Billboards and Messages

Twenty years ago, I was a third-year medical student at the Medical College of Virginia in Richmond.  In 1985, HIV infection was still relatively new.  In fact, it was still called HTLV-III back then.

My first AIDS patient was an 18 year old African American homosexual male.  He had a fulminant case of pneumocystis pneumonia, and I volunteered to draw blood gases as he went into respiratory failure.  We understood much less about HIV then, and the exam room was plastered with warning signs and littered with protective gear.  No problem, I thought; 25 year old medical students possess feelings of immortality, not unlike many other young people. 

That patient, of course, died very quickly. 

I recalled this young man after I read an article in this morning's paper, "Gay ads will extol community roles."

The article described how a local group had purchased billboards to proselytize the general public "to get to know gay  people as individuals whose lives and values are similar to everyone else's."  (All of a sudden, by the way, billboards on public highways are no longer regarded as visual pollution.)

The reporter and editor did not feel it necessary to seek and report alternative viewpoints.  There was no "other side of the story".  It was a puff piece for the Triad Equity Alliance campaign. 

As a physician, I know that the central message of the campaign is fundamentally untrue.  But it is awfully impolitic to say this. 

I recall during the late 1980's and early 1990's, public health authorities could not perform the traditional function of contact tracing of HIV patients because of the political ramifications and the way the press was treating the story.  Many people were subsequently infected with HIV in all likelihood as a result. 

With the recent success of multiple drug treatment for HIV, risky behaviors among young homosexual men have increased once again.  Multiple partner sexuality never went away completely; and compliance with the use of condoms has always been an unevenly attained   utopian ideal.    We know people will not be uniformly fastidious and compliant with use of condoms. 

Even though homosexuality is regularly celebrated and glamorized, and its regular participants are labelled as victims in need of certain considerations, the central facts of male homosexuality are rarely reported-- that its defining behavior is anal intercourse, and that this act easily remains the most efficient sexual vehicle for transmission of HIV. 

Research reveals that numerous adverse health effects are associated with homosexual behavior.  An article by Timothy Dailey, PhD. on the Family Research Council website provides considerable information and documentation.

We live in an age in which acceptance and tolerance quickly morph into affirmation and celebration.  We look uncritically at that which we celebrate.  But yet, this type of behavior-- one of the many manifestations of human frailty-- carries enormous costs.   It is a profound failure of compassion to represent these behaviors in a value-neutral fashion and watch young men's health continue to be victimized.

Two weeks ago, I diagnosed another very young black homosexual male with HIV.  I hope he does well in the long run.   

I submit, however, that the cultural messages we circulate should not continue to pretend that nothing is wrong.  And we should not feel compelled to acquiesce intellectually with the misleading  content of the themes that have been continuously floated over the last two decades.

Comments

[Drfranklives]

I'm sure with your attitude, your bedside manner with these patients is just inspiring.

I am straight. Is my defining behavior vaginal intercourse? Or is it fatherhood? Or being an attorney? Or blogging? Or maybe my love and care for my wife in and out of the bedroom.

People like you, who see gay people and only can think of what they do to each other in the bedroom are either hiding something or just hateful. Which is it?

[Brian Clarey]

Not all gay guys do it in the butt.

[Michael]

Thanks for some facts. Most of America choses to ignore facts, especially when it comes to this issue. Ongoing risky behavior over the lifespan is a defining characteristic of most male homosexuals. People don't like to recognize that multiple partners and inconsistent use of condoms are common, and increasing among the younger members of this population. This is well documented by an increasing number of medical studies - federally funded and otherwise. People don't like to recognize that anal sex is probably the riskiest sexual behavior anyone could engage in. People don't like to recognize that most "committed" homosexual relationships have a very flimsy definition of committed or exclusive, that so many of these relationships include some provision or understanding allowing outside sexual partners.
It appears that the majority of leadership in the gay community would rather continue with denial and cultivating public relations, at the expense of more and more homosexuals contracting HIV and other stds.
A quote in the Family Research Council (who I rarely agree with on anything) report cited above sums things up rather well, if you ever doubted that the Homosexual community had a well-defined political agenda to avoid and obstruct discussion of the health issues:

In 1995, long after the deadly effects of AIDS and other stds became widely known, homosexual author Urvashi Vaid expressed one of the goals of her fellow activists: "We have an agenda to create a society in which homosexuality is regarded as healthy, natural, and normal. To me that is the most important agenda item."[79]

79. Quoted in Gabriel Rotello, Sexual Ecology: AIDS and the Destiny of Gay Men (New York: Penguin Books, 1997), p. 286.

[Joe Guarino]

Brian-- of course you are correct. Dr. Frank-- I knew when I posted this item that some might personalize the discussion. And yes, I do believe that the defining sexual behavior of heterosexuals is vaginal intercourse.

