The latest and greatest "The View From the Bottom" is now live! Jackson and I filmed this new piece while on gaycation on the Connecticut Coast. How very East Coast yuppie of us! In this episode, we dish on boyfriends who don't like to give head, dating another bottom, rectal microbicides, having HPV warts removed, and more! Enjoy!

"WE WERE HERE: VOICES FROM THE AIDS YEARS IN SAN FRANCSICO"
Director: David Weissman and Bill Weber
Trevor's Rating: 5 / 5 Stars

I can recall sobbing uncontrollably exactly three times in my adult life. Last night was one of those times. I ventured out to the Castro theatre for the "sneak peek" screening of "We Were Here: Voices from the AIDS Years in San Francisco." I knew I was in for a tear-fest, but I had no idea just how incredibly moving and utterly devastating the film would be. Before the screening, both the filmmakers admitted not wanting to make this film -- how can you possible represent the horror of those years without doing some injustice, without leaving some story untold? The idea is daunting.

No documentary to my knowledge exists that chronicles these years so intently, most likely because these stories are so incredible painful to tell -- and just as painful to listen to and absorb. I can only imagine that this film's road to the screen is paved in rivers of tears. As someone who did not experience those years, these representations are my only access to the memory of an era that shaped my gay world. It's why I have the kind of sex I do. It's why I have so few gay mentors from that generation. It's why bathhouses closed and disco died. And it's probably why gay marriage is the 21st century gay raison d'être.

As such, I listen to these stories intently whenever I can, mostly in the form of movies -- Longtime Companion, It's My Party, Angels in America, Sadness, and the like. With the exception of William Yang's incredible Sadness, these representations are rarely retrospective. They are told from the battleground itself rather than the hill overlooking the cemetery years later. This kind of war analogy is invoked several times in the film: as one interviewee explains, AIDS was what World War II was to many Americans. But of course as a comparison it is somewhat limited in its utility. War involves a coordinated opponent that you can see or at least pinpoint on a map. AIDS turned gay men's own bodies against them, crippling the young and muscular as quickly as it did the old and infirm. And during the first years of the epidemic, they had absolutely no idea how it was transmitted or who might already be infected.

Five individuals -- four gay men and one woman -- narrate the film, each with a unique experience that adds a new facet to the incredibly rich and devastatingly moving story. A flower vendor remembers giving away flowers to neighbors who wanted to bury their friends with dignity but had no money to give. An artist chokes back tears as he relives his lover dying as he frantically drove him to the hospital -- and in a heartbreaking turn, losing a second lover to the disease a few years later. A volunteer at the AIDS ward in San Francisco's General Hospital remembers finding a way to be a part of a gay community in comforting those who were dying. Their stories are heart wrenching.

The film was screened to a sold out crowd at the Castro Theater. Many in the room had lived through those awful years -- some in San Francisco, others elsewhere. Sitting in that room full of so many sobbing, hurt, and mournful gay men was one of the most challenging experiences of my life. At one point early in the film, a series of self-portraits by the photographer John Davis flashed across the screen. The series, titled "FIERCE," shows the artist emaciated, his body decimated by his illness. His naked, pale figure is contorted, stretched into alarming positions. An IV line is implanted in his chest. The crowd was silent except for the wailing howl of one man towards the back who could no longer hold back his tears. Even now as I write this, I cannot help but bury my face in my hands and cry. I will never forget the sound of that man's anguish. It will haunt me for the rest of my life. (And I'm not the only one to have this experience at the premier, it seems.)

Davis' self-portraits are both grotesque and stunningly beautiful at the same time. After the film, the director noted that these photos documented the duality of the epidemic so beautifully that they helped him to conceive of the film. On the one hand, you have thousands of men dying -- leaving behind friends, lovers, tricks, clients, parents, children, and admirers. On the other, you have an outpouring of support from both gay men and those outside the community, helping to take care of those who were dying and to fight for the support HIV-positive people needed to survive. AIDS could have destroyed gay community. But it didn't. Gay men's resilience in the face of death itself is nothing short of awe-inspiring.

The moment the film ended and the credits began to roll, the floodgate of my emotions let loose. I bent over in my chair, put my head in my hands, and gasped for air in between sobs. The crowd rose to its feet for a standing ovation, but I could not get out of my chair. I stayed in my seat, bawling. Crying for all those men I never knew, who I wish desperately were here today. For all their sass, for all their sex, and for all their creativity that was snuffed out far before it's time. But they're not here. And that is one of the hardest parts about being a post-AIDS gay man for me. Missing what I did not know. Longing for what I cannot have.

