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AIDS, HIV, and PromiscuityWhile the focus of this paper is about Adventism and homosexuality, one cannot discuss homosexuality without some mention of HIV (human immunodeficiency virus) and AIDS (acquired immunodeficiency syndrome). This illness deserves a much longer discussion and review than this paper's intent. However, some attention (albeit brief) is warranted and valuable to the primary topic. AIDS is a clinical syndrome caused by an infecting virus: HIV. HIV infection and AIDS represent an illness--recognizable and diagnosable. At this point in time, this illness cannot be cured (not unlike some cancers or diabetes), but steady gains are being made in improving long-term survival. Because this infection was first recognized in gay men, it has been associated with homosexuality in American society. However, the majority of HIV infected individuals are heterosexual and dwell outside of the industrialized world.68 Like other diseases, it is spread by contact with human body fluids, namely via blood and semen. It is important to emphasize that neither homosexual orientation nor homosexual behavior are sufficient conditions to cause HIV infection or AIDS. Certain sexual practices (like promiscuous intercourse without condoms) or blood exposures (like illicit intravenous drug abuse) place human beings practicing those behaviors at risk for this infection--gay/lesbian or straight. HIV and AIDS, as a deadly epidemic, affects all segments of American society. Its direct effect in the gay/lesbian community cannot be overstated. Furthermore, because it was first associated with gay men, AIDS has increased the stigma of all gay/lesbian people in society. Some Christian proclamations regarding AIDS were notable, judgmental and prejudicial against the homosexual community. Some of the rhetoric subsided after 1983 when HIV was isolated and the infection characterized. But to the minds of many Christians, HIV and AIDS will be indelibly linked to homosexual orientation and homosexual identity--when in fact, it is linked to sexual behavior. The formidable Adventist health care community did not take a leading societal role in meeting the challenges of this illness nor did other Christian health care organizations. Instead, leadership came from secular organizations, government, and from within the gay/lesbian community. Fortunately, new drug therapy offers some promise for the future, but the illness and its scourge are far from over. HIV and AIDS poignantly illustrate the distinctions between sexual orientation, sexual identity and sexual behavior. The gay/lesbian community has been motivated to reassess sexual behavior--and admittedly, has more work to do. But being gay/lesbian is not synonymous with promiscuity, HIV and/or AIDS. Some American Christians have argued vehemently for a return to the "disease model" of homosexuality believing that homosexuality rather than promiscuity caused the AIDS epidemic. Despite sensational rhetoric to the contrary, credible research (which may more honestly represent a true cross-section of gay male society) actually reveals that homosexual men and heterosexual men will typically have about the same number of sexual partners during the course of their lives beyond age 20 (studies of homosexual women compare similarly to heterosexual women).69 The Adventist institutional response to HIV infection and AIDS has been tepid and somewhat awkward. Twenty years after initial reports of HIV, the church appointed its first task force to address HIV/AIDS which met January 2001.70 Accountable written institutional Adventist directives on homosexual orientation are not prescribed by the SDA Church Manual (1995, 15th edition) and homosexual behavior is considered immoral. Many Adventist clergy and health care providers tacitly view HIV and AIDS infection as a justification of the church position against all homosexual behavior. As a gay Adventist physician, trained by and associated with Adventist health care institutions, I have witnessed the "love the sinner, hate the sin" approach as prejudice, bigotry and condescension. In the face of a serious illness or the end of life, this patronizing attitude hurts and stings. I have lost many friends (including Adventists) to AIDS. Sadly, as a patient advocate, I have felt compelled to steer many of these patients to non-Adventist health care facilities because I felt they deserved Christian love and compassion--better delivered elsewhere. New drug therapies have transformed the treatment of HIV infection--nothing short of a miracle in many cases--but the new drugs offer far less than a cure (and should not fuel complacency). While HIV and AIDS will always be linked to homosexuals in North America, the numbers of heterosexual victims in Africa and Asia is staggering and these groups have little access to anti-retroviral therapy.71 Thus, HIV prevention through “safe sex” education remains the foundation of AIDS care. In the United States, the number of new HIV infections continues to rise among young gay men despite widespread educational programs.72,73 Unfortunately, the global societal message that continues to be sent to gay youth is a negative one. Gay-bashing continues to be a societal norm. When gay young people are banished from their families, schools, churches, and friends, they have little anchoring to the wisdom and maturity of elders--and little but the moment to live for. Rather than an expression of love and commitment, sex becomes an event in the lives of gay youth--youth who know that they may be murdered, beaten, robbed, or heckled at any moment. 68. "Estimated HIV Infection and Reported AIDS Cases" (Source: UNAIDS Program, United Nations) in The World Almanac 1998. Mahwah, New Jersey, K-III Publishing, 1997.
69. RE Fay, CF Turner, AD Klassen, JH Gagnon. "Prevalence and patterns of same-gender sexual contact among men" in Science, 1989; 243: 338-48, cited by RC Friedman, JI Downey, in the New England Journal of Medicine 1994; 14: 923-930.
70. Bettina Krause. Adventist News Network. “AIDS is Everyone’s Problem: Adventist Church Establishes New HIV/AIDS Committee.” October 31, 2001.
71. Mark Schoofs won the Pulitzer Prize for his AIDS coverage in Africa: “AIDS: The agony of Africa,” in the Village Voice, a series from November 3, 1999 through January 4, 2000.
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