A Suicide Problem ?
In the same year, in A prescription for Suicide, Ian Young reported an ongoing social fact:
The plain fact of it is that this society wants homosexual people to die. It kills us directly, as it killed Harvey Milk (who prophesied not only his own murder but the method his murderer would use), or indirectly, in a variety of ways. One of the most time-honoured and effective of those ways has been suicide.Some gay males, however, were experiencing variations of the following life scenario:
At the tender age of 12 he thinks about taking his own life for the first time... With drugs and booze plentiful he plans the exit: a razorblade and some time alone and it will be over. Getting totally trashed, he cuts his wrists and begins smashing his head on the floor. The end is near, finally release. It does not work and he regains consciousness the next day and ends up in the mental ward of the local hospital... Death, Death, Death - that's what he wants. More drugs, high risk gay sex with many partners, it's his own form of roulette. Death will come soon. Another suicide attempt with prescription drugs fails, he can't even do that right. People are still abusing him - why?... My main objective with my story is to make people think about how they treat others, it can make or break them. (Story # 14)By the mid to late 1990s, however, some individuals were recognizing that thre may be an association between risky sex and suicidality:
"If you teach a young person that their life has no value, they'll treat their life like their life has no value," said Kevin Jennings, a former history teacher now working for the Gay, Lesbian and Straight Educational Network. "They will do things that show that they don't really respect themselves, such as use drugs or attempt suicide or engage in unprotected sex." (Gay teens finding more support amid hostile school hallways (Feb. 1999)Unfortunately, HIV risk behavior studies published after 1988 did not explore the (predictable?) idea that, at least for some gay males, contracting HIV was associated with suiicidality. These studies therefore did not solicit the "suicide attempt" history of GB males studied, but researchers seem to have solicited information on current personality disorders, psychiatric histories, drug and alcohol abuse / addiction histories, sexual abuse histories, depression, etc.; these factors are all recognized to be implicated in suicide problems as noted in the Colorado paper and in the San Diego paper. Why then would exploring the likely "suicidality" association with contracting HIV have been neglected (avoided?) by researchers? Do some of the researchers who solicited "psychiatric histories" have related data and maybe forgot to incorporate it in their published papers? Or did they consider such "suicidal" data to be irrelevant?
One study result presented at a 1997 conference, however, did report a statistically significant association between homosexually active male risk takers with respect to "safer sex" and having attempted suicide. (Vanguard Project Conference Paper.)It is often noted by gay/bisexual male youth problem prevention experts that youth generally feel invincible, and even that the "I'll live forever" syndrome is common and apparently implicated in unsafe sex practices. Unfortunately, this belief is incorrect for all gay/bisexual males who are suicidal on a regular or occasional basis (about 30% of the population), and probably for all (or most) gay/bisexual males who have attempted suicide (about 25%); these males would certainly not believe they are invincible. There is nothing worse (or more counterproductive and deadly) in problem prevention work than seeing professionals operate on beliefs opposite of the reality existing in the minds of the "most at risk" segment of the target population. Tragically, this is only one of the lethal flaws which have existed in HIV prevention education, thus partly explaining the ongoing HIV tragedy for GB males in general and for GB male adolescents and youth in particular.
How significant would The "Suicide" Factor be in the gay community? In the article Promiscuity = death, Dan Perreten (Article not online.) describes the ongoing AIDS epidemic and the associated promiscuity: "It does mean that a culture that encourages promiscuity is one that, condoms or no condoms, will continue to commit group suicide." Insightful work is needed to understand the phenomenon - beyond the apparent "promiscuity" issue, but suicidologists, especially the ones who are psychiatrists or psychologists, are nowhere to be seen in this tragedy.
These professionals, however, have had a history of advocating cures for homosexuality, meaning that they once blatantly manifested (and acted on) the Nazi-like ideology that "homosexuals should not exist." Maybe, their indifference in the AIDS problem, like their recent effort to deny (even invalidate) the "suicide problem" epidemic in the gay/bisexual male adolescent/youth population, is the new way they are rendering the same lethal (usually unspoken) belief. Most gay males also learned the same belief at a very young age, and many act accordingly.
Ageism in gay communities may also be a factor negatively affecting "safer sex" practices - as revealed by a conference speaker who "recounted meeting a Gay man who said that what he liked about having AIDS was not having to face growing old. These are the dramatic examples of ageism affecting younger people. The more subtle examples are, of course, more difficult to identify. Edmund White also commented on this factor in a 1997 Salon Magazine Interview:
If you say you're going to be dead by 40, they say, "So what? There's no gay life after 40, anyway." Especially in France, but even here. You can easily be a gay in his 20s and never meet a gay over 40 because you don't see them in the bars. They don't go out, they're not part of your world, and if you do see them, you consider them pathetic.From the Seal et al. (2000) study of young men who have sex with men (YMSM):
They [YMSM] figure that they will have as much fun as they can now because they see old guys sitting in Venue X who like 40 and 50 and 60 years old and who haven't done anything with their life. Or, if they have, they're single and sitting in Venue X hitting on the young guys. The [YMSM] figure if they die young they wouldn't have to worry about that. It's the fear of age that many kids don't want to face - that they will get old. They figure that they have do do lots of things before their beauty fades. (Seal et al. 2000, pp. 10-11)A previous anecdotal reports of the relationship between suicidality and high risk for contracting HIV for gay and bisexual male youth had only blamed society's homophobia for the phenomenon, as many GLB community leaders have done with respect to other serious GB youth problems often made worse after they become part of gay communities.
