DEADLY GAME OF CHANCE

The young men come into the Carlton surgery looking so afraid. The doctor
finds the shame on their faces painful to behold. Sometimes, they cannot
even look the doctor in the eye, even though he is gay, too.

Grown men, heads down, acting like they have come to see the headmaster.

A couple of years ago, Jonathan Anderson's medical practice was diagnosing
a new HIV case every three months. These days, there is a new diagnosis
every few weeks.

There is a new gay HIV crisis. Last week, Victoria recorded a 41per cent
rise in HIV diagnoses for the first six months of 2000 compared to the same
period in 1999 - a 67per cent rise for gay men alone.

AIDS experts are in furious debate: Why now? What have we done wrong? Dr
Anderson is 39. The gay men of his generation know the safe sex messages.
For the younger ones, those in their early 20s, perhaps, you might at least
say the virus has not struck down many, or even any, of their social circle.

It is not just the youngest men failing to heed the messages, however. The
average person being diagnosed today is 33, male and gay. The median has
fallen only slightly in recent years.

Often, it is a slip-up. Sometimes gay men feel ugly because of the body
culture of the gay community and the lack of acceptance of their sexuality
in some quarters of wider society. Depressed, they will have unsafe sex,
says Dr Anderson.

And then there are those who wilfully and nihilistically defy the basic
rules, thinking the new AIDS drugs will save them, or they are
indestructible. Some even glamorise unsafe sex.

"Many people are telling me when they come to have a test that people are
offering them unprotected sex," Dr Anderson says. "It's happening at home,
in sex venues, after dance parties.

"Two guys said to me this week they were shocked by the level of
unprotected sex. They said anything was on offer."

Dr Anderson believes the American gay sub-culture of "barebacking" -
fetishised unprotected sex - has not gained such popularity here that it is
responsible for the sudden surge in diagnoses.

But the Internet tells a more depressing story. The Bareback Melbourne site
speaks reverently of gay sex without condoms.

In July, an Australian Drug Foundation report commissioned by Melbourne's
Alternative Lifestyle Organisation (ALSO), made links between recreational
drug use - ecstasy, speed, crystal meth, GHB and alcohol - and impaired
judgment leading to unprotected sex.

But gay community sensitivities have prohibited full discussion of this link.

The survey of 518 gays and lesbians found rates of ecstasy and speed use
were much higher among gay men than the general population. And 43.5per
cent of gay men in their 20s had had unsafe sex while under the influence
of drugs and alcohol.

People Living with HIV-AIDS Victoria president John Daye says most of the
people were surveyed at dance parties. But the ADF report says the
questionnaire was "distributed to gay, lesbian, bisexual and queer
communities throughout Victoria".

Mr Daye says the link between dance parties, drug culture and unsafe sex
has been around for a long time.

But other gay community members say there has been an increase in the size
and frequency of the parties, while anecdotal evidence suggests the use of
illicit drugs has grown exponentially.

Many gay community members are frustrated by an apparent lack of political
will to freshen HIV prevention campaigns. A draft copy of the fourth HIV
national strategy was delayed eight months because of federal Cabinet's
social sensitivities, much to Health Minister Michael Wooldridge's chagrin.

Chris Gill, a former AIDS education worker and ex-editor of the Melbourne
Star Observer gay newspaper, says the untold story is that, since the late
1980s, the AIDS councils have made HIV prevention education for gay men a
lesser priority.

Mr Gill says materials and activities promoting safer sex to gay men are
largely invisible in gay venues in Melbourne. He also says outreach work
appears to have dwindled.

The new gay HIV crisis is a Western curse. A gay Melbourne man, Peter, says
there has already been a huge culture shift in New York and London, where
he has been living for four years.

He says the change in Melbourne was evident when he returned five weeks ago.

"It is pretty clear that safe sex is seriously under threat," he says.

"Perhaps there is just a lack of political consciousness or will. Or maybe
it's just complacency or good old hedonism run rampant."

An AIDS researcher from the AIDS Policy Research Centre in San Francisco,
Jay Newberry, says the rise in HIV diagnoses in San Francisco is an
alarming indicator for other cities, such as Melbourne, that are only just
beginning to experience a rise.

Dr Anderson says many gay men, "not all of us", have "disengaged" from
worrying about HIV.

"Sometimes it's fatigue (with safe sex)," he says. "Sometimes it's because
they have other things in life to worry about."

Most gay men, he says, know about HIV transmission.

"What intervenes are feelings - love, lust, intimacy, feelings of anger and
depression, and I think there's a lot of alienation," he says.