Monday, August 21, 2006

The kindness of strangers

Yesterday I watched, for the first time, A Streetcar Named Desire. Asides from the fact that Marlon Brando was just criminally hottt in that movie (although such a bastard, that halfway through the film I forgot that and saw him as plain ugly - I guess that is the measure of a great actor, and nothing like those vacant poster-boys DiCaprio or Pitt or whoever), I was stunned at what a great movie and story it was. And like most great movies, stories (or songs), deeply menacing, disturbing, even haunting.

Guess who I identified the most with? Blanche of course, although there is the Stella in me too. Nothing of Stanely, that's for sure. I am a 100% miserable woman.

It was truely haunting, the desperation, the fear, the one-way street of the fallen state (and could anything be regarded as more fallen that HIV I wonder). After the movie, I read an email from a new penpal that kind of annoyed me. She wrote about the responsibility (or rather, irresopnsibility), of people who become infected. It woke up the sleepy "AIDS activist" in me, and I wrote her an email, but I wasn't 100% satisfied, so I drafted it. And this morning I realized why I wasn't satisfied: because, no matter how articulate and unapologetic, I don't think such (even gentle and hidden) blames should be addressed at all! It is like I wouldn't waste time on antisemites, as civilized and intelligent as some of them may be - and I have come across a couple. The only dignified response is no response. Anyway, here's what I wrote her:

It's a tough one, what you say, about the beginning. In the beginning, people were just dying, and no one knew from what. No one even knew how it was spread exactly. That went on for a few years. In the meantime, HIV was spreading. It's not a "punishment" for using heroin, or going to prostitutes, or having anal (gay) sex - these are just effective ways that HIV was first spread (in the West; in Africa HIV is a different strain and spreads ususally through heterosexual sex), but it would have spread anyway, just at a slower pace.

Because HIV doesn't have clearcut syptoms, it's hard even to diagnose, so imagine the early years. I mean, 3 days away from 2006, I practically reached advanced AIDS myself (on paper), and went to see different doctors with all sorts of small problems that could have easily identified me as suspected HIV had someone pieced them together, and was even told straight out that my immune system was weak, but no one, not a single doctor, ever told me to take a HIV test, and I took it completely by accident - I asked to add the test to another test: they were testing why my white blood cells were so low, and HIV "eats" immune cells which are white cells - and the only reason I asked was to get the test out of the way so I could give my then-BF a nice surprise and have sex without a condom. So even doctors are being neglectful, because they don't realize.

I can tell you that nowdays there are 4,000 registered patients in Israel. It is estimated that the actual number is much higher, let's say 12,000, even 20,000. Back when I was infected, 8 years ago, there were much less (this was the last year that I failed to use a condom). Let's say for argument sake that there were 4,000 even back then. Out of these, half are women, and out of the men, I would say at least 85% are gay. Out of the straight men, a large part is Ethiopian (I am talking about Israel), 30% are drug addicts, that I would stay away from. We are talking about a handful of men left that I could potentially have sex with. Can you imagine the bad luck, that of the 2 men I had unprotected sex with in that year, 1 was one of these men?

It seems so unlikely, and then you realize, that a person who has unprotected sex with 3 people in their lifetime, has been exposed to 5000 prospective "partners" through partners of partners.

So, to answer your question: Yes, HIV spreads because people continue to have unprotected sex. Unresponsibly, like I did. In fact now it's spreading almost exclusively like that (disregarding junkies). Unlike the sterotype, it is not usually through casual sex but through relationships. the reason is that for a woman, the chance of being infected in a one time (unprotected) intercourse with a positive man is 1/1000. For a man with a positive woman, 9 times lower. There are other factors that increase chances of infection such as other STDs. But the bottom line is, most people are infected within a relationship. and when you are in a relationship, and you discuss HIV with your partner, people calm down after a while and neglect using a condom, and that's the most dangerous part.

Having said that, HIV is very elusive. There are people who were having unprotected sex with a positive partner for months, even years, and did not get infected. There are people that did this just once, and were infected (this has to do with the levels of the virus, which fluctate in different stages of the disease).

Of course, when people are fucking hundreds of people, such as some gay men, that also increases the statistical chance of coming across someone infected (also anal sex is the most contagious type). I won't talk about gays, because that's a whole different ball game. In that cicrcuit HIV is much more common. I will just say that if it wasn't for the "irresponsible" gays of the 80s and 90s, I wouldn't be alive today... Just like Israel wouldn't exist without support from the US, no one would be inventing the drugs that I take now if it wasn't for strong pressure from the (mostly gay) community. So I think pointing and blaming is useless. In the early days, people were infected in all sorts of ways, many were infected through blood transfusions. My point is, when you have an epidemic, when a virus mutates and starts to spread (and HIV is constantly mutating; that's why no cure has been found), it's very hard to pinpoint who is "guilty". It's easy to say people are irresponsible, when in fact there is so little education in so few sectors to use a condom, when governments like South Africa where there is 25% infection rates refuse to acknowledge that HIV causes AIDS and passes through sex, when the Catholic church refuses to stop the epidemic in Latin America and Africa by speaking about condoms.

