One recent Sunday afternoon in January, I was on my way to my usual brunch spot in the Castro when the Department of Public Health managed to spoil my appetite. I was crossing Market Street headed towards Cafe Flore when I looked up to find the latest effort to tame gay men's desire: a giant billboard emblazoned with these words: "New Year's Resolution: I won't infect anyone." I stopped and stared blankly at the silver and purple letters – a cringe slowly spreading across my face. I had spent New Year's back home in North Carolina and so I had to remind myself whether or not I was really back in the allegedly more progressive San Francisco. I pinched my arm but I did not awake – I was still on Market Street, my brunch ruined.
I was furious. On the surface this message may seem entirely innocent – after all, who wants to infect anyone this year? However, there is an insidious subtext that lives just below the superficial, as is often the case with public health campaigns. Positive men, invisible to the naked eye, are apparently on the prowl - - purposefully infecting unsuspecting HIV-negative youngsters. Hide your children! The DPH may have tolerated shenanigans of this sort from poz men in 2005, but – oh no – not anymore. For god's sake, make 2006 different. Spare a few lives this season, won't you?
This latest visual assault from DPH would have us believe that HIV-negative men have no part to play in the transmission of the virus. Negative men are merely potential victims just waiting to be infected. Instead of being actors with an important role to play in stemming new HIV infections, they are instead things that are acted upon. On its Web site the DPH claims that their "new approach to HIV Prevention" includes making sure that prevention is "relevant for both HIV-negative and HIV-positive men." Is this what they had in mind? Further, just what exactly would this billboard have positive men do? Is it merely another manipulation of the tired, washed up public health mantra of "use a condom every time"? Or is the DPH quietly beginning to advocate serosorting (only sleeping with men of the same HIV-status), which has been for several years now the giant pink elephant in San Francisco's gay community that no one is willing to acknowledge.
Whether or not the DPH has finally noticed that gay men are actually developing their own strategies to fight this epidemic, the truth still remains that campaigns like this one make positive men out to be the shady villains lurking in the shadows of the Castro. I was foolishly convinced that such a brazen display of pozphobia would have local activists up in arms within a few days. I sat on my hands and waited for the letters to the editor calling for the campaign's immediate end to appear in Bay Area LGBT newspapers. I expected nothing less from a community with such a deep-seated history with the virus. Even a recent transplant from North Carolina could recognize this repugnant brand of public health bologna for what it is – surely, I thought, those who have weathered the storm for years here in San Francisco could see what I saw.
I waited anxiously, but weeks passed without anyone so much as mentioning the billboard. A month after I first laid eyes on the billboard, I attended a meeting of local Bay Area sexuality activists, journalists, and researchers. The topic du jour was the state of HIV Prevention here in San Francisco. One long-time Bay Area gay male activist quickly brought up the billboard – my face became flush with a month's worth of anxiety. He saw this latest DPH effort as a sign that our public health infrastructure was not only failing to do its job, but perhaps was doing more harm to our community than good. Everyone seemed perfectly comfortable with this assertion. This kind of squabbling from activists was nothing new - people have been criticizing the public health model and its many implementations around HIV for many years now. What was shocking was another member's suggestion that we immediately defund all public health organizations in San Francisco. Put our tax dollars somewhere else where they're actually needed.
It is past time that we seriously consider whether or not a narrow Public Health model is really the correct way to go about HIV prevention. The answers to several key questions are long overdue. First, sex is a complex, nuanced event that is full of vulnerability, contradictions, and irrationality. Is a public health model simply unable to deliver messages about sex that account for those complexities? Second, in making unprotected sex the most shameful sexual act for gay men, have public health initiatives actually served to eroticize the behavior? And, if the answer to both these questions is yes, is the solution to defund prevention organizations?
All of these questions require careful consideration with answers that I do not attest to know. What I do know is this: the billboard sitting above Cafe Flore is unacceptable and should be immediately removed. If you agree, let the Director of the DPH, Dr. Mitch Katz, know how you feel with an e-mail: [email protected].
Trevor Hoppe, 22, a North Carolina native, is a Masters student in
Human Sexuality at San Francisco State University. He welcomes feedback at [email protected].