Keep up with the movie's progress on its website or its Facebook group.

I stumbled across 50Faggots today through their Facebook group. Their website is stunning, as is the footage they've collected from interviews with 10 femme gay boys in NYC, DC, and Chicago over the past two years that you get a taste of in the trailer below:

Can't wait to see more! They're having a launch party May 13th at Hydrate in Chicago, hosted by the *incredible* Cyon Flare (who I saw perform back in 2008) and Acid Betty. Road trip!

I love when people pretend to have something new or powerful to say about HIV/AIDS. 99% of the time, they are more likely to recycle tropes that we've been telling ourselves for the past decade or two. The latest example of this is David Mixner's post at DCAgenda, "What happened to silence = death?", in which he makes the tragically pseudoradical claim that we just need to talk about HIV more to end the epidemic. You know, silence=death, y'all!

Now let's put aside the fact that he seems to misunderstand the silence=death mantra of ACT UP -- it wasn't really just about mentioning HIV or getting tested, but about coming out into the streets and demanding action from homophobic institutions that were helping to fuel the silence and the epidemic, like the Roman Catholic Church and the CDC. But this gross misunderstanding aside, I still have a few words to say in rebuttal:

David,

While I appreciate your commitment to HIV Prevention, your editorial doesn't shed any new light on the issue. You make no mention of the fact that Public Health's stigmatizing and demonizing efforts to smear gay men and their sexual practices may be part of the reason why gay men checked out of prevention and of thinking about HIV/AIDS more generally. You tell people they're a piece of shit for long enough, eventually they stop tuning in to hear more.

My problem with Public Health is that there is no accountability for the racist, sexist, rabidly sex-negative, and often antigay messages that are trumpeted from the mountaintop under the guise of HIV prevention. "Oh, that campaign was racist? Well at least it started dialogue." You hear it time and time again, from the local to state to national level. In their minds, reducing HIV infections is the only end worth measuring - and if it reinforces or reproduces racism or antigay sentiment along the way, so be it.

And don't make the mistake of thinking more funding = better prevention. Most of the CDC dollars allocated to prevention fund tired, useless, and ineffective interventions that have no relation to the complexities of gay men's lives. Just take a look at the available "DEBIs" that ASOs have to put up with. Many people on the ground tell me that they have to pretend to be engaged in these pathetic excuses for interventions while secretly radically changing the curriculum on the ground. The CDC's efforts force ASOs into positions of dishonesty and secrecy. Where's the critique of the CDC's infrastructure in your analysis? Of the damning and devastating impact of abstinence-only education? Of Congress' forcing states to pass HIV disclosure criminalization laws, even though they are harmful to Public Health, if they accept Ryan White dollars?

So forgive me if I'm not sympathetic to your critique. But I think you've missed the point. It's not gay men who need to shape up. It's the CDC, local, state, and federal governments, and the larger institution of Public Health that needs to get its priorities straight.

Trevor

Phew. And that's how Sue sees it.

"Being fucked into an orgasm without touching yourself is something that bottom boys like me dream of - it's a fantasy because it's so downright difficult to achieve. It's only happened to me three times, and each time poppers made it possible. Here's why."

I had already been having sex for a decade before I tried poppers for the first time. They always seemed a bit seedy and scary to me - classified under the header "drugs" in my mind and thus were suspicious. But there I was, on all fours, when suddenly my partner put a bottle under my nose and instructed me to breathe in. "What the hell?" I thought. You only live once!

It is difficult to describe the kind of sensation that poppers provide. A bit of chemistry to start. Chemically speaking, most are members of the alkyl nitrate family and they are found in stores in liquid form. They may be labelled as "video head cleaner" or -- the more ridiculous and more common label -- "liquid incense." (Amyl nitrate -- the most famous of the family -- is also a medical treatment for cyanide poisoning!) To call them fragrant would be misleading. While they have a strong aroma, it is not the kind you want your linens smelling like when you wake up in a luxurious hotel. It's more noxious that alluring, a fact that scares many away.

Poppers have the direct effect of relaxing your body's smooth muscles (including the chocolate starfish!), which results in the dilation of your blood vessels and thus an increased heart rate. This is why you should never use them with Viagra or other ED medications - the result could be a dramatic drop in blood pressure and heart attack.

Okay, chemistry and medicine aside. Let's get to the good stuff. The first time anyone attempted to describe what they did for them, it was a friend with a few years of experience under his belt. He looked at me dramatically in the eye, and with a very serious tone told me this: "It's like you're going to die from a disease whose cure is lodged deep inside you. Your partner has to get it out." What a statement, indeed! I was a bit taken aback.

