The Death of Safe Sex

Now that STD-awareness campaigns and AIDS paranoia have faded, young men are throwing caution—and condoms—to the wind. Trouble is, the dangers are as clear and present as ever.

The roof lounge at the Hotel Gansevoort enjoys the somewhat dubious honor of being the center of New York City’s vast white-collar meat market. This late-summer Saturday, a trio of clean-cut married guys on the balcony are clutching highballs and trading anecdotes about great moments in poor sexual judgment during their recently ended bachelor days. The one thing they agree on is this: There’s not much to fear out there.

“The only disease I ever got was crabs,“ says Mike, 35, scanning the banquettes of women in too-short-for-Casual-Friday dresses, "and that was worth it!“ This delights his friends, Evan, 37, and Alan, 43. Handily one-upping his pal, Alan recalls a wild night in a Miami swimming pool. “She ended up giving me chlamydia,“ he says. “And the sick thing is, two or three weeks later I saw her at a party and told her what happened—but she looked even better! So, dude, I took her home, and I got it again!“ They all burst into laughter.

“The biggest thing to me is, I don’t know anyone—nobody straight—who’s ever gotten AIDS,“ Mike says. “And the rest you can fix with a shot.“

“Not herpes,“ Evan says.

“Not herpes,“ Mike agrees, “but surprisingly few girls ever asked me to wear a condom. I mean, look at us—we look clean, we look professional. The most that happens is you put it in there and ask if they’re on the Pill—when you’re already doing it!“ Mike kills with this one. It’d be easy to dismiss him and his friends as marginal sleazebags, but here’s the thing: Evan and Alan are physicians. And Mike? He works for a major pharmaceuticals company. If these guys weren’t practicing safe sex, who is?

Today AIDS doesn’t evoke the kind of terror it once did. The swarm of other sexually transmitted diseases is seen as little more than a nuisance. And what about the other classic motivator to use protection, unplanned pregnancy? After all, it’s been known to destroy perfectly happy relationships, whether the pregnancy is terminated or the woman decides to keep the baby and go it alone. But even before the FDA finally approved over-the-counter sales of the controversial Plan B “morning-after pill“ in August, some straight men seem to have decided to go without the little latex insurance policy.

Of course, putting exact numbers on the bedroom habits of a nation is a dubious enterprise. But plenty of signposts suggest that the Gansevoort Three are more the rule than the exception. Condom sales in the United States are flatlining. Syphilis is making a comeback—between 1999 and 2003, it shot up by 43 percent among American men. Chlamydia cases doubled between 1994 and 2004. Even HIV is making a quiet return: Since 2001, the number of new cases in the U.S. has been edging upward.

Dr. Steven Berman, a Manhattan urologist who’s been in practice for 20 years, blames a new complacency for the recent rise in STDs. “It keeps us in business,“ he says. “It’s across the board, heterosexual and homosexual. I’m talking about a tremendous rise in human papillomavirus [the cause of genital warts] and chlamydia in the heterosexual population. People don’t want to be bothered. There’s a tremendous number of people with multiple partners now who might use a condom on the first contact but then frequently drop using condoms quickly afterwards. Even populations who are at risk—patients I’ve treated before for STDs—some men are resistant to using condoms. It’s not sinking in—the message is just not clear.“

Berman says it’s not only men who’ve become careless. “A lot of it is also on the woman’s part, because they’re allowing men to have unprotected sex with them,“ he says. “I think they just don’t have the same fear instilled in them as they used to. There’s just a very relaxed attitude.“ Patients who should know better have relaxed their standards as well. “I’ve seen intelligent businessmen, married for years, who go on a business trip and have unsafe sex with a hooker—whether it’s in Asia or Las Vegas—and come back with an STD,“ Berman says. “Even people in the health-care profession. I saw a nurse recently who came back with gonorrhea because he had had unsafe sex.“

What the hell happened? There used to be rap songs about condoms (see “Protect Yourself/My Nuts,“ by the Fat Boys, from Crushin’, 1987). They appeared on billboards. Fishbowls overflowed. Your friends used to talk about “double-wrapping“—and they did it. But the panic and dread that plagued the Reality Bites era went away—along with the bedroom protocol that once defined sex for our generation.

“Recently I went to a sex party. Watching the behavior of these guys, it was as if HIV didn’t exist. There was a bowl of condoms, but no one was using them.“ This is how Dr. Jeffrey Fishberger, supervising psychiatrist at the Samuels Center for Comprehensive Care, a full-service HIV facility at Roosevelt Hospital in New York, opened a recent safe-sex lecture. The quote is his patient’s, not his, but he uses it to illustrate a point: Some people just can’t be bothered anymore. “Barebacking“ parties are getting popular, like the one Fishberger’s patient attended, or the event in an East Harlem apartment this May that was announced (the third in a series) with an invitation that warned, “Anyone caught using jimmies will be asked to leave with no refund given!!“ That soirée was called off after activists announced that they would protest outside the building, but others rage on. Some prohibit discussion of HIV altogether, some insist all participants be virus-free (not an easy thing to verify when collecting the cover charge), and a few are for the HIV-positive only—which, of course, leaves participants vulnerable to the whole gamut of other STDs.