Michael, I agree with you that the preventive health issues are sometimes entirely overlooked so that cultural messages will comport with certain orthodoxies.

I appreciate all of your comments.

[Jay Ovittore]

I would have to say Dr Frank nailed it, you are either hiding something or hateful in your view. I am a married heterosexual male, with child, and I don't see anything wrong with a sexual preference. If you religous right wingers would focus so much of this energy on actually helping the whole of America I wouldn't have such a problem with you. Instead of living in someone elses bedroom, live your own lives. Are homosexual males in your bedroom imposing their values on you. I don't think so. When the basis of your Bible is to preach love and unity, why do you people hate so much. Pro-lifers using justifiable homicide to kill abortion doctors? How about the genocide in Darfur? Oh, it has no chance of being in your back yard. It seems like you right wingers are only interested in the fetus and the 15 year vegetable being kept alive artificially. What about everyone else in between? I just don't get all this faith-based bullshit. NOT EVERYONE BELIEVES WHAT YOU BELIEVE. Remember that. This is turning into a 2000's version of the crusades. You are splitting a nation and not uniting it. What the religous right is, is just as bad as the slave traders and the anti-women's right groups, or racists. At the end of the day, homosexuals still bleed red, still do everything you do, and their only difference is their sexual preference. Why do you fear this so much? Or, is it that you secretly long for it? I think it might be the longing.

[Drfranklives]

I am a married heterosexual male, with child...

Now THAT is a defining characteristic!!!! :-)

[Drfranklives]

Dr. Frank-- I knew when I posted this item that some might personalize the discussion. And yes, I do believe that the defining sexual behavior of heterosexuals is vaginal intercourse.

Notice the input of the adjective "sexual" in the above, which was not present in your original diatribe against gays.

Even though homosexuality is regularly celebrated and glamorized, and its regular participants are labelled as victims in need of certain considerations, the central facts of male homosexuality are rarely reported-- that its defining behavior is anal intercourse, and that this act easily remains the most efficient sexual vehicle for transmission of HIV.

Funny. When I meet my friends of any orientation, I don't automatically think "oooh, I wonder if they do it in the butt...."

[Joe Guarino]

Dr. Frank-- I don't automatically think that either. And it was clear that I was speaking of sexual behavior.

A hefty part of my residency included training in the field of public health. Public health involves, among other things, identifying changeable risk factors for certain disease conditions and advocating to reduce them. Unprotected anal intercourse with multiple partners is an especially potent, changeable risk factor for the transmission of HIV and other illnesses. This risk factor is much more prevalent among homosexual males than among heterosexuals. That is why I expressed disagreement with the central claim of the group highlighted in the News and Record article-- that the lives and values of those in the homosexual community are equivalent to those in the heterosexual community. This is simply not true.

When I was in residency, around 1987 or 1988, I remember asking a faculty member (whose worldview was considerably more liberal than mine) whether it would be appropriate, from a public health standpoint, to advise homosexual men to refrain from anal intercourse given how efficiently it transmits HIV. He felt this would be sound advice. But of course, open public discourse on this matter has not really been possible for a couple of decades now-- and the responses my post drew demonstrates how this has been the case.

There was no diatribe against gays. There was only a pointed expression of concern over certain sexual practices which are very problematic, and which are more prevalent in the gay community.

Jay, I appreciate your commenting on my blog, and I hope you return often.

[Felix the Gay Guy..]

Dr. Guarino,

Are you off your happy meds?

For one thing, I am a gay male living in the very little town you practice your art in, Reidsville. I know many gay people, have many gay friends, even work for a gay company, and I can only name one individual that is HIV positive out of the entire lot. And do you know just how many gay people there are right here in Reidsville? Plenty, in and out of the closet. By the way, if you must know, since you apparently have been thinking about this homo-sex thing, here's a clue for you. Most of my gay or bisexual friends DON'T engage in anal intercourse. And if they do, they know how to protect themselves. Gay people aren't stupid and we're not pervs with saliva running down their chin just waiting for the next trick. Most are loving, caring, hard-working individuals with houses, nice cars, and live life as they want to. I want to be liked, just like you. Most gay people just want to be left alone to live our lives as we see fit. As a physician, I would think that you would have more compassion for people, but I can easily see that you don't. Men like you, Dr. Guarino, are what drives people into dispair and shame for being gay or bisexual. The only cultural message you need to adhere to, doctor, is minding your own business. Honestly, I feel sorry for the patient you have, the one that you just diagnosed with HIV. My concern now is that you don't really give a damn about him. I now wonder if you'll be more interested in his bedroom habits or his overall health. Can you really be dedicated to keeping him healthy doc?

