Petrelis Files

Ex-POZ Editor:
SF Strangles Gay Hopes From Swiss Study

The letter below is from Walter Armstrong, a veteran ACT UP organizer, proponent of realistic HIV prevention strategies, and the former editor of POZ magazine. Thanks so much, Walter, for adding your important voice to the (non)-debate taking place in San Francisco over the Swiss report!

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Michael,

Your criticisms of the warning issued by DPH and SFAF in response to the new Swiss study and guidelines are very important, and I only hope that they do not fall on deaf ears. Even more important is your attempt to draw attention to the study and guidelines themselves. Thank you very much.

I would like to add my own voice to your callout.

The significance of the Swiss study, and especially the new guidelines, cannot be underestimated. They are simply the biggest event in HIV prevention in a decade or more. The fact that they essentially ENDORSE BAREBACK SEX AS SAFE (under certain circumstances) should be emblazoned on billboards in every gay community rather than buried by frightened warnings from experts.

To the prevention establishment, the new guidelines are nothing less than a worst nightmare. To many gay men, on the other hand, they are a dream come true. These opposing responses are a sad commentary on how alienated DPH and SFAF is from the communities it is meant to serve.

Even sadder is the need of these experts to immediately attempt to strangle any hope for an end to condoms, and to do so without debate or discussion. This shows such a profound disrespect for the people whose health they are supposed to be protecting.

There is no question that the new guidelines are very controversial. They overturn 25 years of safe-sex education overnight, and that makes them potentially very confusing for people. So it is appropriate for DPH and SFAF to offer to help us make sense of the new science and the new guidelines. What is inappropriate, as you point out, is just about everything in the warning and also the attitude behind it.

The superficiality of the warning suggests the sense of urgency these experts feel about the Swiss support for natural sex among serodiscordent couples when viral load is undetectable. The shoddiness of the warning suggests that they were even afraid to draw attention to the study at all, for fear they might only further tempt people into unsafe sex. And the absence of any official name, contact, follow-up, not to mention further debate, suggests that no one had the guts to take responsibility for the warning. What does it say about these experts that they are so paralyzed by fear?

Still, knowing that the new guidelines are so controversial and so significant, they nonetheless went ahead with their careless warning that is completely lacking in any acknowledgement of what the guidelines mean—sexually, emotionally, even spiritually—to people who have been living for more than two decades with the shame and fear of sex as infectious, all the while longing for the day when natural sex could return. It is ironic, but if they had only thought through this communication, they might have realized that the new guidelines are not telling gay men anything we have not been saying, and often making HIV risk decisions with, for years now. Can they not see that the notion that all of a sudden everyone was going to rush out and start barebacking based on this one study was crazy?

Compare this to the Swiss prevention experts who went so far out on a limb as to conduct a study into natural sex and then officially endorse the findings as new guidelines. Yes, that is a risky thing to do. But it is also a compassionate and innovative thing to do. It shows proper respect for the deep significance of sex in the lives of both poz and neg people. It also shows respect for people as thinking beings willing and able to make their own informed decisions about sexual risk.

It has always been clear to gay men that we could not expect such respect from our own public health establishment. The least we have asked is that they not burden us with their own fears. When they could not do even that, we stopped listening.

The danger, of course, is that we also stop listening, and maybe stop thinking, about safe sex. In blocking out all the fear and shame and bad news, though, we also might overlook the rare piece of good news. And I suspect that this has happened now, with the Swiss guidelines. Just because DPH and SFAF, and the media too, have leapt to catastrophic epidemiological conclusions, we can still celebrate this news from Switzerland as the start of a sea-change in HIV prevention. There can be little doubt that it is the wave of the future.

As such, we would be making a big mistake not to start discussing in public meetings what it might mean and how or if it might be possible to implement the findings. (As if we were not doing so already, but covertly.)

So, I repeat, this is the best thing to happen in HIV prevention in many years because it promises safety beyond condoms, or at least opens up the discussion for real. Whether our prevention agencies can recognize it or not, we should respect ourselves and each other enough to recognize it. And to put it at the top of our agenda.

Many gay men died never imagining that such a day could come.

Walter Armstrong

New York City, NY