Cocktail Hours

The latest AIDS medications give life to the dying--but what kind of life?

Comments (0) By Mark Donald Thursday, Nov 13 2003

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After nine months, he moved back to Oak Lawn, got a job waiting tables and immersed himself in the world of late-night clubbing, after-hours parties and drugs. "I used to have this saying," he recalls. "I have to go to work so I can buy some drugs so I can stay awake so I can go to work so I can buy some drugs so I can stay awake so..."

When you're speeding like a freak at four in the morning, there are just so many places you can go. If Wal-Mart got too boring, Warner might wind up at a local bathhouse known as Grandma's. "It was a playground for people who were totally fucked up on crystal meth and GHB," he says. "It was like a Candyland of unprotected sex."

Mark Graham

Melissa Grove, the executive director of Legacy Counseling Center, the largest provider of HIV counseling services in Dallas, says that "HIV puts a magnifying glass on every other problem you have, bringing out existing issues and adding another layer of stress to them."

Mark Graham

Dr. Louis Sloan, a Dallas HIV specialist, says that approximately 30 percent of patients do not take their cocktails with the discipline that the medications and the disease require. "It will catch up with them," he says. "But you can't convince them that five years from now they might have a problem."

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But why risk infection when "use a condom every time" was still the clarion call of every AIDS prevention message? "We are talking about an epidemic connected to sex, and sex isn't always rational," says Douglas Shehan, an HIV researcher at UT Southwestern who coordinated an extensive survey of young gay men in Dallas. "Seventy percent of the guys surveyed didn't even perceive they were at risk for HIV infection, despite their risky behavior." A surprising "18 percent of the gay men surveyed in Dallas between the ages of 23 to 29 were infected with HIV, more than any other city studied, including New York." Fifty-three percent reported unprotected anal sex in the past six months, "an alarming marker of risk-taking," Shehan says.

Yet there is a growing feeling, particularly among younger gay men, that condom absolutism is as unreasonable as it is unpleasurable. It has created a "barebacking" backlash, which celebrates skin-on-skin sex as being more spontaneous and intimate than latex sex. Although this younger generation is still AIDS-aware, time and medicine have made them less terrified of the disease, less likely to use a condom because someone a decade ago didn't and died. Even for the fearful, a lifetime of safe sex could seem unrealistic and overly rigid. "When everything is prohibited and dangerous, people throw in the towel because adherence is impossible," says Dr. Walt Odets, a Berkeley, California, clinical psychologist and AIDS prevention expert.

With an estimated 300,000 people in this country who are unaware they are infected, the idea of qualifying the safe-sex message is an epidemiologist's worst nightmare. But the truth is, even unprotected anal intercourse carries no risk of HIV transmission if neither person is infected. The chance of getting HIV through oral sex is less likely than being struck by lightning. The risk of contracting HIV from someone testing positive is greatly reduced if his or her viral load is undetectable. "People take risks all the time for things they value," Odets says. "But the whole assumption behind prevention is that sex between men is some kind of recreational, superfluous activity, and it's not worth any risk at all. But gay men know it's emotionally completing and a very important, human part of their lives."

Barry Warner saw no value, however, in having sex at Grandma's--unprotected or otherwise--because he still felt vulnerable after his breakup and didn't want to risk rejection, even in a public bathhouse. He went deeper into his addiction, turning from using methamphetamines to selling them until he began mainlining his profits and found himself homeless and broke. "My life had turned to shit, and it was nothing I ever imagined for myself," he says.

He had just enough relationship left with his parents that they agreed to pay for his rehab, and he spent the next eight months among the newly sober. That's when his life began to change, he says, as well as his self-image. "I stopped thinking of myself as unattractive and started dating again."

Because he had "a hard time separating love from sex," he chose not to have sex with the men he dated. Instead, he began cruising the Internet, meeting men in chat rooms and leaving his apartment for late-night liaisons. These clandestine parties seemed a throwback to a more closeted age, but their anonymous nature made things more erotic and dangerous. No test results were compared before bodily fluids were exchanged, and no one talked about whether they were negative--or not.

"It is both parties' responsibility to disclose, as it should be in any sexual act," says Dr. Stephen Tankersley, a Dallas psychiatrist who has been treating HIV patients since 1984. "But if the person who is positive is not comfortable disclosing, he should make sure the sex is safe."

Warner claims he always wore protection, and besides, as long as he was the one on top, it was impossible to contract HIV--or so he thought. The truth is, it's less likely but still possible, particularly if the "asserter" has cuts or open sores on his penis.

In May, Warner chatted online with several men who were partying at the Oak Cliff house of a man named Gary, someone Warner had previously met on the Internet. That's why he felt comfortable going over there, even though "everyone was watching porno, talking online and getting sky-high on drugs." Warner remained sober and after a while paired off with another man. Preoccupied with getting a blow job, he says, he didn't see Gary, who "came out of nowhere and surprised me from behind." Gary wasn't wearing a condom and, in the heat of the moment, neglected to discuss his HIV status.