There was once a time, in the not too distant past, when there wasn’t a gay social function — whether held at a club, community center or festival — that didn’t stock condoms seemingly by the truckload.
There was once a time, in the not too distant past, when many gay men — older men, teens, even gay porn stars — wouldn’t think about having unprotected sex, particularly with casual sex.
Times have changed.
Jay Dempsey runs the P.O.O.L. program for gay men at AID Atlanta, and begins each new group by asking attendees whether condom use is still the sexual norm among local gay men.
“The answer’s always no,” Dempsey said.
The change in gay men’s views toward condoms is often associated with the onset of highly effective anti-AIDS drugs in the mid-’90s, when the perception of the disease transformed from an automatic death sentence to an almost invisible, manageable illness. Experts agree that no longer seeing friends suffer or die from AIDS has affected how gay men approach safer sex, but other factors have changed as well.
The condom-friendly sex education of the ’90s has been replaced wholesale by the Bush administration’s devotion to abstinence-until-marriage, while, simultaneously, marriage has become a legal impossibility for most gay and lesbian Americans. And as gay people fight for rights and acceptance from society at-large, many continue to struggle with self acceptance, tensions with their families and creating healthy intimate relationships.
“If you have this feeling of yourself as not being worthy, perhaps you don’t really care about yourself, you don’t care about your health, and so you might not use a condom,” said Celia Lescano, a researcher at Brown University who studies condom use among young people.
And then there are gay men who believe wearing a condom is futile. “There’s a deep linkage in the minds of some gay people that if you’re gay, you’ll inevitably get HIV,” said Donna Futterman, professor of clinical pediatrics and director of the Adolescent AIDS program at the Children’s Hospital at Montefiore in New York.
’OUTSMART THE SYSTEM’
Colton Fitzgerald thought he could navigate HIV/AIDS as successfully as he navigated being an openly gay teenager in Loganville, Ga., a small town of about 9,000 residents located 35 miles east of Atlanta.
Before and after he came out as gay at age 13, Fitzgerald was bombarded with messages from his family, school and church about homosexuality being dirty and sinful.
“Where I grew up, I always heard gay is wrong, and all gays have HIV,” said Fitzgerald, who is now 18. But Fitzgerald persevered as the only gay teenager at his high school, and finally discovered a more accepting environment when he attended his first Atlanta Gay Pride festival in June 2005.
As he began frequenting gay venues and indulging in promiscuous sex, Fitzgerald developed a crude HIV-detection system that he thought would keep him safe. His screening process led him to start a relationship and have unprotected sex with a boy he met at a birthday party in early June 2006.
Fitzgerald had never seen the young man before, which he interpreted as a good sign.
“I figured he was somewhat of a new person who hadn’t been around the block,” said Fitzgerald, who had a three-and-a-half week relationship with the young man. Three months later, on Sept. 17, 2006, Fitzgerald tested HIV-positive at age 17. “I never felt like I was Superman, I just felt like I could outsmart the system,” he said. “I always felt like it definitely could happen to me, but I thought I could figure out a certain method of how it was dispersed by people.
“It’s definitely something I was not expecting, especially this early in my life,” Fitzgerald added.
The HIV rate for gay and bisexual men 13-24 years old declined by 30 percent from 1994 to 1998, but skyrocketed 41 percent from 1999 to 2003, according to a 10-year analysis of HIV diagnosis among youth ages 13-24 conducted by the Centers for Disease Control & Prevention.
“The study found that HIV diagnosis among young females declined steadily from 1994-2003 in every racial/ethnic and age group,” said CDC spokesperson Jennifer Ruth. “Among young males, however, an initial decline was offset by significant increases in more recent years, driven primarily by increases among young adult [ages 20-24] men who have sex with men.”
The CDC notes that although HIV diagnoses are on the rise among gay youth, studies “indicate that teens are making more responsible decisions about sex,” with more teens delaying sex, or using a condom more often.
In a June 2006 CDC report, 53 percent of gay men ages 18-24 who engaged in anal sex said they didn’t use condoms with their primary sex partner, and 31 percent said they didn’t use condoms with casual partners. Both of those percentages were the lowest of any age group, with 63 percent of gay men over 55 not using condoms with their primary sex partners, and 42 percent not using condoms with casual partners.
