This article appeared in The Georgia Straight, May 11-18, 2000.
by Janet
Smith
As if Romi Chandra didn't face enough of a lonely struggle realizing he was gay while growing up in Maple Ridge, he was convinced he was doomed to die young. By the time Chandra was 14 years old, he believed that AIDS was part of being homosexual. A lack of sex education at high school, combined with a deluge of media images-from the movie Philadelphia to reports of the death of Freddie Mercury-had led Chandra to internalize a stereotype and twist it into reality.
Now 20 and employed at a support group for gay youth, Chandra
seems like a poster boy for the pride movement. He has bleach-blond
spiked hair and small silver hoops studding his ear; he has a
wide, confident smile and speaks about his sexuality openly and
articulately. It quickly becomes obvious he remembers the torment
of his "discovery" six years ago as if it were yesterday.
"I was totally devastated," Chandra says. "I was
thinking, 'I not only have to tell my parents I'm gay, but that
I'm dying of AIDS.' On TV or in the movies, that's all I saw."
Afraid to go to a doctor for advice because his parents might
find out, he embarked on a self-directed regimen of herbal remedies.
Perversely, the assumption that he had AIDS may actually have
saved him from killing himself during the painful throes of coming
out: "I'm kind of scared now, thinking back to it. I thought
about suicide so many times, and I might have tried to kill myself
if I didn't think I had AIDS. My thoughts were, 'You're going
to die anyway, so why commit suicide?' " And yet, his belief
that he already had AIDS could also have put him in danger of
contracting the disease if he had become sexually active: "When
you think the day you realize you're gay is the day you get AIDS,
it never occurs to you that you would have to do something risky
to get it."
At first, Chandra's linking of homosexuality with AIDS seems almost
laughably naive. But AIDS workers say his experience is not unusual.
Flick on the news, and it's not uncommon to see a vocal contingent
spreading the message that being gay is a death sentence. In one
recent case, parents descended on a Burnaby hall to protest B.C.
Teachers' Federation support for gay-straight clubs in local schools;
they handed out Evangelical Fellowship of Canada pamphlets claiming:
"The incredibly rapid spread of AIDS through the homosexual
community is a tragic commentary on the extraordinary promiscuity
that is associated with homosexuality." Soon after that,
Vancouver Sun columnist Trevor Lautens suggested supporting
gay-straight clubs, and therefore gay culture, was tantamount
to saying "Live and let die".
Talk to young gay men, and look at recent studies, and you'll
find that despite the ongoing hysteria, being homosexual is far
from being doomed to contract HIV. Yes, young
gay and bisexual men continue to become infected with the virus,
and even if those numbers are small, some health workers fear
a creeping complacency or recklessness toward HIV. But to many,
the safe-sex messages of the past 15 years appear to be getting
through-perhaps much better than they are in the straight community.
Although the fight against AIDS is far from over, it appears,
for now, that Chandra's generation of young gay men may
not have to face the kind of holocaust that decimated the homosexual
community in the '80s. For him, being gay does not have to equal
AIDS, neither figuratively nor in reality.
Kevin Craib, an epidemiologist at the B.C. Centre for Excellence
in HIV/AIDS, recently led a study that found young gay and bisexual
men in Vancouver were far more likely to use condoms in the '90s
than their counterparts were in the mid-'80s. Although some of
his colleagues in the AIDS-research community still fear another
wave of infections, he is part of a growing number who
are cautiously optimistic: "It isn't reason to celebrate
and throw the condoms out the bathroom window," he says,
weighing the inch-thick study in his hand. "It just shows
that safe-sex messages can have an impact-not just in the gay
community, but everywhere."
Romi Chandra was fortunate to find the support he needed before he fell deeper into his hole of confusion. He took it upon himself to look up the address of AIDS Vancouver and started taking the two-hour bus ride from Maple Ridge into the city to use its resource library. At least one night a week, he'd sit there, poring over literature on AIDS and homosexuality-information he hadn't received in school.
"A lot of the classes were structured around heterosexual
sex, and it was very rare that I got information that applied
to me," Chandra says, leaning back on a chair in the small
office headquarters of Gab Youth Services, a support group and
drop-in for gay, bisexual, and transgendered youth. It's located
in a safe meeting place and resource centre for the queer community
called the Centre. "When they [the teachers] said
there are gay people who have HIV, they'd stop there and talk
about regular hetero sex."
