A midlife HIV crisis: men in their 30s and 40s are old enough to remember AIDS at its worst--so why are so many of them still getting infected? (Aids).

Tom Tinder saw two friends die of AIDS in the mid 1990s. And for months afterward he worried that the slightest symptom of a flu meant he was next. He practiced safe sex diligently, especially after getting into a long-term relationship with an HIV-positive man. But after that relationship ended, his hunger for intimacy sometimes loomed larger than his memories of his friends' deaths. "After a couple months [of dating], the condoms came off," he says, adding that he was afraid he would scare guys away if he asked them to wear protection.

It wasn't long before Tinder developed the suspicious symptoms he had so feared: fatigue, constant napping, the pimple he'd pop that wouldn't heal. But this time he ignored them. He felt sick for a full three months before he finally went in for an HIV test. The results came back positive in September.

"In your 20s sex is more about you," the 33-year-old says. "In your 30s it's about sharing with the other person and trying to find a lover you think you can be with for the rest of your life.... It's easy to trust someone you like a lot."

This past summer the Centers for Disease Control and Prevention reported that an alarming number of gay and bisexual men in their 20s were testing positive for HIV. Health officials chalked up the trend--which they labeled a possible resurgence--partly to the fact that these young men were children in the 1980s and '90s and therefore don't remember the height of the AIDS crisis.

But just how strong a factor is memory when it comes to HIV prevention? While the rate of new infections among 20-somethings is certainly cause for concern, equally staggering are the large numbers of more mature gay men--some of whom remember burying friends and lovers--who are now testing positive.

The CDC doesn't gather nationwide HIV statistics. But numbers from the states that do track infections suggest there may be more gay men in their 30s testing positive than those in their 20s. Florida records show that 569 men in their 30s tested HIV-positive last year. That constitutes 47% of new infections among men who have sex with men, compared with 23% from those in their 20s. In Massachusetts it was 48% versus 23%. In Illinois, in the first half of 2001, 37% of new cases among men in all risk categories came from those in their 30s, 23% from those in their 20s.

The Advocate talked with more than a dozen men in their 30s or 40s who seroconverted in the past two years and asked them the circumstances behind their infection. Some said they took out-and-out risks. Others slipped up. One man said he was high on cocaine. A few others were simply looking for more intimacy. Many of them thought HIV wasn't any worse than diabetes. Today, some of them are taking as many as 20 pills a day, and one of them has lost his job. Another man is struggling to explain his status to his parents, who never much got the "gay thing" anyway.

Some of those who seroconverted say they really believed they were being safe. For example, one 31-year-old from Chicago, who asked that his name not be used, decided it would be OK to "top" without a condom. Although being the active partner during anal sex is certainly less risky than the alternative--resulting in infection about six in 10,000 times, according to one 1999 study--the risk, of course, increases the more that you do it.

"My luck ran out one night," says the 31-year-old, who tested positive early last year. When his friends found out he had seroconverted, he says, they all wanted to know how he had been infected. "When I told them," he recalls, "they said, `What? That's what I'm doing too.'"

Others say they knew they were taking risks--partly because the success of protease inhibitors helped persuade them to let down their guard. "You look at ads for HIV drugs and see models celebrating birthdays and scaling mountains and having civil unions," says Doug Wells, a 36-year-old from suburban Chicago who found out he was positive in February.

"Safe-sex fatigue" also has taken a high toll on gay men in their 30s and 40s. A Stop AIDS Project survey of gay men in San Francisco last year found that 35- to 44-year-olds were more likely than younger or older men to have unprotected anal sex with multiple partners: 51.1% of men age 35-44 had engaged in the activity versus 47.9% of those age 25-34 and 44.4% of those 45 and older.

Some men see condoms more as a mood breaker than a necessary precaution. "You're in bed and [condoms] are not an issue," says David, a 33-year-old from near New York City who tested positive in June. It's not easy, he says, "to have to be the one who makes the point to stop and say, `We need to use a condom.'"

Compare this attitude to that of 20 years ago, when, recalls Jim Arth, now 42 and a lawyer in Austin, "everybody was petrified [of HIV] and no one was having sex." The landscape has changed dramatically. Where once gay men were paranoid each time they got a flu, now some think they can slip up from time to time without putting themselves at risk.