Live from Acapulco! Well, not quite live - but we did film this past weekend on our beautiful balcony during our Spring Break vacation in Mexico. Me and Maxime have quite a great episode in store for you, complete with frank discussions on being a femme bottom, having sex without fear of HIV, cruising, vacationing with straight friends, and having straight friends in general. Fasten your seatbelts, girls, it's gonna be a bumpy ride!

Enjoy! And as always, e-mail us your questions!

Got something to say about gay sex, but don't want your name attached? Every Wednesday starting next week, we'll be posting anonymous columns from gay/bi/queer men just like you! Anything goes: Best sex you ever had, tips and tricks you've learned along the way, and reflections on the trials and tribulations you've encountered in your sexual escapades are all welcome.

Submissions should be at least 500 words with a rough maximum around 1000 words. They will be posted in the order received, with editing only for grammar. Send your submissions by e-mail to . Include a title and I'll publish them here under an anonymous user account. Once published, the e-mail will be destroyed. Your identity will never be revealed!

Looking forward to reading and sharing your dirty thoughts!

xoxo

T

"Risk" as a conceptual approach for much of the research on health has come under attack from many sides. Risk is everywhere and nowhere, it seems. When it comes to gay men's health, gay men's sexual risk practices have particularly been scrutinized by researchers who wish to stop gay men from doing such naughty things as having sex without condoms. Many have suggested that rethinking "risk" (traditionally conceived of through the lens of an isolated rational actor making complex cost-benefit analyses aimed at maximizing returns and minimizing harm for him/herself) as a concept is a necessary step towards creating a more effective / ethical / social public health.

As I was reading for my class today on the Sociology of Law, I came across this very interesting distinction between "risk" and "uncertainty" that gets made in the literature on organizational behavior:

"On the whole, then, high-technology start-up financing poses challenges not only of risk but also of uncertainty. Although lay parlance often employs these terms interchangeably, the organizational decision-making literature uses them to describe two distinct conditions. Under conditions of "risk," decision-makers may not be able to predict the future deterministically, but at least they can describe it probabilistically: with a little effort, individuals can identify the full range of options and outcomes, and they can determine roughly how likely it is that any given option will produce any particular outcome. Consequently, despite the presence of risk, decision-makers can still make rational choices based on expected-value calculations, and markets can still produce efficient coordination based on contingent-claims contracts.

Uncertainty, on the other hand, arises when decision-makers cannot determine either (1) the full menu of alterative behavioral options or (2) the relative probability of alternative possible outcomes. Unlike risk, uncertainty is deeply incompatible with the neoclassical model of fully rational decision-making. Instead of producing a careful expected-utility analysis of all lines of action, conditions of uncertainty tend to produce "boundedly rational" decision strategies, involving "good enough" choices, gut feelings, and rules of thumb. At a more macroscopic level, uncertainty elevates transaction costs and exacerbates intra-organization strains and power struggles. Consequently, unresolved uncertainty poses a fundamental cognitive and organizational obstacle to the formation and maintenance of stable markets for high-technology start-up capital."

-- Suchman, M. & Cahill, M. (1996) "The Hired Gun as Facilitator: Lawyers and the Suppression of Business Disputes in Silicon Valley." Law & Social Inquiry, 21(3): 679-712.

So my questions of the day: What would it mean to reconceptualize men's safer sex practices as enacted in an environment of uncertainty -- rather than in an environment of risk? Is "risk" really the appropriate concept for understanding these complicated, negotiated practices?

I was overwhelmed by the turnout last Friday night for the forum in Chicago, "What is justice for the black gay man?" I'm not particularly good at estimating crowd size, but the room was very spacious and it was standing room only. In attendance was a regular who's-who of Black gay men and their allies in Chicago, including a few local politicians and government officials. In this regard, I want to applaud the organizers of the event for bringing together a fabulous group of Black gay men and their allies for a discussion devoted to some rather difficult topics.

I was excited to hear the panelists, of course -- particularly E Patrick Johnson and Keith Boykin, both of which have done some pretty groundbreaking work in their respective fields for advocating for LGBT issues broadly and for Black gay men specifically. Johnson's performance work, "Pouring Tea," I particularly love for the way it brings to life an extremely diverse set of experiences of Black gay (or otherwise same-gender-loving) men living and thriving in the South. Keith's critical work on the down low was also I think an incredibly important invervention into the stigmatizing discourses around this issue that became hyperbolic when writers like J. L. King (who went on Oprah to spread his pathologizing understanding of the phenomena) and Benoit Denizet-Lewis, who wrote a grossly distorted piece for the New York Times. Denizet-Lewis has actually made something of a career of pathologizing gay men, which probably explains mainstream media's love for his alleged "exposes."