Once Chandra realized he was healthy, he started coming out to
his friends at school. Today, at Gab, Chandra devotes his
time to helping other young adults make it through the same struggles.
He helps run several workshops and drop-ins on Wednesday and Friday
evenings. Among his friends, he says, condom use has become second
nature. "Me and my friends always remind each other, if someone's
going on a date, 'I hope you're using a condom,' " Chandra
says. "With a lot of my friends and me, sex equals condoms;
that's cool. People are talking about themselves and being honest
with each other and themselves. I've said to my friends, 'I love
you and I don't want to lose any of you to something society has
been educated about for all these years.' "
The new study by the Centre for Excellence's Craib shows that
15 years of safe-sex messages are reaching more than just Chandra
and his friends. Titled "Comparison of Sexual Behaviours,
Unprotected Sex and Substance Use Between Two Independent Cohorts
of Gay and Bisexual Men", it appears to contain some of the
first good news the gay community has received about HIV infection
since the virus detonated within its ranks in the early '80s.
Craib compared data collected from two long-term surveys of gay
and bisexual men run out of the Centre for Excellence: the Vancouver
Lymphadenopathy-AIDS Study (VLAS), which ran from 1982 to 1998,
and the more recent, ongoing Vanguard Project, which started in
1995. He focused on men 18 to 30 years old over a three-year time
period of each study: 1985 to 1988 for the VLAS, and 1995 to 1998
for Vanguard. Craib found that young gay men were nine times more
likely to report high-risk sexual behaviour (anal sex without
condoms with casual partners) in the earlier study.
Interestingly, he found that young gay men in the '90s were having
sex more often, with higher numbers of both regular and casual
partners, than those in the '80s. But condom use was higher, and,
most importantly, the incidence of HIV was much lower. The numbers
have been cut by two-thirds in the past 10 years alone. The B.C.
Centre for Disease Control reported that 416 of the province's
gay and bisexual men contracted HIV in 1991. By 1994, that number
was down to 209, and in 1999, only 95 gay men were registered
as new cases of HIV infection in B.C.. In the past two years,
the only population where the rate of HIV-infection rates increased
was among heterosexual men.
The Centre for Disease Control's statistics on gay men reflect
those in Craib's study: 21 percent of the mid-'80s VLAS participants
contracted HIV in the period Craib looked at; only four percent
did in Vanguard.
"The use of condoms has drastically reduced the spread of
HIV among men who have sex with men," Craib says, sitting
in the office in St. Paul's Hospital where he has been poring
over the numbers for months. "From a prevention viewpoint,
the message 'Use Condoms' got through to the majority of them.
Now, have we rid HIV as a threat to this community? Not at all.
But it appears we can drastically reduce how fast it's spreading."
Craib's findings seem considerably more optimistic than a two-year-old
study that received a flood of national coverage earlier this
year when it was belatedly republished by the Canadian Medical
Association Journal. That study, based on Vanguard Project
surveys, had shown that, of the men participating in the research
who had casual partners, 18.5 percent had reported at least one
episode of unprotected anal sex in the past year. A headline
in the Vancouver Sun read: "Risky Sex by Gay, Bisexual
Men Increasing: The decades-old safe-sex message is being lost
among these young males", while the National Post
announced "False sense of security over AIDS, study shows".
Perhaps because it was less sensational, Craib's newer study received
little coverage. It shows the effort among the gay community to
promote safe sex to be at least a partial public-health success
story.
"There's been a huge shift in the gay community," says
Steve Martindale, coordinator of the Vanguard Project. "It's
been an enormous phenomenon with widespread social change."
Still, Dr. David Patrick, director of epidimiology at the B.C.
Centre for Disease Control, says the real test will be to watch
HIV-infection rates over the next five years. "There's lots
of reasons for possible declines in infections," he warns.
"One is behavioural change, and I hope that's what it is."
The other, less appealing, explanation is that the virus may simply
be out of circulation among Vancouver's gay-male population for
a while.
Fifteen years into the war against AIDS, it's almost more devastating
than before to meet a young person who has become HIV-positive.
Because people know so much more about how it's passed and how
to protect themselves, the illness seems all the more unnecessary.