“They think AIDS is not a big deal,“ Fishberger says. “They look at it like a chronic, manageable disease—like diabetes.“ And why shouldn’t they? Back in the eighties and early nineties, the disease claimed a 90 percent fatality rate as it slowly and cruelly reduced many of its victims to sarcoma-covered skeletons. But in March 1996, protease inhibitors hit the market—miracle drugs that attacked the virus’s ability to multiply. The number of deaths dropped 70 percent virtually overnight.

The culture of safe sex faded with the mortality rate, and one of the first losses was public education about AIDS and other STDs. Between 1987 and 1992, the federal government developed a series of public-service announcements called America Responds to AIDS, which ran more than 59,000 times. But months after the “cocktail“ therapy was introduced, the campaign abruptly ended. People seriously debated whether a national media strategy on HIV/AIDS was needed at all, and the funding switched from national campaigns to local ads targeted at high-risk communities. Now even that modest goal has been scaled back; by 2003, the Centers for Disease Control had diverted $42 million in education funding away from people who were at risk of contracting the virus to those who already had it. The news media, which once beat a relentless tom-tom drum of panic, went silent as well, and the message heard by the general public was: All safe. Come out and play.

Then, in 2001, a new administration in Washington took direct aim at the “wrap it up“ lessons most of us grew up with. The federal government has sunk hundreds of millions of dollars into abstinence education since Bush came into office, slashing prevention programs by a third to do it. The result? Last year, for the first time in 14 years, there was no increase in condom use among U.S. high-school students, according to the CDC.

“Abstinence education’s taken away a substantial amount of resources from programs that have been known to work,“ says Dr. Jeffrey D. Klausner, medical director of the STD Prevention and Control Services at the San Francisco Department of Public Health. The federal government now spends twice as much on abstinence programs as it does on the Division of STD Prevention at the CDC—the department that managed to quell outbreaks of gonorrhea and syphilis among soldiers after the Second World War. “By displacing those funds to abstinence programs that don’t work, you actually put young adults at more risk for STDs when they become sexually active,“ Klausner says. “It’s a complete horror story.“

Dr. Judy Kuriansky, a sex therapist and radio host, believes that larger cultural forces have chased safe sex from our national dialogue, too. “STDs just aren’t in the public consciousness anymore,“ she says. “War has taken that over. This is another thing I hear: Well, we’re going to die tomorrow anyway. The world’s going to end. I hear that all the time. It’s denial and nihilism. It’s depressing. People don’t do the due diligence: ‘Have you ever had herpes?’ Nobody asks that question anymore.“

Even more alarming, Kuriansky says, is the emergence of a kind of magical thinking that rivals anything Washington’s faith-based apostles of abstinence could come up with. “I cannot tell you how many times I hear people now saying things like ‘Well, I just won’t allow things like that in my life,’“ Kuriansky says. “People are getting more spiritual and they feel like they’re more empowered—that they can will it not to enter their lives.“

The shifting messages in the media no doubt helped persuade the average guy to move condoms from his back pocket to his bottom drawer. But in retrospect, it’s hard to avoid the conclusion that what killed safe sex was our sneaking suspicion that all that vigilance over HIV was a bit excessive in the first place—especially for straight men. That’s what Mike, the pharmaceuticals manager from the Gansevoort, ultimately decided.

“Back in the eighties, it was all over television, and you just never knew who was going to get it,“ he says. But Mike started noticing something: None of his friends were getting sick. Nobody he knew was dying. He got a little careless about slipping on the protection—and pretty soon he found that he was just fine with that. “By the end of the nineties, I was fairly convinced that the whole AIDS thing for straight people was overblown, and that it was pretty horrifically low odds that it would ever happen to me. Now, shit—I’m very convinced of that.“

Mike’s not the only one who’s run his own cost-benefit analysis and has decided to stop worrying. This year, according to a Kaiser survey, only 15 percent of people polled said they were personally very concerned with becoming infected with HIV—down from 24 percent in 1997. The rest are people like John (not his real name), a married 33-year-old lawyer in Los Angeles. This year, John scored himself a mistress—an aspiring actress who has him paying her rent in exchange for something that’s a little harder to put a number on.

“She’s 23 and presumably dating,“ John says about his mistress. But he, too, has never seen anybody he knows get sick, and so he’s been making his own risk assessments about his shadowy sex life. He actually insists they don’t use condoms. “I didn’t take a mistress so I could feel like I’m back in college again,“ he says. “I’m not sure why she acquiesces, but she does.“

And like the Gansevoort Three, he’s not worried. Sure, he’s an Ivy League graduate and should probably know better, but he thinks “the risk of a male contracting AIDS from heterosexual intercourse with someone in her socio-economic class in the United States is very small.“ How small? He’s not sure. But the one thing he is sure of—along with many other guys in his generation—is this: It’s just not worth fussing over a little foil packet.

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