So needless to say, I was eager to hear these thinker's thoughts about how best to advocate for and understand the experiences of Black gay men. I expected to hear about social justice rooted in a denial of access to social benefits, racism, pathologizing discourses about Black MSM's sexualities and behaviors, an HIV epidemic that is crippling agencies working with these populations and disproportionately infecting Black men, and an interwoven network of stigmas that makes daily life for these communities trying at best, and unbearable at worst. Alongside these problems, I also wanted to hear about the ways in which many Black gay men are surviving and even thriving despite these obstacles.

I didn't really hear either of these things. Instead, I was shocked and nearly appalled when it became clear that justice for the speakers was primarily about "loving yourself" and "being true to who you are." Indeed, the problem that was posited as the most trying for Black gay men was their own internalized racism and homophobia, a kind of pathologizing and psychologizing approach to social injustice that I found utterly baffling. No, it wasn't pervasive systems of racism, homophobia, sissyphobia, and pozphobia that are systematically embedded in social institutions and cultures that should be the focus of social justice movements -- but rather the internal psyches and emotions of Black gay men themselves.

This is not far from the latest self-help craze for Oprah to latch onto, "The Secret," which proposes that to succeed in life we merely need to imagine ourselves as successful, wish for that to be true, and think positively. If we aren't rich, then it's our fault for not wanting to be rich. If we don't have health care, then it's our fault for not wanting to become insured. This isn't just offensive, it's downright manipulative for the way that it seduces people into believing that the onus of achieving loosely defined "success" in life falls entirely on individuals. Nevermind the vast libraries of scholarship that illustrate the ways in which various forms of social inequality make achieving these markers of success difficult if not impossible for many social groups -- particularly those born into poverty but also those marked by certain socially ascribed characteristics such as race, gender, and sexuality. Under this individualistic / rational framework, you are a free agent whose choices in life are the only factor that will influence whether or not you grow up to be a CEO or a garbage collector. As a sociologist, this is the kind of ignorant, distorted, and highly conservative perspective on the world that erases the foundations for a politics of social justice.

I'd call attention here to two comments from the audience after the short presentations by the panelists that I think help illustrate the underlying politics (or lack thereof) in their comments. First, there was a question from a self-identified "successful" Black gay men near the front of the room who noted that he loved himself, his life, and his partner just fine -- but his self-love, well-paying job, and house didn't translate into his ability to formally marry his partner of many years. Thus, I read him as trying to point out the ridiculousness of the panelists' claims about what justice should mean for Black gay men -- it cannot be framed just in the terms of psedo-scientific self-help jargon, but rather must first and foremost recognize the structural and social injustices that make that self-love difficult to achieve. The self-love is the OUTCOME of justice, not the root CAUSE.

Second, a man near me later stood up to ask why it was that the panelists were defining homophobia as a kind of psychological problem, rather than as a pervasive social system of power relations that is embedded in institutions and cultures. Heterosexism, he posited, would perhaps be a better way to situate the claims for justice that could foment a Black gay politics. "No, no" the panelists said (I'm paraphrasing), "I don't think that's how we understand homophobia." But it was clear that this was EXACTLY how they were positing homophobia and more broadly the social justice politics that should stem from that form of social inequality -- as I hope is made clear by my (distilled) description of their talks above.

Don't get me wrong, I hope that Black gay men are happy. That's a good thing. But you just don't build a social justice politics based on psychological concepts like internalized homophobia and depression. That's the building blocks for a public health intervention, which increasingly are supplanting actual social justice movements for gay men in general -- Black, white, or otherwise. It's perhaps not a coincidence that these efforts are funded by state agencies that perpetuate these very injustices. The disease or problem in this model becomes not the system and the dramatic injustices it enables, but the various medical problems experiences by minority groups like "self-destructive behaviors" and "low self-esteem." It is precisely though this pathologizing reconfiguration that political movements become neutered and inequality gets perpetuated, reproduced, and made more insidious because these injustices come backed by medical authorities with so-called "evidence."

Let's take care not to fall victim to these alluring models for social change. They may make us feel warm and cuddly, but that isn't going to mean a damn when said happy person gets denied health insurance because he's HIV-positive. Or when he gets fired from his job because a co-worker saw him kissing his boyfriend at a local nightclub. Let's see how happy they are after that.

