Living
Gay, bi men remain key to HIV epidemic
After 30 years of AIDS, many breakthroughs but infection rates on the rise
On June 5, 1981, the U.S. Centers for Disease Control and Prevention published an article in its authoritative journal Morbidity and Mortality Weekly report that experts now consider the first signal that an unprecedented worldwide epidemic had begun.
“In the period of October 1980-May 1981, 5 young men, all active homosexuals, were treated for biopsy-confirmed Pneumocystis carini pneumonia at 3 different hospitals in Los Angeles, California. Two of the patients died,” the MMWR article stated.
“Pneumocystis pneumonia in the United States is almost exclusively limited to severely immunosuppressed patients,” said the article. “The occurrence of pneumocytosis in these 5 previously healthy individuals without a clinically apparent underlying immunodeficiency is unusual.”
It would take another few years before scientists named the condition detected in the men discussed in that MMWR article as Acquired Immune Deficiency Syndrome or AIDS. The name AIDS followed an earlier term used by some researchers and the media – Gay Related Immune Disorder or GRID.
In reflecting on the tumultuous developments surrounding AIDS over the past 30 years, leaders of AIDS advocacy organizations and LGBT activists in the U.S. who lived through the early years of the epidemic say that, to some extent, the MMWR article of June 1981 still has considerable resonance for gay men.
They acknowledge that so much has changed for the better over the past 30 years, including breakthroughs in biomedical research resulting in highly effective drugs that transformed AIDS from a death sentence into a manageable, chronic illness like diabetes.
But AIDS activists also point out that HIV and AIDS continue to disproportionately impact gay men or men who have sex with men (MSM) in the United States and other countries.
And although the perception of AIDS as a “gay disease” has largely receded from the minds of most Americans, AIDS activists say they find themselves in the ironic position of having to remind Congress and state and local governments that more resources and funding are needed for HIV prevention programs targeting gay and bisexual men.
“MSM is the only group for whom, according to the CDC, new infections are still increasing,” said Ronald Johnson, vice president for policy and advocacy for AIDS United, a national group formerly known as AIDS Action.
“So there continues to be a concern that there is not enough targeted prevention resources to MSM, particularly MSM of color and young MSM of all races and ethnicities,” Johnson said.
According to the CDC, while MSM account for about 2 percent of the U.S. population, more than half of all new HIV infections in the U.S. each year (53 percent) occur among MSM. CDC data also show that MSM make up nearly half of all people living with HIV in the U.S. – 48 percent.
CDC figures show that white MSM “account for the largest number of annual new HIV infections of any group in the U.S., followed closely by black MSM,” according to a CDC fact sheet released last month.
“There are more new HIV infections among young black MSM (aged 13-29) than among any other age and racial group of MSM,” the fact sheet says.
The Obama administration, with input from AIDS advocacy organizations, released a National HIV/AIDS Strategy document in July 2010 that, among other things, calls for an aggressive effort to develop better HIV prevention programs targeting MSM.
Johnson and Carl Schmid, deputy executive director of the AIDS Institute, a national advocacy group, praised the administration for developing the strategy document, which they say covers most of the bases needed for addressing HIV prevention programs for MSM.
But the two said the proposals in the strategy document have yet to be fully implemented. They note that delays in its implementation are due, in part, to the U.S. economic situation that has prevented needed increases in federal AIDS funds and severe cutbacks in state and local funding for AIDS-related programs.
Phill Wilson, president and CEO of the Black AIDS Institute, said in a commentary last week in the Washington Informer, a black community newspaper, that he fears the horrors of the AIDS epidemic of the 1980s, when friends and family members watched loved ones die due to a lack of effective medical treatment, could return to some degree in the next few years.
According to Wilson, if the federal government fails to boost funding for the federal-state AIDS Drug Assistance Program (ADAP), low income people who rely on the program to provide them the medications they need keep the AIDS virus in check could become casualties just as their predecessors became casualties years earlier. But this time, he said, an inability to gain access to medicine due to funding shortfalls would be responsible for their fate at a time when effective medicine is readily available.
He called such an outcome “immoral.”
