April 25, 2012

Generation Fear: How I Survived HIV Education in the 1990s

by biancajames

“Social Living”

I was eleven years old in 1991, poised on the brink of growing boobs, having periods, and getting crushes on boys. This also marked the beginning of “Social Living” presentations and classes at my public school, where the mysteries of sex and puberty were unveiled bit by bit.

I was lucky enough to attend public schools that offered comprehensive sex education (we were taught how to put condoms on bananas, but we were still encouraged to stay abstinent until marriage.) My 10th grade Social Living teacher Nancy Rubin is even a minor celebrity in the world of high school counselors, a Lily Tomlin lookalike who published a book called “Ask Me If I Care: Voices from an American High School” about her experiences. Topics covered in Ms. Rubin’s class included drug use, pregnancy and abortion, sexual assault, and of course STDs. She made us keep anonymous journals of the drugs we’d done over the weekend, which she then read out loud to the class. I still don’t understand the point of that exercise.

Ms. Rubin was not above using scare tactics to keep us on the straight and narrow, whether it was slide shows of graphic photos of a woman who was murdered by her brother who was high on PCP, images of genitalia mutilated by untreated sexually transmitted infections. She even showed us before and after pictures of her friend who died of AIDS in the 80s, emphasizing that he had contracted the virus as a white, middle class heterosexual male: proof that nobody was safe.

While we were taught to use condoms, we were also taught that if god forbid we didn’t use a condom, or if a condom broke, we would absolutely become pregnant, catch STDs, and quite possibly die of AIDS.

One day a visiting speaker passed out candy, giving each student the choice between Snickers and bubble gum. Of course most of the kids took the Snickers- duh, chocolate! The speaker then dramatically revealed that he was HIV positive, and that if you took the gum (and I guess I was in a gum mood that day) it symbolized a sexual act with a condom. If you chose the Snickers, it meant that you had chosen to have UNSAFE SEX and now had hypothetical candy HIV (Cavities?)! Ok, I guess the point I’m trying to make here is that it was implied that if you ever had sex without a condom, you would contract HIV.

But is that true?

We now know that even if you have unprotected sex with an HIV positive person, the likelihood of transmission from a single sex act (and the risk factor varies between sex acts) is shocking low – less that 1% in most cases.

I am by no means condoning foregoing condoms, but I also think that the moral panic surrounding the HIV epidemic of the 90s led to fear mongering that not only fed into the HIV stigma, but made people afraid of sex, period. The 1995 film “Jeffrey” is a pretty good snapshot of that era: it’s the story of a gay man who has decided to give up sex altogether because he’s so afraid of contracting HIV. Until of course, he meets an awesome HIV+ man, and has to deal with his issues.

Sex = Death

My social living education intrinsically linked sex and death in my psyche. My teenage wet dreams frequently became nightmares where condoms broke, possibly infecting me with DEATH, and I’d wake up in a cold sweat.

I became sexually active in my late teens, obsessively using barriers for all sex acts. I remember getting tested for HIV when I was 19, after a condom broke with my lover, whose virginity I had taken. I was getting tested more for his safety than my own (since I’d slept with others before him), but the nurse didn’t see it that way.

“It doesn’t matter that he was a virgin,” she berated me, “what if he had some blood transfusion when he was a baby that you don’t know about?”

Nevermind the fact that if this were the case, he probably would have been diagnosed well before 1999. In hindsight her attitude strikes me more as a symptom of moral panic than valid concern- but at that time, it seemed irresponsible not to live in a state of constant fear. There was a knot of anxiety in my stomach until the test came back negative three days later. Thank god for the rapid testing they offer now!

I’m not saying that HIV prevention isn’t serious business. But was it really necessary to plan my funeral when in reality, my risk factor was so low as to be laughable?

Sometimes it takes a Leatherman to open your eyes.

A few months later, my Human Sexuality professor made a remark that stood in stark contrast to Panic Nurse’s cautionary warning.

“The likelihood of anyone in this town being HIV positive is so low as to be laughable,” he snarked to a few students (myself included) after some campus health educators had encouraged every single one of us to get tested for HIV regardless of our sexual history.

They presented the same chirpy “YOU JUST NEVER KNOW THAT YOU MAY HAVE BEEN EXPOSED!” tone as the nurse at the testing center, and my professor, a gay Leatherman in his 50s who had no doubt lost countless friends to the epidemic, wasn’t having it.