I was nostalgically flipping through my Master's thesis this morning, when I stumbled upon this quote from "Tom" - a 20 year old San Franciscan who I interviewed about being gay and staying HIV-negative. He was struggling to develop his own gay community, and I will never forget the passion and intensity with which he said this to me in our interview (note: "Jake" is one of the other participants, who in our focus group together came out against monogamy):

I'm really sort of a romantic idealist, you know? I always have this image of gay guys being very hard and very like cold, you know, one-night-standish - shunning love. When Jake said... 'monogamy doesn't work' - like, for me, and seriously, my heart just broke into a million pieces for like the millionth time. I was sad. I was like, GOD! That's a terrible thing to say. It can totally work! I totally want to get married - I'm so into getting married. I want to go to IKEA, I want to pickup my fucking furniture, I want to have parties, I want to have a good group of gay husbands, you know have dinner parties, and have fun, and yeah. It's in my future, I hope it is. It's what I want. So when he said that, it just made me totally sad. I totally got totally sad. I don't want that suspicion confirmed.

You know, I think some of my colleagues would quick to pounce and critique Tom's vision of his gay future. His "gay American dream," as I called it in my thesis. But he really, truly wants this. And who are we to critique him for that? Critique the (hetero)normative system in which he lives, sure. But I just can't critique Tom.

You can bet your buns I'll be hounding all you Trevorade drinkers to head out to Fort Lauderdale, Florida for the 2010 Gay Men's Health Summit! While technically the 11th anniversary of the first, we'll of course be celebrating the 10th anniversary (in gay years, as Lady Bartlett put it). Here's the as-official-as-GMH-gets release, written up by the lovely Michael Scarce:

SAVE THE DATE: National Gay Men's Health Summit, August 25-30, 2010, Fort Lauderdale, Florida.

The mission of the Summit is to create a stronger, more diverse, and increasingly visible grassroots movement among gay, bi and trans men, focused on strengthening our communities and tackling a range of health concerns that include, but are not limited to, HIV and AIDS.

Next year's event marks the ten-year anniversary of the first National Summit, convened in Boulder, Colorado. Notably different from traditional health conferences, many have experienced our earlier summits as nurturing retreats, exciting think tanks, and moments of great enlightenment.

We hope to continue building on the success of previous summits as we mobilize to better our health and wellness, conduct strategic organizing, celebrate our past achievements, and create a renewed vision for the next decade of the Gay Men's Health Movement.

Be there! It's a lot of fun with a lot of wonderful, sexy men! And don't worry: It's not a conference. We strive for our gatherings to be more low-key, more personal, and less informal than professional associations. Hot tubs and hotel room parties are key to its success! If you are invested in Gay Men's Health at all - in any shape or form - and especially if you'd love to be surrounded by a group of guys who ARE similarly invested -- THIS is the place for you.

Well color me proud! Our very own Chris Bartlett is featured today in a New York Times story on social marketing for the dead. Chris has jumpstarted the Gay History Wiki, which is a project that attempts to gather the bits and pieces of Philadelphia's gay history 1960-present on one little site. Archiving those who died of AIDS is a key part of that project. From the Times piece:

Beginning in 2005, Mr. Bartlett began assembling the names of every gay male Philadelphian who died after being diagnosed with H.I.V. or AIDS, searching obituaries and the Names Project registry of people commemorated by the AIDS quilt, combing through records of social clubs and the rosters at St. Luke and the Epiphany, the Philadelphia church that took on the task at the epidemic's height of "burying the people no one else would," Mr. Bartlett said.

Inspired by Steven Spielberg's Shoah project, a Holocaust memorial, in 2007 Mr. Bartlett built a database on wikispaces.com, the free portal that invites editorial interventions, and by the end of last summer was ready to broadly promote his site. Unlike the AIDS quilt, an intensely elegiac but largely static artifact, the Gay History Wiki is a sprightly free space open to posts and tags, to biographical data added and amended by survivors for their vanished friends.

[snip]

Beyond the novelty of this approach is something equally important, Ms. Schulman of the Act Up Oral History Project suggested: the opportunity to fill in blanks in a haphazard narrative. "The AIDS story has been limited to depictions of doomed individuals," and not impassioned, ad hoc communities, she said.

A conviction that gay men and women and their friends came to one another's assistance during the crisis -- improvising buddy systems, treatment groups, food banks and other survival networks -- fueled Mr. Bartlett's pursuit, as he recreated a mesh of lives that unexpectedly turned out to have meaning for a cohort of young gay men.