The ADAP program was created under the Ryan White AIDS Care Act to provide life-sustaining drugs for low-income people with HIV and AIDS who are under insured or don’t have any health insurance to help pay for the drugs.
ADAP funding cuts by states and a large increase in the number of people applying for ADAP assistance has resulted in nearly 8,000 people being placed on state waiting lists for the AIDS drugs they need to remain healthy.
The health insurance reform law that President Obama proposed and Congress passed two years ago was expected to relieve the ADAP funding pressure on states when it takes effect in 2014. However, some states that oppose the law have filed lawsuits seeking to prevent its provision requiring all citizens to buy some form of health insurance from going into effect, making its outcome uncertain.
Nearly all AIDS advocacy groups support the law, saying it would strengthen medical care for large numbers of people with HIV/AIDS.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, an arm of the U.S. National Institutes of Health, has been the leading federal government official monitoring the AIDS epidemic and directing AIDS-related research since the disease burst on the scene in 1981.
In a speech commemorating the 30th anniversary of AIDS at NIH headquarters in Rockville, Md., on Tuesday, Fauci said he’s optimistic that an AIDS vaccine can be developed in the near future.
“We have scientific evidence that a safe and effective HIV vaccine is possible,” he said in a statement released on May 18.
“In 2009, a clinical trial in Thailand involving 16,000 people demonstrated for the first time that a vaccine could safely prevent HIV infection in a modest proportion of study participants,” he said. “Many of the best minds in HIV vaccine science are examining blood samples and data from the Thai trial to learn how the vaccine candidate prevented HIV infections and to consider how it could be modified to be more effective.”
Fauci said NIAID is also optimistic about development within the next few years of effective vaginal and rectal microbicides that can be used to prevent the transmission of HIV during sexual contact.
Fauci and other researchers have also pointed to studies showing the effectiveness to a certain degree of prescribing HIV drugs for use by non-infected people believed to be at high risk for HIV infection, such as men who have sex with men.
Known as pre-exposure prophylaxis, or PrEP, the use of this prevention measure is said to have the drawback of being less effective if people fail to take the drug as required. Some also have expressed concern that people using this prevention method are subject to potential side effects of the drugs and may be discouraged from using condoms, which experts say is one of the most effective methods of HIV prevention.
Events and developments in the early years of AIDS
• 1981: The CDC reports in its June 1981 edition of MMWR and subsequent editions that year that an estimated 170 gay men had succumbed to Pneumocystis carini pneumonia and Kaposi’s sarcoma, a rare skin cancer, over the preceding two years. The CDC studies of these cases cited a serious malfunctioning of the body’s immune system in those who contracted the conditions.
• 1982: Gay Related Immune Disorder, or GRID, became the first name to describe what is now known as AIDS. Cases reached epidemic proportions in the U.S., moving beyond clusters of gay men in New York, San Francisco and Los Angeles and into groups with no obvious risk factors.
• 1983: Gay leaders, independent medical researchers and health and social services agency officials testify before a congressional committee that the federal response to AIDS was highly inadequate. They issue a plea for the federal government and the Reagan administration to increase federal funding and federal initiatives to fight AIDS.
• 1985: In late July, actor Rock Hudson stunned the nation when he issued a statement saying he had AIDS and was receiving treatment in Paris that he said he couldn’t get in the U.S. He died three months later at age 59. His announcement and death drew massive mainstream media attention to AIDS. His death prompted his close friend, actress Elizabeth Taylor, to help found the American Foundation for AIDS Research to raise funds for AIDS causes.
• 1988: The NAMES Project AIDS Memorial Quilt makes its second trip to Washington in the spring, where it’s displayed on the Ellipse near the White House. Later that year, about 1,100 AIDS activists staged a protest at the headquarters of the U.S. Food and Drug Administration in suburban Maryland outside D.C., denouncing the FDA for taking too long to approve new drugs for people with AIDS. Police arrested at least 176 of the protesters after they blocked access to the FDA building’s main entrance.
Hi Michael,
When is it worth stopping being friends with someone, or more than one person?
Lately I feel like my friends aren’t being very nice to me. In fact it reminds me of high school, and junior high school, when I was being bullied.
