This is part 2 of an essay of which the first part was featured in the last issue of Continuum. An expanded version of the whole article appears in The AIDS Cult: Essays on the Gay Health Crisis, edited by John Lauritsen and Ian Young (Asklepios, Box 1902, Provincetown, MA 02657-0245, USA.) See Review in this issue.

The much vaunted safe sex and AIDS education programs have been a spectacular failure

"Purposely, the twenty-something boys, who have never known a sex life without AIDS, fatalistically expose themselves to HIV as a test of ritual manhood"
—Jack Fritscher, Mapplethorpe: Assault with a Deadly Camera, 1994

"Deliver me from blood gatherers, O God, Thou art the God of my health."
—Book of Common Prayer

Eric Rofes of the National Gay and Lesbian Task Force, who provides an introduction to HIV Negative, describes himself and other antibody-negative gay men, the "population of supposed survivors," as people "left to walk the earth like robots or zombies, telling ourselves and others that everything’s fine while we are actually numb, cut off from our emotions." This contrasts vividly with the dark, vampiric glamour of AIDS. Walt Odets refers to "the appeal of illness." All these attitudes fuel the desire to seroconvert.

Another common observation made of HIV testing is that testees often doubt or question their Negative results, but seldom their Positive ones. The psychologist Rachel Schochet found that the more bereavements men had experienced, the more they tended to doubt their own Negative status – and the more they engaged in unprotected sex.

This doubting of Negative results is built into the administration of the testing system itself. Positive results, we are told (falsely), are never wrong, but Negative results may be "premature" or "false Negatives", or unreflective of the alleged virus’ supposed "window of opportunity". And so when we test Negative, we are encouraged to restrain any relief we might feel, and to return regularly to the Test Site. If we did not keep coming back like a yoyo, presumably we would snap our strings and go careening off, cavalierly spreading HIV around, to ourselves or to others, typhoid Mary off on a bender. In fact, the AIDS System, by failing to support thoughtful self-knowledge, and by subliminally suggesting that a Positive outcome is inevitable and desirable, encourages the behavior it claims to prevent. The constant state of anxiety it instills damages both the mental faculties and the immune system.

The HIV antibody test (usually called "the HIV test" or "the AIDS test") is surrounded by an enormous amount of stress, with unfortunate immunological consequences. "Paul Fielding", a pseudonymous gay man quoted by Johnston, makes the point that "you weren’t supposed to have stress, because stress could destroy your T-cells... So you had to try to smile living in a pressure cooker."

Warnings about "risk groups" and "risk behaviors" strike a profoundly ambiguous note in a society where risk is associated with entrepreneurial behavior, glamorous chance-taking and competition, and is highly valued. Risking danger has always provided a test of manhood for rebellious youth: practicing "unsafe sex" is a challenge, a way of accepting a dare, a contemporary version of the "chicken run" depicted in Rebel Without a Cause.

The French writer Hervé Guibert, wrote of his lover Muzil, who routinely visited the baths for sex, in spite of his poor health. Muzil remarked that "the baths have never been more popular, and now they’re fantastic. The danger lurking everywhere has created new complicities, new tenderness, new solidarities. Before, no one ever said a word; now we talk to one another. We all know exactly why we’re there."

The "danger lurking" is of course the demonized "AIDS virus" whose alleged propensity for "lurking", "hiding", and other "clever" behavior is said to explain the many cases of HIV Negative AIDS. And the men are there to live dangerously.

Pervasive pressure to seroconvert has produced the phenomenon of the compulsive repeat tester, the uninfected individual who is caught on a "testing treadmill", making frequent visits to a Test Site, or to several Test Sites ("Is it a good lab?") and always doubting Negative results. Johnston discusses an attempt in Boston to start a discussion group for such compulsive retesters. "The group didn’t work, because they all wanted individual attention...They didn’t want their story to compete with anybody else’s, because their story was the most important." A compulsive need for attention is easily met by the ministrations of the AIDS industry, which is set up to provide all the attention needed, once seroconversion is achieved. The compulsive retester is a seroconvert in the making.

The much vaunted Safe Sex and AIDS Education programs of the Eighties and Nineties have been a spectacular failure. They are as counterproductive as the campaign against unmarried teenage pregnancies in the Black community – and for the same reason: the under-lying causes of the phenomena remain unaddressed.

