The 10 biggest lies about AIDS. (Commentary).

Bug chasers. Condom haters. Plague denialists. Is it any wonder that DAVID EHRENSTEIN is fed up with the prevarication and ignorance that are killing gay men and countless others? Amid a mountain of misinformation, these are ...

1. The AIDS epidemic is over.

It started sometime around 1996. A murmur at first, then a rising chorus of chatter, increasing in volume, insisting that the AIDS crisis was now "over." This didn't come out of nowhere. The massive flood of deaths that washed across the 1980s and early '90s had started to slow, as the new AIDS drugs--the combination therapy treatments known as the "cocktail"--began to work, prolonging lives that once seemed quickly and painfully finished. But a cure for AIDS has yet to be found, and 42 million people worldwide are HIV-infected.

What good news we have is overshadowed by the enormity of the pandemic. Sure, a recent Centers for Disease Control and Prevention report noted that "the number of deaths among persons with AIDS declined sharply and continued to decline each year [from 1996] through 2001." But the report also noted, "AIDS prevalence has increased steadily over time: At the end of December 2001, approximately 362,827 persons in the United States were living with AIDS. Through December 2001, 807,075 adult/adolescents had been reported as having AIDS; of these, 462,653 (57%) had died."

Gay columnist Dan Savage has been one of the most vocal "the AIDS crisis is over" town criers, but even he has recently made note of alarming new figures about the uptick in syphilis among gay and bisexual men--which means they're having unprotected sex and may well be spreading HIV as well as other STDs. It constitutes what Savage has called "a stupidity crisis."

"We still have people who are dying from opportunistic infections, and they find out that they're positive in the emergency room," says longtime San Francisco-based AIDS activist Hank Wilson. "It's like back in the '80s." Moreover, as ACT UP cofounder Larry Kramer is quick to note, in spite of all the relative good news of recent years, "It's not au epidemic. It's a plague."

2. There's a pill you can take for it, right?

Viramune, Epivir, Crixivan, Norvir, Zerit--those are just a few of the names. Doubtless they'll be joined in time by others. And they've all done wonders.

But that's no cause to let down our guard.

"We're in that middle time where we know how to deal with HIV but the drugs we have are still lousy," Wilson says. "If we could just get this generation to dig in a little bit longer [with safer sex], then we'll have less people getting infected. A lot won't die, but they'll pay the price of dosing fatigue and side-effect problems."

And there's no vaccine coming to the rescue anytime soon. The recent failure of the VaxGen's AIDSVAX was particularly discouraging--but not as distressing as the company's initial attempt to "save face" by claiming the faulty vaccine showed "promise" with nonwhites, a claim quickly withdrawn. Hanging a BROTHERS WELCOME sign on a failed treatment in hope of partially recouping costs in the third world is--dare we say it?--racist.

It's also a reflection of the drug industry's compulsion to put a positive spin on every shred of AIDS news. Partly as a result, Wilson says, young gay men out partying tell themselves, "We have all these new drugs and don't have to worry about dying." But they do. And if they're having unprotected sex, the very least they have to worry about is the host of other STDs they might contract besides HIV. Which leads us to another lie we tell ourselves:

3. Everybody knows about safer sex.

Wear a condom for penetrative activity. Be aware of any possible fluid exchange. Use caution for oral sex. You know the routine by now, right? Maybe so, but an increasing number of us aren't being so careful. "We have guys who have a Ph.D. in safe sex who can tell you precisely the week they got infected," Wilson says. "They're having a mixture of safe sex and unsafe sex."

And they're also mixing in drugs, like ecstasy and GHB and, perhaps most dangerously, crystal meth and poppers. "Partying with crystal fucks up your immune system and makes you susceptible [to infection]," Wilson says. Susceptibility is even greater if the crystal is combined with inhaled poppers, he adds. "Poppers are drugs. They're being promoted all over the place now, and they keep turning up as a susceptibility cofactor in terms of infection"--meaning they also depress the immune system and facilitate HIV transmission. "I think guys don't understand that [danger]," Wilson says. "If your partner's hot and if he offers poppers to you, then you have the same sex you've been having before, but all of a sudden you put your immune system at risk."

4. AIDS is something the older generation had to deal with--not us.

"I've been lucky, "says longtime AIDS survivor Steve Schalchlin, a singer-songwriter (The Last Session) who has faced death on more than one occasion. "The new drug therapies have saved my life. But there are many others who can't take these drugs, or can only take them for certain periods of time. I've done AIDS counseling and worked with many different groups. Often I go online into chat rooms to find out what people are up to. And I am amazed at the amount of barebacking that's going on with little or no regard for becoming infected."

Wilson adds, "There's so much complacency when it comes to AIDS education. The new generation thinks of the institutions that were established in the past, Well, that's their job. That's what they do. I don't have to do anything. I can't tell you how dangerous that is. My friends started getting diagnosed in '83. By '85 the fire in the belly about acting had gone away, and I moved to San Francisco to become an AIDS activist. There were all sorts of grassroots organizations. Now the grass roots are dead."

Those withered roots have left our most vulnerable generation few places to turn for the kind of support they need. "Every year a new graduating class of gay kids is dumped on the doorstep of the gay community," says longtime AIDS activist Ken McPherson, "and they're completely warped by their heterosexual parents, who don't know any better. And the area of entry [into gay life] is the bars and the raves. We have to challenge heterosexuals: `Do you know what you're doing?'