"Everyone knows AIDS is a big issue, but for people 25 and under, it's not really a topic of discussion," said Evan Urbania, a 29-year-old marketer who regularly visits the Gay History Wiki. "I'm a social media guy, and the importance of involving the stories of people who have passed on, particularly as a gay man whose development was influenced by people who are 20 or 30 years older, is very powerful to me."

Oh, Chris! I'm tearing up a bit just reading this! Thanks for all you do, honey! xoxoxoxoxooxoxox

Cover of Gay City Anthology, Vol. 2

From our friends in Seattle:

Call for Submissions (short form) Gay City: Vol.3- Repulped Lurid covers, sensational titles, scandalous storylines: the books of gay pulp were denounced and sometimes even banned but they also informed and delighted readers. Gay City Anthologies is currently seeking fiction, poetry, art, comics and photography that revisits, renews, reacts, reshapes and reinterprets the gay pulp genre of the '50s and '60s. Don't just imitate the genre; raise the bar as far as you can and make it relevant to modern issues. Happy endings are not always required but the work must reclaim positive representations of gay people and culture. Despite pulp's sometimes pornographic roots, we are not looking for erotica at this time unless it has something unique and very literary to say. For complete guidelines and important submission details contact Editor Vincent Kovar at anthology@gaycity.org.

Deadline for submissions is April 1st, 2010.

Peter from Gay City gifted me with a copy of Volume I -- some very lovely stuff inside!

I've been spending the afternoon in bed, lazily catching up on my favorite TV shows. What a life! But color me surprised to find ABC's Ugly Betty seriously indulging what has now been a multi-episode storyline concerning little Justin's need for gay mentorship -- and finding that guidance in the form of the show's flamboyant Marc. On the most recent episode, Marc gives Justin some guidance about bullying: "Get ahead of the joke." Meaning, if the bullies think you're in on the joke and unaffected, they'll quit making fun of you (okay, we know it's not so easy -- but it can often work!). This is a classic storyline that you see time and time again, but I don't think I've ever seen it in the form of sissy-to-sissy mentorship like on Ugly Betty. I'm really loving this storyline, for obvious reasons -- gay / intergenerational mentorship like that featured here is precisely how I managed to survive and thrive in high school.

Unfortunately, I think this is precisely the kind of intergenerational support structure that is almost totally absent from gay youth organizations. The fear -- of course! -- is that older gay men will prey on youth / sexually abuse them / etc. It's the kind of gross assumption that shows how stereotypical remnants of gays-as-pedophiles still lurk in the shadows of discourse today. Alas, funders get freaked out at the possibility of older gay men sitting in the same room as teenagers, and rarely are willing to put their money to support that kind of thing.

Curiously, I think Ugly Betty circumvents these kinds of fears by not just making it gay mentorship, but sissy mentorship. Marc's character is just about as close to asexual as you can get, dissipating any potential for fears over intergenerational sexual tension. But this obviously is not to criticize the show. Rather, I think it's fabulous to see sissy-to-sissy mentorship. So, thanks, writers of UB!

And does quite a wonderful job!

Does anyone else get the sense that lovely Varla may have been reading my blog? :)

I was having drinks with a friend of mine -- we'll call him Patrick here -- this weekend when the subject of having sex with HIV-positive men came up. "Oh, I would never have sex with an HIV-positive guy," he casually remarked -- as if such a thing were already obvious. I was shocked not just by Patrick's statement, but also by the categorical bravado in his delivery. To have sex with HIV-positive men, as he went on to explain, was to expose himself to unnecessary risk of infection. I've been replaying this conversation again and again in my head. How could he be so outrageously calculating in his cooIly expressed exclusionary strategy? Today I want to spend a few moments reflecting on these kinds of statements, because I think many people would uncritically read them as legitimate prevention strategies. I will argue here, however, that in reality that these kinds of strategies that are totally bankrupt in terms of actual risk reduction. Moreover, what I think this kind of statement actually tends to do is not actually promote any real reduction in risk, but rather to reinforce and reproduce harmful stigma against HIV-positive people.

Before we get into a discussion of the ethics of "serosorting" -- the practice of choosing to engage in sex with only sero-concordant men -- I think we should bracket my friend's comments as existing only at the very periphery of this term's broad meaning. While taken at face value, it does indeed seem that my friend is practicing serosorting. But correct me if I'm wrong here, but it seems to me that serosorting was more intended to describe men who were seeking to minimize risk of transmission while engaging in sex without condoms. For my friend, this wasn't the goal of his strategy -- condom use was still part of his risk reduction strategy with other HIV-negative men. This is a very important distinction. What I'm going to be talking about here is men who report consistent condom use, but who continue to latch onto serosorting discourses that discourage serodiscordant sexual practices.