I’m not the most attractive in the group, I know that. They are always ribbing me about not working out enough or that I should get a hair transplant (I am balding) or making fun of the way I dress. I am not that stylish, I just don’t have a good sense for clothes. I thought about asking for some advice but I worry that would just lead to more mocking.
That I am not having as much sex as they are—it’s actually my preference, but of course I get comments about not being able to get someone to hook up with because of my appearance, clothes, low-key personality etc.
As I’m writing this I could go on and on. I think I’ve just tried laughing with them or ignoring it, but it does really get to me.
There’s a standard in this town that I know I don’t fit. Great body, handsome face, overall hot, witty and sarcastic sense of humor, make a lot of money in some impressive job. I am sure you know the type I am describing.
Some of the things I can’t help (appearance), some I don’t really want to fix (hooking up a lot). My brother died of an overdose so I don’t use drugs or alcohol, which, no surprise, evokes more judgment.
My job is my job, I like it a lot and it is meaningful to me but I’m never going to be rich.
The problem with that is, all my friends like to take a lot of expensive vacations. I can go on some but not on all. When we go I am watching my expenses, which provokes more judgment and jokes, always delivered as if they are “kidding” but it hurts.
I started off by saying I feel like I’m back to being a bullied kid. You know, laugh it off so that they don’t see you crying. But it doesn’t feel like I am respecting myself when I do that.
If I speak up and ask them to stop, I just get more jokes. I am NOT taken seriously.
The idea of walking away is scary, though. Who else would I have to spend my weekends with? I am afraid of being lonely.
I could write more but I think I’m conveying why I am feeling pretty hopeless about these friendships.
Michael replies:
I think it’s a bad idea to spend time with people who are mean or abusive toward you.
But before you walk away from your friend group, do you think it’s worth talking to them, individually, or as a group? In a serious way, without joking, laughing, or minimizing your pain so as not to make them uncomfortable.
Their behavior sounds very junior high school, but they are adults. Telling them how their behavior affects you might lead them to confront themselves, but it might not.
You didn’t write anything about what you actually like about these friends. Is it just that they allow you to spend time with them? Or do they have some good qualities? Getting clear about this would help you figure out if you want to push for change here.
I know what you mean about “the standard” in D.C. (and very likely in other locations). I hear from clients over and over about the hierarchy of attractiveness and success. When people don’t feel they measure up, it is easy to feel less-than, and invisible.
There are lots of reasons why gay men can be mean to other gay men. (Of course, everyone can be mean, and for all sorts of reasons). One biggie: it’s nice to feel like part of the in-crowd, after growing up feeling like an outcast. But this means establishing a pecking order so that there are others to look down on and exclude. It’s understandable, all too common, and unkind.
It’s also true that the heterosexual world tends to value beauty in women and financial success in men. Gay men hit themselves with a double whammy, glorifying both.
Still, you’re not going to single-handedly change the problematic aspects of gay culture. You may be able to influence some of your friends, however. That remains to be seen, and would take some courage on your part if you want to tackle that.
It does sound like it’s time for you to make some new friends. This may seem even more scary than speaking up to the friends you have, but it also might give you a sense that you are taking control of your life.
True, in D.C. (and elsewhere), there are a lot of gay men focused on the attributes you say you lack. But “the scene” is not the only game in town. There also have to be a good number of guys out there who are looking for other qualities that you may possess, and that you may also admire in others. These are the people for you to find and befriend.
I can’t tell you exactly how to go about that. You’re going to have to be creative and try some new things. Activity groups, hobbies that involve other people, sports. You never know whom you might meet, where. Don’t forget that you might enjoy meeting and hanging out with people who aren’t gay, as well.
You didn’t mention anything about looking for love in your life. Maybe that’s not your interest; maybe you don’t feel like adequate partner material (if so, I hope you will work to challenge that belief); or maybe you’re doing just fine in that area. I don’t know. But if you would like to find a good guy, I hope that widening your field will help.
Michael Radkowsky, Psy.D. is a licensed psychologist who works with couples and individuals in D.C., Maryland, Virginia, New York, and all PSYPACT states. He can be found online at michaelradkowsky.com. All identifying information has been changed for reasons of confidentiality. Have a question? Send it to [email protected].
