just referring to the more apparent biographic facts of his hard knocks life (a song, by the way, that he much enjoyed both in Annie and in the Jay Z rendition), though I am in part referring to those:
Growing up as the child of a single mother in the 1960s (he told me once that he identified fiercely with the Supremes’ song “Love Child” when he was a child).
Growing up living in public housing tenements in the Bronx.
Losing his mother when he was fifteen.
Dealing with the same tribulations that most every gay man in this culture deals with in coming to terms with that gayness.
Living with HIV for well over a decade.
Living with and dying from cancer and the horrible pains it brought.
Dealing with a host of “lesser” medical issues, like the osteoporosis (possibly a side effect from HIV meds) that led to fractures in his hip and at least one rib.
None of these made it easy to walk through life.
I’m also referring, though, to the combination of innocence and a strong sense of justice with which he continually encountered this unjust world.
One thing the two of us shared was a sense of how we thought the world should be, fair and equitable, with thought and beauty in all its forms valued.
But he combined this with a sort of innocence. He kept expecting the world to be fair and just, for people to be thoughtful and to value reflection rather than ignorance, and as a result he was often disappointed about the state of the world, but one of his most charming traits, that I miss so, was that he kept on presuming the best of people.
Some who knew us, but not in depth, thought I was the optimist and he the pessimist of the couple. They were wrong. In reality, I’m much more likely to view the world through a deeply cynical and pessimistic lens, with one consequence being that I can almost always envision things being even worse than they are. I may become angry, upset, or feel loathing towards aspects of the state of the world, but rarely are my expectations disappointed when people or things are stupid, hateful, vile, or otherwise bad. It’s more that I’m pleasantly surprised when things are good and beautiful.
Though it meant he often bumped up against disjuncture between his expectations and the state of the world, his sense of justice combined with optimistic innocence was a part of his charm that I sorely miss, and that I feel unbalanced without.
Showing posts with label HIV. Show all posts
Showing posts with label HIV. Show all posts
Tuesday, January 27, 2009
Sunday, November 9, 2008
Disco Gets Me Down: Things I Miss, 6
I’ve long had mixed feelings about disco. Much of it’s great music that’s fun, upbeat, and uplifting, but I typically have a bittersweet feeling whenever I listen to disco, as it tends to evoke for me a generation of dead gay boys.
(Perhaps ironically, it was not the HIV that took so many of his generation but cancer that took my gay boy. Reginald was quite open about his HIV+ status from the time I met him, and so I always knew that down the road, serious health problems could be part of our relationship, especially since at the time I met him in late 1998, while protease inhibitors were a godsend for many with HIV, including Reginald, no one could say with certainty whether combination therapy would work well in the long term, as those drugs were still relatively new. As it turns out, Reginald never really had any problem with HIV. I do wonder if it contributed to some of the complications that ultimately allowed the cancer to take over after an initially good response to chemo – some of his doctors thought it probably did, others were less sure, though none of them thought it was a good idea to have HIV and cancer at the same time.)
Since Reginald died, my disco emotions have been amplified, and I’ve found it almost painful to listen to disco or most any other dance music. While it’s far from what I miss most with his loss, one thing I do miss is seeing him dance. As most who knew him well know, Reginald could dance like nobody’s business, and probably the most pleasurable thing about watching him dance was the look of sheer joy he had when dancing. Thinking about it as I write, I’m laughing with the joy of that memory and crying as I know I’ll never see him dance again.
(Perhaps ironically, it was not the HIV that took so many of his generation but cancer that took my gay boy. Reginald was quite open about his HIV+ status from the time I met him, and so I always knew that down the road, serious health problems could be part of our relationship, especially since at the time I met him in late 1998, while protease inhibitors were a godsend for many with HIV, including Reginald, no one could say with certainty whether combination therapy would work well in the long term, as those drugs were still relatively new. As it turns out, Reginald never really had any problem with HIV. I do wonder if it contributed to some of the complications that ultimately allowed the cancer to take over after an initially good response to chemo – some of his doctors thought it probably did, others were less sure, though none of them thought it was a good idea to have HIV and cancer at the same time.)
