I have been struck lately by the ubiquity of media in New York from the early part of the AIDS crisis. In the span of three months, ACT UP had a successful summer exhibition at the White Cube Gallery, the Actors Fund staged Larry Kramer’s play The Normal Heart as a reading, and Tony Kushner’s play Angels in America reopened just this past week. The AIDS-era history is reentering the communities’ consciousness and reaching a new, young gay audience.
These renewed dialogues are important, as evidenced by troubling statistics that one in five gay men in urban areas are living with HIV. The revivals and exhibitions are initiating conversations between gay New Yorkers who lived through the crisis and those who either moved here or were born after it began. We return to these plays and organizations, many of which are older than some of the gay men newly affected by HIV, because they are effective at making the news media and the government pay attention to a crisis they would have rather ignored.
However, we appear to face a continued problem in getting the news media and government to pay attention to the issue of HIV and AIDS as it affects the gay community. Following reports of successful trials in women of vaginal microbicides at the international HIV/AIDS summit this summer, numerous publications lauded the findings as a breakthrough in the fight against the disease. While the American media reported extensively on the findings of the study in women, news outlets made little or no allusion to the potential application of the treatment in HIV prevention among gay men. Considering that the population most affected by HIV and AIDS in the United States is men who have sex with men, how can this not be an important issue for the American media to consider?
Clearly, researchers are developing vaginal microbicides to stem the international AIDS epidemic, which affects many more millions in Africa than in the U.S. The microbicides in development are not effective enough to replace condoms as the most viable preventive measure and are currently only being tested for use in developing countries. One could argue that the American news media coverage only reflects these realities.
However, in considering advancements in international HIV prevention, it may be possible to see how national policy will be formulated as well. An October 25 announcement from the Food and Drug Administration and the CONRAD research institute declared that a vaginal microbicide will be fast-tracked for approval for use as a preventive tool against HIV. As American-led international bodies begin planning to manufacture and distribute vaginal microbicides, the Centers for Disease Control and Prevention has yet to finish trials to determine the treatment’s potential efficacy for gay men. The only study that the CDC has completed involving gay men and rectally administered microbicides determined that long-term use of the treatment does not seem to cause any physical harm. The study concluded nothing regarding the effectiveness of the treatment in preventing HIV in gay men.
The efficacy of rectal microbicides will not be known until the completion of the study. Regardless, microbicides seem to be the most important recent advancement in fighting HIV infection. The fact that FDA approval has already been announced for heterosexual use, but no report has yet to be released regarding potential efficacy in men who have sex with men, is reason for concern. This process demonstrates that new HIV treatments are being developed for heterosexuals first and have not been simultaneously tested in gay men.
The recent advances in microbicide research raise important questions about the future of HIV prevention. If and when the medical community finds a treatment that is dependably effective in preventing HIV, will gay men be the last demographic to receive it? Why does it seem like gay men, after 25 years of negligence on the part of our government in our own fight against HIV and AIDS, are still the last demographic to receive preventive treatments? The answer is obvious to me: lack of advocacy. The widely reported issues of suicide and antigay violence are important to our community, but the threats they pose are not nearly as grave as the continued threat of HIV and AIDS. Had the nine nationally recognized teens who committed suicide because of antigay bullying in the last two months lived, statistically at least one of them would have contracted HIV. The national news media still seem hesitant or disinterested in advocating for gay men’s health interests regarding HIV and AIDS. I would conjecture, based on the developments regarding vaginal microbicides, that the media’s coverage of HIV and AIDS reflects the United States government’s policies and programs, which treat heterosexuals first and gays last.
The troubling rise in HIV cases among urban gay men should be evidence enough that drastic changes in policy and increased funding for awareness, treatment, and prevention are imminently necessary. On the one hand, I am disappointed with the news media and the government for not taking more action on our behalf. However, I cannot say that it is surprising, given the history of the AIDS crisis in the United States, that we must continue to fight and advocate for ourselves in order to be heard. In revisiting the stories and histories of the crisis, activists and forebears are sharing their knowledge and experiences with a new generation of gay men and women. The recent revivals and reexaminations of the initial fight against HIV and AIDS will, I hope, inspire a new generation of activists to continue the fight against HIV in our community and against indifference from our society.