Real Estate
With gas prices soaring again, a staycation is a good plan
Home can be your personal retreat and your own private resort
When airfare costs more than your monthly utility bill and a weekend road trip requires a second mortgage just to fill the gas tank, many homeowners are discovering an unexpected luxury: the staycation.
A staycation isn’t settling for less—it’s reaping the benefits of one of the biggest investments you can make: your home. Much more than a place to sleep, it’s your personal retreat, your gathering place and, with a little preparation, your very own private resort.
Whether you own a single-family home, a townhouse, or a condo, creating a memorable staycation starts with appreciating what made you fall in love with your property in the first place.
Start with a home refresh. Think about checking into a beautiful vacation rental. It’s spotless, organized, and inviting. You can recreate that same feeling by spending a day preparing your home before your staycation officially begins.
Clear away clutter, deep clean the bathrooms and kitchen, wash the windows, and put fresh linens on every bed – even if you’re not expecting guests. Fluff the pillows, light a favorite candle, and place fresh flowers on the table. These small touches instantly make your home feel more luxurious.
If your budget allows, hiring a professional cleaning service can be one of the best staycation perquisites you make. After all, vacation should begin the moment you wake up and not after you’ve spent the day scrubbing floors.
Treat your staycation like a real trip. Set away messages on your phone and out of office notices on your email. Skip unnecessary chores for a few days. Giving yourself permission to relax may be the most valuable part of the entire experience.
One of the greatest advantages homeowners have over travelers is private outdoor living space. Whether it’s a spacious backyard, a screened porch, a rooftop terrace, or a cozy condo balcony, these areas can become the centerpiece of your staycation.
Stringing lights and adding comfortable seating, colorful planters, and outdoor rugs can completely transform the atmosphere without spending thousands of dollars. Add a portable fire pit, a tabletop fountain, or a hammock, and suddenly your backyard starts competing with many resorts.
Host an evening cookout, organize a game night, invite neighbors over for dessert, or gather around the fire pit for conversation after sunset. These simple moments often become the memories we treasure most.
Inside, transform your family room into a home theater complete with popcorn and comfortable blankets. Turn your breakfast room into a morning coffee café. Designate a quiet reading corner where phones are prohibited. Create a spa-like bathroom with plush towels, candles, bath salts, and relaxing music.
One of the highlights of traveling is experiencing new food. Instead of dining out every night, create themed dinners inspired by your favorite destinations. Prepare homemade Italian pasta one evening, Caribbean grilled seafood another, or a backyard Texas barbecue over the weekend. For a touch of whimsy, dress the part.
Pair each meal with music and libations from the region and enjoy dinner outdoors whenever possible. Suddenly, your dining room becomes part of the vacation experience instead of just another place to eat.
Families with children can turn a staycation into an adventure by seeing their home through a child’s eyes. Set up a backyard camping experience with a tent, flashlights, and s’mores around the fire pit. Transform the living room into an indoor campground complete with sleeping bags and a movie under a blanket “fort.” Organize a backyard Olympics with relay races, water balloon tosses, scavenger hunts, or miniature golf using household items.
Encourage children to plan a family picnic in the backyard or on the patio, choose a theme for a movie marathon, or help prepare meals inspired by countries they’d like to visit someday. The goal is to create experiences your children will remember long after summer is over.
Enjoy the amenities you already pay for. Condominium communities and many planned neighborhoods offer amenities that residents often overlook.
Swimming pools, fitness centers, tennis and pickleball courts, walking trails, clubhouses, grilling stations, and community gardens are designed to enhance your lifestyle. During your staycation, make a point of exploring everything your community offers. You may discover you’ve been living beside your own private resort all along.
Real estate professionals often talk about resale value, appreciation, and return on investment. While those things certainly matter, there’s another return that’s harder to measure: the enjoyment you get from living in your home every day.
You don’t need a boarding pass to recharge. You don’t need a hotel reservation to make memories. Sometimes the perfect getaway is the one you already own.