Since Reginald died, my disco emotions have been amplified, and I’ve found it almost painful to listen to disco or most any other dance music. While it’s far from what I miss most with his loss, one thing I do miss is seeing him dance. As most who knew him well know, Reginald could dance like nobody’s business, and probably the most pleasurable thing about watching him dance was the look of sheer joy he had when dancing. Thinking about it as I write, I’m laughing with the joy of that memory and crying as I know I’ll never see him dance again.
Saturday, October 13, 2007
Recent News on Gay Men and HIV
In the past couple days, I’ve encountered two interesting news articles pertaining to current trends in HIV epidemiology among men who have sex with men.
Science Daily has published the article “Lack Of HIV Prevention For Male Sex Workers In The Caribbean Could Fuel AIDS Epidemic.”
The following two paragraphs are a quotation from the article:
“Male sex tourists, largely from the United States and Europe, may be fueling an HIV/AIDS epidemic in the Caribbean, and efforts to stop the epidemic will be severely hampered unless HIV prevention dollars are diverted to help male prostitutes, a new study suggests.
“Additionally, the study should serve as call to action for the tourism industry to implement HIV/AIDS prevention programs for tourists and tourism employees, said assistant professor Mark Padilla of the University of Michigan School of Public Health. The Caribbean is second only to sub-Saharan Africa in HIV/AIDS cases. The disease has been described as primarily heterosexual, Padilla said. However, Padilla's book shows that sexual contact between Caribbean male sex workers and male tourists may be a much larger contributor to the HIV/AIDS epidemic there than previously thought. Currently, prevention dollars in the Caribbean serve primarily heterosexuals, and this particular population of male sex workers who have sex with tourists is largely neglected. That population of male prostitutes grows larger as the traditional, agricultural jobs dry up. Funding comes from a variety of sources: governments, multilateral organizations such as the World Health Organization, and private foundations.”
The Oregonian has published “Guessing about HIV may keep epidemic going.” The following are quotations from the article:
“More than two decades after the first warnings that condoms prevent the spread of HIV, an increasing number of gay men are instead betting their lives on vague conversations and verbal assurances from their partner before having unprotected sex.
“The Centers for Disease Control and Prevention reports that nationally, the number of HIV and AIDS diagnoses among men who have sex with men increased 11 percent from 2001 to 2005. Researchers in Oregon and elsewhere say one reason could be that men attempt to sort themselves. HIV-positive men limit their partners to others with HIV; those without the disease avoid sex with those who have it. But some experts say it's more of a guessing game because too few men directly ask or answer, "Do you have HIV?"
“Serosorting is a shaky prevention strategy for healthy men, not so much because men lie to their sexual partners -- most don't, especially not those who are HIV positive. Instead, HIV prevention specialists say, men afraid of rejection or who are embarrassed to talk about sex dance around the topic, behavior also seen in heterosexuals. Gay and bisexual men might drop hints about taking medication, for example, and hope their partner understands they mean HIV medications.
“Some men, aware that anal sex is riskiest for the receptive partner, assume it's that person's responsibility to ask for a condom. Other men who say they're negative cite outdated HIV test results. And 1 in 4 people infected with HIV doesn't know it.”
Science Daily has published the article “Lack Of HIV Prevention For Male Sex Workers In The Caribbean Could Fuel AIDS Epidemic.”
The following two paragraphs are a quotation from the article:
“Male sex tourists, largely from the United States and Europe, may be fueling an HIV/AIDS epidemic in the Caribbean, and efforts to stop the epidemic will be severely hampered unless HIV prevention dollars are diverted to help male prostitutes, a new study suggests.
“Additionally, the study should serve as call to action for the tourism industry to implement HIV/AIDS prevention programs for tourists and tourism employees, said assistant professor Mark Padilla of the University of Michigan School of Public Health. The Caribbean is second only to sub-Saharan Africa in HIV/AIDS cases. The disease has been described as primarily heterosexual, Padilla said. However, Padilla's book shows that sexual contact between Caribbean male sex workers and male tourists may be a much larger contributor to the HIV/AIDS epidemic there than previously thought. Currently, prevention dollars in the Caribbean serve primarily heterosexuals, and this particular population of male sex workers who have sex with tourists is largely neglected. That population of male prostitutes grows larger as the traditional, agricultural jobs dry up. Funding comes from a variety of sources: governments, multilateral organizations such as the World Health Organization, and private foundations.”
