On the Verge

Tommy Atz looks like he'd be comfortable in just about any of Philadelphia's gay bars. He's young, he's blond, and he seems to know just about everyone at the neighborhood haunts. But unlike the regulars perched on stools or meandering to the dance floors, Atz has been visiting these bars for very different reasons over the past four years. He's an outreach worker with the SafeGuards Project, a nonprofit that offers HIV testing services and safer-sex education. "Most people will have conversations about HIV," says Atz, who carries with him a large bag filled with free condoms and lubricant that he passes out. "But when you start personalizing it, there's definitely a fear." And according to a survey by the Kaiser Family Foundation released in April, there's also a growing sense of apathy. The survey shows that Americans' sense of urgency about HIV as a national health problem has fallen dramatically during the past decade. Among younger people -- those between the ages of 18 and 29 -- the share who named HIV as the most urgent health problem facing the nation dropped from 30% in 1997 to just 17% today, according to Kaiser. Among Americans overall, "urgent" concern about HIV fell from 44% in 1995 to just 6% today. There are many reasons for the growing detachment, says Mitchell Warren, executive director of the AIDS Vaccine Advocacy Coalition in New York City, including better antiretroviral drugs that have transformed HIV into a manageable disease and decreased fears of infection, government programs that failed to educate teens about condom use and risk reduction, and the ongoing challenge of engaging members of high-risk groups about subjects as inherently personal as sex and drug use. Atz says he's also noticed a definite change in attitudes toward safer sex over the past few years. "People don't want to be infected, of course, but the desire to enjoy sex without condoms often wins out," he says, adding that men of all ages regularly tell him that they simply don't like using condoms.   Yet despite all of these signs of growing indifference, Warren says today is actually one of the most promising times in the fight against the virus. "We have new research that we couldn't have dreamed of 25 years ago," he says, pointing to the new political administration in the White House, which has promised unfettered HIV research and science-driven education, including a five-year, $45 million "Act Against AIDS" public-awareness campaign. "While I understand where the apathy comes from, this should be one of the most hopeful times. We're on the brink of great promise."