Sex, Safety, and the Trauma of AIDS

For most gay men who came out in the period after the Stonewall riots of 1969, the 1970s were a golden age of sexual freedom. It was an era that not only opened up the possibility of openly acknowledging one’s homosexuality and fostering a sense of identity and community, it also initiated a period of radical sexual experimentation (during the sexual revolution of the 1960s and 1970s). The discovery of AIDS in 1981 destroyed that utopian dream.

It is now almost thirty years since the discovery of HIV/AIDS. Since then, the ravages of HIV and AIDS have swept the world—with an estimated thirty-three million men, women, and children infected and currently living with HIV. Initially discovered among gay men in North America, the disease continues to have a disproportionate impact on men who have sex with men in North America and Europe whether or not they identify as gay or bisexual.

The epidemic provoked a devastating crisis—one that was political, cultural, and sexual. For homosexual men, AIDS was a historical trauma that shattered the experience of sexual freedom and disrupted new patterns of identity and community. In addition to the individual devastation caused by a mysterious and novel disease striking down hundreds of one’s friends and fellow community members, critical personal, social, and clinical issues soon emerged: diminished erotic desire, increased sexual dysfunctions, sexual addiction, and declining participation in community institutions.

The impending epidemic provoked debate and conflict over what aspects of the “gay lifestyle”—either sexual practices or recreational drug use—might have contributed to the pattern of immune deficiency among gay men. Many observers attributed the outbreak to sexual promiscuity, the frequent patronage of bathhouses and other public sex venues, along with the general availability of sexual activity in the urban centers of San Francisco and New York. The “lifestyle” argument had dramatic public health implications. It suggested that prevention could be achieved only by modifying the whole lifestyle itself: reduce the number of anonymous sexual partners, know your partner and his sexual history, close the bathhouses, stop using poppers, stop having sex.

The discovery of a new sexually transmitted disease, one that destroyed the very mechanism that normally protected the body from diseases, posed a challenge to the future of homosexual sex itself. Not only a crisis about sex in general, but also one about the kinds of sex that gay men in particular engaged in—fellatio, fisting, anal intercourse, casual sex with strangers and with multiple partners—anal intercourse being one of the most efficient means of transmitting the disease. Anal sex is considered by many gay men one of the most valued aspects of their sexuality. “The rectum is a sexual organ,” argued Joseph Sonnabend, a prominent AIDS physician, “and it deserves the respect a penis gets and a vagina gets. Anal intercourse has been the central activity for gay men and some women for all of history. . . . We have to recognize what is hazardous, but at the same time, we shouldn’t undermine an act that’s important to celebrate” (Rotello 1997, 101).

For most gay men, abstaining from sex was not a long-term option, but the epidemic instilled a profound sense of paranoia about homosexual desire. “Sex is just a completely different thing now,” porn star/director Al Parker exclaimed. “The entire time you’re having sex you’re thinking: ‘I’m having sex with everybody this person ever had sex with. I wonder what he’s done and where he’s been and if he’s positive or negative. I wonder if I’m giving him anything.’ If you can keep a hard-on while all this is going on in your head, you’re better than I am” (Escoffier 2009, 178–79). Was the sex that gay men engaged in “inherently” dangerous...