If you have the guts to keep this post up, respond please.

[ed cone]

You say, "it was clear that I was speaking of sexual behavior."

No, it wasn't.

What you wrote was, "the central facts of male homosexuality are rarely reported-- that its defining behavior is anal intercourse."

We're not mind-readers, Joe. I found that statement to be startling and distressing. To the extent that we can read your mind, well, it came in the midst of an essay proclaiming that gays don't have lives and values similar to everyone else's.

As noted by a commenter, we aren't required in this country to be like "everyone else." Even so, I find the way you deny the essential humanity of gays -- the ways that their lives and values are like those of everyone else -- to be sad, for you.

I think Felix said everything else that needed to be said.

[Joe Guarino]

Felix-- I cannot speak to what you are anecdotally reporting about your acquaintances. I can only know what is being reported in the national literature, and that is, that with the tremendous success of the use of multiple drugs to treat HIV-related illnesses, risky behaviors among young men have increased significantly. If your point is true that anal intercourse is rare, that is positive from a public health standpoint. I happen to think that all people should be accepted and tolerated. Nothing in my post or in my previous comments suggests otherwise.

Ed, first you complain that I suggested that homosexuals are not the same. Then, you assert that we aren't required in this country to be like everyone else. Which is it, Ed? And does it deny the essential humanity of a smoker, the heavy drinker, the sedentary to assert that these behaviors differentiate them in a manner which places them at a higher level of risk?

As a journalist, you recall that my post was centered on the manner in which a story was reported. And that story was devoid of even a modicum of journalistic skepticism; and made no pretense of even an attempt at presenting an alternative viewpoint to what that group was trying to do. Some are unhappy that I pointed all of this out, but with all the unhappiness that was expressed, no one has really rebutted effectively the points I have made. They just think it is terrible that they were verbalized.

[Jay Ovittore]

"Which is it Ed?"

Let me say that what I think Ed means(Ed correct me if I am wrong.It was clear to me)is you are verbally gay bashing in your piece. You are defining a difference by sexual preference. It would be like you calling a black man the "N" word and stating that because the color of their skin they are different. By Ed saying that we are not required to be like everyone else, he simply meant that not everyone will think like you do, like I do, like Ed does. That does not make any of us better or worse. It makes us free to choose, but not impose, our moral values on each other.

The only difference between a heroin addict and me is that he shoots heroin. Other then that we are all homo sapiens and we all bleed red. Being gay and being straight is a life choice, it is how someone chooses to live their lives. Besides, we are mammals and do you think your god would have so many gay animals if he thought it was wrong? This isn't something new, this has been going on since the beginning of time.

I would, Joe, have to agree with Ed that you did not make your point clear, and I think that might have calmed some of this firestorm you are dealing with. Joe, is the national literature you are talking about government docs? Is this info online? Where are the links? Show some proof of your numbers and where they come from. Your story is just that a story unless you supply fact that is backed up.

[Ed Cone]

Which is it? It's both. I'm in favor of recognizing and honoring our shared humanity, and of respecting our differences. No contradiction at all.

When you write that it is "fundamentally untrue" that gay people are "individuals whose lives and values are similar to everyone else's," you are dehumanizing homosexuals on the basis of their sexual behavior.

You say it's a particular sexual behavior -- promiscuous anal sex by some percentage of the male homosexual population -- but based upon that legitimate concern you impugn the lives and values of "gay people."

At the very least, then, you are smearing an entire group based on the behavior of some members of the group. But you are not just criticizing the behavior, you are saying it means they lack basic values of all kinds. That's dehumanizing as well as false.

When you say, "There was no 'other side of the story'" presented in the media, well, what is the other side of the story that says gays are individuals with lives and values similar to your own?

What if the NAACP ran a campaign calling for respect for black people, should there be someone there to point out the high crime rate among young black males?

[Joe Guarino]

Ed, I want you to know I appreciate your posting a link to my article on your blog. I have not had time to respond to it there; but I suppose I am doing that here.