I was blindsided by his comment at the time, because it seemed like an irresponsible reaction to a very important social issue. But in hindsight, I can see his point – while our academic community aggressively promoted HIV education, awareness, and testing, the tiny mostly white, straight and affluent town where we lived was not exactly a high risk environment. HIV wasn’t a hypothetical bogey man to my professor – it was a hard reality that he understood better than the chipper student health educators ever would.

HIV Abroad

After graduation, I moved to Japan in 2002 for three years, and was disturbed, though not entirely surprised, that my Japanese partners were incredibly lax about condom use. They would almost never initiate condom use, though they consented to using them if I brought it up.

Unlike the “nobody is safe” HIV panic in the US in the 90s, HIV was seen as a foreigner’s disease in Japan. Some people believed that it didn’t exist in Japan at all.

Education Breeds Carelessness?

When I returned to the US in 2005, I was concerned when I noticed that many American guys weren’t particularly concerned with using condoms either. If I’d ask why, they’d reply something like “Well, I figured you’ve been tested, and would warn me if you had an STD.”

HUH?

As much as I’d like to chalk this up to ignorance, one of the guys who said this was a PhD candidate with a minor in women’s studies. I wondered what had changed in the collective cultural consciousness in my absence, but when I thought about it, it made sense.

Hadn’t we all been warned about the dangers of smoking, alcohol and drugs as little children, alongside the perils of unsafe sex? But then we hit adulthood, and had freedom of choice, and lots of us started lighting up cigarettes or joints to cope with the stress of adult life. Yeah, we knew it wasn’t good for us, but it felt good and it was fun, and in most cases, there didn’t seem to be any majorly detrimental consequences in the short term.

We found out that the occasional cigarette wasn’t that much worse than breathing polluted city air, and that marijuana actually had medical benefits for some people. In essence, the issue became a lot more complicated than the black and white “JUST SAY NO” rhetoric of our youth. And I think the same thing started happening with sex.

We’d get tested every year, and the tests seemed to always come back negative, even when we weren’t always perfect about using condoms with every single sex act.

Researchers would discover the risk of catching HIV from oral sex was virtually negligible, and that the risk of contracting the virus from a single sex act was less that than 1% in most cases. Skipping the condom wasn’t a great idea, but the risk factor was much, much lower than we’d previously believed. And that made us complacent, and perhaps even a little rebellious.

Shifting Focal Point

It’s been over thirty years since HIV first emerged on our collective cultural radar. While there’s no cure, and intense stigmas still remain, HIV testing, treatment and support in the United States is better than it’s ever been. New infections have decreased substantially, and advances in treatment allow HIV positive people to live long, healthy lives. Magic Johnson is still alive and well, over 20 years after his diagnosis. There is no denying that HIV and AIDS remain serious problems in Sub-Saharan Africa and other developing areas, but the terror we once felt has been replaced by hope and optimism.

Of course, this doesn’t mean that we should all stop practicing safer sex, and in fact one of the most at-risk demographics at this time are older divorced people who weren’t socialized to use condoms the way Generation Y members were. And it is interesting to observe how the moral panic that once accompanied discussion of HIV has shifted to a virus with a mere one letter difference – HPV.

While vaccinations can help prevent transmission of the deadlier forms of HPV, they’re not available to people born before 1980, and condoms cannot offer protection against transmission. But guess what. Studies show that in most cases, a healthy immune system can eliminate HPV within a year or two, and pap smears remain a highly effective method of detecting and preventing cervical cancer.

In conclusion...

I don’t think that we should throw caution to the wind when it comes to STDs and stop getting tested and using condoms because the risks may be lower than we previous thought. But I do think that fear mongering and moral panic merely contributes to stigmatization, and even to people avoiding getting tested out of fear, or practicing unsafe sex due to attitudes of complacency or rebellion against unrealistic abstinence-only dogma.

I do feel that a lot of this fear is rooted in the sex-negative attitudes of our culture, and the puritanical concern that we deserve be “punished” for enjoying sex. We all deserve to enjoy sex, and STIs are not a symptom of moral failure. Until we learn to develop healthy attitudes towards sex, we won’t be able to approach STI education in a healthy manner either.

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