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An Exchange on AIDS

In response to:

Anatomy of an Epidemic from the August 18, 1983 issue

To the Editors:

Professor Lieberson’s “Anatomy of an Epidemic” [NYR, August 18] would be just another in that growing series of disguised journalistic assaults on homosexuals if it were not that his views on AIDS are being given the implicit imprimatur of intellectual authenticity which The New York Review of Books represents for many; and so his account demands rebuttal.

Professor Lieberson documents the now familiar numbers of those afflicted with AIDS, and its mortality rate. He introduces “distinguished authorities” he will quote. (“Radicals” will be dealt with later.) The phrase “promiscuous homosexual men” enters early to identify those among whom the disease has been purportedly found most frequently. He does not omit the fact that there are cases of AIDS among those “with no ascertainable risk factors”—that is, heterosexuals who are not hemophiliacs, drug-users, nor Haitians, the three other “high-risk” groups. He establishes a pattern: He will leave unexplored any aspect or implication that may become bothersome in his developing argument. Here, he looks away from the importance of that heterosexual “non-risk” group which, through its very “exceptionality,” might provide significant clues to the origin of AIDS.

Two theories prevail about the cause of the immunological breakdown which allows “opportunistic diseases” otherwise tolerated by the body to attack fatally, the viral theory and the immunity-“overload” theory. He focuses the latter on homosexual behavior: “…. the explosion of homosexual promiscuity in the late Sixties and during the Seventies produced extraordinarily high levels of relatively common viruses and predisposed homosexuals to immune breakdown.” He ignores the concurrent “explosion” of so-called “promiscuity” among heterosexuals. Further, cursory research into the literature of earlier times confirms that “promiscuous” sex occurred among men virtually as often before the late Sixties as now (my own early books assert this); the major change was a shift to “safer” locations and a wider awareness of its existence.

Professor Lieberson decries the press’s “inexcusable” reaction in the serious matter of AIDS. That allows him to repeat the most scurrilous of those attacks, labeling them “ugly,” “intemperate,” “fatuous.” Without forceful contradiction, such inflammatory remarks are only emphasized by full repetition.

He agrees the government has responded “torpidly.” Yet the assertion by homosexuals that bigotry is involved, he finds “nicely balanced by Jerry Falwell’s recent claim that the Reagan administration is doing nothing to stem the ‘plague’ out of deference to homosexual voters and lobbies.” Finding a “nice balance” between what he earlier attributed legitimacy to and the ragings of Falwell, links both as equally dismissible.

The not-narrowly-held view that AIDS may be a consequence, intended or not, of government biological experimentation, he attempts to ridicule with a long narration of a report of swine flu passed on in “a sealed, unmarked container.” Swine flu has been discarded as connected to AIDS; yet he allows that convoluted narrative to stand in place of serious expressions of the biological-experimentation theory. When the “unthinkable” is revealed daily—experiments with LSD on unsuspecting soldiers, the sterilization without consent of black women, the mysterious effects of dioxin—is it remote to suggest that experimentation on the immunological system might be conducted on men not likely to reproduce?

Reading the recent medical literature I have not found any claims that promiscuity itself ‘causes’ AIDS, as suggested by the novelist John Rechy, who says that ‘sexual acts are being condemned as producing AIDS—acts which have occurred since before the time of Christ.” How he plucks from my words his astonishing inference is a puzzle. Nowhere in that sentence, nor in the full interview he quotes from, do I make any reference whatever to “promiscuity”; the quoted verb “causes” is his, but by juxtaposition he attempts to attribute it to me. (The thrust of my paragraph was that “the danger of AIDS cannot, must not be minimized.”) Those distortions allow him to make his point: “But it is also difficult to find evidence that promiscuity did not predispose certain men to AIDS.” He cites a control study as revealing that AIDS patients had an average of 60 sexual partners per year compared with 25 for controls. But: In that sample, did one of those patients have only five contacts (far fewer than the “average” control), while another had 115; did another have only one while two others had 120 and 59, respectively? Those uneven combinations all produce an “average” of 60. Professor Lieberson is now pushing his argument into staked territories: homosexual “morality” and “promiscuity.” “During the past decade….a small but influential group of homosexuals developed a way of life that encouraged this kind of satyriasis.” In “satyriasis,” with its connotation of pathology, he has found his true tone, which he extends in denouncing among homosexuals “a dreary sexual conformism…rigidly defined and routinized sex moves in the theatrical costume of police or ranch wear [sic].”

