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Culture War Roundup for the week of January 27, 2025

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Do you remember the '80s? That "since they're gays and addicts, let's just let them die" appeared to have been the Reagan administration's policy / is often how it's characterized, thus the title of the famous history of the early years of the epidemic, And the Band Played On.

My first thought is, there's the issue of HIV in the blood supply. Discussion of the risk of HIV from blood transfusion. "Most of the current risk from HIV in blood transfusion relates to the possibility of blood donation during the preantibody phase of HIV infection. This emphasizes the importance of self-selection by potential donors to eliminate those who have engaged in high-risk behaviors." Even now there are those who claim they still do (donate regardless), saying they feel justified due to homophobia (have personally heard people say this in the past). (See also a case: "A blood center in Missouri discovered that blood components from a donation in November 2008 tested positive for HIV infection. A lookback investigation determined that this donor had last donated in June 2008, at which time he incorrectly reported no HIV risk factors and his donation tested negative for the presence of HIV. One of the two recipients of blood components from this donation, a patient undergoing kidney transplantation, was found to be HIV infected, and an investigation determined that the patient's infection was acquired from the donor's blood products [the other recipient had died despite the transfusion].... Initially, the donor declined repeated contacts by MDHSS to be interviewed. In April 2009, he agreed to a brief interview with MDHSS, and an OraQuick rapid HIV test...was performed. This test was reactive and confirmed by a positive Western blot at MDHSS. During his interview, the donor reported he was married but had sex with both men and women outside of his marriage, including just before his June 2008 donation. He indicated that the sex often was anonymous and occurred while he was intoxicated.... The sequence of events in this case is consistent with transmission by transfusion of HIV-contaminated plasma collected from a donor during the eclipse period of acute infection (i.e., the interval between infection and the development of detectable concentrations of HIV RNA in plasma).") An explicit policy of "just let them die" seems likely to vastly increase the incidence of this.

Then...I'll type in this quote from Maggie Kneip's memoir Now Everyone Will Know because it shows the kind of experience "upstanding citizens" who lived near gay enclaves, and/or worked in professions where a lot of gay men also worked, had with AIDS in the '80s (my parents had gay friends too):

Chris and his boyfriend, Steve, had lived on a charming little stretch of West 13th Street in the Village. Chris and I sang and waited tables together, wearing marinara-stained aprons printed with "Make a cow happy, eat fish today!" After our shifts, we'd close down the place, drinking cheap wine and smoking pot. When I was eventually cast in a regional dinner theater production and Chris was cast as the lead in a national tour of Joseph and the Amazing Technicolor Dreamcoat, we saw less of each other. I did summer stock, met John, and got married; Chris continued his life on the road. Once in a while, I'd get a letter. "Miss you," he'd write.

One chilly April day in 1988, just after [my daughter] Caroline was born, Chris came by to meet her. His normally glowing face was ghostly and he stifled a cough.

"It's just a cold," Chris protested when I expressed concern. He was full of his usual energy and his warm brown eyes shone, especially while he was holding my child. What a sweetheart he was.

Soon afterward, Chris landed an overseas tour of South Pacific while I became consumed with mothering and domesticity. We lost touch.

Two years later, pregnant again, I was reclining on the living room couch, my swollen feet propped up on the coffee table, when the phone rang. It was Steve. "Chris is in the hospital," he said, "and he doesn't have long." It was AIDS....

In the room that was supposed to be Chris's, there was a shriveled old man shivering in one of the beds. "Chris?" I ventured. He slowly turned his head and focused his alert, beautiful brown eyes on mine....

I hugged his sack of bones and sat with him, holding a cup to his cracked lip. His face was burning hot but his stiff little hands were ice cold. I'd never seen anyone that ill.

After a few minutes, I ran out of things to tell him about my absurdly carefree existence. I was swollen with life, while he, at just twenty-seven, was at the end of his. I stood up to leave and leaned over to kiss his lined, sweaty forehead. "I love you," I said.

"I love you, too," he whispered, closing his eyes.

Big as I was, I bolted for the elevator and nearly broke the down button, pounding on it until the doors opened to take me to the lobby. I rammed every pound of my swollen might against the revolving door and burst out into the fresh spring air, gasping. John was there, waiting in the car where I'd left him.

"How was he?" he asked.

"Awful! He--it--was awful," I reported, shaking, unable to make sense of the ghoulish transformation of my once vibrant, magnificent friend.

3 months later, her husband John was diagnosed with AIDS. He remained closeted about being bi right up until he died; he only admitted to her once that he'd ever had sex with men. (Before he met her, he said. When he was diagnosed, 6 years after they'd met, the doctors estimated he'd had it for 7-8 years or more.)

And:

From the moment of his diagnosis, he never once mentioned or acknowledged that he had AIDS. The closet was where he would steadfastly remain. Four times during the course of his illness, John was hospitalized for infections and placed in the hospital's AIDS cluster. And every single time, he demanded to be relocated. "I don't belong here," he'd say.