In my own city, Toronto, promiscuous unsafe sex is a popular feature of the bathhouses which have been springing up again over the past few years. Some of them are now licensed to sell beer, which they supplement, unofficially, with poppers and crack cocaine (smoke it in your room) as additional perques. Here too, the rate of seroconversion among young men – and subsequent entry into the ramshackle labyrinth of the AIDS System – is climbing. And Xtra’s obituary column isn’t getting any smaller.

It is becoming apparent that the actual consequences of the AIDS System are at variance with its stated aims. There are unconscious factors at play here – unidentified, even unacknowledged. "Something is happening to us which no-one wants to face."

Odets describes the AIDS System’s current approach to prevention as based on a "public health/social marketing model" composed of relentless propaganda ("Information and Education") and the utilization of what he delicately describes as "selected community leaders" to mould group behavior. Complex psychosocial issues are avoided; feelings about sex and death, personal worth, goals, intimacy and human needs remain for the most part unexplored outside a relatively few independent therapy groups. Its simplistic strategy is based on the assumptions that sex for gay men is merely a mechanical procedure without human meaning, and that immune suppression can be contracted only through intimate contact with the blood or semen of an "infected" partner. (Public concerns about saliva, tears and sweat are occasionally expressed, but so far have been fairly successfully dismissed.)

The nature of the relationship of "HIV" to AIDS has been a subject of fierce dispute, though the debate has been rather one-sided: the skeptics (who include a scattering of scientists and three Nobel prizewinners) present detailed critiques, which the HIV fundamentalists either ignore or respond to with abuse. If, as seems increasingly likely, "HIV" turns out not to be the sole cause of AIDS, every AIDS Education program on the continent will have to be rethought from the ground up and some people might even be cleaning out their desks. Naturally, critiques of HIV dogma are vehemently resisted by the growing army of HIV support staff.

The question of how Positive results are achieved seems equally problematic. HIV Positive test results have frequently registered in individuals who have been exposed to certain pathogens such as malaria, or who have suffered a recent bout of influenza. The current tests, it seems, are not as specific as they might be. A ground-breaking paper from Australia, published in Bio/technology in June of 1993 demonstrated that the favored "AIDS tests" fail three basic criteria: they are not specific, there is no standard interpretation, and their results are not reproducible.

In addition, several series of research experiments have shown that under certain conditions, lab animals may develop antibodies to "parts of HIV" without ever having been in contact with the virus. When some animals in a group were exposed to proteins and developed antibodies, other, unexposed, animals in the same "cohort" also began to test Positive. Could gay men, too, be developing antibody Positive status in resonance with already "infected" members of their Cohort? If so, it might help to explain the increasing number of "anomalous seroconversions" now being reported.

The issue of drugs (both legal and illegal) provides another example of poorly examined assumptions generating a dangerously simplistic approach. Official AIDS education literature almost always warns that recreational drugs may "impair judgment" and so "lead to unsafe sex", but the health risks and immunosuppressive qualities of many drugs are seldom mentioned. In the absence of community-based programs to counter heroin use, we are simply urged to bleach, and never share, the hygienically wrapped needles generously distributed by AIDS organizations. Many physicians regard drugs and alcohol as "coping mechanisms" and sanction their abuse by troubled gay patients. Kicking a drinking or drug habit, like giving up promiscuous sex, is regarded as a near impossibility for gay men, and substance abuse programs (particularly if peer-run) are often regarded as threatening to the doctor-patient relationship.

The version of public health marketing that dominates AIDS Education is patterned on the treatment of addictive/compulsive disorders. This is hardly surprising as the medical establishment has traditionally assumed that gay men necessarily regard sex as a mechanical process without deeper meaning. Educational proposals that attempt to address spiritual matters are dismissed as unrealistic. Inquiry into the reasons for addictive/compulsive behavior would entail an examination of socioeconomic pressures, motivations and group beliefs – and is usually ruled out as too difficult, too dangerous or too expensive.

We encourage what we assume. The current AIDS System fosters the addictive/compulsive psychology that social beliefs ascribe to gay men, and group behavior is then played out according to social expectations, alternating between two phases representing control and release.

