D'ja Vu

'HIV Rates Are High and Climbing Among Gay Men,' 'Risky Sex on the Rise,' 'Gay and Bisexual Men Bear the Brunt of New HIV Infections.' Do headlines like these seem familiar? They should. They were commonplace throughout the '80s and early '90s, when the epidemic was first taking hold. But these reports aren't from years ago. They're happening right now. New Centers for Disease Control and Prevention data show that, while HIV infections are dropping among all other risk groups, the transmission rate among young gay and bisexual men is on the rise, climbing 12.4% each year between 2001 and 2006. It soared 14.9% annually among young African-American men. While part of the increases can be attributed to better detection efforts under expanded testing initiatives, soaring rates of other sexually transmitted diseases among gay men show that risky sex has become commonplace. 'We actually found so much high-risk behavior that it felt like it was the 1980s again,' says Public Health Solutions vice president Mary Ann Chiasson of her agency's survey, which was given to men who use Internet sex sites. While several theories exist for why risky sex is on the rise, there are alarming parallels to the earliest days of the U.S. epidemic that are linked to the increase'among them, scarce federal prevention dollars and a reluctance to publicly talk about gay sex. 'Fucking and getting fucked feels good, but how many prevention campaigns today say that? None, because they can't,' says Jim Pickett of the AIDS Foundation of Chicago, noting that federal guidelines prohibit interventions deemed to encourage sexual activity. 'Instead of being able to make condom use sexy and fun, we're forced to revert to focusing on disease, stressing what's bad.' Federally supported prevention programs also must be drawn from 49 CDC-approved interventions, only four of which specifically target men who have sex with men and none of which are geared toward gay and bisexual men of color, adds Craig E. Thompson, executive director of AIDS Project Los Angeles. 'By having our hands tied and given so few options,' he says, 'it really does feel in many ways as though we're reliving some of the early days of the epidemic'when we had to make our own way and adapt what was out there for use in our own communities.' But if it is true that everything old is new again, there is a bit of a silver lining in the similarities. 'We know from the lessons of the '80s and '90s that infection rates do eventually go down if prevention messages are consistent, culturally relevant, and reinforced in both public and private settings,' says Jesse Milan, board chair of the Black AIDS Institute. 'So our challenge is to create prevention strategies centered on the needs and realities of the lives of young gay and bisexual men.'