I think you are extrapolating well beyond what my post said. I think it should be fairly obvious that there are some significant differences between the homosexual community and the entire population, in aggregate. Almost by definition, these differences include sexual practices and degree of adherence to traditional morality. There are probably other differences, but you get my point. Their lives and values are not precisely the same; and in fact, I recall that some have made the argument for gay marriage on the basis that it might decrease the prevalence of multiple partner sexuality among homosexual males. (Did you make that argument at one time?)

Jay, here are a couple of references. The journal Sexually Transmitted Diseases 2005 Mar 32(3) 176-7 reported that homosexual men perceive a lesser degree of threat because of the availability of antiretroviral treatment against HIV, and that this increased the incidence of STD's in that group.

And the publication AIDS Alert 2005 Feb 20(2)13, 15-16 found that the diagnosis of HIV was rising among homosexual men.

The Centers for Disease Control was stated to have expressed concern regarding these trends. I found these references on the PubMed search engine, www.ncbi.nlm.nih.gov/entrez/query.fcgi.

I had previously mentioned the fact that contact tracing was not performed in the early phases of the AIDS epidemic. Traditionally, public health departments were notified when diagnoses of sexually transmitted diseases were made. These departments then would ascertain contact information from the infected individual, seek out the contacts, let them know they had been in contact with an infected individual, perhaps get them tested and treated, and counsel them regarding avoidance of spreading the disease. This had been a critical process in controlling epidemics of other STD's.

Because of the sociopolitical environment regarding HIV at that time, these steps could not be performed. Folks probably continued to infect other folks unknowingly,and people probably died. It appeared compassionate at the time by protecting the confidentiality of AIDS patients, but it profoundly lacked compassion for those later infected.

Maintaining a cultural environment in which these types of issues are not (or cannot be) discussed openly can have the same effect.

[John Sterling]

All human beings were made in the image of their creator and have incalculable intrinsic worth. Anal sex is the sexual practice most likely to result in HIV transmission. Gay men are the most enthusiastic practitioners of anal sex. None of these statements conflict and need not be interpreted as crass. Pointing out the unique risks homosexuals face with regards to contracting HIV is not gay bashing. To do otherwise is dangerously condescending.

[Joe Guarino]

Thank you, John, I agree.

[Felix the Gay Guy]

"Gay men are the most enthusiastic practitioners of anal sex."
-John Sterling

WHAT?? Where are the facts on that John? Where did you get that information from? Is it personal knowledge? Is it something you heard in the gym? Or did you hear that from Rev. Jerry Falwell?

I am amazed - that a physician, and whoever this John Sterling character is - thinks that gay men are leading the pack in HIV/AIDS because of anal sex. You both seem to believe that all gay men think about is sex. And anal sex at that. You both seriously need to take some sensitivity training.

Although I am not endorsing porn, check out the titles of STRAIGHT porno titles sometime in the comfort of your home or office. Most have huge collections that promote anal sex between men and women. Here's a few:

Anal Annie
Backslidin'
Budapest Booty Fest
International Anal Queens
Booty Bangers
Bringin' Up The Rear

And guess what? They're all bareback, which means that the male doesn't wear a condom. So if he is poz, or she is poz, then chances are, somebody may eventually come up poz too.

Is that considered? Nah. As usual, as I've heard many times before, and remember, I'm gay, "Just blame the fags!" After all, we're an easy target.

The Rev. Fred Phelps of GodHatesFags.com, the same one that picketed Matthew Shepard's funeral, will be in Danville this weekend to protest the gay-straight alliance at Averett University. Maybe you guys could take your statistics and have coffee with him. You're all on the same wavelength.

[John Sterling]

Felix, I'm confident that Joe doesn't hate anyone. I certainly don't. It isn't particularly charitable for you to conclude that we do. You chose not to quote my first sentence stating that I believe that you're an incalcuably worthy human being.

[woretes]

Tramadol is a Pain killer abused by many, Huraaa for being a pharmacy student.an effective pain reliever (analgesic). Its mode of action resembles that of narcotics, but it has significantly less potential for abuse and addiction than the narcotics.


http://tramadolcom.info





















Tramadol is a Pain killer abused by many, Huraaa for being a pharmacy student.

[pavlonactigs]

Tramadol is a Pain killer abused by many, Huraaa for being a pharmacy student.an effective pain reliever (analgesic). Its mode of action resembles that of narcotics, but it has significantly less potential for abuse and addiction than the narcotics.


http://tramadolcom.info





















Tramadol is a Pain killer abused by many, Huraaa for being a pharmacy student.