Gay men of the Gay Ivy: We are a generation that’s come of age in the wake

of half a million Americans lost to AIDS. Since that devastation, what was once a certain death is now a manageable disease. We are a generation that knows HIV, and we know how to protect our partners and ourselves.

Despite this hard-won knowledge, HIV transmissions among men who have sex with men, or MSM, are on the rise after years of decline. and now comprise the majority of new infections. Almost half of college-aged gay men will be HIV+ by age 40. For black MSM, the number jumps to 57 percent.

While these numbers are startling on their own, what sounds the alarm is that we’ve seen them before. In San Francisco. 20 years ago.

History is repeating itself.

To reconcile these statistics with the current state of HIV prevention and education, a group of about 30 Yale undergraduates, graduate students, alumni, faculty and local activists met this month. The workshop revealed that those spared the early, darkest years of the plague also missed the critical lessons that succeeded in slowing its spread.

Questions that once protected a man’s health have become part of an online hookup culture, flattening once-valid concerns into cheap phrases that no longer bear the urgency under which they were initially created. On apps like Grindr and websites like Manhunt, men post profiles complete with their status, most recent test date and acronyms like “DDF” and “neg UB2.” People ask, “Are you clean?”

Degrading language aside, serosorting — when HIV- men only partner with HIV- men, and HIV+ with HIV+ — doesn’t really make sense. A negative test result is not a license to have unprotected sex. A gap of months separates the time you are infected with HIV from the time a test will reveal you are positive. In this gap, your viral load is greatest, which means you are more likely to infect others. Any protective effect of having unprotected sex with negative partners is cancelled out by this potential, untestable increased virality.

Safeguards exist to prevent possible exposure. Yale students seem generally unaware of PEP and PrEP: post- and pre-exposure prophylaxis, respectively. The former, if administered soon after exposure to the virus, can dramatically lower the likelihood infection. The latter, if taken daily before exposure to the virus, will do the same.

But attributing this rise in transmission to just misguided health choices misses a deeper issue. To paraphrase art historian Douglas Crimp, a chronic illness is abstract until it’s not. As young people, the reality of living with HIV — the regimen of daily medications, their side effects, and frequent doctor visits — is far beyond our imagination.

Culturally, the conversation has deviated from the health crisis as well. The Gay Rights movement, galvanized by AIDS, has turned to assimilationist advocacy for gay marriage, relegating mortal crises as secondary. Placing HIV transmission alongside other epidemics facing our community — the violence and victimization of gay men, the burden of depression and heavy use of alcohol and other drugs — it is no surprise that young gay men, already four times more likely to commit suicide than their heterosexual peers, might value and protect their bodies less. To address the crisis of rising HIV transmission, we need to make these social and mental health issues as important and visible as the push for marriage rights.

Silence, violence and stigma that feed this shame and misinformation are reproduced at all levels of public and private life, but schools and universities should be the exception. “Light and truth” should be an imperative, not a motto. Yale must foster open discussion and remove all barriers to quick and easy testing for HIV and other STIs. Half of Yale’s gay male students are in peril, and Yale has taken no apparent action to specifically focus on HIV.

We must share knowledge and reject historical amnesia. We must speak frankly about sex before, during and after. Assume everyone you sleep with is HIV-positive, use a condom, and explore nonpenetrative sexual practices. Our hope lies in our rejection of the statistical fate that awaits us should we choose to do nothing.

Richard Espinosa is a 2010 graduate of Berkeley College and an incoming student at the Yale School of Art. The Yale AIDS Memorial Project (YAMP) contributed writing. 

  • theantiyale

    http://aidsatyale.blogspot.com/

    I departed this battle at Yale (and on 60 Minutes–link above) in 1985, realizing, in the words of King Lear, “That way, madness lies.” Nothing much has changed in 33 years. Worse, the medications have lulled folks into a false complacency.

    People will die. This is certain.

  • lakia

    “Yale must foster open discussion and remove all barriers to quick and easy testing for HIV and other STIs. Half of Yale’s gay male students are in peril, and Yale has taken no apparent action to specifically focus on HIV.”