"Men [who are] 30 and older are saying, `Why did this happen to me when I was only unsafe once or twice?'" says Mark Hodar, manager of HIV/STD services at Howard Brown Health Center in Chicago. "Ten years ago that comment would not have been said."

Men coming out of long-term relationships seem to be particularly susceptible to this sexual risk taking. Many of them have become used to having condomless sex and now suddenly find themselves navigating a dating scene where it's sometimes awkward to bring up the topic of safe sex.

"I probably on four or five occasions let someone be inside me for a couple of minutes," says Arth, who broke up with his longtime boyfriend last year. "I would say to myself, Why am I doing this? I'll only do this for a minute and stop. I wish I could tell you why. Part of it was, I would think if this guy is topping me, he'd tell me if he was positive."

Breakups themselves pose another problem. David, the New Yorker, says he contracted HIV after splitting with his boyfriend. Then, when they got back together for one night, David ended up infecting his ex because they didn't use a condom. "I didn't think I was at risk," David says. "That was pretty stupid on my part."

HIV counselors say some gay men put themselves at risk out of latent guilt--or a sense that they do not deserve to live--impressed upon them by widespread homophobia. Chris, a 40-year-old Chicagoan, also attributes his seroconversion to a crisis of self-esteem but thinks it had little to do with homophobia.

Three years ago he started frequenting a bathhouse, where, he figures, he had as many 245 sexual partners in nine months. "My attitude was, I may get infected, but I don't really matter," he says. "It only mattered to me that my partners didn't get infected." So if a sex partner wanted him to wear a condom, he did. If not, he didn't. He realizes now, almost two years after testing positive, that he was letting others decide his fate for him.

By contrast, Ed, a San Francisco health educator, has always been a paragon of resolve. "Anything anal was always with a condom," the 33-year-old says. His uncle, who was also his godfather and the first gay man he knew, died of AIDS complications in 1985, and Ed vividly remembers his own and his family's sorrow following the death. "You play according to the rules, or you don't do it," he says. "I'm sorry if that doesn't work for you."

Ed refuses to speculate how he contracted the virus this year. He deems it counterproductive to look back and regret what happened. But condoms do break, and according to one study, oral sex with an infected partner leads to seroconversion in four out of 10,000 cases, regardless of whether it involves ejaculation.

Knowing how safe Ed says he has been and then knowing that he was infected anyway may lead some people to question the reasoning behind taking precautions in the first place. But Ed cautions against that kind of thinking. He continues to think his example speaks strongly to making one's rules and sticking with them.

"Regardless of whether the other person says he is negative or not, do your research," he says. "If you let someone compromise the integrity of what you believe in, you will not allow yourself to live peacefully if you get HIV."

Health officials are still at a loss when it comes to stopping the spread of HIV--especially among a generation that saw firsthand the devastation the virus can wreak. "If I had the answer, I'd be out of a job," says Howard Brown's Hodar. "It used to be that death was the message. That was what made people make great strides in reversing the number of HIV cases."

Today, Hodar says, the answer may lie in the host of problems people with HIV still face: The virus is not necessarily the immediate death sentence it once was. But as these men and many others will attest, infection can change your life profoundly.

Today, all of them say they worry about finding men who are comfortable enough with their HIV status to date them. Some of them say they have felt depressed and isolated at times. Others suffer from exhaustion, which makes it harder to keep a job. Wells, who last worked in July, says even a volunteer job answering phones wears him out.

Arth, who tested positive in April, is trying to figure out how to tell his parents. "Part of it is not wanting to make them scared. Part of it is, `How stupid of me that I let this happen.'"

Another HIV-positive man, Rob, says the hardest part is knowing that even if he staves off illness, he will never be completely well. "There's a price on your head. There's no cure," says the 33-year-old Chicagoan.

He was in one very casual relationship in the six months before a test canoe back positive in July 2000, and neither he nor his partner used condoms. "I wasn't out dating 50,000 men. But there were some people you'd practice safe sex with and some people you wouldn't," Rob says. "You don't think about it until you are in that boat and you can't go back."

Schuerman also writes for Details and The New York Times.