Because of these important differences, I want to suggest that Patrick's comments cannot possibly be said to be purely a method of risk reduction. To explain why I think this is so, we need to evaluate whether or not there is actually any risk worth avoiding by excluding HIV-positive men from your pool of eligible partners. Thus, to help illustrate this, let's attempt to assess the risk of transmission between a known HIV-positive partner and an HIV-negative partner when condoms are used. There is no data to suggest that many HIV infections occur in these contexts, absent condom failure -- rates of which are outrageously low (between 0.4% and 2.3%, depending on who you ask). If we take a generous account, let's presume that rate is 2%. In a single incidence, then, the risk of potential exposure is 1:50.

But exposure does not equal transmission. You can be exposed to the virus and not actually seroconvert. Thus, we need to add into this equation the risk of transmission per sexual encounter in the absence of condoms,which vary depending on a number of factors: whether the poz guy is insertive or receptive, his viral load, genital ulcerations, etc. Let's say the poz guy is doing the fucking, for example's sake. The generic risk in this scenario for a receptive HIV-negative man is 1:122 -- that is, statistically speaking, there is a 1 in 122 risk of seroconversion after getting fucked once without a condom by an HIV-positive man (see here for a summary of this data). If we multiply these two risks together, we get something like a 1 in 6000 probability -- give or take. According to risks of death statistics, this puts a person's risk of seroconversion in this abstract, theoretical scenario somewhere between their risk of death by electrocution (1:5000) and their risk of death by drowning (1:8942). Obviously, this is a gross use of statistics -- but I think it helps illustrate the point: the risk of transmission between serodiscordant couples in one sexual encounter when using condoms is EXTREMELY low. Just about negligible. And this example likely grossly overestimates the risk, due to the fact that condom failure is not the same as sex without condoms. Many people will quickly realize the condom has broken, leading to a much smaller window of possibility for exposure. Thus, the 2% exposure rate included in this example is likely much, much smaller in practice.

Obviously, if we extend this risk over time, then we run into increased risk of transmission for a variety of reasons -- namely condom fatigue reported within serodiscordant couples. But if you use condoms, your risk of becoming infected from hooking up with a HIV-positive guy is probabilistically very low. Thus, excluding them from your dating pool cannot and should not be considered a risk reduction strategy -- unless you are having unprotected sex.

Now that we've established that there is no real prevention rationale for categorically excluding HIV-positive men from your pool of eligible partners, we need to seriously consider the ways in which doing so actually works to reinforce stigma against HIV-positive men. If you ask any HIV-positive man what kinds of difficulties come with seroconversion, many will immediately respond that stigma and the resulting fear of disclosure are today some of their most pressing concerns. New medications have alleviated what used to be a very immediate sense of death, and their adverse side-effects have been dramatically reduced with even more recent advances in treatment protocols. Rather than "purely" medical, the problems that men describe today with living with HIV are very much in the realm of the social.

Take for example a scenario another friend (we'll call him Matt here) described to me recently at a gay bar in Detroit. Matt was dancing with a cute young man, who curiously told him that "You should stay away from me. I'm dangerous." Matt asked him why, and he ambiguously answered that he was contaminated. Matt then asked him directly if he was HIV-positive, at which point the guy stiffened and gave a sheepish affirmative reply before running away. In this scenario, the young man had so internalized this harmful discourse of transmission that paints HIV-positive people as dirty and dangerous, that he himself did the running away. Matt has slept with HIV-positive men before -- this is not a problem for him. But he didn't even have to not reject him -- the HIV-positive man did the rejecting for him!

While this seems like a very contextual and bracketed example, I think it serves to illustrate the kind of emotional damage that stigmatizing discourses may be having on HIV-positive people's lives. I contend that Public Health -- in its ambiguous and contradictory uses of the term "serosorting" (a topic for another essay) -- is part of the problem here. By refusing to explain what this term means, and by remaining quiet in the way it gets practiced, Public Health is serving to reinforce stigma against HIV-positive people by allowing many men to use it as a rationale for their exclusionary practices. This essay is just a gloss on these issues -- it admittedly raises more questions than it answers -- but I desperately think we need to think critically about the way we (I mean both we as gay men, and we as people invested in promoting Public Health) allow stigma to continue operating in our communities through the lens of "health" and "risk reduction." Backed by medical logic, stigma seems rational, logical, and unproblematic. But we need to expose the ways in which these allegedly science-based logics are actually totally bunk in terms of their validity -- and are actually just forms of stigma veiled by scientific authority.

