Friday, July 22, 2005

HIV Decline Denialism; Nostalgia For More Gay Deaths


Talk about bad timing. In the same week in which the SF Chronicle heralded decreasing HIV infection rates, and forceful quotes from the city health officials declaring prevention programs as effective, an out-of-touch with statistical reality AIDS expert at the University of California at San Francisco goes against the grain and states in the Bay Times that HIV is up.

"James W. Dilley, MD, executive director of UCSF AIDS Health Project, said the organization serves about 10,000 people a year [...] Dilley spoke about HIV infections rising last year in San Francisco. The infection rate rose fastest among young gay and bisexual men; among this group African American men are at highest risk.

"'A generation has grown up without the warning that pages of obituaries and gaunt faces once provided. For many, the virus appears less deadly—even benign,' he said. 'Yet no one knows the long-term outlook for people on the combination therapies that have provided so much hope. HIV is still a life-threatening virus—and we must fight it.'" [1]

Apparently Dilley reads different data than our leading health official.

This quote ran in the July 20 Chronicle story: "HIV incidence among men who have sex with men in San Francisco appears to be decreasing,'' said city health director Dr. Mitch Katz. [2]

What's going on here? How can two top AIDS experts in San Francisco say such contradictory statements about a vital issue: HIV infection rates?

I have a sneaky suspicion Dilley is simply not up to speed on the latest infection stats and was asked by the Bay Times to mouth off about why he and his group are supposedly so crucial to gay men. Would be nice for this gay publication to print a correction about the false claim of rising HIV infections.

Moving beyond Dilley's ignorance about current stats, what also bothers me, and should be of concern to the gay community's health workers and activists, is Dilley's nostalgia for the good ol' bad days of dozens of weekly obits appearing in the papers. He bemoans the lack of gaunt faces, because without lots of ill gay men, Dilley can't maintain his alarmist message and keep his business going.

But that lack of obits and obvious signs of disease and wasting syndrome are not enough for this doomsayer. His comment about no one knowing how long the anti-AIDS drugs will remain effective contains more than a hope on his part that the drugs fail more people.

Dilley has company from other AIDS Inc executives who express a collective death wish on their gay brothers, or at least a few opportunistic infections, preferably very visible ones.

Remember this quote from Michael Weinstein, the head of the AIDS Healthcare Foundation, based in Los Angeles, with affiliates around the country and abroad? "People are in such denial about how serious HIV is. Unfortunately, the best prevention is seeing people die."

Weinstein's offensive remark appeared in an April 3 New York Times story about alleged AIDS apathy among gay men. [3]

And who can forget these cheery sentiments from a colleague of Dilley's and Weinstein's, reported in the SF Chronicle on June 30, 2000?

"AIDS prevention educators said the changing portrait of the epidemic has caused many gay men to let down their guard. 'We don't have the visual reminders of what it can be like to have HIV,' said Steven Gibson, program director for the Stop AIDS project. 'We don't see the wasting syndrome. When was the last time you saw someone with KS lesions in the Castro?'" [4]

I sense that Gibson is only happy when he sees his gay brothers ailing on the streets of San Francisco; Weinstein desires larger numbers of gay deaths; and Dilley is suffering from decline denialism.

Just another day in paradise.


Sources:
1. SF Bay Times
2. SF Chronicle
3. NY Times story
4. SF Chronicle, 2000

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