The compulsive, Control phase involves strict abstinence or avoidance – in this case, rigid adherence to the proclaimed principles of Safe Sex, which are presented as unclear, yet essential – even when there is no apparent reason for them, as with sex between Negative partners. This attitude generates tension, confusion, demoralization and suspicion.

In the second, addictive, Release phase, the restrictive psychic controls become too stressful and collapse into a "slip" or "binge", involving deliberate self-exposure to "HIV" and other pathogens, often under the influence of immunosuppressive substances and mental states. Attempts are made to prevent, minimize, postpone or substitute for the Release phase. But such simplistic attempts at enforcing control (whether by propaganda or legal injunctions) rarely work, and when they fail, guilt feelings are reinforced. The notorious failure of most "diet" plans provides a typical example.

One of Odets’ most astute insights is that social organizations often act as containers for forbidden feelings. Shared, organizationally approved feelings are substituted for genuine ones; emotional impoverishment is masked, and anger repressed. Rather than encouraging thoughtfulness and understanding on the part of gay men, current AIDS Education programs have insisted on politically correct scripts, placing us in the familiar role of dependent children.

Odets sees HIV-diagnosed gay men as allowing themselves to be cast in the role of the "needy" child in a family, with antibody Negative men assuming the role of the resentful, "needless" child, desperate for his share of attention from parental figures. If the sick sibling is perceived as getting all the attention, one solution is to become sick oneself. The metaphor of gay men as children or perpetual juveniles is not new; of late, even gay protesters have adopted it: "acting up" is, after all, what children do to get attention.

And there is something else going on here. The growing ranks of seroconverts are approaching the seroconversion process as an opportunity for something that young men, and especially young gay men, in our society, desperately need – an initiatory rite of passage.

Our society’s ideology is a consumerist one, and its rituals tend to be the vapid pseudo-activities of consumerism – shopping, smoking, television watching, package holidays. But rites of passage (coming of age, for example) demand a special kind of ritual to mark the transition from one psychological and social state to another. Apart from the melancholy duties of draft and voter registration, the only such rituals now generally available to young men involve the acquisition of a driver’s license and a first car (either purchased or stolen).

Rites of passage signal the ritual death of the old self and a symbolic rebirth into a new identity, accepted and honored by the community. For young gay men, "coming out" once served this function, but as secrecy about being gay has lessened and sexual categories are blurring, coming out has become less meaningful to young gays, and unsettlingly inconclusive. For the most part, significant gay rites of passage have simply been unavailable. Instead, we are offered rituals of addiction and compulsion, which we adopt as our own. Seroconversion fills the need for a gay rite of passage.

Journalist and AIDS dissident Celia Farber has aptly called HIV "a demon, which we worship with our terror" and attempt to placate with buildings, organizations, conferences, and global programs. No such cult can continue for over a decade without developing its own forms of ritual obeisance, and the AIDS system has proved to be no exception.

The HIV testing ceremony is highly ritualized, demanding a visit to a special, rather fearsome place – a sacred place, the Test Site – with priests and acolytes in attendance: the various physicians, psychiatrists, social workers, peer counselors and AIDS workers hovering or bustling about, many wearing their white robes of office.

The ceremony involves a literal blood sacrifice, drawn with a hypodermic needle by a nurse or paramedic. Some initiates faint. It is accompanied by highly structured readings from sacred texts – AIDS Education and Safe Sex scripts. It incorporates a Time of Trial – the stressful period of several days or weeks involved in waiting for one’s results. During this time, one’s thoughts are concentrated almost continuously on "HIV" as the shared object of fear and devotion. And – if the test is passed, if the results are Positive – one is embraced into the community with new status, HIV Positive status, and increased attention. One enters the AIDS System, "the HIV/AIDS Community".

The very way we look at the phenomenon of AIDS has its psychological consequences. Belief in HIV as the cause of AIDS has led not only to a vast, self-perpetuating AIDS industry, but to the establishment of a medico-religious cult.

A recent issue of a Canadian gay magazine contained a news item about a Toronto gay man, Sean Martin, who had been diagnosed as HIV Positive. A year later, a second test reversed the verdict, and Martin is quoted as saying that though the HIV Positive friends he had made were "very nice to me about it", telling them he was Negative was one of the toughest things he’d ever done. He couldn’t help feeling that he was "abandoning" them, he said, and his new status made him feel he was "breaking the faith."