It seems he was so ashamed of his attraction to men that he was almost incapable of admitting it even to himself; it seems that's what happens in a culture like we had back then where it's considered shameful.

So whaddaya think: Guy is attracted to men, guy has sex with men when young and single, guy decides to settle down and marry a woman and have kids...guy (possibly also unsuspecting wife and minor children) dies of AIDS? Is this...OK? Regrettable but a rounding error? Bad? Unavoidable? Possibly unavoidable but we should still try? Or what do you think?

Kneip was lucky: Her husband also had herpes and was responsible about it, so they often used condoms. So she and the kids didn't get AIDS. (A New Haven doctor OTOH in his summary of his years caring for AIDS babies mentioned that about half the mothers were drug addicts--the other half had gotten it through sex. And the babies caught it not in utero but from the birth or breastfeeding. Like the "Starsky & Hutch" actor's daughter, if you remember that--the guy who played Starsky (who I remember better for being Perchik in Fiddler on the Roof) lost his wife and daughter because his wife got AIDS from a blood transfusion at the birth, then gave it to their daughter through breastfeeding.)

So anyway, in personal instinctive reaction I do agree with many who learn in clear detail about the sexual practices that developed in gay enclaves in the '60s and '70s, that these were completely disgusting and repulsive, that they were behaviors no human being anywhere should ever have engaged in. (Gay Men's Health Crisis co-founder Larry Kramer famously pointed that out himself in his 1978 novel Faggots.) But someone's sexual practices aren't something you normally ever discuss with them, let alone the first thing you know about them. You make a friend because of their good qualities, and aside from their good qualities you have no reason to assume they're particularly disgusting in any way because why would you?

And the Band Played On:

[Describing the experiences of Dr. Selma Dritz, the new assistant director of the San Francisco Department of Public Health's Bureau of Communicable Disease Control] Normally, five or perhaps ten cases of amebic dysentery a year crossed her desk, and they were usually from a day-care center or restaurant. Now [1967] doctors were reporting that many a week. She checked the figures again. Nearly all the cases involved young single men, and an inordinate number were diagnosed at the Davies Medical Center on Castro Street. She mentioned to another health department staffer that it was odd because she hadn't heard any complaints about neighborhood restaurants. Her colleague took Dritz aside to explain that the cases were concentrated among gay men. Dritz didn't understand the relevance of the observation.

"It's oral-anal contact," he said.

"It's what?"

They didn't teach these things when Selma was in medical school in the 1940s, but she quickly learned the down-and-dirty realities about enteric diseases. Gay doctors had long recognized that parasitic diseases like amebiasis, giardiasis, and shigellosis were simply a health hazard of being gay. The problems grew with the new popularity of anal sex, in the late 1960s and early 1970s, because it was nearly impossible to avoid contact with fecal matter during that act. As sexual tastes grew more exotic and rimming became fashionable, the problem exploded. There wasn't a much more efficient way to get a dose of parasite spoor than by such direct ingestion.

Although all this was common knowledge among gay physicians, the awareness had evaded the public health profession. Earnest health officials at one point dispatched inspectors to Greenwich Village to test water after detecting unusual outbreaks of amoebas in the neighborhood.

If even public health officials don't know, what hope has the average "upstanding citizen"?

By the time you find out how unbelievably, vomit-inducingly terrible their behavior has been, you've been friends for years and possibly even already watched them die horribly. You've likely thought and said that "nothing" could justify the terrible suffering you've seen them experience. That's the reality of how this went down.

Personally, because I was a child in the '80s, I saw the illness decades before I happened upon a description of the subcultural sexual practices online.

(With quotes from Faggots. As Wikipedia says: "Reviewers found it difficult to believe that Kramer's accounts of gay relationships were accurate; both the gay and mainstream press panned the book. On the reception of the novel Kramer said: 'The straight world thought I was repulsive, and the gay world treated me like a traitor. People would literally turn their back when I walked by. You know what my real crime was? I put the truth in writing.'" Because yeah. A subculture did evolve of engaging in such behaviors, and generally speaking most people who learn of such behaviors find them unbelievable and repulsive.

Also. A bit after I first read about it online, I mentioned it to my parents--and they dismissed it as a stereotyped myth. As for me, I later read And the Band Played On, which confirms the truth of it. I said "most people" above and not "straight people" because And the Band Played On quotes gay men too who had the same reaction upon encountering that subculture. Anyway the fact remains that my parents still don't know what their friends (or those friends' sex partners) did in the '70s that led to their deaths. BTW they don't know about Rotherham either, same reason, I tried to mention it to them and they just pattern-matched it to "blood libel type things.")

From And the Band Played On:

Most of [New York] city's AIDS babies were born to drug-using parents, and virtually all the cases of heterosexual transmission were among the female sexual partners of minority drug users.... Dr. Arye Rubinstein [pediatric immunologist who had seen many AIDS babies] was afraid that the virus would spread from addicts into high schools, where it could proliferate among sexually active teens.