"Added to that is the new generation's aversion to accepting the label of `gay' as an identity," he continues. "If they're `not gay,' they don't have to think about AIDS. So AIDS is presented as `just one of those things in the gay community.' There's also a myth that some people think they're immune because they've had a lot of unsafe sex and they're not infected--including unsafe sex with guys who are positive. So then all of a sudden they come up infected and they're shocked."

It's a willful ignorance related to another big lie:

5. You can be safe without using condoms.

Yes, condoms are such a drag, aren't they? Such an "encumbrance" to do the one simple, basic thing designed to save yourself from being infected or passing your infection on to others. You want "real sex," right? Then you run the risk of real HIV infection or any of the other STDs that go along with unprotected sex. Gay old wives' tales like "I can't get it 'cause I'm a top" and its evil twin "I won't get it if he pulls out" provide the unwary with a sort of idiot's reassurance. And compounding the problem is the fact that the Bush administration wants to remove all mention of condoms from AIDS prevention education. Their solution to AIDS? Marry a member of the opposite sex and stay monogamous. Pity the disdained, lifesaving condom: Who knew conservatives would end up in agreement with sex radicals? Which brings us to:

6. The government is doing everything it can.

Indeed, it is: Everything it can to derail AIDS education and prevention efforts. The much-discussed withdrawn nomination of Jerry Thacker, an HIV-positive Christian activist who calls homosexuality a "death style," is just the tip of an iceberg called the Presidential Advisory Council on HIV and AIDS. The council still includes Joseph S. McIlhaney Jr., a physician who promotes widely discredited "abstinence education," discounts the effectiveness of condoms, and calls heterosexual marriage "the best public health strategy" for fighting AIDS. Agreeing with the doctor on every point is another council member, former Republican congressman Tom Coburn, an ally of the rabidly antigay and antisex Christian Coalition and Family Research Council.

The not-quite-good-enough news is that executive director Patricia Ware left the council in February, in the wake of revelations that she made several comments to gay members of the council suggesting that gay white men are responsible for infecting the African-American community with AIDS.

All the energy being expended simply to keep or discard condom education is depleting valuable resources needed elsewhere. Far off the Bush administration's radar, for example, is the issue of organ transplantation for the HIV-infected. "That's going to be next," says Kramer, the activist firebrand who in 2001 acquired a new liver himself. "More people are going to need new organs because of debilitation from HIV and the drugs used to treat HIV, and there is no system in place to deal with what's going to be coming down."

But you don't have to look as far as organ transplants to see just how far President Bush is willing to go to follow through on the AIDS efforts he outlined in his State of the Union speech: not very far at all. For one thing, he clearly believes:

7. There's nothing to be done about drug prices.

Wrong. Brazil's health minister, Jose Serra, simply ordered the government to manufacture generic AIDS drugs and provide the cocktail free under the public health system to those who need it. As a result prices were driven down, and Brazil's proactive policy has become a model for the rest of the world.

There's no reason that we can't do that here--except one. The pharmaceutical lobby and its congressional supporters are vehemently opposed to any alteration in the status quo. President Bush has recently voiced support for making drugs less expensive for senior citizens. But whether that or anything else can be pushed through in today's pro-business climate remains to be seen. There are, however, clear solutions at hand--if anyone in a position of authority is interested in considering them.

8. AIDS is no big deal: Seroconvert, get steroids, look great.

A by-product of the success of the new drug therapies has been the use of steroids to counter the physical wasting that many have experienced in the wake of infection and illness. As a result many seropositives look better than many seronegatives, leading in turn to greater carelessness. The real story behind the now-notorious February 6 Rolling Stone article about "bug chasers" is that people consciously seeking to infect themselves with HIV is not a new trend. It's a fringe phenomenon that's been known about since the start of the epidemic. But to claim, as Rolling Stone did, that 25% of all newly infected men are "bug chasers" means lumping the consciously suicidal in with those who are simply in denial about the risks they're taking. It's a monstrous oversimplification. Precious few of the newly seroconverted would claim "bug chaser" status for the very good reason that rather than seeking infection, they were simply "taking their chances." Getting to these "chance takers" is what really needs to be done. And that can be accomplished only through serious HIV education--as well as education to counter the persistent lie:

9. Nobody dies of AIDS.

Yes, we know the drill: People die of the infections they contract as a result of AIDS. On a literal level that's true. But ceaseless repetition of this "clarification" over the years has led to what can only be called a recloseting of the disease, removing from most obituaries any mention of the role HIV may have played in the deaths of openly HIV-positive men such as photographer Herb Ritts.

"I've observed this phenomenon for several years," says McPherson. "I've been shocked when rd be out with friends and mention something casually about HIV and I'd be taken aside later--by some `role model' in our community--and told, `Don't talk about that. We don't talk about that anymore.' Now that people are living with AIDS to some degree, the stigmatization hasn't ceased at all. It's reasserted itself in a new form."

And so it's necessary once again to mention that Ritts--like Halston, Michel Foucault, Colin Higgins, Rudolf Nureyev, Vito Russo, Anthony Perkins, Amanda Blake, Leonard Frey, Robert Reed, and, oh, so many, many others--didn't die simply of "cardiac arrest."

Finally, there's the frightening flip side of the "nobody dies of AIDS" lie:

10. We're all going to die, and there's nothing we can do.

Well, we are all going to die. But not all of us are going to die of AIDS. The HIV-positive can lead longer and less troubled lives if they take care of themselves and the drugs to treat infection improve. Many more can avoid infection to begin with--if they begin to think seriously about AIDS, commit themselves to their own well-being, and act accordingly. The refusal to consider that we can do this is the biggest lie of all.

Ehrenstein has contributed to Los Angeles and New Times.