Altman on AIDS (and homosexuality)
Posted by Henry Bauer on 2013/02/05
“AIDS and homosexuality” described how two of Dennis Altman’s books helped me get a better feel for the intensity of emotional release that “gay liberation” beginning with Stonewall had brought to some number of gay men; which made it even more plausible for me that the small proportion of gay men who contracted AIDS did so as a result of a decade or so of exuberant but unwise “fast-lane” living.
A few years after AIDS appeared, Altman published AIDS in the Mind of America, (Anchor/Doubleday, 1986). Neither there nor later has he expressed doubts about HIV = AIDS; yet his writings continue to provide evidence for the lifestyle hypothesis. For example, Altman views sex and sexuality as central to his and others’ sense of identity:
He cites (p. 7) Richard Goldstein: “For gay men, sex, that most powerful implement of attachment and arousal, is also an agent of communion, replacing an often hostile family and even shaping politics. It represents an ecstatic break with years of glances and guises, the furtive past we left behind”. Another man put it like this: “Whenever I threw my legs in the air, I thought I was doing my bit for gay liberation” (p. 143).
Altman acknowledges, directly but also indirectly, that there was a great deal of unwise behavior: “Far too many of us assumed that modern medicine could cure any of the illnesses that seemed to accompany ‘fast-lane’ living” (p. 93). Some gay men were more interested in having fun than in the political activism of gay liberation: “We’d be out partying on Fire Island during the Gay Pride marches” (p. 104) — and for a sense of what partying on Fire Island in the 1970s meant, see the 2003 TV documentary, When Ocean Meets Sky. There were T-shirts saying, “So many men, so little time” (p. 142). For most heterosexual people, promiscuity might mean several extramarital partners during the life of a marriage, to some gay mean it meant more partners than several in a single night (p. 144). Being responsible was commonly interpreted as having frequent checks for syphilis and gonorrhea, and such “doubtful practices as taking a couple of tetracycline capsules before going to the baths” (p. 143) — practices that can wreak havoc on the intestinal immune system.
Altman also knew that the average age of the early AIDS patients was mid-30s (p. 20), surely a pointer to the result of years of burning the candle at all ends, rather than a sexually transmitted disease since the latter tends to strike at younger ages already. Altman knew that hepatitis and enteric parasites, not easily treatable, had become well known among gay men in the 1970s (p. 143), and Altman himself had experienced an opportunistic infection, toxoplasmosis, in the mid-1970s (p. 96).
I would guess that for those gay men for whom sexual freedom was a central feature of gay liberation, cognitive dissonance would be hard at work to avoid a lifestyle explanation for AIDS and to accept the virus hypothesis. Yet if Altman had followed the statistics, he would have learned that AIDS remained largely a phenomenon of gay men and drug abusers, with the addition — following on the re-definition of AIDS as “HIV-positive” — of TB patients and people of African ancestry. Surely such restriction to a few social sectors makes no sense for a sexually transmitted condition. Admittedly, the mainstream emphasis on AIDS in Africa muddies the waters by providing apparent support for the prevalence of heterosexually associated AIDS.
At any rate, Altman has been far from alone among gay men in failing to recognize the significance of the evidence for the lifestyle explanation; exceptions have been few indeed. A powerful incentive will have been the degree to which AIDS had been associated since the beginning with gay men, and a desire that the stigma of AIDS should not fall only on gay men. Official agencies had included representatives from gay groups in discussion from the earliest years (pp. 12-3). It was a shibboleth (p. 22) that the most characteristic gay activity of the 1980s was to examine the skin for signs of Kaposi’s sarcoma. Chapter 5, “The Gay Community’s Response”, recounts how prominent a role gay men played in everything to do with AIDS research and treatment, and they were the chief pressure groups for public funding (Chapter 6).
So AIDS in the Mind of America makes the lifestyle explanation for AIDS yet more plausible, and also illustrates how difficult it must nevertheless be for even highly intelligent, well-read, cultured gay men to take it seriously. The book is also of historical interest, not least for reminding how hysterical the popular reaction was to the notion of a fatal sexually transmitted disease (pp. 60-5, 184-5): medical personnel refusing to treat AIDS patients, airlines suggesting they might not load passengers suffering from AIDS, schools excluding “HIV-positive” students. In hindsight this makes remarkable reading: suggested measures to be taken included the possible quarantining of gay men, suggested by no less than James Chin, then epidemiologist for California and recently author of The AIDS Pandemic which makes the extraordinary suggestion that 20-40% of sub-Saharan adults are in concurrent sexual relations with about a dozen people at any given time and change those partners about annually.
We are reminded that the “HIV” tests encountered difficulties before finally being licensed, that it took nearly a year after Gallo’s claim to have identified HIV.
As in his earlier books, Altman mentions some of the uneasiness in the relations between lesbian groups and organizations of gay men. Cited is a complaint that “women’s health issues” were being ignored in favor of funding AIDS ventures (p. 94); one outcome of which was that the Centers for Disease Control & Prevention looked intensely for some way to include women among at-risk groups and coming up with cervical cancer as an AIDS disease.
Given my interest in science, and how it has become increasingly unreliable and corrupt in recent decades (scimedskeptic.wordpress.com), I was struck by a citation (p. 180) from historian June Goodfield who recognized already around 1980 that “grantsmanship as much as discovery, has become the art form of American science” (An Imagined World, Penguin, 1982, p.105).
Once again I recommend Altman’s book as well worth reading. My interest in his work led me to get his autobiography and to learn of several similarities to my own history: son of German-speaking refugees, growing up in Australia, experiencing the University of Sydney at roughly the same time, continuing education in the United States.