The Oregonian has published “Guessing about HIV may keep epidemic going.” The following are quotations from the article:
“More than two decades after the first warnings that condoms prevent the spread of HIV, an increasing number of gay men are instead betting their lives on vague conversations and verbal assurances from their partner before having unprotected sex.
“The Centers for Disease Control and Prevention reports that nationally, the number of HIV and AIDS diagnoses among men who have sex with men increased 11 percent from 2001 to 2005. Researchers in Oregon and elsewhere say one reason could be that men attempt to sort themselves. HIV-positive men limit their partners to others with HIV; those without the disease avoid sex with those who have it. But some experts say it's more of a guessing game because too few men directly ask or answer, "Do you have HIV?"
“Serosorting is a shaky prevention strategy for healthy men, not so much because men lie to their sexual partners -- most don't, especially not those who are HIV positive. Instead, HIV prevention specialists say, men afraid of rejection or who are embarrassed to talk about sex dance around the topic, behavior also seen in heterosexuals. Gay and bisexual men might drop hints about taking medication, for example, and hope their partner understands they mean HIV medications.
“Some men, aware that anal sex is riskiest for the receptive partner, assume it's that person's responsibility to ask for a condom. Other men who say they're negative cite outdated HIV test results. And 1 in 4 people infected with HIV doesn't know it.”
Sunday, September 16, 2007
HIV and Gay Men
A recent article on Science Daily, “Different HIV Rates among Gay Men and Straight People not fully explained by Sexual Behavior,” discusses recent research pertaining to the continued disparity of rates of HIV infection when comparing gay men (really "men who have sex with men," regardless of whether gay-identified or not) with heterosexuals in the U.S. For example, though a much lower proportion than in the 1980s and early 1990s, men who have sex with men still comprise just over half of new HIV infections in the U.S.
What’s interesting about the research reported on is that it doesn’t attribute the difference in infection rates to different rates of unprotected sex. In fact the research indicates roughly comparable rates of unprotected sex and numbers of partners for unprotected sex by homosexual men and heterosexuals. (I emphasize unprotected because there’s no given comparison for total numbers of partners for protected or unprotected sex. Given what I know of the gay community, I’d also find it hard to believe that the total number of partners per year is comparable for homosexual men and heterosexuals on average, even if the average number of partners for gay men is likely far down from the pre-AIDS heyday of the bath house scene.)
Instead, the research emphasizes different rates of infection for unprotected receptive anal versus vaginal intercourse (in itself, not particularly new news) and what they refer to as “role versatility.” Because many gay men practice both inserting and receptive roles in anal intercourse, it’s easy for gay men to become infected, especially through the receptive position, but also to pass it on to other men, especially when practicing the inserting position. Obviously, there is no analogous situation for heterosexuals, whether practicing vaginal or anal intercourse.
One thing the research doesn’t seem to take into account is the higher baseline infection rate for men who have sex with men. For men who have sex with men, the reality is that any given sex partner is more likely to be HIV-positive than is the case for heterosexuals. My own experience researching HIV prevention has indicated that in the community I studied, gay-identified men were much more knowledgeable of HIV prevention than others and much more likely to take safer sex practices seriously (even if this doesn’t mean they always practiced safer sex), but in cases where individuals did have unprotected sex, the chances that they did so with an HIV-positive individual were much higher than the corresponding chances for heterosexuals.
What’s interesting about the research reported on is that it doesn’t attribute the difference in infection rates to different rates of unprotected sex. In fact the research indicates roughly comparable rates of unprotected sex and numbers of partners for unprotected sex by homosexual men and heterosexuals. (I emphasize unprotected because there’s no given comparison for total numbers of partners for protected or unprotected sex. Given what I know of the gay community, I’d also find it hard to believe that the total number of partners per year is comparable for homosexual men and heterosexuals on average, even if the average number of partners for gay men is likely far down from the pre-AIDS heyday of the bath house scene.)
