The Flaw in Dan Savage's AIDS-Prevention Plan
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From this week's column, about an promiscuous HIV+ guy who is irresponsible at best and psychotic at worst:
If people are looking for a truly radical step — something that might actually curb unsafe sex — I've got a suggestion. But first some context: When extremely promiscuous gay men assess the risks and benefits of unprotected sex, most assume that if they get infected, or if they infect someone, that an AIDS organization or state health agency will pay for the AIDS meds they or their sex partners are going to need to keep themselves alive. It seems to me that one surefire way to curb unsafe sex would be to put the cost of AIDS meds into the equation. I'm not suggesting that people who can't afford AIDS meds be denied them — God forbid. No, my radical plan to curb unsafe sex among gay men is modeled on a successful program that encourages sexual responsibility among straight men: child-support payments. A straight man knows that if he knocks a woman up, he's on the hook for child-support payments for 18 years. He's free to have as much sex as he likes and as many children as he cares to, but he knows in the back of his mind that his quality of life will suffer if he's irresponsible.
So why not drug-support payments? If the state can go after deadbeat dads and make them pay child support, why can't it go after deadbeat infectors and make them pay drug support? Now that would be radical. Infect someone with HIV out of malice or negligence, and the state will come after you for half the cost of the meds the person you infected is going to need. (The man you infected is 50 percent responsible for his own infection.) Once a few dozen men in New York City, San Francisco, Toronto, Los Angeles, Chicago, Miami, and Vancouver are having their wages docked for drug-support payments, other gay men will be a lot more careful about not spreading HIV. Trojan won't be able to make condoms fast enough.
The thing is, though, how do you know who infected someone with HIV? I wouldn't assume that "extremely promiscuous gay men" know the names and contact information of all their partners. Furthermore, if a guy got fucked by ten HIV-positive guys over the past year, how do you know who actually passed the virus along? And what insane kind of bureaucracy would it take to track down all these people, test them, follow up and collect payments?
Wishful, if harsh, thinking Dan. It'd never work.
This is coming from the same Dan Savage who thinks that really fat people just shouldn't date and really ugly people should just solicit hookers.
Posted by: Jackie on February 24, 2005 10:47 AM | permalinkStrange that it would take the threat of severe monetary loss to change behavior, instead of, say, the fear of dying a painful death from AIDS complications.
Posted by: Adam V. on February 24, 2005 12:53 PM | permalinkAdam:
The threat of contracting a fatal disease hovers over the HIV- guys, but the threat of drug payments hovers over the HIV+ ones.
Those risks don't affect the same groups. Once someone already has AIDS, the threat of catching AIDS is irrelevant.
Posted by: Joe Grossberg on February 24, 2005 1:21 PM | permalinkHere in my homestate we have a different way to charge these guys. It's called First Degree Murder.
You see, if they know they are HIV+ and have unprotected sex, that's attempted murder. If their partner catches this 100% deadly virus, its capital murder.
I'm fairly militant on this one guys. If you are HIV+ and you have unprotected sex with an unknowing partner, that should warrant a bullet in the head within 24 hours of conviction. Charging them with drug costs should be the least of their worries. Torture on the court square at noon sounds like a better way to stop these serial killers.
Posted by: Bubba on February 24, 2005 4:24 PM | permalinkDear Joe,
I would be possible to trace some infections, not others. I don't think we could discover who infected the dispshit in NYC who had sex with a hundred guys over the last 12 weeks while high on meth, but in hundreds or thousands of cases every year the infector could be identified. According to a biologist who wrote me at Savage Love...
"I love the drug support payment idea. To answer the concerns of Ana Oliveira had about determining who infected who: by sequencing the genomes of HIV viruses from the two individuals, it is possible to determine to a high degree of accuracy whether or not one person infected another. It's like a paternity test; because this virus mutates so rapidly, each carrier will accumulate quite a few new mutations. If those new mutations in person A's strain are also in person B, then odds are person B's virus is a descendant of the virus in person A. The actual test is a bit more complicated (like a paternity test, there are some fairly advanced statistics to arrive at those one-in-a-billion odds), but the technology to do this sort of test is getting much cheaper and more automated all the time.
Biologist In Kansas City"
As for going after folks who infect people and charing them with murder, well, those kind of charge are almost never brought against gay men. Whenever you read about charges being brought against someone for passing HIV on, it's always a straight guy, usually black, who infected a series of women, usually white. I leave it to others to work out the deeper meaning of this.
Finally, I don't think we would have to dock all men who infect others for a program like this to act as a deterent. Even if only a few hundred a year were smacked with drug support payments, the program would work to deter some of what we're seeing.
Okay, finally for real: You should see my mail. The anger is amazing--and people are mad at me. Most the of the mail is from people who think guys like Help Me Do The Right Thing's friend should be arrested or shot or castrated. A lot of the mail is from gay people who are fed up with the status quo: compassion for the positive is being sapped by people who insist that we have to be compassionate even to positive people who are doing horrible, immoral things.
Dan
Posted by: Dan Savage on February 25, 2005 6:59 PM | permalinkOh, and I never said that fat people shouldn't date. I said that they shouldn't pretend that being fat is healthy, and that they have to accept that most people find fat unattractive -- including many fat people, it seems, since I get letters from them all the time bitching about how skinny people who won't date them. Why aren't they hitting on other fat people?
No more comments! Either someone has violated Godwin's Law, I'm tired of the discussion or, most likely, the ten-week window has closed. You can, however, contact me through email.