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The new sex police: with AIDS diagnoses on the rise and a scary new strain of HIV looming large, some activists are advocating radical methods to halt unsafe sex

Advocate, The,  April 12, 2005  by Todd Henneman

With AIDS diagnoses on the rise, more gay men having unsafe sex, and a potentially new "super-strain" of HIV discovered, Marc Cohen feels compelled to take drastic action. As president of Miami's United Foundation for AIDS, Cohen routinely visits Internet chat rooms for men who have sex with men. Using the screen name HIV-outreach Miami, he talks about the perils of contracting HIV, especially to those whose profiles list barebacking--having anal sex without a condom.

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Some might say Cohen's method is unorthodox, even inappropriate, but he has enjoyed some success: He encouraged participants in a weekly sex party to end their barebacking practices and instead use condoms, and 40 of the 47 people in a crystal methamphetamine counseling program came from his group's online outreach. "It's done in a very approachable, nonjudgmental, nonconfrontational manner," he says. "My initial engagement is to build trust. Nobody is going to tell you anything until they trust you."

Many gay men nationwide might describe Cohen, though he shuns such a label, as a member of the new "sex police": AIDS activists who patrol chat rooms; online bulletin board "bloggers" who denounce anal sex in their forums; and pundits who propose solutions like universal HIV testing and the levying of medical-support payments against those who pass along HIV. The recent diagnosis in New York City of what could be a deadlier new strain of HIV, which is resistant to medications and progresses rapidly to AIDS, has caused some public-health authorities, activists, and others to advocate radical ways to police those most at risk for the disease.

The doctors who announced the stronger HIV strain said their "patient zero" used crystal meth at a sex party with multiple partners. The drug has been linked to risky sexual behavior. "We have to ask ourselves why we're using such a dangerous drug," says longtime AIDS activist Peter Staley, who spent $6,000 of his own money on ads that say HUGE SALE! BUY CRYSTAL, GET HIV FREE! The Institute for Gay Men's Health, a collaboration between New York's Gay Men's Health Crisis and AIDS Project Los Angeles, has come up with its own method for combating unsafe sex. According to director of education George Ayala, the institute is placing fake crystal packets in bars and bathhouses. Inside, patrons will find a risk-reduction message.

Perhaps most sensational among the new AIDS activists are those who campaign against anal sex. Bisexual blogger Jim Lynch describes it as "shit sex" and says the way to avoid the "supervirus" includes no longer depicting anal sex as erotic. "It's truly unfortunate that some folks perceived [me] to be antigay when nothing could be more pro-gay than keeping gay and bisexual men alive and healthy," Lynch says.

Bill Weintraub, who runs the Web site Man2ManAlliance.org, also encourages gay men to give up anal sex in favor of what he calls "frot," or frottage--rubbing bodies and genitals together. He remained HIV-negative without using condoms during his 13-year relationship with an HIV-positive man because they stuck to frottage, Weintraub says. He insists frottage is "hotter" because anal sex "cannot give you the same experience as direct genital-on-genital sex."

But psychologist Walt Odets says efforts to make anal sex unerotic reflect homophobia. "I think that anal sex has for gay men the same emotional significance that vaginal sex has for heterosexuals," says Odets, author of In the Shadow of the Epidemic. "No one would propose that we initiate a public-health measure by de-eroticizing vaginal sex. It would sound like a ridiculous idea. It's no less ridiculous for gay men."

Another strategy would be to rekindle the fear that has waned since the worst years of the AIDS epidemic, says Gabriel Rotello, author of Sexual Ecology: AIDS and the Destiny of Gay Men. "The basis of safer sex is fear," Rotello says. "It is now, and it always was."

Indeed, fear and urgency marked the AIDS epidemic in the 1980s and early '90s as it claimed the lives of hundreds of thousands of people, including many prominent stars, like actor Rock Hudson and Queen front man Freddie Mercury. Then in late 1995, researchers announced that a cocktail of antiviral medicines provided hope of turning HIV infection into a manageable illness, and the number of AIDS deaths declined greatly.

But that may be having a detrimental effect. "In many different communities of gay and bisexual men, safer-sex norms do not appear to be as important as they once were in the '80s," says Ron Valdiserri, MD, a top AIDS expert at the Centers for Disease Control and Prevention. The number of new HIV diagnoses among gay and bisexual men rose 11% between 2000 and 2003 in the 32 states studied by the CDC. Syphilis also increased. And a rare form of chlamydia has been seen in New York, Atlanta, and San Francisco. "We're creating the exact same disease settings ... that allowed AIDS to explode in the first place," says Dan Savage, a nationally syndicated sex columnist who recalls the most devastating years of the epidemic. "It's going to happen again."