"Suddenly, anything goes"

Sounds terrible, doesn't it?

Yet truth is, many substances disinhibit.

Such as alcohol.

Indeed, it was Dorothy Parker who observed, way back in the 1920s, that "Candy is dandy but liquor is quicker."

And sure enough, 80 years later TwilightChild was to blame his lapse on "too many Malibu pineapples."

While anyone who was around in the 70s knows that lots of guys got fucked while on Quaaludes -- powerful "downers."

And that those guys had "unprotected anal sex with many different partners in a single night."

That's how HIV got its start in the gay community.

So while meth may be the drug du jour, is it intrinsically more disinihibiting than alcohol or "ludes" or ketamine?

I doubt it -- I think it's just the substance which "safer sex counselors" are currently pointing to in lieu of discussing the real problem.

So what's going on now is not new, and it's not the fault of a drug -- though drug use, from amyl nitrite on up, has been and is certainly integral to anal; nor the internet, though the internet is certainly facilitating people "hooking-up."

No, the problem isn't meth -- even though at some point in the New Yorker piece a safer-sex counselor declares, echoing Bill Clinton's James Carville, "It's the meth, stupid";

and it's not the internet.

The problem is anal.

It's the anal, stupid.

The problem has always been anal.

And the promiscuity and effeminacy which are integral to anal.

Anal has been the problem since anal became king thirty years ago.

It was in 1975 that what I've called "the great anal sex frenzy" began.

I was there, and I saw it.

And it was six years later -- though there are many variables, it seems to take HIV on average five to seven years after infection to manifest -- that the first report of a new disease striking down homosexual men appeared in the CDC's "Morbidity and Mortality Weekly Reports."

First anal, then AIDS.

Not mysterious.

Not a secret.

Not even a story.

This is the basic truth of the MSM ("men who have sex with men") HIV epidemic:

Among MSM, HIV is anally-vectored.

Anal penetration is the "sine qua non" -- the "without which, not" -- of the MSM HIV epidemic.

No anal; no epidemic.

A few weeks ago I was privileged to take part in an email colloquy among some of the nation's leading AIDS epidemiologists, anthropologists, and other researchers on the question: why is HIV prevalence low in the Philippines.

The answer, it turned out, has to do with risk factors and risk behaviors.

Without certain risk behaviors, there can be no epidemic.

So, for example, in the Philippines, there is a risk behavior which has been much looked at: truck drivers frequenting prostitutes.

You can see where this would be a problem, since if a truck driver picks up HIV from a prostitute in Manila, and then drives to Davao and gives the pathogen to a prostitute there -- you've got the makings of an epidemic.

But in the Philippines, it turns out, almost all men, including those truck drivers, are circumcised.

And male circumcision confers powerful protection against HIV.

So powerful, that these guys are not getting infected.

In the case of the Philippines, then, a risk behavior -- frequenting prostitutes -- is offset by a mitigating risk factor -- male circumcision.

But among American MSM, nothing mitigates anal penetration.

Because the anus, when penetrated, is uniquely vulnerable.

Which is why in America, anal penetration alone has created the MSM AIDS epidemic.

Anal penetration.

Anal penetration is the pre-eminent risk behavior.

Without anal, nothing else matters.

For example, I'm on the internet right now.

Am I going to get HIV?

No.

Because I don't do anal.

Suppose I was using meth right now.

Would I get HIV?

Not unless I did anal too.

Maybe I'm feeling depressed.

Will depression give me HIV?

Not unless I seek false solace in anal.

Suppose I jerked off with five guys a night for the next ten months.

That's 1500 guys.

I don't, for many reasons, recommend you do that, but would I get HIV?

No.

Not unless I did anal too.

Anal penetration is the MSM risk behavior par excellence.

NO ANAL, NO AIDS.

That's the beginning and end of the story.

Yet once again, in the New Yorker piece as in all the others, there's no mention of non-anal alternatives.

Nor of changing the sexual culture of men who have sex with men so that anal is no longer at its center.

Nevertheless, the fact is that the tyranny of anal -- and its equally ugly bedfellow AIDS -- has totally deformed gay male life and to some extent the lives of all men.

