We have a popular saying these days: "What goes around comes around." But certain things will very likely not come around again, not in a form any of us would recognize. HIV has changed the world, probably for a very long time.
We're nearly 30 years into the pandemic now. The losses have been terrible. The early response of the health-care establishment and of our government was nothing short of criminal, for a whole raft of reasons, above all a rising tide of anti-gay bigotry.
There has been great progress on a number of fronts, especially in molecular biology, genetics, and pharmacology. It's great that various therapies have extended the life expectancy of those living with the virus in their systems. The social, economic, and political climates, though still distressing, have improved, at least in the developed world, and there is reason for cautious optimism about further improvements.
But even so, I think the full force of HIV's effects are still ahead of us. Generations of erotophobic religious bigotry have demonized sex -- and thereby made it irresistibly alluring -- and it is now further stigmatized by the threat of sickness and death. I have a hard time finding the silver lining in that particular dark cloud.
Sexual mores are changing, and definitely not for the better, in my opinion. The danger of infection renders the fear of sex understandable, but as with most fears, it rests on ignorance more than on a not unreasonable apprehension about the unknown. But even education cannot fully address all the psychological and emotional issues raised by the virus in our midst.
Given my own long past before all this came on the scene, I really can't imagine directly what it must be like to have lived under this cloud for all of one's existence as a sexual being. The nearest analog I can think of -- not a perfect one, either -- is the period since the invention of nuclear weapons: living under the threat of total annihilation. Of course I recall times well before that.
Not long ago, however, in an online discussion group there was an exchange with a young Dutch fellow who seemed to be entirely relaxed about sex with condoms. For him, there simply was no alternative in his own experience. Sex meant condoms, period.
I don't know what light is cast on my perceptions of all this by my own history, both social and medical. I've had to face the prospect of dying a couple times now: conditions that could have been cancers of a not too easily treatable kind (lymphoma, prostate, bowel, lung), all of which proved not to be cancer, thank goodness. When you're actually threatened with such grave illness, your priorities sometimes sort themselves out with a certain clarity. For instance, I'm not at all afraid that I might die, but I would be terrified by the prospect of a protracted final illness marked by much pain and suffering.
However, through the vivid examples of various friends whose final illnesses from complications on account of HIV were indeed protracted and marked by much pain and suffering, I've realized that death and dying do not submit to any abstract analysis: only a person who is actually in such a situation really knows anything about it.
Having survived with a long history of serious depressions and being more concerned about dying from that than about dying from AIDS, I put off being tested for HIV antibodies for 11 years after the last so-called unsafe sex I'd had. I didn't want to know. I was convinced that nothing could be done, and why know in advance that I was doomed?
One thing that helped change my mind -- I had resisted my doctor's advice for years -- was being with my friend Howard in Los Angeles. He had been living with AIDS for several years already, and when we finally met we had a chance really to talk about it. He has since died, a terrible loss for his family and his many many friends, but I learned from him how strong the will and determination to live can be, not so much to avoid dying as to live fully while you're still living.
Being tested was still no picnic. Everyone I talked to who had been through it told me the wait for results had been very taxing. As it turned out, I was so incredibly busy for those six days that I really didn't have any anxiety until I got to the clinic to hear the news. "Ah yes, you're here for your HIV test result," the doctor said, "I'll be right back." In less than a minute she was back, but that was a pretty long 60 seconds for me.
Negative. It's some years ago now and I'm still relieved about it. Having taken zero risks since, I think I need no longer worry much about HIV in my own case. I've been tested lots of times since, routinely. It's extremely unlikely I would take risks in that department; besides, I'm not active sexually, as far as sex with others is concerned.
But those who are sexually still active face a different set of circumstances. There is widespread and increasing panic about sex. One cause of that, I suspect, is exaggerated concern. While it's true that the only really safe sex is no sex at all (total abstinence), it's also true that sexual urges are too strong to be resisted, even if one really wanted to do that. And I think abstinence has profoundly undesirable emotional consequences as well.