Though his article is elsewhere littered with footnotes, he uses words quoted without attribution to give borrowed legitimacy to his views on “moral questions concerning sex practices” among certain homosexuals—and he now ignores all other “high-risk” groups. He inverts his denunciation in the form of praise for homosexuals who have made “righteous reflections on sex and politics quite different from those of the radicals…. Some have become ‘twice born,’ despising their former promiscuous selves…. Sometimes they blame the ‘sexual revolution’ for AIDS, or call the homosexual ‘rights’ movement a failure on the grounds that it… degenerated into a preoccupation with sex… oblivious to human welfare and ‘liberation’—and health.” He commends those who have found “sexual habits better suited to present conditions,” those who have turned to monogamy, “closed circles of partners.” (How sudden monogamy or impromptu “closed circles” provide protection from a syndrome whose incubation period is purported to range from one year to three years is not explained.) Professor Lieberson extends his approval to those who have “embarked on what one writer calls ‘immunological lent,’ ” and those who employ ” ‘phone sex’ intended to alleviate in a ‘healthy’ way the melancholic condition of celibacy.” How eagerly do even perhaps “good heterosexuals” impose grim sentences of abstinence on others!

While Professor Lieberson glances at “reports” of the terror of AIDS patients—isolation, financial hardships, desertion, medical mistreatment both before and after death—what appears concern is at best compromised quickly: “The New York City Health Commissioner, Dr. Sencer, told me that although such behavior presents ‘a problem,’ these are relatively isolated cases.”

Another of the “opportunistic diseases” AIDS has exposed homosexuals to is the proliferation of these journalistic assaults. For more than two years we demanded attention to a matter of literal life and death—and instead we got indictments. The most chilling aspects of these media accounts are their lack of compassion and their many buried cruelties—like the constant, arbitrary extension—without substantiation—of what is considered to be the length of the incubation period of AIDS; thus the effect of a lingering death sentence is created for millions of homosexual men. Unglimpsed are the ramifications of the possible emergence of a pressurized generation of once healthy homosexual males branded forever by the association of sex with death. And cruelly ignored is the rage the men who have AIDS must feel to be pillaged by these journalistic rampages.

In all these accounts, there is a note of harrowing triumph, the authentication of bigotry, the triumph of rancid repression.

John Rechy

Los Angeles, California

Jonathan Lieberson replies:

Contrary to what Mr. Rechy’s singularly unreliable summary of the purpose and content of my article asserts, I wrote it in order to provide an account of the main views on the causes and consequences of AIDS, as well as a brief analysis of some of the debates about the sex practices of homosexuals that have appeared in the press, homosexual and “mainstream.” Since Rechy belabors me for concentrating on the latter issue and ignoring the practices of other “high-risk” groups in my discussion, I must answer that I did so because homosexuals have been afflicted by AIDS far more than any other high-risk group and because the disease is widely believed to be sexually transmissible. Indeed, since I wrote the article, the debate concerning whether there are any prominent high-risk groups outside homosexuals and users of intravenous drugs has intensified: in New York City, Haitians (or Haitian-Americans) are no longer classified as a high-risk group because the number of cases among them is too small to justify its inclusion and because many cases among them have been reassigned to the other high-risk groups.

Mr. Rechy is correct that I did not let the clinical picture I tried to present suggest its own moral. I deplored the slowness with which the Reagan administration responded to the disease; I wrote about the unfortunate condition of AIDS victims and expressed sadness that fear of AIDS may have generated discrimination against homosexuals. I wished to indicate that there is no single pattern of life among homosexuals and no single “gay community.” Homosexuals are not a school of fish and do not uniformly obey a single sexual code: it is doubtful that homosexuals in general are at high risk for contracting AIDS any more than “Haitian-Americans” are. I praised homosexual groups that promoted education about AIDS and that raised money to help victims of the illness. On the other hand, I criticized some homosexual spokesmen and some members of the homosexual press (as I did members of the “mainstream” press) for their views on the disease and its social implications. (In this I have not been alone: in a recent article in the New York Native [August 15-28, p. 16], the managing editor of the Washington Blade asks whether the homosexual press has provided better coverage of the AIDS story than other newspapers. He says, “I don’t believe it has, and conversations this week with several colleagues at other gay papers indicate that many gay editors agree with me.”)