Dr. Rubinstein is mentioned earlier in the book when he cited 3 patients, all children of the same prostitute, and pointed out that this illness did not fit the pattern of a genetic disease as other pediatric immunologists were assuming, because these children had 3 different fathers.

OK, don't use prostitutes, don't be creating damaged children you never even tried to know about, etc.... Some will, though. Rubinstein had a point that teens are more likely to make bad decisions.

From the New Haven doctor's article linked above:

Among a series of impediments, we faced one insurmountable problem: we were not able to discharge HIV-exposed babies to the care of mothers still battling addiction; and experienced foster parents refused to take “AIDS babies” into their homes for fear of infection. There was only one alternative—the nurses, doctors, and social workers became their de facto guardians. The babies stayed in the hospital for months, sometimes for more than a year....

the hospital was carrying a heavy burden and...babies and toddlers were beginning to fill isolettes in the nurseries and cribs on the wards.... [so they set up an AIDS-focused treatment center]

Connecticut Public Act No. 99-2 [making AIDS testing a standard part of prenatal care] was the powerful tool we were waiting for. We went into the community and educated physicians who cared for pregnant women....

our intensive educational efforts in the hospital and community resulted in a steady decline in the number of newborns testing HIV-positive. The last infant that tested HIV-positive was born at YNHH in 1996. For each of the past 24 years, we have screened and treated about twenty HIV-positive pregnant women, a significant decrease from earlier decades. None of the babies born to HIV-positive mothers between 1996 and late 2019 were infected. Nevertheless, we still care for a few HIV-positive children who have come to us from other parts of the world, mainly Africa, and for a handful of adolescent men who have had sex with older HIV-positive men....

Data collected by the CDC in 2007, revealed that approximately 24,000 American youth, ages 13-24 years, were living with HIV/AIDS. This was a 25 percent increase from 2004, attributed to high-risk adolescent sexual behavior and increasing survival of children infected perinatally....

Unfortunately, in late 2019, an HIV-positive baby was born at YNHH after a gap of 23 years. The teenage mother received prenatal care at a clinic unaffiliated with YNHH. She was non-compliant with the antiretroviral regimen that was prescribed for her. She was surprised to learn that her newborn baby was infected.

So, I'm not sure if you meant to suggest letting AIDS babies die too, but they certainly didn't have any way to avoid it. Then there's again the adolescents...they don't have adult judgement, and may have been groomed...are they included?

(BTW, this is only peripheral to the topic so I'm not going to spend a lot of effort on it, but I personally believe Cochran's "pathogen hypothesis" to be the best fit for the data we currently have re homosexuality. Like I'm not 100% convinced this is definitely the cause, we don't have the data for that, I just think with the data we do have that's the way to bet. And obviously if someone "became gay" due to a pathogen which infected them in childhood, they didn't make a choice. "Dear ants, if you climb up that blade of grass in the middle of the day, you deserve to be eaten. Just choose not to!" Actually I do think "Ants, even if you feel a really really strong compulsion to climb up that blade of grass, it's bad for you so please try your hardest not to do it" is good advice! It's not going to be very effective, but it's better than not giving it. But well...Eliezer was right that it's not really a happy satisfying just world situation, it's a terribly sad one. (The appropriate link here is of course Policy Debates Should Not Appear One-Sided but the quote I was thinking of is from Are Your Enemies Innately Evil?: "When you accurately estimate the Enemy’s psychology—when you know what is really in the Enemy’s mind—that knowledge won’t feel like landing a delicious punch on the opposing side. It won’t give you a warm feeling of righteous indignation. It won’t make you feel good about yourself. If your estimate makes you feel unbearably sad, you may be seeing the world as it really is."))

(BTW2, Maggie Kneip's mom told her that John had once hinted to her about how, as a senior in high school, he was very lonely and an older man "kept inviting him up to his room." A lonely minor, possibly groomed... Plus if Jayman's casual hypothesis is correct, which it may well not be but if, then this happening at 17 rather than say 12 might explain how John kept his attraction to women as well...)

Meanwhile, And the Band Played On:

The anecdote was precisely the story Dr. Jim Curran had feared he might hear, even though it was the kind of information that interviews with 75 percent of the living "gay plague" victims were supposed to engender: One man lives contentedly with his long-time lover in a small, remote town. He doesn't live in the fast lane of big-city gay life; he doesn't use poppers; he's dying. His lover, it turns out, is a traveling salesman who is generally faithful, except when he gets to New York, where he screws his brains out in the gay bathhouses. Shortly after his monogamous lover gets sick, the salesman gets sick too.

(Yeah Larry Kramer didn't die of AIDS...but his semi-autobiographical play about it, The Normal Heart, implies the man he loved did.)

Which brings me back to Maggie Kneip's situation, too.

After her husband's diagnosis, she got a therapist, who connected her to: a support group for AIDS wives. Because she wasn't the only one. Even the social workers running it were AIDS wives.

(Sorry this is kind of thrown together, as a homeschooling mom I don't have time to refine it as I'd like.)

Wow, that was thoroughly researched. If that's what counts as thrown together for you, I'd love to see what you write when you've got time on your hands.