Chris doesn't look like he has the virus, but neither did any
of the guys he slept with over the past few years. The slim 21-year-old
has golden skin, Caribbean-blue eyes, and cropped dark hair, but
there's a barely-masked pain in his face that speaks to years
of drug use and partying and the test results he found out about
only three weeks before our interview. He doesn't want his real
name used (he hasn't even told his parents that he has HIV yet),
but his story runs in stark contrast to Romi Chandra's and reveals
a lot about how much further we have to go to drive HIV stats
down to zero in Canada.
Chris takes responsibility for what happened. He came from a well-off
Alberta family and he had a promising career in figure-skating.
And, although a lot of older gay men have suggested that younger
people haven't seen the carnage AIDS has wreaked in the past,
Chris saw it firsthand: at 13, he lost his skating coach to the
disease.
Chris started using cocaine in his late teens, after his skating
career waned and he'd moved to Toronto to live with his father
("it started to get out that I was gay in the small town
I lived in in Alberta"). After getting clean for a few months,
he got back into drugs when he moved to Vancouver's West End
in early '98, never holding down a job but never having to steal
or sell himself to pay for his habit, either. "I always knew
I could call the 1-800-Mom-and-Dad line to get money," he
says matter-of-factly. His mother sent him to rehab in Saskatchewan
in late 1998, but when he returned a month later to the West End,
things got worse.
"I wasn't going to do coke or alcohol again, but then I got
into the gay rave scene," he says, seated in a back room
of the Downtown South Community Health Centre. "I started
doing a lot of crystal methamphetamine and ecstasy, and I started
going to bathhouses afterwards for sex while I was high."
Chris was sleeping with anyone who came along, and he was
attending "barebacking" parties, where no one used condoms.
He'd wake up in the morning, sober, and worry about not practising
safe sex, but then he'd start taking drugs again and go out and
do it some more. "Before you knew it, my $20 crystal here
and there had become $300 or $400 a week."
Friends tried to get Chris get off his drugs; when they asked
whether or not he was using condoms on his all-night sex-and-drug
binges, he'd lie to them. The young man admits he was being
self-destructive, and he says his judgment was impaired by all
the illicit chemicals he was pumping into his system.
Chris is sober now. After his mom cut him off from money and after
finding a friend from his treatment centre dead of an overdose,
he appears to have finally kicked the habit and is living in a
rehab house. Doctors can tell from his blood results that he
contracted HIV in the past four months. This means that even
though Chris says he slept with more men than he can count in
the past two years, he caught the virus during his last spree
before sobering up.
He insists he would never have slept with the guys he did if he
had known any of them were HIV-positive. Ironically, when he went
into the doctor's office to discuss his HIV results, he saw three
people he had slept with sitting in the waiting room.
Part of the reason he might have put himself at risk, he says,
was that youthful feeling of being immortal and invulnerable.
"I thought I'd be young forever," Chris admits. Some
researchers have suggested young gay men are becoming less vigilant
about safe sex because they see that the new antiretroviral
drug cocktails have made AIDS a "chronic", manageable
disease. But Chris says he dreads the nausea and other side effects
from the drugs and is worried about how they'll make him look.
"Because my family's already been through a lot, I still
haven't decided whether I will choose the option of the drug cocktails.
I may just let myself go. I don't want to be 50 years old and
have HIV."
Chalk it up to self-destructive impulses or drug addiction, but
whatever the reasons Chris contracted HIV, it appears that AIDS
education campaigns have yet to hit home with the risk-takers
out there. "They offer free condoms and free lube now everywhere,
but some people don't think they're going to get it and they don't
care until they actually do," he says.
"I think they need to send people that are around the same
age of kids in high school and say: 'Do I look like I have HIV?
Because if you say I don't, you're wrong.' I've found this disease
has no prejudice."
Back in the mid-'80s, when AIDS was burning through Vancouver's gay community, the fear campaigns came first. Advertisements sent out a message of, as Andrew Barker dubs it: "Use a condom or you're gonna die." Today, the biggest challenge for Barker's Man to Man, AIDS Vancouver's outreach program targeting gay and bisexual men, is to reinvent safe-sex education for men who have heard it all before-people like Chris. "That fear-based message is fine if death is all around you," he says. "Now there's a potential to become somewhat complacent. For a lot of younger gay men, HIV has been in the media for most of their lives, and at the same time, they haven't seen their friends or lovers die around them."