It's left men fearful of sex; as Robert Lorspir has described, it's contributed mightily to the degradation of masculinity; it's responsible for much of the drug use among gay and bisexual men; it's put sex under the control of a new and parasitic class, that of the "safer-sex counselor" and in so doing removed sex from the realm of the natural and spontaneous to that of the artificial and controlled; it's destroyed sexual spontaneity and replaced it with "negotiation"; and it's created two totally false and destructive MSM categories, top and bottom.

That's the truth guys.

Sex between men four decades ago wasn't perfect.

But it was a lot better than what we've got now.

We're now in the thirtieth year of the supremacy of anal penetration.

And the 24th year of the epidemic.

24 years is a long time.

We've got 500,000 dead in America alone and another million infected, at least half of whom -- and probably a lot more -- are gay and bi men.

And every day 60 more gay and bi men get infected -- minimum.

How do they get infected?

Through anal penetration.

That's the problem.

That's where and how the bad stuff happens.

In the anus and rectum during penetration.

Clearly, we need to get rid of anal.

Instead, with each passing day, anal gets more entrenched.

And that's not an accident.

It's because of the actions of the gay establishment.

Which you can read about in the New Yorker piece.

It's because that establishment NEVER questions anal and instead does all it can to prop up anal and promiscuity and effeminacy.

Early in the New Yorker piece, for example, a prominent San Francisco psychotherapist appears in drag to host "Tina's Cafe" -- a drop-in group about crystal meth.

Here's the New Yorker's description of the scene:

Even today, with a million Americans infected with H.I.V. and half a million others already dead, many of the clinics and counselling facilities that focus on the health of gay men remain dreary places, largely hidden from view. Magnet[, located at the heart of San Francisco's ultra-gay Castro district,] is neither of those things. Its bright setting, modern furniture, and polished wood floors make it look far more like an art gallery than like a doctor's office. One needn't be sick to go there, nor is it necessary to make an appointment. Drop in any time, to be tested for syphilis, chlamydia, gonorrhea, or H.I.V. It also functions as what its director, Steven Gibson, calls a "hotel lobby for the people of the Castro, a place to talk, to worry, to smile, to cry," or, as Magnet's Web site puts it, to "cruise (online or real time)."

Last month, on one of the first genuinely warm nights of spring, the center held a small gathering called Tina's Cafe. The sidewalks of the Castro were filled with men. So were the bars and coffee shops; the Men's Room, the Midnight Sun, and even the "gay" Starbucks, on Eighteenth Street, were all bustling by 8 p.m., and a small crowd had begun drifting into Magnet. A new exhibition had been installed -- a series of sexually suggestive pictures taken from the Internet. The visitors stared at the walls in awkward silence for a while, then took seats at tables covered with lollipops and M&M's. There was a bar with wine and soda in the back, where a d.j. was setting up his equipment. Soon, a tall man in a short dress appeared. His name was Michael Siever, and he wore a brunet wig, high-heeled pumps, and magenta stockings. "Welcome to Tina's Cafe," Siever told the crowd. "I am really glad you are here. We are going to talk about what's real tonight. About paranoia and violence and anger and fear. About reality." A couple of dozen heads nodded in unison. "We are going to talk about what is happening to our world." Siever has the soothing voice of a psychotherapist, which he is. He is also the director of the Stonewall Project, a highly regarded counselling program. "Tonight, above all, we are here to talk about Tina."

Tina is crystal methamphetamine, a chemical stimulant that affects the central nervous system. It is hardly a new drug, and it has many other names: biker's coffee, crank, speed. It has also been called redneck cocaine, because it is available on the street, in bars, and on the Internet for less than the price of a good bottle of wine. ...

[emphases mine]

"Soon, a tall man in a short dress appeared. His name was Michael Siever, and he wore a brunet wig, high-heeled pumps, and magenta stockings. "Welcome to Tina's Cafe," Siever told the crowd. ... Siever has the soothing voice of a psychotherapist, which he is. He is also the director of the Stonewall Project, a highly regarded counselling program."

Think about that:

The intersection of drag and drugs and anal receptivity in this well-appointed gay meeting place at the symbolic center of the gay male world.