Low self-esteem and self-worth, a lack of self-care and self-love, hopelessness and depression and teen suicide factors were believed to underlie unsafe sexual behavior:
There are time when I wished to God I would have just been dead. I couldn't go through the pain of who I was or the pain of trying to live my life. There was so much hurt. It wouldn't have mattered if I had gotten HIV. To be that would have been the simplest solution. I wouldn't have had to do a thing. I just would have had to lay there. I wouldn't have had to slit my wrists or commit suicide any other way. It's a more painful way, but if you're on a suicide mission it doesn't matter. (Seal et al. 2000, p. 10)
Participants further pointed out that may YMSM, and particularly YMSM of Color, lived with a pervasive sense of hopelessness in multiple aspects of their lives. Consideration of adverse long-term consequences of behavior was difficult for men who lived with daily violence, poverty, and despair and who held few expectations about a lengthy life:
When it comes down to it, the guys I talk to just don't care about life. They say life has nothing to offer them. A lot of times their mothers and fathers have disowned them and their family won't deal with them anymore because they are gay. They have no life, no family no future. (Seal et al. 2000, p. 10)
Physical arousal was cited as a reason that YMSM practice unsafe sex, an action that could have dire consequences, as illustrated by this story:
This man was beautiful. After the fourth time we had sex in 14 hours, we were laying and he said he had something to tell me. I was just thinking please don't tell me he's going to say that he was HIV or something. And he just kind of turned to me and said I should have told you earlier, but I'm positive. I was like, oh my God, but I didn't freak out because I knew what I had done. I had chosen to let him fuck me without a condom. What was I going to do? Take out a knife and stab him? So I rolled over and went to sleep. The next morning I woke up and saw he had a hard on and made him fuck me again. The sex was just that good. (Seal et al. 2000, p. 11)
Some YMSM derived excitement from conscious unsafe sex: 'There's times with anonymous pickups that I won't use a condom. The thrill of not knowing whether he (an anonymous pickup) is gay or straight makes it difficult for me to stay safe.' Several respondents reported that more and more YMSM found sexual excitement in the 'Fuck of Death', that is, conscious unprotected receptive anal sex with a known HIV-positive partner or 'bug giver'. (Seal et al. 2000, p. 11)
For younger gay men, a different kind of despair may lead to seroconversion, a despair born from growing up in a society that devalues gay youth. "I hear in AIDS prevention circles the term 'passive suicide,'" said Wolf. "It refers to young people growing up in a homophobic, hateful society - especially young people living at home who have no support in their high schools and colleges - putting themselves at risk for AIDS as a way to passively kill themselves. They don't want to stick a gun in their mouth and pull the trigger. But because they grew up in a society which taught them to hide and to hate themselves, they are needessly putting themselves at risk" (Johnston, 1995, pp. 227-8).Some of the counterproductive ways that gay communities have behave with respect to AIDS-related education and "safer sex" education are outlined in the paper Safer Sex, Risky Identities by Peter Keogh (1996). Maybe some of the problems listed by Keogh reflect a collective suicidal element which has existed in gay communities, thus producing the following outcomes.
The GB Male Youth HIV Situation in San Francisco: Continuing high prevalence of HIV and risk behaviors among young men who have sex with men: the young men's survey in the San Francisco Bay Area in 1992 to 1993 and in 1994 to 1995. Study by MH Katz, et al., Journal of Acquired Immune Deficiency Syndrome and Human Retrovirology, Vol 19(2), Oct. 1, 1998, pp. 178-81. For males aged 17 to 22 (average age = 19), the HIV rate has been in the 6 to 7 percent range, and increasing as males advance in age. It has been estimated that, by about the age of 40, about 35% of GB males in San Francisco will have contracted HIV, and a similar estimate has been made for GB males living in Vancouver, Canada.
Seal DW, Kelly JA, Bloom FR, Stevenson LY, Coley BI, Broyles LA (2000). HIV prevention with young men who have sex with men: what young men themselves say is needed. AIDS Care, 12(1), 5-26. Medline Abstract.
The Study: Qualitative: semi-structured interviews, with some open-ended questions. Seventy-two (72) YMSM (Young Men Who have Sex With Men) - ranging in age from 16- to 25-years old (Mean Age = 20.9 years) - from Milwaukee (n = 41) and Detroit (n = 31). Local service providers were used to identify "a number of young men's social network segments. These segments included YMSM who patronize gay bars, YMSM under 21 who frequent coffee shops and cafes, non-gay identified YMSM, drag queens, YMSM college groups, church-affiliated YMSM, young commercial sex trading men, public sex environment participants and other groups. The sample of YMSM recruited for interviews... wa selected purposefully to include representation from all these segments and to yield a sample with maximum heterogeneity with respect to age, ethnicity and sexual identity." Sample = 44% white, 32% black/African-American, 10% Latino, 14% others (p. 7). "Data... were collected as part of a Centers for Disease Control and Prevention (CDC) community-level multi-site research project" (p. 23)
Johnston, William I. (1995). Retesting and seroconversion. In: William I. Johnston, Ed. HIV-Negative: How the uninfected are affected by AIDS. New York: Insight Books, Plenum Publishing Corporation, pp. 219-234.
Internet Resources Related to HIV & AIDS.