Saturday, 19 April 2014

Another high-profile crank

AIDS is big business now, and that’s not necessarily a bad thing because with over a million people with HIV in the U.S. in need of fairly costly medical care and auxiliary services, it’s natural that a lot of cash should be flowing through and to provider networks, social welfare agencies, and pharmaceutical companies. We can debate the fees and prices involved and the relative merits of this spending, but a humane response to the epidemic is going to mean major bucks.

That said, there is something particularly creepy about the American Healthcare Foundation and its expanding tentacles, especially given the demagogic posture of its publicity-hound president, Michael Weinstein. His latest play for the grandstands came last week when he referred to Truvada used as pre-exposure prophylaxsis ("PreP" in the lingo) as a “party drug.” The entire AIDS advocacy and prevention industry rose up in indignation, and Weinstein promptly doubled down by trashing his critics as “all associated with bareback porn.”

Although our historical memory about AIDS focuses on antigay discrimination, like Jesse Helms and Pat Buchanan gloating over god’s punishment of people engaged in the wrong kinds of sex, there has long been a streak of neo-Puritan self-righteousness within the gay community itself about who was getting it. It’s not pretty but somehow understandable that people distance themselves from a frightening disease by thinking that the only people who will get it are big ho’s like that other guy, not me. Weinstein appeals to that mentality with his insistence that exclusive condom use—notoriously inadequate as anyone knows who is paying attention—should be promoted to the exclusion of all else.

He’s also a ready-made quote machine for reporters who want to write about something novel and unfamiliar like PreP and need a “balancing” opinion from someone who seems to have credentials. Weinstein has a big business, and his AHF treats a lot of patients. So he has the right to his opinion.

But he’s also completely full of shit, and lazy journalists should be confronted with the harm they are doing to public health by allowing this guy to rant about a new prevention tool that health departments around the country are still trying to convince doctors to use. There are a whole lot of gay men (and plenty of straight ones, too, as well as women) who are not using condoms with any consistency and are not going to. We can debate that until the cows come home, but it’s been true for 30 years—or more like 3,000. It ain’t gonna change any time soon.

No one’s saying to toss the condoms out though blowhards like Weinstein pretend to think so. Social workers and health educators who deal with actual human beings trying to avoid HIV know that PreP is can mean the difference between an infection and avoiding one. It’s a handy alternative for people who know they’ll run some risks in the future and aren’t going to obey Weinstein’s condom rule no matter how many times he repeats it.

Weinstein is exploiting people’s puzzlement about how gay men, in particular, could knowingly engage in risky sex with partners whose HIV status is not entirely or reliably clear. Well, guess what, they do, and if the moralists would examine their own bedroom habits, they might admit they’re not 100% squeaky-clean either. It’s very satisfying, no doubt, to tut-tut at such persons as far less intelligent and responsible than ourselves, and Weinstein enables that posture expertly.

For those of us looking to be effective in avoiding new infections rather than indulge our smug self-regard, PreP is an important innovation. Weinstein should STFU, and reporters should be ashamed of themselves for amplifying the reach of this crank.

Someone on got up a petition to call for Weinstein's ouster. Sign it here.

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