’WHY DO WE NEED TO WEAR CONDOMS?’
The numbers suggesting steady condom use among gay youth don’t harmonize with 23-year-old Kelvin Barlow’s experiences in Atlanta. “A lot of my partners are not thinking about condoms,” said Barlow, who was diagnosed with HIV at age 17. “I think I’m usually the first one to bring [condom use] up [in sexual situations]. Sometimes my partners know my status and sometimes they don’t — they just want to jump in the bed.”
Barlow believes a combination of ignorance and emptiness led to his seroconversion. “At that time I was the dumbest thing walking — I thought I was invincible and could do whatever and not get ill,” said Barlow, who was 15 and dating a 35-year-old man. “I thought I was in this relationship with this man who loved me, why do we need to wear condoms?”
Fear of disturbing a relationship — either by making a partner suspect cheating, or losing intimacy — is a common barrier to youth using a condom, said Lescano of Brown University, whose research primarily focuses on youth with severe stress, anxiety or other psychiatric disorders. Teens may also avoid using condoms if they don’t believe they’re available, comfortable or socially acceptable, Lescano said. Lescano’s research found that “psychological distress during sexual situations may precipitate risk behavior,” and with gay teens experiencing higher levels of distress than their peers, Lescano speculates negotiating condom use in same-sex relationships can be even more difficult.
Like many gay youth, Barlow was numb to the mental anguish he endured as a gay youth, substituting inner pain with sex. “They may not do it consciously, but unconsciously you’re going out, looking for some … validation,” Barlow said. “We’re so broken apart because of society, and it’s taken a lot of validation away.”
Latex condoms have been around since 1912, and have been the primary weapon to in the fight against HIV/AIDS for more than 25 years. Companies like Coca-Cola launch new advertising campaigns every few years to capture new generations of youth, while the wear-a-condom-to-avoid-AIDS message hasn’t been modified in decades, Children’s Hospital’s Futterman said.
“Unless we give each generation the message with the same kind of passion, intensity and updatedness, [youth] are not going to get it, they’re not going to believe it’s for them,” said Futterman, author of “Lesbian & Gay Youth Care & Counseling.” HIV-prevention strategies must address “the interaction of so many forces” that prevent gay youth from using a condom, including various mental health stressors, Futterman said.
“We can’t isolate one factor [that causes unsafe sex] and so our approaches have to be multi-factoral,” said Futterman, who added that a societal taboo about condoms prevents them from appearing in commercials, movies, music and all other mass media. “If condoms are just in the public health sphere, and not in the real world sphere, why should young people think condoms are for them?” Futterman said.
Condoms also rarely appear in sex education classes across the country, particularly in Georgia. A growing number of states are beginning to refuse federal funding for sex education because they don’t want their content restricted by President Bush’s abstinence-only mandates, with New York joining 11 other states last month in rejecting federal abstinence funding. The Georgia Department of Education adhered to an abstinence-until-marriage policy for sex education classes even before Bush took office, with local school boards and parents having to “develop procedures that come into compliance” with the department’s guidelines, said Matt Cardoza, a spokesperson for the Department of Education.
“Of course, the distribution of condoms, I guess, goes against what the [department] policy says,” Cardoza said. Sex education classes in Loganville were vague and useless when Fitzgerald was in school.
“During our sex education, they, No. 1, never talked about gay sex, and No. 2, they never talked about having sex and using condoms,” Fitzgerald said.
With abstinence-until-marriage messages contradicted by constitutional same-sex marriage bans, gay youth “are basically told their very existence is not accepted,” said Futterman. Even sex education programs that talk explicitly about sex may not resonate with gay students, Lescano said.
“Kids who self-identify as gay, and who are out and know that, do need interventions that are specific to them,” Lescano said.
AID Atlanta works with schools through its “Ask Us” program to bring young HIV-positive speakers to talk with their peers. “If a young person can deliver their story to young people and say, ‘This is what it’s like dealing with this disease — yes, I may look healthy but this is what I deal with,’ that in itself is a powerful prevention tool,” Dempsey said.
But despite condoms not being in vogue, “until we discover a better tool, this is the tool we have and must use,” Futterman said.
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