by Terry O'Neill
For more than a year now, AIDS activists have been bothered by a deadly question: Why is it that, after more than 10 years of educational programs and millions of dollars in expenditures, so many young gay men still haven't taken the "safe-sex" message to heart? Now, experts in Vancouver are launching a three-year study of 1,000 "men who have sex with other men" to see if they can find the answer.
It's called the Vanguard Project, and the very fact it's taking place appears to shatter the widely-held perception that HIV transmission is under control in the gay community. The truth is that while there is a "slow decline" in the number of new infections among gay men, the numbers are still high, and officials agree the figures could be even greater if more young gay men were tested.
Dr. David Patrick, associate director of the STD/AIDS Control Division of the Ministry of Health, says there were about 220 new HIV-positive results in BC's gay population in 1994, roughly the same number as in injection drug users, where there has been "an explosive growth in the last two or three years." In total, at least 7,300 people have been infected with HIV in BC since testing began in the early 1980s, and about 1,800 AIDS cases have been reported.
Stories about the unsafe sex practices of many young gays first began appearing in the gay press last year. "The bottom line is that maintaining a commitment to safer sex is a lot more difficult than anyone bargained for," David Richardson, then coordinator of AIDS Vancouver's Man to Man program, was quoted as saying last April. Writing in Xtra West, Gareth Kirkby concluded: "A new generation of men who have sex with other men are not always practicing safe sex."
They blamed everything from "surging testosterone" to "internalized homophobia" (society's negative feeling about gays leading to "self-hate and low self-esteem") for the problem.
Despite such theories, though, exactly what motivates young gays to flirt with death by engaging in unprotected anal intercourse in unknown. And that, in turn, is providing a major challenge for the medical community. Dr. Michael Rekart, the director of the STD/AIDS Control Division, was quoted as saying last fall that, "In the next decade of the AIDS era, the critical question is not what behaviours cause this epidemic to grow but why these behaviours occur in the first place."
The Vanguard study is designed to provide
some answers and get hard facts on the actual number of infected
men, says Dr. Steffanie Strathdee, a researcher with the BC Centre
for Excellence in HIV/AIDS, which is conducting the new Health
Canada-funded project in conjunction with the University of BC.
Doctors may lack hard data, but she says they do know that young
homosexual men have a life expectancy of eight to 20 years less
than all men because of the AIDS epidemic. "That's comparable
to men in 1871," she says.
The study is recruiting 1,000 young gays and bisexuals. They will be asked to fill out questionnaires and submit to an HIV test annually for three years. Questions will centre on socio-economic status, drug use, sexual practices and psychological health. "We're not judging people's behaviour," says Dr. Strathdee, the project's manager. "We're just observing what's happening." She hopes the results of the project can be used "to influence policy-making and education decisions at a government level."
Currently, many anti-AIDS programs are
aimed at the general population, even though the instance of HIV
infection among heterosexuals is quite low. Last year, the provincial
government spent about $3.8 million on AIDS-prevention initiatives.
For more information, contact:
Bonnie Devlin
Vanguard Project Coordinator
608 - 1081 Burrard Street
Vancouver, BC, Canada, V6Z 1Y6
Tel: (604)806-8306
Fax: (604)806-9044