Another problem is that fear campaigns can breed a backlash. One
such rebellion is the appearance of the word barebacking in
print and chat-line ads and Web sites. Ads that openly ask for
"bareback bottom boys" and a "bare kind of guy"
have Barker concerned about a return to condomless sex
too. "If it's younger menI think some of them may perceive
HIV to be less of a threat than it once was," he says. "Perhaps
some older gay men who lived through that whole period of devastation
are reacting to survivor guilt or having to maintain condom use
for all those years."
A more widespread concern, though, is the number of men who know
how to protect themselves but frequently slip up. Epidemiologist
Craib found that 46 percent of the more recent Vanguard Project
participants reported using condoms in less than a third of their
risky sexual encounters (receptive anal sex) with casual partners.
Enter the Frooty Booty Pocket Guide, one of a collection
of witty, street-smart, and graphic manuals from Man to Man that
take a more holistic approach to sexual health. Amid outrageous
photo-collage illustrations, the booklet blends info on everything
from intestinal infections and different sex acts to advice on
negotiating safer sex. "The idea is it's in a format that's
pretty accessible, and not to use any high-falutin' medical language,"
Barker says.
Although he agrees condom use has become a part of the "out"
gay-male culture, Barker is trying to reach the closeted men or
the young men who are just coming out, those who haven't linked
up with support in the community. Some, like Chris, might fall
in with the wrong crowd; others might get kicked out of home when
they come out, and end up getting into drugs or working the street
to support themselves. All are situations that could make them
vulnerable to contracting HIV, and one of the only ways to
reach them is to educate them before they leave high school, Barker
says.
"I'm really concerned about that time in their life between
acknowledging they're gay and coming to a support group like Gab,"
Chandra says.
But teaching about safe gay-sex practices is not likely to go
over well in schools where the very mention of gay-straight clubs
is enough to invite a horde of TV cameras and placard-waving parents.
Fortunately, groups like YouthCo AIDS Society and Chandra's Gab
Youth Services are able to go into some Lower Mainland high schools
to give talks. Other schools, according to Gab's program coordinator,
Jennifer Horgos, are "still in the dark ages". At some
facilities, students clearly aren't getting much more AIDS education
than Chandra got six years ago: "We were just in a Grade
7 classroom the other day, and one of the questions they asked
when they found out [we were gay] was, 'Do you have AIDS?' "
Horgos says.
Horgos and Chandra are pushing for more consistent educational
policy in schools. Outside of school, at the Gab drop-in groups,
they help adolescent gay males build self-esteem and a network
of friends. One of the biggest pressures Horgos hears about, she
says, is that guys in their mid-teens feel that they have to "prove"
their orientation by having sex with the first person who comes
along. "It's common that people will say to them, 'How do
you know you're gay? Are you sure?' So a lot do it to consummate
the label. If that person's going to validate you, are you going
to put your foot down and insist on condom use? What we look at
here is 'What are healthy relationships?' "
Although Chandra is doing his part to reach young gay men early, he also feels confident that his generation can avoid the tragedy of the past. To the older gay men who worry about whether or not HIV-infection rates can continue to plunge downward, Chandra has this to say: "We already know what's dangerous and what's not. I can see what might cause the concern, but I think a lot of people give youth too little credit."
As it turns out, Chandra is more worried about a segment of the
young population other than the gay community.
It's something that's been eating away at him since a straight
friend, a woman he knows from high school, called him a couple
of months ago. She knew about Chandra's work at Gab and thought
he'd be a good person to ask about condoms. She was in a new relationship,
and she had some basic questions about safe sex, asking for the
kind of information that had become second-nature to Chandra and
his gay friends. "I was really shocked, but I was glad she
was asking me," says Chandra says. At the end of the conversation,
the woman asked Chandra to buy her a pack of condoms; out of concern,
he bought an extra-large box in case he didn't see her again soon.
"I was thinking, 'I wasn't paying attention in those sex-ed
classes, and I guess you weren't paying attention either.' I was
pretty surprised.
"My 10-year reunion is in 2008, and I really want to go back
for it. But because of what my friend said about condoms, I wonder
how many of my straight friends are going to be there if people
like her haven't gotten the information."
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