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December 20, 2008

Neoliberalism + HIV = Rational Sexual Choice
FILED UNDER: "Fucked Up Bullshit"
TAGS: gay men's healthGay.comHIV / AIDSHIV PreventionHIV-positive
By Trevor

I was reading a totally banal post from a doctor over at Gay.com responding to a reader who claimed he had unprotected anal intercourse with his HIV-positive partner, and was asking whether he will test positive. The comments are so predictable and trite, but I think this comment in particular sums up many gay men's problematic / neoliberal / rational choice attitude about gay sex and sexuality:

Knowingly having unprotected sex with an HIV+ partner, particularly when you are the bottom and let him cum inside you is just foolish. If you don't care about your health then you probably have some serious self esteem issues. You should seek professional mental health counciling. The part that steams me is that with all we know people will still make a "selfish" choice. Accidents will happen and it is great there are organizations to help with funding, staffing and meds but to knowingly participate is ridiculous. If you become positive then please do not drain the public resources for Poz guys. You made the choice, you should pay for all your testing and support your own treatments if it comes to that. Don't waste funding and millions of volunteers time.

The moral of the story: people who test positive should have known better, and it is therefore their own fault. Therefore, they don't deserve publicly funded medication or treatment.

Disgusting isn't even the word. Terrifying is more like it -- that so many men out there agree with this person. Sigh.

PERMALINK | Posted at 6:42 PM | Post a Comment (11)

11 Comments

Well, I think there is always going be a struggle between where social responsibility should end and personal responsibility should start, and vice verse.

But I do find it absurd that the person who wrote it thinks this person needs counseling (though logic of the small group of gay people that consider themselves bug catchers and gift givers does baffle the mind). I wonder if he advocates smokers and social drinkers to get counseling?

But to play Devil's advocate, if the person who wrote that comment is wondering like many gay people why, despite years of prevention advocacy and much else, AIDS is still so big as it is, some of his displaced frustration might be easier to swallow.

Nevertheless, suggesting that people who contract the disease not through the "accidental" means he speaks about shouldn't get assistance is ridiculous. After all they are still sick and are still citizens last time I checked. Not to mention if they cannot get the medicine and help it only perpetuates the disease, not aid in making it manageable, if not extinct.

But the world is filled with crazies and village idiots. Too bad we cannot devote the resources to coming with a cure for that.

J. Clarence | December 20, 2008 7:56 PM

Yeah, that is one damned ugly comment. But that kind of thing will always show up on the interwebs. Sometimes though, it's hard to tell where it's coming from. A middle aged lady in my life expressed something similar when she learned that a very young gay man we were close to had tested positive--right before she fell apart crying. It wasn't how she really felt; she was just shocked, in pain and scared for him. I wonder whether our community doesn't experience some of that?

Note however, that she did not say that to the young man in question as the people who placed these comments in practice have done. If one must have a temper tantrum it's best done behind closed doors. The commenter was exhibiting the selfishness he was accusing the writer of.

Ted | December 20, 2008 8:55 PM

Ultimately, I think people who take that kind of attitude have never been swept up in the heat of the moment, when no matter how much we wish logic would dictate our actions, it doesn't always happen that way, even when the stakes are extremely high. To this extent, we can probably pity them, because they come across as too cold and judgmental for us to imagine that they have every really lived, or more important, loved (to the extent there is a difference). I'm obv not advocating that anyone should go out and start barebacking, but I do think that forgiveness and compassion is very much a part of the overall solution.

The Gay Recluse | December 20, 2008 10:50 PM

TGR I love the idea of pitying them for their obvious lack of sexual excitment :) Minus, of course, the fact that many of the folks holding the purse strings for prevention funding think along similar lines. Not to mention a minority (but a sizable one) of HIV counselors I meet, who see themselves as sexual missionaries of some kind. Oy.

Trevor Hoppe | December 20, 2008 11:18 PM

Well, Trevor, once again I find myself squarely in your cheering section for your response to this article!!

You're right that it's scary so many people in this world, and even our community, buy into this same idiotic simple-minded view of risk and desire and self-worth. I've been having an email conversation on a topic very similar to this with a friend of ours from the summit. What's MOST concerning about this mentality, however, is what happens when those who have been inundated with (and often believed) these messages seroconvert themselves....and end up internalizing all these messages about how they are a failure or must not truly care about themselves, etc.----when, in truth, that's an insulting oversimplification of some very complex issues relevant to risk & desire.

Oy, it gives me a headache!!

Erik Libey | December 21, 2008 2:57 PM

Gosh, Trevor, you post the toughest issues... Yes, it's disturbing that he's suggesting we should engage in some adjudication of how someone became infected and make them pay for their own meds if it was anything less than the immaculate seroconversion. But he's expressing the tiredness and frustration so many prevention workers feel, as HIV-negative men simply refuse to take responsibility for staying negative. They'll talk about the dangerous behaviour of Other Men, the prevention obligations of Positive Men, the importance of Using A Condom Every Time, and never about their own occasional practice of unprotected sex with guys who say they're negative. It's just not sustainable, and as community health people burn out and leave the sector, they're being replaced by public health types, and so the neoliberal chorus just gets louder.

(PS - your comment preview template is fxcked!).

Daniel Reeders | December 21, 2008 8:29 PM

lol Daniel yes I know the comment preview template is messaged up. I've never bothered to edit it because so few people wind up seeing it. But I guess now that a complaint has been voiced, I should get around to doing it. Sigh.

I hear the frustration you and others are referring to. But this to me is something much bigger than individuals, and to place blame at that level is misguided. If Prevention wants to remain relevant, I think it's practitioners needs to seriously think about structural interventions for HIV prevention. Because while individual's choices are amassing to create the epidemic, structural forces (culture, economics, sexual fantasies, etc) are mediating that decision-making process (or lack of that ability to make decisions).

Trevor Hoppe | December 22, 2008 1:57 PM

Making positive men pay for meds will have no impact on neg men's behaviour; most of the neg men are having unsafe sex precisely because they believe they will never become positive. But my frustration is with negative men as a collective, opting out of concern for the HIV epidemic as a threat to our community's health, and declining to take part in community-based programs to educate them. Just a caution though -- 'structural interventions' is the kind of language Dr Klausner would use, and it's often justified by saying individual gay men don't have the capacity to adopt long-term health promoting dispositions like condom use. The rational choice model sees all this stuff as being about decisions, whereas we know a lot of it isn't really 'decided' per se; whether someone uses condoms with one guy often depends on the pre-existence of a habit or skilled practice, rather than any decision made in the moment.

Daniel Reeders | December 22, 2008 4:46 PM

Well you're just pointing to what Bourdieu would call habitus, which has been critiqued for its lack of agentic possibilities. I'm not convinced that focusing promoting condom use is going to get us very far in radically reducing new infections.

Trevor Hoppe | December 22, 2008 5:42 PM

Yep, I am absolutely pointing to Bourdieu on this one, because he's backed up by the psychological literature on judgment and decision-making and behaviour change - it's a total fantasy that this stuff takes place in a decisional mode. The most agentic of the behaviour change theorists is Bandura, and in social cognitive theory he makes the point that environmental (or structural) factors are only one element of a reciprocally determinist triad which also include personal and behavioural factors. But leaning on structural interventions isn't particularly agentic, either! :)

Daniel Reeders | December 22, 2008 10:57 PM

As you can see, I'm conflicted :) Queer theory has postmodernized my sensibilities. But sociology and social justice has structuralized me. I need a new theorist.

Trevor Hoppe | December 23, 2008 1:52 PM


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