I wrote this because the issues at hand would never be printed—much less discussed—in my city, Philadelphia, corrupt and contented, where bureaucracies get richer and where the free press was born and now has died. Since the CDC has decided that they are going to fund secondary prevention—targeting those with HIV—and wink at primary prevention, our local HIV/AIDS bureaucracies have jumped into the money pool with a vengeance. Our local LGBT press follows them right along like a pig after a truffle.

To even try to get an editorial printed regarding primary prevention, or HIV/AIDS, is just not possible in this city. I am singling out the LGBT press because, traditionally, they have provided coverage of HIV/AIDS, even for straight people here in Philadelphia. Most heterosexuals don’t frequent our bars or baths or pharmacies, so they get what they can by gleaning it from our one LGBT weekly. Our one editor seems more interested in making sure that he and his chums are all over the papers looking great at balls than reporting HIV/AIDS information. Primary prevention literature lays wasted in a dustbin or is distributed at the LGBT balls where the disco crowd has collected enough free condoms and brochures to stock a small African nation.

If the thought weren’t so disturbing it would seem that we are ignoring primary prevention and those who espouse it in this city in order to guarantee jobs for the folks espousing secondary prevention.

Secondary prevention should be going on, anyway, without extra funding or jobs. If a person is diagnosed with HIV or AIDS the person conferring the diagnosis should be held criminally liable if they do not inform that person how to prevent transmission. Where we are missing out in stopping this virus before it starts is on the front lines, with primary prevention efforts. We should have a press railing against this, LGBT or straight. Instead, we have a tired collusion of the same people squawking the same lines for twenty years and the same people reporting it as sunshine. We have vast, untouchable, even promoted bureaucracies preaching prevention to the sero-converted.

We are creating paid “peer educators” here at such a pace that most of them work two hours a week sitting in waiting rooms. This year they will all be paid $50 bonuses to recite the Arizona Fact Sheets, on top of a $150 “stipend” for completing a sixteen-class course and $10 a week to attend weekly gossip-fests disguised as continuing education. This would be all well and good, money going to folks with AIDS after all, but Philadelphia is in a commonwealth which provides nothing for the special needs of people with HIV/AIDS, with the exception of a recently updated ADAP formulary.

If you have AIDS and are poor in Pennsylvania, you are basically screwed. If you were paid on the books you have a one-year wait for SSD, each application rejected in turn by the state so the whole process gets delayed. If you cannot get SSI or SSD, you are put on public assistance at $276 a month, you get the shelter systems and food lines in the cold or searing heat, you get public health clinics which look more like stables, and your CD4 counts and viral loads are of little concern to anyone but you.

As I write this my CD4 count is 93, my viral load greater than 150K off medication—do you think I would do well in a public dorm?

The new face of AIDS in my city is black, Hispanic, heterosexual, and they are coming in at a nice and steady rate. Where is ACT UP; where is our LGBT press? Who is angry, who is screaming in public outrage at this ride to social and economic—not to mention human—catastrophe? ACT UP Philadelphia is bussing people to the White House to protest HIV in prison; it makes great press, but even the press here, our one paper, can only see fit to happily discuss how all of the “homosexual elite” had a nice gala at our LGBT Welcome Center.

People with AIDS are sleeping in shelters, standing in lines in January, and living lives of destitution they didn’t ask for and our HIV/AIDS bureaucracies play their same old songs and our self-serving press makes it sound like a symphony. Just ignore primary prevention; keep them coming, darn it—we have town houses and BMWs to support.

Charles Towsley lives, paints, and writes in Philadelphia, sharing life with his partner of eight years, Manuel, and dog, Gaston.

June 2004