    Or here’s an idea: PERSONAL responsibility. If you aren’t smart enough to keep yourself safe, keep it zipped up. Why is YALE responsible for taking action when the individual did not?

    Unlike many diseases HIV is 100% preventable.

    • stdepi

      Because Yale is a community. Community members support one another in protecting themselves from sexual assault, other forms of violence, overdose of alcohol or other drugs, and cancer. You are correct that the gay men of Yale must protect themselves from HIV. They likewise have responsibilities to their partners and their generation particularly in the light of the huge number of them who may become infected in coming years.
      Edward White, YSPH

      • lakia

        Yale, like all people and entities, has limited resources. Limited resources need to be allocated responsibly. Especially in light of the fact that many will contract HIV from less than responsible behavior.

        This is 2013. Everyone is VERY aware of “universal precautions” and how to avoid HIV. The fact that this is ignored, does not excuse it.

  • Gregg Gonsalves

    So, Dear Lakia, by your logic, preventive medicine for cardiovascular disease or diabetes or cancer shouldn’t be anyone’s responsibility. If people ate right and exercised regularly, didn’t smoke, they wouldn’t have high blood pressure etc. Yet, part of comprehensive medical care is trying to get people to adopt better eating habits and exercise regimens, to minimize alcohol consumption and quit smoking, etc. HIV is preventable, but so are many other conditions, which don’t seem to arouse your moral ire. Furthermore, healthy behaviors aren’t simply a matter of personal responsibility, changing behavior is difficult and where we live, with whom, etc. can make it more or less difficult to do so. We also know that marginalization of communities can set members of that group up for worse health outcomes than the population at large: social forces can exacerbate risk. Lastly, your tone is far from constructive and your bottom line seems to be: don’t give these young men any support, it’s all their own damn fault. One day when you’re in need, I hope your friends are more generous than you have been in your posting here. We are our brothers’ keepers–that sense of community, of feeling for our fellow man or woman is what makes us human. If there was a little more love thy neighbor, and less judge thy neighbor in this world, it would be a better place.
    Gregg

    • lakia

      The difference is: you don’t have a group of overweight people DEMANDING that Yale intervene on their behalf. Which is my point. But nice try.

      • Gregg Gonsalves

        Well, the point is that the institution already supports certain kinds of preventive services for students, staff and faculty, healthy eating, smoking cessation, offers vaccination for HPV and hepatitis B, etc. without any appeals. Preventing HIV infection is a public health necessity-with young gay men at highest risk having Yale mount programs to reduce new infections among its young men, now and as they graduate isn’t an optional matter; it needs to be part of Yale’s core health efforts. HIV/AIDS is an epidemic in the USA and we don’t sit on our hands in an public health crisis because someone thinks that those facing the disease should be left on their own. The government tried this in the 1980s and let the epidemic flourish for over a decade before any serious response was taken up. It’s sad to know that those voices from the past are still here saying: let them get infected, it’s their own fault, they don’t deserve anything from us. It shows exactly why we need to be demanding action: there are still those around who would prefer to let people get sick and die because of who they are.

  • k.

    i agree with the article but i also want to raise a question, why is it simply stated to gay men of the ivy? granted it isn’t, we can all read it.. but i feel given the status of yale and the joke around being the “gay ivy”; would leak into other areas as well. this is also an issue within the community that is new haven.. which is the same as any area affected. but why not take a look at this also? who are these guys hooking up with from these sites? guys from new haven. most hook up with one another, preference usually, the idea that being a “yalie” is the milestone.. either way, i feel we can make a bigger impact on this and actually see progress if we go about things the correct way. one way would be not address the gay men of the gay ivy, but using that to also create a broad span addressing to the gay men of new haven as well. it’s bigger than we think it is and it doesn’t start within the gay ivy. history is repeating itself. we can’t look out for one group and expect help or to find an answer. we need everyone as a unit.

  • AVG

    The scary thing is all over the world you have having liberal/gay groups demanding, calling people b igots, for still wanting to exclude gay men from donating blood. They seem to be in denial about the HIV epidemic still going on, and are prepared to destroy other people’s lives so they get a feel good moment.