Valerie M. Blake is a licensed Associate Broker in D.C., Maryland, and Virginia with RLAH @properties. Call or text her at 202-246-8602, email her at [email protected] or follow her on Facebook at TheRealst8ofAffairs.
The latest Honda Civic hatchback and Subaru Impreza are two of the segment’s stars. Both offer sensible pricing, excellent utility and enough personality to avoid feeling like appliances.
The Civic is more polished. The Impreza, more rugged. Luckily, neither is trying to be obnoxiously flashy.
HONDA CIVIC
$28,000
MPG: 30 city/38 highway
0 to 60 mph: 8.9 seconds
Cargo space: 24.5 cu. ft.
PROS: Fuel efficient. Spacious cargo area. Good resale value.
CONS: No all-wheel drive. Fussy infotainment. Low rear headroom.
WHAT’S NEW: Only minor updates for 2026. The biggest change carries over from last year’s refresh: the addition of the hybrid, which has become a star performer.
The Honda Civic hatchback won’t scream for attention. It won’t arrive wearing sequins and carrying a smoke machine. It’s more like Nomi Marks from “Sense8”: intelligent, sophisticated and impressively capable.
The styling remains handsome and clean. Long hood. Low roofline. Crisp lines everywhere.Honda resisted the urge to make this vehicle look like a spaceship or an angry robot. That’s refreshing.
Inside, the dashboard is simple and elegant. The honeycomb air-vent treatment remains one of the coolest interior details in the segment. Materials feel expensive. Controls are easy to understand. And visibility is excellent.
I love how the cargo space is generous, with rear seats that fold flat. A bicycle, several suitcases or enough supplies for an ambitious weekend road trip fit without much hassle.
Then there’s the hybrid. The system produces a healthy amount of power while delivering fuel economy that borders on the absurd. Around town, handling feels smooth, quiet and surprisingly quick. You almost glide through traffic. The standard gasoline engine isn’t bad, but the hybrid is stellar.
The Civic also shines on twisty roads. Steering is precise. Body motions stay controlled. The suspension strikes a sweet balance between comfort and sportiness.
Biggest weakness? No all-wheel drive. For drivers in snowy climates, that’s not so good.
Still, the Civic’s stellar combination of efficiency, quality, and driving enjoyment remains incredibly hard to beat.
SUBARU IMPREZA
$27,000
MPG: 27 city/33 highway
0 to 60 mph: 8.5 seconds
Cargo space: 20.4 cubic feet
PROS: All-wheel drive. User-friendly tech. Safety cred.
CONS: No hybrid version. Some road noise. Modest cargo room.
WHAT’S NEW: The Impreza receives relatively minor updates for 2026. Subaru continues refining this hatchback rather than reinventing it.
If the Honda Civic is urbane, the Subaru Impreza is unfussy. There’s a kind of Kristen Stewart energy here. Cool without trying too hard.
The styling isn’t dramatic, but it works. This hauler appears ready to tackle rain, snow, dirt roads or an impromptu weekend escape.
And all-wheel drive comes standard on every Impreza. (Most competitors only offer front-wheel drive or include all-wheel drive as a pricey option.)
The result: Slippery roads simply don’t create much anxiety. The suspension absorbs bumps nicely. Long trips are comfortable. Visibility is great, thanks to relatively thin roof pillars and large windows.
I like how the cabin is functional rather than fancy. Materials don’t quite match the Civic’s upscale vibe, but everything feels sturdy. A large infotainment screen dominates the dashboard and generally works well, though some drivers may prefer more physical buttons.
Cargo space is respectable, and the design makes loading bulky items easy.
Performance depends heavily on trim. The base engine gets the job done, but nobody will confuse it for a sports car. The RS trim’s larger engine provides more power and makes the ride livelier. But even then, acceleration remains merely adequate.
The Impreza’s real appeal lies elsewhere, with a mix that few rivals can match: hatchback practicality, standard all-wheel drive, strong safety scores and reasonable pricing.
Perhaps that’s the key difference between these two hatchbacks. The Honda Civic impresses immediately. The Subaru Impreza grows on you.
Fortunately, choosing between them is less stressful than deciding who gets the last mimosa at brunch.
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