Instead, the research emphasizes different rates of infection for unprotected receptive anal versus vaginal intercourse (in itself, not particularly new news) and what they refer to as “role versatility.” Because many gay men practice both inserting and receptive roles in anal intercourse, it’s easy for gay men to become infected, especially through the receptive position, but also to pass it on to other men, especially when practicing the inserting position. Obviously, there is no analogous situation for heterosexuals, whether practicing vaginal or anal intercourse.
One thing the research doesn’t seem to take into account is the higher baseline infection rate for men who have sex with men. For men who have sex with men, the reality is that any given sex partner is more likely to be HIV-positive than is the case for heterosexuals. My own experience researching HIV prevention has indicated that in the community I studied, gay-identified men were much more knowledgeable of HIV prevention than others and much more likely to take safer sex practices seriously (even if this doesn’t mean they always practiced safer sex), but in cases where individuals did have unprotected sex, the chances that they did so with an HIV-positive individual were much higher than the corresponding chances for heterosexuals.
Monday, August 13, 2007
Abstinence Only Sex Education
News-Medical.Net recently posted an article on research related to abstinence-only sex education programs, “Abstinence Only Sex Programs – A Waste Of Government Money?”
The following is a section of the article:
“The latest research confirms and supports earlier work which has stated that programmes which exclusively advocate abstinence from sex in order to stop risky sexual behaviour or help in the prevention of unwanted pregnancy, are ineffective.
The researchers from Oxford University in the UK found abstinence only sex programmes had no negative or positive impact on the rates of sex infections or unprotected sex and did not appear to affect the risk of HIV infection in high income countries.
The Oxford team reviewed 13 U.S. trials involving over 15,000 people aged 10 to 21 and their conclusions question the continued use of public money to fund abstinence only programmes especially in the United States.
Abstinence only programmes encourage sexual abstinence as the exclusive means of preventing HIV infection, without promoting safer sex behaviours, but their effectiveness in high income settings has been unclear.
Abstinence-only programmes are very popular in the U.S. and also have their supporters in the UK, but such programmes fail say experts because they provide no safety net for young people who do have a sexual relationship, which many do.”
I’ve long felt, both on the basis of intuitions arising from research I’ve done in the past on HIV prevention efforts and because the logical basis for abstinence only programs doesn’t make much sense to me, that abstinence only education doesn’t work very well on pragmatic grounds. Hopefully, the upshot of this and similar recent research demonstrating on empirical grounds the lack of pragmatic efficacy of such strategies will be greater support for other strategies demonstrated to have greater effect – though I’m not holding my breath with the current U.S. administration.
I have other objections to abstinence only sex education beyond the pragmatic. First, it’s bad education. No educational program on any topic can convey to students all the possibly relevant information nor all possibly relevant perspectives on the issue at hand. So, no teacher, no program, no policy can be faulted for not teaching students everything about a topic. It’s quite another thing, though, to forbid teachers from discussing with students information or perspectives that are clearly pertinent to the topic at hand, e.g. discussing the documented facts regarding the rates of efficacy of condoms at preventing pregnancy or various sexually transmitted diseases. Educationally, it’s a bit akin to a classical-physics-only class where Einstein is verboten, or disallowing the teaching of Darwinian evolutionary theory (and nowadays, as controversial as Darwin can be in the U.S., most creation scientists and intelligent design mavens are “simply” demanding equal time for their pet ideas, not a taboo on teaching scientific evolutionary theory per se). Abstinence-only programs are anti-intellectual and anti-educational in structure and design.
I’ve written frequently of the importance of individual autonomy. In addition to objecting to abstinence only programs for pragmatic and educational reasons, I object for ideological and moral reasons to attempts to inculcate an inhibition on consensual activity, including an inhibition of consensual activity into legal adulthood up to the point of marriage. Let me be clear, lest my words be distorted: I’m not advocating active promotion of youth sexuality. Nor do I object to anyone saying publicly that they think that people should not have sex before marriage – I might disagree with them, but support anyone’s right to say such things. I object to the incorporation into formal public education an educational strategy that emphasizes inhibition of free individual autonomy.
