The Stigma of the Mythical 'Superbug'

Gay and HIV circles are buzzing with the news that New York officials have reported a surprising new case of a 40-something gay man who used crystal methamphetamine while having unprotected anal sex with multiple male partners, tested positive for HIV and progressed rapidly to AIDS within a matter of months. The strain of HIV the man is infected with, known as 3-DCR-HIV, is apparently resistant to three entire classes of anti-HIV medications.

However, some AIDS activists and public health officials are starting to question the actions of New York officials to release the information through a press conference and media release.

"Those who practice good science would have waited,"
said Martin Delaney, founder director of Project Inform,
one of the oldest US non-profit AIDS organisations.

"They would have shared and discussed the date with
scientific peers and then -- most importantly -- they
wouldhave gone back to the labs and followed up on
the patient for another six months before drawing
any hard conclusions," he said.

Some activists were harsher: Julie Davids, executive director of CHAMP (Community HIV/AIDS Mobilisation Project) warned that officials ran the risk of promoting the image of gay men as "crazed drug addicts, carelessly or wantonly spreading a killer bug." As anyone who is involved in the gay community knows, the presence of "crystal" has reached near epidemic proportions. To paraphrase Martin Delaney, it really isn't helpful to freak the community out with reports of a superbug which is amplified by crystal use when the community is still freaked out by the prevalence of HIV and crystal use itself.

The facts are that it is well known that there are strains of virus out there which are resistant to one, some or even all anti-HIV medications and even virus which is susceptible to the drugs may be in a person who can't tolerate the side-effects or dosing of these powerful drugs. It is also well-known that although most people take 8 to 11 years to progress from initial HIV infection to immune-compromisd AIDS without treatment, some untreated individuals proceed from infection to AIDS quite rapidly. It is still not clear if this one case (The Los Angeles Times reported that other possibly similar cases have been found, in San Diego, and Massachusetts) is a medically significant occurrence, but what is clear is the message the broader community will be receiving and it is this message which CHAMP and Delaney (and myself) are trying to dispel.

The stereotype of hypersexuality has been applied to many subjugated groups throughout history (Black Male, Black Female, Gay Male, Bisexuals, Latino Male, Latina Female, etc). However with gay men the message is doubly stigmatised because not only are they portrayed as "wanton, sexual beasts" but they are "wanton, sexual beasts who carry a horrible disease." The disease is sometimes homosexuality itself, but more recently it has been HIV. It is precisely the salience and ubiquity of these messages which keeps people in the closet (and on the down low) and by stigmatizing sexuality, causes more unsafe sex and teen suicide by LGBT questioning youth. We should all be fighting for truthful representations of minority groups, not just because it's the right thing to do, but because it can literally save lives.

UPDATE Sunday, February 20: The NY Times has an article in today's edition covering the backlash to Frieden's actions, where they basically quote Julie Davids and Martin Delaney, as I did.