So, was I irresponsible? yes, but no more (and actually much less) than most of my girlfriends & guy friends. I was just...unlucky. There is always someone who wins the lottery, there will always be someone who gets HIV. The odds increase as the epidemic spreads. But don't forget that in the 70s and 80s women were taking the pill and told to enjoy sex. I started the pill when I was a teenager - it was prescribed by a gynocologist. By the time I was 18 all my peers were on the pill. Who thought of a condom? Guys didn't... But through my 20s, I used condoms mostly because I couldn't stand the pill at some point, I kept switching brands and trying to find one, but I could never stick with a pill for more than a few months, so I used condoms more than everyone I know. It was a joke between my friends how much money my BF was spending on them.
There are 2 guys that could have infected me. With one, I used condoms, but then he asked me to switch to "the sponge", which was a kind of diaphragm (later taken off the shelves for being ineffective as a contraception). This is a guy I used to work with. I went to the doctor (the sponge needed to be prescribed). I am not taking myself off the hook, but did the doctor say "who are you fucking?". I have never heard a gynocologist suggest condoms, or mention a HIV test, in all the years I am having sex. I have never seen a box of condoms in a a gynocologist's office, or an advertisement for them even, when so many of the problems such a doctor treats can be prevented with a condom (I am not even talking about HIV here). With the other guy who is a possible candidate for infecting me, I used condoms, except when I was having my period, because I knew I couldn't get pregnant then. I stayed with him for more than 2 years. When I was diagnosed, I was certain it was the first guy, because he was a bastard and treated me like shit. I only began to suspect the second guy after he was contacted and never made contact with me, and I am his girlfriend before last, and he has my phone number and email address. But to this day, I don't know which one of them it was.

I never had any STD except HIV, not even something minor. In this I am very lucky because the combination of "normal" STDs and HIV is just vicious. Of course, the irony is that from my mid-20s I became more and more aware of HIV, and after these 2 guys I used condoms religiously, but it was already too late (I am 32 now).

Don't worry, I don't mean to preach at you, it just brings so many issues to the surface that I have to keep writing... I went through all the stages. I even went through a stage of hating gay men, and then bisexuals (without whom, I thought, HIV would remain a "gay disease"). But I realized it's no quite true. It's not the first time that a sexually transmitted deadly epidemic started. In the middle ages syphilis was a huge plague in Europe. It's too bad that 25 years into HIV, in 2006, the only organization that tries to advertize and promote condom use in Israel is the Israel AIDS Foundation, which is a voluntary organization that is not even funded by the government. You see what I mean... it's stupid to have unprotected sex nowadays, if you know the risks, but to point at this person or that person and say they were irresponsible at that point in time is hard. It's true some people tried to spread it purposefully. This is a criminal offence. But that's a tiny tiny minority.
I know one thing: if HIV is to be stopped it shouldn't be left to the individual. In countries where they had a large epidemic, like Thailand, where 1/100 people has it, the government invested billions in making condoms cheap and available everywhere for free - in hotels, every kind of clinic (and not just sex clinics), schools - and in educating children, yes, children and not adolescents, before they even think of sex. And that was highly effective. And also giving condoms to prostitutes. In short, HIV won't stop by itself. In Israel HIV is completely neglected. The fact that people think they can get it from sitting next to a positive person or eating their food, and on the other hand people who should know better take risks because they are in a relationship and they think they know the person, is testimony to that. But to do that you have to invest money, time, and you have to deal with conservative powers that associate condoms with promiscuity, which brings me back to the Catholic church and in Israel the Ministry of Education, the army - all these bodies that should be giving condoms and promoting their use instead of burying their head in the sand, at best, and opposing prevention-education, at worst... I answer a lot of questions on the ynet HIV forum and I see how uninformed people are, and these are people intelligent enough to use the internet. Even in the Netherlands, where I am treated for my HIV, I had to come to the doctors and say: I am having sex and I want my partner to be educated and not by me because I don't want to take the responsibility. And then we were sent to a councelor. But even when you already have HIV, the doctors don't suggest this kind of thing unless you ask for it. They treat the patients, but they don't deal in prevention.

So that was that - in the middle of cutting and pasting, I heard moans and yelps from under the window, and the poor dog has had another epileptic seizure, or stroke, or whatever shitty thing happens to her, after which she starts running around completely disoriented, in circles, drooling on herself, and ended up stuck helplessly in some bushes in the yard. And then this whole thing was stopped, me and my parents retrieved her, and they gave her some kind of dog tranquilizer that put her to sleep immediately. And the talk is to put her to sleep permanetly. And the three of us sat around the table in the patio smoking (bugger) and me drinking milk on top of the beer I just had on top of who knows how much food, and my dad with his whiskey, and it's all just so damn scary and depressing I can't even process it right now, and P. never asks me about it, never asks about my fears of death and a fate like this poor old dog as a result of my HIV and/or my drugs and/or my unhealthy choices in life, and maybe that's for the best, keeping it as light as possible, even if I have to swallow it all in. So this distracted me from all the amendments I wanted to post here with regard to that unsent email, and maybe I will get back to them at some later point - I have them scribbled down.

It's all so heavy, I feel it in my chest like a lump. Just heavy. I don't dare touch or apparoach those fears. This is the most unrestful, painful vacation I could be having.

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