The anal, the drag, and to a large extent the drugs too -- are all institutionalized.

Siever, the guy in drag, isn't some marginal figure in the gay male community.

He's the director of "a highly regarded counselling program."

He's part of the gay male establishment.

He's part of the problem.

Also consider how these anally receptive men are going to be on drugs of one kind or another for the rest of their lives

They'll do meth till they get HIV.

And then they'll do antivirals for the rest of their days.

Like I say, gay life did not used to be that way.

If you did drugs, it was because you wanted to.

Not because it was compulsory or because you needed them to stay alive.

Once again, it's not the meth, stupid.

It's the ANAL -- STUPID.

ANAL IS THE PROBLEM.

And NOTHING can fix it.

Doesn't matter how many times Mr. Siever aka Tina conducts his meth cafe.

Because an anus is not a vagina.

There's no risk-free way to get penetrated or to penetrate anally.

That's the truth.

But no one wants to speak that truth.

For example, there's another prominent gay San Francisco psychotherapist named Walter Odets, and though he's critical of certain aspects of AIDS prevention, he too in my view is part of the problem.

In an email, Dr. Edward C. Green, the AIDS anthropologist who described the success of ABC in Uganda, noted this passage about Odets in the New Yorker article:

Odets believes that the gay community split in 1985, the moment a reliable H.I.V. test was available. "Before that day, everyone was in it together," he said. "Nobody knew who had it and everyone acknowledged that it was a horror. And then, in April of 1985, we started protecting people who had H.I.V. And we did that by normalizing infection-and we have done that all along. It has completely compromised prevention work, to the extent that when the AIDS Health Project, in San Francisco, put up a banner outside its facility that said 'Stay Healthy Stay Negative' the gay public was incensed. Men wrote in and said, 'I have H.I.V. and I am perfectly healthy. How dare you imply that I am not?' " While it has always been important to protect and support H.I.V.-infected men in the gay community, Odets argues that it has become difficult to teach men who test negative how essential it is for them to remain uninfected. "This is not about making positive men feel good about themselves," Odets said. "It's about protecting H.I.V.-negative men."

Dr. Green added, "This "normalization of infection which took place in the gay community" is the exact opposite of the "fear arousal" message that Uganda favored in the earlier years of national response, the period when behavior changed and HIV prevalence plunged."

Dr. Green is correct about that.

Chuck Tarver responded to Dr. Green that

I wholeheartedly agree with that assessment. It really struck a chord with me. I will say however that there is an even more fundamental problem and it is what Bill has been pointing out all along. The culture of anal sex. If anal sex were not so valued in the gay male culture drugs, meth and viagra, which enhance the ability to perform it all night long would not be attractive.

The concern about making HIV+ men feel good is layered on top of that. It's a major factor but it is not at the very foundation of what drives the epidemic.

I do recall an online discussion I entered into with regard to how HIV+ men feel. One such man was saying that the "Virus Ends with Me" campaign unnecessarily demonized those who are HIV positive. He argued that it was each individual's responsibility to protect himself. I told him that while I agreed that people should protect themselves, that from a disease prevention model the "Virus Ends with Me" campaign makes perfect sense. An HIV- person can only prevent the spread of the disease to one person, him/herself; while an HIV+ person who contains the disease, can prevent it from spreading to potentially hundreds, thousands or even millions of people.

Needless to say, for saying this, I'm considered CRAZY by community standards.

As am I.

Let me add that I've never understood where Odets, who's very respected, is coming from, when as the article says, "Odets argues that it has become difficult to teach men who test negative how essential it is for them to remain uninfected."

The first time I tested negative, which was in 1988, I knew immediately that it was essential I remain negative.

It was a no-brainer.

I also knew that I was negative because I hadn't been doing anal.

That was a no-brainer too.

Why would you need to be taught that it's "essential" that you not get infected with a universally fatal pathogen?

You already know that.

And why would we need to avoid "demonizing" HIV+ men by telling them they're not responsible if they give someone HIV?

We prosecute drunk drivers who kill people.

If we didn't do that, there'd be an "epidemic" of alcoholic vehicular homicide.

Wouldn't there?