Mr. Rechy has, incredibly, found in these points a “journalistic assault” on homosexuals, although, in what I can only imagine to be a desperate effort to diminish the implausibility of this charge, he calls the assault a “disguised” one. Mr. Rechy, a novelist who was recently described by a book reviewer in the homosexual paper The Advocate [August 4, 1983] as “best known for combining a strong defense of promiscuous, or outlaw, sex with an equally strong condemnation of sadomasochism,” brings one spurious charge after another against me. He thinks that I should have more forcefully repudiated some “media accounts” of AIDS, as if the words he himself quotes from my article were not forceful repudiation enough. He thinks that I attributed “legitimacy” to the idea that bigotry lay behind the slowness of the government in meeting the AIDS crisis, whereas I gave a number of reasons for regarding this interpretation as unacceptable. He oddly thinks that my compassion for AIDS victims is surrendered or “compromised” because I quoted the opinion of the health commissioner of New York City that mistreatment of these ill people by health personnel and others is not as widespread as some have thought. He thinks that I unfairly ridiculed the view that AIDS is a result (deliberate or accidental) of “government biological experimentation,” and yet offers no evidence whatever for thinking that it is anything but a wild guess.

It seems disingenuous of Mr. Rechy to say that I made an “astonishing inference” when I wrote that he “suggested” that some, doctors or others, think that AIDS is caused by promiscuity. In the interview with him that I cited, Mr. Rechy, described by his interviewer as “tough and mean,” as a “legendary sexual outlaw,” is asked: “In an essay you once observed that the most radical thing one could do would be to have sex in the streets. Given the fears of promiscuity and cruising these days, do you still embrace that style of radicalism?” There follows a long response by Mr. Rechy, which begins: “We are living through the most crucial period homosexuals have faced in modern times. Because of AIDS we confront a threat as horrible as the Inquisition and the concentration camps. The danger of AIDS cannot, must not be minimized. Our entire lives are being judged and condemned by heterosexuals, by doctors who know absolutely nothing about us. Sexual acts are being condemned as producing AIDS—acts which have occurred since before the time of Christ. We are under assault because AIDS just happened to strike us first,” etc. [Gay News, July 8-14, 1983, p. 12]

I wrote that this “suggested” that Mr. Rechy thinks that some believe that promiscuity “causes” AIDS. I used the word “causes” (in quotes) as a synonym for “produces,” and I assumed (what is evident) that if sex acts themselves cause AIDS, then so do these same sex acts when performed repeatedly and indiscriminately. Accordingly, there is no “astonishing inference” from Rechy’s words. Nor, as the passage makes clear, was his statement that “the danger of AIDS cannot, must not be minimized” what it seems to be in his letter, namely a call to responsible conduct in the face of a virulent epidemic; for Mr. Rechy, it seems, this “danger” is social and political, and not medical.

In my article, I reported that a number of prominent writers on AIDS have claimed that promiscuity may have “predisposed” certain men to the illness and may have “amplified” its incidence. I cited a case control study of 1981 about which Dr. William Foege, the ex-Director of the Centers for Disease Control (CDC), said in the volume I was reviewing:

from these interviews came some answers to the question of who was at greatest risk of developing AIDS. Epidemiologists identified a subset of homosexual men who were more likely to have many anonymous sexual partners, to have a history of a variety of sexually transmitted diseases, and to engage in sexual practices that increased the risk of exposure to small amounts of blood and feces. The most important variable was that AIDS patients had more male sexual partners than the controls, an average of 60 per year for patients compared with 25 per year for controls.

As Mr. Rechy says, there may have been variations in the number of sexual contacts among the AIDS patients (as indeed there might have been among the “controls”). But this point is true of any statistical reasoning of this kind, and Mr. Rechy does not say why making this elementary point should impugn Dr. Foege’s point.

Mr. Rechy apparently sees the fully realized homosexual as a Siegfried defiantly seeking release in heroic alleyway sex, and so he regards measures designed to prevent the transmission of AIDS as politically unacceptable if they conflict with this way of life. He accuses me of “imposing” abstinence on homosexuals. I did nothing of the kind. I praised sex practices “better suited to present conditions,” and I took pains to distinguish this view from both the romantic promiscuity celebrated by the characters in Mr. Rechy’s books and the self-righteous views of the prophets of celibacy. Indeed, I questioned whether defining an appropriate sex ethics in the AIDS crisis is best approached as a political question (say, as a threat to “gay identity”) or as a portentous choice between sex and death. Rather, the issue seemed to me as one of reducing the risk of transmission of the disease. The plain fact is that people need constantly to choose between pleasurable activities and forbearance in the interests of health: we do so every time we contemplate eating a raw oyster.

It is curious to find Mr. Rechy condemning the sex practices of others (including homosexuals) in his books and yet invoking the stupid catchall expression “homophobia” to characterize my criticism of a “small but influential group of homosexuals,” as if he were somehow empowered to speak for homosexuals in general. His intolerance, his shrill and bullying tone are all the more regrettable at a time when it seems that (contrary to what appeared to be the case when I wrote my article) the number of AIDS cases reported weekly has more than doubled in recent months, if not in New York City, then (as reported by the CDC) in the nation as a whole.

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