In his classic study of modern initiatory behaviors, the psychologist Luigi Zoja writes that "the archetypal need to transcend one’s present state at any cost...is especially strong in those who find themselves in a state of meaninglessness, lacking both a sense of identity and a precise social role." This description appears to fit many of the men interviewed in Odets’ and Johnson’s books; it is particularly applicable to seroconverts.

The gay health crisis has reached a stage in which seroconversion has become institutionalized as the most important rite of passage in the life of a gay man. Significantly, its place in consumer society is a paradoxical one. The seroconvert who adopts the Positive Lifestyle is, like the drug addict, someone who participates in social ritual, but denies the dominant social imperative – to be a "responsible" economic being. His Positive status gives him the permission and the means to solve one of the perennial problems of youth – how to conform and rebel at the same time.

In his consideration of drugs and ritual, Zoja points out that in our society, the addict "is not absent from the economic picture, but rather present in a destructive way." The seroconvert is also motivated to be "present in a destructive way." He drops out of the workaday world to live on disability or viatical benefits – income predicated on the assumption, the tacit agreement, that he will soon die. And after he "progresses" to "full-blown AIDS" he is even more "present in a destructive way."

This suicide by degrees, abetted by so many forces, is the latest manifestation of the Homosexual as Sacrificial Victim, an idea embodying remnants of ancient themes of ritual sacrifice. The Sacrificial Victim has finally become aware of his role, but as yet unable to slough it off, has begun to accede to it with some degree of deliberation. The seroconvert sets out to prove himself worthy of the sacrificial ritual, the testing, that he under-goes. This quest exemplifies what Zoja calls the "negative sacrifice, where only the destructive part of the act survives, and which is carried out by that person we call a negative hero." Of course, there is a positive side as well. The afflicted homosexual also becomes a "cross carrier", taking onto himself a complex of rejected and projected group feelings, fears and impulses. With his death, all these are, temporarily, exorcised.

In the classic pattern of initiation, desire for the death of the old self is followed by symbolic rebirth and the welcoming of the new self into the community of initiated peers. In the self-sacrifice of the seroconvert, this process is inverted: the old, negative self, rather than being overcome and sloughed off, is incorporated, with all its negativity, into the new self, who, instead of being enriched with new life, assumes new burdens of guilt and early death – burdens which novels, movies and folklore have long projected onto the figure of the Homosexual.

Seroconversion induces both the expectation of a short life and the feeling that one’s desirability as a lover is diminished. It is a combination that frequently leads to the feeling: I’m dying and no-one will want me, so I may as well party with whatever short time I have left. And so the party becomes a Dance of Death. In his book The Savage Garden, the novelist and diarist Paul Reed muses that many of his friends "have resumed a life that is in many ways similar to the life we pursued a decade ago – the gym, an afternoon rest...the clubs...The difference is that we now no longer work to pay the bills, we simply collect our disability checks. And we no longer feel that this is the beginning of a hot, fast life. It may be the last party, the final fling."

In the Nineties, that final, AIDS-related "fling" has become both a phobia and a macabre obsession. One gay club in Manhattan recently hosted a creepy and popular new event called "Res-Erection", which consisted of a go-go boy feigning death in a pseudo-Victorian setting while "horny revelers circled him and felt him up." Tres fin de siecle!

It is becoming painfully evident that the AIDS Establishment’s admonition to gay men to stay healthy is proving less effective than its subliminal inducements to seroconvert, to enter a system predicated on early death. Old assumptions about the homosexual’s social status as scapegoat and victim are easily assimilated by the "victim culture" of the Nineties which encourages troubled individuals to seek relief from their problems by adopting the role of irresponsible victim – which illness, addiction or past abuse is felt to confer.

It is curious that the authors of both these studies apparently believe that, in Odets’ words, "a quirk of nature and timing has brought this epidemic to gay communities." One can only wonder which epidemic is being referred to. AIDS? Or the "psychological epidemic" that has grown up alongside it? Or are these concurrent epidemics merely aspects of the same overall pattern of psychoimmune disturbance – with the same underlying psychic, socioeconomic and environmental causes?

