Farewell to AIDS

Sexologist Martin Dannecker started using the term „the new AIDS” at the end of the last decade in order to mark the change that occurred in the physical appearance of AIDS and HIV thanks to the then new antiretroviral therapy. On June 19th, 2010, Dannecker received the Civil and Moral Courage Award of the Berlin CSD Committee. For our series of features of the subject of the new AIDS, Dannecker contributed an excerpt from a speech he gave in 2005. Five years later, the content hasn’t lost its timeliness.

Today western industrial countries have come to understand that an HIV infection is no longer synonymic with Aids. A person can be infected with HIV but this doesn’t necessarily mean they will develop Aids – at least not in the foreseeable future. Moreover, the anti-retroviral medication can also help a medically defined Aids status retransform back to an HIV infection, simply in view of the fact that treatment can eliminate many of the Aids-defined symptoms. Aids is in this part of the world still a latent threat for every HIV infected person because the possibility of said person contracting Aids is not completely ruled out. At the same time, in this part of the world, for many HIV infected persons the thought of remaining „only“ HIV infected for the near future is not wholly irrelevant. […]

This is to say, that the social relationship in western industrial nations has together with medicinal science created a situation that allows us to collectively and individually bid Aids farewell. Surprisingly, this fact is only ineffectually understood in general. It is the former significance of Aids that is called forth to take a position in demanding the end of the erosion apparent in HIV prevention.

As in the recent reaction to rise in the infection rate among homosexual men reported by the Robert-Koch-Institute; especially disconcerting was a comment my friend Jan Feddersen published in the „taz“ newspaper. The text is not only teeming with false and dangerous concepts: it also entertains already long overcome obsessive beliefs.

Feddersen implies as if the old Aids hasn’t long lost its molded-together implication of conscious and awaited extinction, a death rhetoric that his commentary loudly exclaims with the title „Death is not a Bagatelle“. With this and through other positions he insinuates that those who have infected themselves in recent times have consciously played with death, fully accepting the consequences. No mention here of the fact that safe sex, in reality as well as fantasy, is associated with a limited sexual desire. And no mention here, that the vast majority of risky contacts are ascribed to partial or situational failure of individual preventive intention. As others, Feddersen too scandalously defines „barebacking” as the latest thing, a willingly accepted trend among homosexual men. The emergence of „barebacking“ in the homosexual subculture is a distinctive sign of the crisis in HIV prevention and at the same time an accepted renaming of the limitations associated with „safe sex”.

At the end of his text Feddersen also comes up with a negative vision and asks with uninhibited aggression how politics will avert the phenomena of new infections in the future. In his own words: „It’s possible, that newly infected persons could be dragged along in the mutually supportive group; or also possibly that if evidence existed that one has frequented a risky location, this could lead to the financial coverage of needed medication being declined. Death is not a bagatelle: gay men know this – also during sex.“ […]

As for the question of a prevention concept underlying these perceptions, the twisting around of assistance for adequate action is rather recognized as a necessity. Prevention is therefore only humane if its purpose thwarts suffering. Its humane orientation falls short in prevention when it becomes a health dictator of simultaneous, normative ideas of a reasonable sexual lifestyle. Should there be a health-police that would examine the evidence to decide whether an infected homosexual man frequented risky places? A dictatorial HIV prevention must then define love as a risky place as well, because risking an HIV infection doesn’t only constitute itself in certain areas of gay culture but also in relationships. […]

Absolutely and relatively seen, the fact that in this country more homosexual men than heterosexual women and men become infected has to do more than anything with the outset of the higher HIV prevalence within the homosexual community and not with a specific psychopathology of homosexuals or with homosexual self-hate, as recent conjecture has shown.

Not that the debate on the reasons for the growing infection rate among homosexual men shouldn’t be conducted. However, we shouldn’t entice projecting the prevention problems that exist amongst heterosexuals too, only on homosexuals – a recurring phenomenon every time that one speaks of the difficulties inherent in adhering to the logic of Aids prevention. These difficulties are often addressed with one-sided examples taken from homosexual attitudes. The rising rate of newly infected persons is doubtlessly alarming. Based on changing conditions, one would expect to actually talk about favorable rates of new infection.

Considering these curious facts questions also arise regarding the reason why it is so hard for so many to accept a HIV infection for what it is: a serious illness that requires treatment. Indeed HIV carries a special meaning through its notable reputation of a sexually transmitted disease and this is accompanied with guilt and shame that lead to attributed conjecturing of failure. Nevertheless one asks why just now, when prevailing conditions show more advantageously than ever the possibility that HIV infection is no longer directly related to death, that again and again death’s heavy toll is awaited.And why are increasing cases of unprotected sexual contact seen as a sign of foolishness? And why are newly infected persons offered the idea that they should have behaved as if an HIV infection is something that it no longer is?

An explication for this persistence on the old meaning of Aids lies in the prevention crisis that is closely related to the success of the combination therapy. Another explication would be that many of those working or involved in the field of Aids have difficulties in parting with the older significance of the autoimmune disease. Not only Aids has become banal. The banal state of Aids also banalises persons living with HIV and all professionals working with Aids.

And to no lesser degree some wish, against their conscious intention, the return of the former, dreadful meaning of Aids because it opened doors, and in paradoxical ways, it has lost prominence.

The rhetoric of death functions obviously as a defense against the fear of a sexuality separated from the shadow of Aids, individually as well as collectively. Because the circumlocution of HIV infection has affected a freer sexuality: slightly distanced from the overwhelming fear of Aids, sexuality has become more open and regained its own unfolding dynamic. Like it or not, this leads to more frequent risky contact and consequently to an increase in infections.
Arguably, dealing with sex is now about reducing the HIV risk to an individually acceptable level and at the same time bringing this decreased sexuality that accompanies minimalizing risks to an individually acceptable level.

That the sexuality that prevailed during the pinnacle of Aids, namely one that bordered on chastising and which continually implicated keeping a distance from others’ bodies – under which especially HIV infected persons still suffer – has yielded another, bigger sexual affinity (and this also always means emotional) should be seen positively, and not as an expression of a totally reckless negation of infection risks. As long as the infection exists in the world and is associated with relevant restrictions in the quality of life, this type of recklessness will not come. Nevertheless new HIV infections cannot be avoided and will most probably increase because our perception of sexuality is given a lighter temperament.

If one believes that new infections are avoidable in respective endeavors, then one denies people the complexity of their makeup that includes a complex sexuality. Neither is consistent with what is considered desirable or rational from the logic of a prevention perspective. And this is precisely the reason why we should regard newly infected persons with a friendlier and more solidary eye than is now the case.