Author's Note: After publishing, I corrected the 1:122 risk of transmission per incidence for HIV-negative people engaging in unprotected receptive anal intercourse with HIV-positive men from the originally cited 1:132. I also added a link to Poz Magazine's summation of this theoretical risk data. Many people have emailed their frustrations with my gross misuse of statistics. I don't dispute this. Indeed, the kind of very sketchy analysis I engage in is problematic if you are interested in the actual, "real" statistical risk. I'm not really so interested in the precise number, and I don't think it matters much in making this argument. To my knowledge, even if we look at the outcomes here -- seroconversions reported when using condoms with HIV-positive partners -- we just don't see large numbers of transmissions. But I certainly welcome and encourage further research that is invested in precisely quantifying these risks -- and the variety of factors that are bound to contextualize them.

After a long separation, Scott and I are finally back together for a new episode of "The View From the Bottom"! We filmed this gem in Central Park, whilst visiting the Big Apple last weekend. We talk about sex in nature, food in bed, "straight acting," and other annoying online profile habits. Enjoy!!!!

Back in August, I presented a monologue I wrote for a workshop on "The Bottom Monologues." It was a strange experience to work on the piece -- which is clearly informed by my experiences as a bottom, but inflected by the narratives we collected for the project. It needs some work, but I think it's pretty sassy so far!

Anyhow, Fernando from Latino Men in Action was kind enough to share the video he shot of the performance. He uploaded it a few weeks ago, but I just finally got the link! Would LOVE to hear your feedback! It's tenatively titled "Masc4Masc: No Fats, Fems or Blacks":

Trevor Hoppe Monologue from Fernando Avila on Vimeo.

After an outrageous delay, we're back! Maxime, Rostom, and I teamed up for this threeway edition of the show about gay men's health told from the perspective of three bottomless bottoms. We had to film the episode TWICE because of some foul play with the audio, and you'll notice the formatting is a bit funky via Youtube. Both of these things will be rectified in future editions. I think what we came up with still turned out pretty darn good! Enjoy!

I finally placed my order for the highly anticipated first book from Australian cultural studies extraordinaire, Kane Race. If you have any investment in Public Health, HIV/AIDS, drug use, and conceptions of biomedical power, you must read this book. Very interesting use of the notion of counterpublics here, with Kane's "counterpublic health." Here's the book's description:

On a summer night in 2007, the Azure Party, part of Sydney's annual gay and lesbian Mardi Gras, is underway. Alongside the outfits, drugs, lights, and DJs is a volunteer care team trained to deal with the drug-related emergencies that occasionally occur. But when police appear at the gates with drug-detecting dogs, mild panic ensues. Some patrons down all their drugs, heightening their risk of overdose. Others try their luck at the gates. After 26 attendees are arrested with small quantities of illicit substances, the party is shut down and the remaining partygoers dispersed into the city streets. For Kane Race, the Azure Party drug search is emblematic of a broader technology of power that converges on embodiment, consumption, and pleasure in the name of health. In Pleasure Consuming Medicine, he illuminates the symbolic role that the illicit drug user fulfils for the neoliberal state. As he demonstrates, the state's performance of moral sovereignty around substances designated "illicit" bears little relation to the actual dangers of drug consumption; in fact, it exacerbates those dangers.Race does not suggest that the use of drugs is risk-free, good, or bad, but rather that the regulation of drugs has become a site where ideological lessons about the propriety of consumption are propounded. He argues that official discourses about drug-use conjure a space where the neoliberal state can be seen to be policing the "excesses" of the amoral market. He explores this normative investment in drug regimes and some "counterpublic" health measures that have emerged in response. These measures, which Race finds in certain pragmatic gay men's health and HIV prevention practices, are not cloaked in moralistic language, and they do not cast health as antithetical to pleasure.

Kane's prose is sometimes a bit dense, but it's often truly revelatory. Here's what my professor and mentor David Halperin has to say:

"Kane Race's Pleasure Consuming Medicine supplies what we have missed for so long: a radical but responsible exploration of both the ethics and the politics of pleasure. Exhilarating in its daring and its intelligence, startling in its originality yet completely sensible in its interpretations, the book unerringly describes the paradoxical world where we now live out the cruelties and ecstasies of human embodiment."--David M. Halperin, author of Saint Foucault and What Do Gay Men Want?

In short, what are you waiting for? Order a copy!