The health crisis in the gay community did not begin with the onset of AIDS in 1981; it was preceded by many years of psychological disturbance and chronic depression, reactions to a homophobia that was endemic and corrosive. In the Seventies, the already high instance of alcoholism and venereal disease among gay men was compounded by epidemics of drug abuse, hepatitis and intestinal parasites. By the first notices of what would come to be called AIDS, the immune systems of most gay men living the lifestyle that was promoted to them had already been severely compromised.

In the early Nineties, the psychohistorian, medical researcher and AIDS activist Casper Schmidt noted a pattern of psychoimmunological events in many of the gay men who develop AIDS. Their immune disturbances, he found, began with chronic depression, rooted in child-hood unhappiness and related to socially induced guilt, internalized homophobia and a protracted "fight or flight" syndrome. As these feelings somatized into the body, the result was a chronically increased level of cortisol production, a steady depletion of T-cells, frantic overproduction of antibodies, and eventual immune collapse.

The evidence presented by Johnston and Odets suggests a continuation of this pattern into a second generation, with the ominous difference that now, with the phenomenon of the seroconvert, gay men’s identification of illness and early death as their destiny has moved more fully into group consciousness. Accepting the subliminal logic of HIV fundamentalism, gay men are beginning to see seroconversion and entry into the AIDS System as a gesture of solidarity with their fellows, a rite of passage, and a political act.

It is unlikely that anyone with a strong sense of self-worth would deliberately seek to seroconvert. But for a gay man who has internalized the negative judgements placed on him by family and society, it may well be "a lot simpler to think about (having) AIDS than about being gay." The film Interview with the Vampire, a work replete with coded references to a variety of contemporary fears (euthanasia, AIDS, immigration, gay families) contains the telling line: "If you think you deserve to die and you don’t kill yourself, that makes you evil." To many, the evils of AIDS seem preferable to the perceived evil of living as a homosexual. AIDS itself may be horrible, but contracting AIDS is a relatively easy – and pleasurable – form of suicide.

AIDS today is not what it was in the early Eighties when the term was coined to avoid the embarrassing acronym GRID – Gay Related Immune Disorder. The definition has changed: illnesses which were once considered key AIDS symptoms are now excluded if HIV is judged not to be present; even the official record now lists well over 4,000 such cases. Pelvic inflammatory disorder in women may now result in an AIDS diagnosis if HIV is shown or assumed to be present. T-cell counts, ignored in the early years of AIDS, are now combined with the ever-changing list of disorders to produce diagnoses on a "one from column A, two from column B" basis. Pneumocystis carinii, long considered a protozoa, is now acknowledged to be a fungus. Consensus is growing that Kaposi’s sarcoma, long regarded as almost a hallmark of AIDS in gay men, is not caused by HIV, and investigations into a suspected "KS virus" are underway. The most popular AIDS drug, AZT, has been discredited, and physicians are reduced to offering their antibody Positive patients the experimental drug (or "cocktail") of the moment on a "try it, you might like it" basis. Many of these drugs are highly toxic, especially when combined, and their "side-effects" read like a list of AIDS symptoms. In short, things are a mess. Meanwhile, the AIDS conveyor belt rolls on, providing employment for an ever-increasing army of support personnel. And every week, the roll of sick and dying young men grows longer.

Gay men have long served as repositories for a complex of group fears and fantasies about sex, sickness and death. Psychohistorian Lloyd deMause has drawn attention to society’s periodic killing off of "its own id-representatives, its youth, who represent itself in the life-phase when it was most sexual and most aggressive." In the past, this filicidal syndrome has usually been acted out through war. The frequent employment of war metaphors in AIDS literature of all kinds suggests that in the Eighties and Nineties, AIDS is taking the place of war, or has become a new kind of war. Under the veneer of a compassionate liberalism, psychobiochemical assault is being inflicted on gay men: not as a conscious intention, but as the result of policies predicated on certain unconsciously held ideas.

It is time to rethink this crisis, to begin to understand how we might extricate ourselves from the nightmare that has overtaken us, and enveloped us now for almost two decades. We will not understand the phenomenon of the seroconvert until we begin to investigate the destructive hold of unconscious belief systems in which we all participate. Until then, all the AIDS Education and Safe Sex Information in the world will not prevent new cohorts of young men from summoning up their courage and heading from the Test Site to the tattoo parlor to take up their cross.