The sex-negativity of abstinence only programs is a further problem – simply put, the implication that sex in itself is bad (especially given the lack of a factual basis – you could discuss – and I think should – with students potential negative consequences of unwanted pregnancy or sexually transmitted diseases – but it’s hard to imagine any empirical basis for implications or explicit statements that sex per se is negative) is a problem for any serious education. I worry about the effects of abstinence only education for all students. I especially worry with regard to lesbian and gay male students. For them, unless they live in Massachusetts or a country outside the U.S. where gay marriage is possible, the message of no sex before marriage is a further unneeded affirmation of the general sense that there’s something wrong with their sexuality.
The following is a section of the article:
“The latest research confirms and supports earlier work which has stated that programmes which exclusively advocate abstinence from sex in order to stop risky sexual behaviour or help in the prevention of unwanted pregnancy, are ineffective.
The researchers from Oxford University in the UK found abstinence only sex programmes had no negative or positive impact on the rates of sex infections or unprotected sex and did not appear to affect the risk of HIV infection in high income countries.
The Oxford team reviewed 13 U.S. trials involving over 15,000 people aged 10 to 21 and their conclusions question the continued use of public money to fund abstinence only programmes especially in the United States.
Abstinence only programmes encourage sexual abstinence as the exclusive means of preventing HIV infection, without promoting safer sex behaviours, but their effectiveness in high income settings has been unclear.
Abstinence-only programmes are very popular in the U.S. and also have their supporters in the UK, but such programmes fail say experts because they provide no safety net for young people who do have a sexual relationship, which many do.”
I’ve long felt, both on the basis of intuitions arising from research I’ve done in the past on HIV prevention efforts and because the logical basis for abstinence only programs doesn’t make much sense to me, that abstinence only education doesn’t work very well on pragmatic grounds. Hopefully, the upshot of this and similar recent research demonstrating on empirical grounds the lack of pragmatic efficacy of such strategies will be greater support for other strategies demonstrated to have greater effect – though I’m not holding my breath with the current U.S. administration.
I have other objections to abstinence only sex education beyond the pragmatic. First, it’s bad education. No educational program on any topic can convey to students all the possibly relevant information nor all possibly relevant perspectives on the issue at hand. So, no teacher, no program, no policy can be faulted for not teaching students everything about a topic. It’s quite another thing, though, to forbid teachers from discussing with students information or perspectives that are clearly pertinent to the topic at hand, e.g. discussing the documented facts regarding the rates of efficacy of condoms at preventing pregnancy or various sexually transmitted diseases. Educationally, it’s a bit akin to a classical-physics-only class where Einstein is verboten, or disallowing the teaching of Darwinian evolutionary theory (and nowadays, as controversial as Darwin can be in the U.S., most creation scientists and intelligent design mavens are “simply” demanding equal time for their pet ideas, not a taboo on teaching scientific evolutionary theory per se). Abstinence-only programs are anti-intellectual and anti-educational in structure and design.
I’ve written frequently of the importance of individual autonomy. In addition to objecting to abstinence only programs for pragmatic and educational reasons, I object for ideological and moral reasons to attempts to inculcate an inhibition on consensual activity, including an inhibition of consensual activity into legal adulthood up to the point of marriage. Let me be clear, lest my words be distorted: I’m not advocating active promotion of youth sexuality. Nor do I object to anyone saying publicly that they think that people should not have sex before marriage – I might disagree with them, but support anyone’s right to say such things. I object to the incorporation into formal public education an educational strategy that emphasizes inhibition of free individual autonomy.
The sex-negativity of abstinence only programs is a further problem – simply put, the implication that sex in itself is bad (especially given the lack of a factual basis – you could discuss – and I think should – with students potential negative consequences of unwanted pregnancy or sexually transmitted diseases – but it’s hard to imagine any empirical basis for implications or explicit statements that sex per se is negative) is a problem for any serious education. I worry about the effects of abstinence only education for all students. I especially worry with regard to lesbian and gay male students. For them, unless they live in Massachusetts or a country outside the U.S. where gay marriage is possible, the message of no sex before marriage is a further unneeded affirmation of the general sense that there’s something wrong with their sexuality.
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