DANCING WITH DEATH

The one thing that was never meant to happen among young gay
Australian men is about to be confirmed. New figures will show a
sudden surge in HIV diagnoses in three capital cities. A new
generation is facing a crisis.

The figures will show an alarming rise in new HIV infections among
urban Melbourne, Sydney and Brisbane gays. It is believed the figures
show a 41 per cent rise in diagnoses in Victoria during the first six
months of 2000, compared with the first six months of 1999. Among gay
men there has been a 67 per cent rise in diagnoses in Victoria.

The figures for New South Wales and Queensland for that period are not
yet available, but the same factors are at play in those states. AIDS
officials are about to hit the panic buttons.

Why, after 17 years of safe-sex messages being pounded into the gay
community, is this happening?

Many will not be surprised. Recent surveys in Sydney and Melbourne
have shown a greater incidence of sex without condoms. Health
professionals believe it is not just casual unsafe sex, but problems
with people getting into relationships and having unsafe sex before
both partners are tested.

More to the point, however, a nexus has been found between drug use -
ecstasy and speed, inextricably linked to the dance-party circuit -
and unsafe sex. Young gay men are taking risks because - like other
young men - they believe they are indestructible. In this case,
however, gay men have had their minds altered by illicit drugs, and
they assume the new protease inhibitor drug combinations will save
them.

Young gay men looking for a way to belong join the dance-party circuit
and feel the peer pressure to over-indulge in drugs, which in turn
impair their judgment over risk-taking behavior.

For many young gay men, HIV has been an esoteric scourge, one that has
not killed their friends. Now, however, they are about to feel its
impact.

Consider that this frightening spike in the Australian figures follows
a rise in HIV diagnoses in several urban gay sites in the United
States, where a culture of "barebacking" - deliberately, fervently
rejecting condom use - has emerged in defiance of safe-sex rules.

This nihilistic culture has been specifically linked by commentators
to the dance-party circuit. It is a culture practised by gay men in
their 20s (even 30s), defying the world outside and the rules imposed
on their sexual freedom.

Are we seeing the beginnings of this culture in Australia? Sadly,
perhaps we are.

In July this year, Victoria's Alternative Lifestyle Organisation
released a report, Beyond Perceptions, which showed gay men used
ecstasy at rates several times higher than those in the general community.

Based on 518 questionnaires, the report, conducted on ALSO's behalf by
the Australian Drug Foundation, linked drugs, dance parties and unsafe
sex.

Sixty-fiveper cent of gay men aged 20 to 29 surveyed had used ecstasy;
23.9 per cent in the month before the survey. In the 30 to 39-year-old
age group, 59.1 per cent had tried ecstasy; 13.6 per cent in the past
month. Most importantly, 43.5 per cent of gay men in their 20s had had
unsafe sex while affected by drugs and alcohol. Sometimes, this
occurred with multiple partners. More than 15 per cent had been
coerced, while under the influence, into sex they did not want.

For groups such as ALSO and Mardi Gras in Sydney, these results
present an inherent contradiction. Such groups rely for fund-raising
on dance parties, which, by their very nature, encourage drug taking.

Against this background, concern is growing that the current crop of
anti-AIDS drugs have a time limit, despite the hopeful predictions
made in 1996 that they would all but cure the virus.

It is increasingly clear that a lifetime on the drugs is impossible
for many. A survey of 920 HIV-positive Australians, released this
year, shows a third failed to gain any benefit from combination
therapies, up from a quarter two years earlier. The result is in line
with the trend predicted by Amsterdam researcher Yope Lange at the
International AIDS Conference in Durban in July, that by 2002 58 per
cent of HIV-positive people would fail to benefit.

The drugs are undoubtedly highly effective at reducing the virus, but
the dosages can be difficult to maintain and, for many, are simply too
toxic.

Yet many gay men are partying on as though illicit drugs will make
them forget the world outside, while prescription drugs will save them
from the threat of virus. Neither outcome is true for all.

According to gay writer Michelangelo Signorile, in his book Life
Outside, which critically examines America's gay scene, the
drug/dance-party culture there has fuelled the growth in an
anti-condom culture. In the US, some gay men refuse to have sex with
anyone who insists on the use of condoms. They even have bareback parties.

This barebacking culture is yet to make significant inroads in
Australia. Or at least it seemed that way, until this week. And as we
know, it's usually only a matter of time before the rest of the
Western world follows America's cultural lead.

Steve Dow is a contributing journalist to The Age. His book on
contemporary Australian gay issues will be published by Common Ground
early next year.