Fear and the supervirus.
(aired in slightly different form on All Things Considered February 18, 2005)

(In the week before this commentary aired, public health officials and AIDS researchers in New York reported that they had found a man with a strain of HIV which was resistant to most anti-HIV medicines, and that the man had developed AIDS ten times faster than people with HIV normally would without treatment.)

The supervirus press conference was about fear, and it also seems to have been held with the idea that pushing up our fear of HIV could get people at risk to work harder to stay safe. The scientists and public health doctors were afraid, they told the press-afraid that this case of multi-drug-resistant virus might be the first of many, afraid that things would only get worse. More than one veteran AIDS doctor shuddered to remember the days when we didn't have medicines to fight HIV, the days when the hospital beds were full of people without immune systems, dying the horrifying death of unmanaged AIDS.

In the early nineteen-eighties, that kind of death transformed the gay community. In my old city of San Francisco, the heroic gay nurse Bobbi Campbell took pictures of his Kaposi's Sarcoma lesions and posted them up in the window of a pharmacy in the city's gay neighborhood. He talked about his disease, the disease that would later be called AIDS, to whoever would listen. He took the fear of the whole community and brought it out into the open for everyone to look at, and then he insisted that people should mobilize to do something about it.

When the New York public health officials told the story of this recent case of resistant HIV, some other scientists publicly objected, saying that a story of one man does not make an epidemic of supervirus. It might be a quirk of the man's genetics that his story turned out the way it has. Other people said that the public health officials were using scare tactics that might backfire if a larger disaster doesn't follow. No one wants to be the Tom Ridge of the AIDS epidemic, issuing orange alerts and yellow alerts and red alerts until people stop paying attention. Fear has real limits as a motivator, especially over long periods of time.

And as the terrible deaths of AIDS have become both more rare and more routine in the United States, HIV prevention has become less about our fear of people dying, and more a debate about how we think about sex and drugs. So the supervirus press conferences were an opportunity for public health officials to try to reframe the issue-to try to make HIV prevention about illness again, and therefore, also a little more about fear.

In Bobbi Campbell's time, fear helped change men's behaviors dramatically-but it wasn't just fear. It's easy to forget, in these days of Will and Grace and Queer Eye for the Straight Guy, that standing up for the lives of gay men was a radical act in those days. It's easy to forget that in many ways, it still is. But some people did stand up. When Bobbi Campbell made himself a poster boy in those early days, he made his own fear into an act of generosity. That transformation and many others like it inspired others to worry not only about their own fates, but the fates of those around them.

The man with the supervirus has been demonized in the press. He is now a stand-in for every imagined drugged-up internet-cruising slutting-around gay man, as if he is the object lesson of those doomed to die for sin. But really, those of us who know the case from press conferences don't know much about him. We do know that whether he helped the scientists reluctantly or eagerly, he never had to help. The supervirus press conference that told his story depended entirely on him and his cooperation, a feat made more remarkable with each news report that both amplifies the fear of a supervirus and makes that fear his fault.

I can be angry with people who don't seem to notice or care that their sexual behavior affects other people, but I can also honor the way this man is changing the meaning of his story. If men taking crystal meth and having unprotected sex are to learn anything from this man's story, it should not be his fear: it should be his act of love. He made his fear into a political and medical gift. Now it's up to the rest of us to follow that example: we must now make our fear of the supervirus into something useful.
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