The problem, I strongly suspect, is that a gay establishment figure like Odets is unwilling to criticize or even critique anal to his clients, whether negative or positive.

Because to do so would bring into question much of the structure of present-day gay male society.

For example, we know that over the course of a year, the condom failure rate -- failure means someone gets infected with HIV -- is about 20%.

And that's for vaginal sex, which is far gentler on a condom than anal.

That means that if the virus is truly going to "stop with me," the poz guy has to stop doing anal.

As does the man who's still negative.

I think what's going on is that a man like Odets is putting "honor diversity" ahead of the health of the community.

That's what Rotello says, and truly, no other explanation makes sense.

Because if we wanted to stop HIV, we could do it today.

It's not a question of means -- we know how to do it.

It's a question of will.

And that's what makes reading articles like the New Yorker's so maddening.

Another researcher quoted in the New Yorker piece, Ron Stall, cites depression, homophobia, partner violence, and childhood sexual abuse as factors which predispose men to participation in "unsafe" anal penetration.

Is that true?

The New York Times said something very similar four years ago.

If safer sex counselors -- who are amply funded -- have known about these factors for four years or more, why haven't they been able to do something about them?

Let's look at them:

Partner violence.

No kidding.

A lot of anal penetration is rape.

And even when it's not overt rape, when you bottom for someone you invite violence.

That's why they call it "getting fucked."

Anal by its nature is a violent act.

As one Alliance member says,

There's no male connection, no bond, just raw lust. It's not sex or love, it's violence and power. The problem is implied in the politically-coerced masculine/feminine roles.

Violence and power.

And political coercion.

He's right.

Which means that if you want to address partner violence, you need to address anal.

Depression, childhood sexual abuse, low self-esteem.

Possibly, in some instances, true.

Those factors can lead to many sorts of dysfunctional behavior.

Yet the fact is, while lots of folks suffer from low self-esteem and depression, most of them don't do unsafe anal.

The prevalence of unsafe anal is a gay male cultural phenomenon, and one we could change.

By changing the culture.

As for homophobia:

I lived for more than a decade in San Francisco, and there's almost no overt homophobia there.

Sure, there are folks who don't like gay people, but by and large they're afraid to say so in SF -- the negative repercussions are just too great.

So, if homophobia causes unsafe sex -- how come there's so much unsafe sex in SF, where there's so little homophobia?

Why does SF need a "Tina's cafe," hosted by a gay male psychotherapist in drag, if homophobia's the problem?

If homophobia's the problem, then the absence of homophobia should have created, in San Francisco, a gay male paradise of intimacy and belonging.

Instead, what's described in the New Yorker and the New York Times and the SF Chronicle is a hell of unsafe sex, promiscuity, drugs, and disease.

Perhaps instead of worrying about what happened to these guys as kids, we should worry about what's happening to them as adults:

Anal penetration.

Anal penetration is a debasing and degrading practice for both top and bottom. If you suffer from low self-esteem, and you get fucked, your self-esteem goes even lower.

As does your self-esteem every time you get shit on your dick.

Once again, it's not the homophobia.

It's the anal, stupid.

We need to get clear about this:

It's not homophobia, and it's not depression and low self-esteem that are the problems.

It's the culture of anal penetration among gay men.

Which we could change.

In a sense, if anyone would have the courage to pick up that particular ball and run with it, it's really good news:

We could quickly and radically reduce the rate of new MSM HIV infection in America.

Simply by reducing the prevalence of anal.

But the guys who write these long, tedious articles blaming all that's gone wrong on meth and the internet and low self-esteem and homophobia -- do not get it.

They refuse to consider that anal penetration itself might be the problem.

Which isn't surprising.

Because for more than twenty years they've been taught that they musn't question anal.

So we have to do that for them.

We have to be out there saying in a loud, clear, and consistent voice that the anal emperor has no clothes;

that anal penetration is not sex;

and that it has no place in the lives of men who have sex with men.

Guys -- please donate.

So that someday -- maybe a month from now and maybe a year from now -- when someone else writes one of these long, tedious articles --

there'll be some mention of the men who don't do anal.

And the men who are turning away from anal.

Because anal isn't safe.

And because there's something which is so much better.