Sebastian White :: In Rochester, HIV a Quiet Killer

ESSAYS

In Rochester, HIV a Quiet Killer

The Empty Closet | April 1, 2003
By Sebastian White

ROCHESTER, N.Y.—News on HIV has gone from bad to worse this year.

Last May, the CDC reported that Rochester had the second highest rate of gonorrhea infection of any American city, 895 cases per 100,000 people, a rate surpassed only in Richmond, Va.

During the summer, an outbreak of syphilis crept into the gay community here and stunned public health officials who had not seen a single case in four years.

For young people in Rochester, the ominous signs of epidemic are even more pronounced: the percentage of new AIDS diagnoses among those under 24 has doubled year-over-year.

Because the CDC estimates that half of all new HIV infections in America occur in young people under 24, HIV surveillance and prevention is a particularly important and challenging task in Rochester with its high concentration of college and university students.

All this news comes despite the fact that prevention and education activities in America are at an all-time high, prompting epidemiologists to rethink their approaches to prevention and outreach.

For some, that means examining how our risk of becoming infected with HIV may be affected by external factors related to the places in which we live. In Rochester, those factors are the same tough social realities that have hit much of the urban northeast so hard: high rates of poverty, large numbers of welfare recipients, and a racially diverse but segregated center city and a homogenous suburban ring.

As a young gay man living and going to school in upstate New York, I've become deeply interested in how social dynamics of a place like Rochester have the potential to affect one's risk of HIV infection. It was a natural decision, then, to devote my senior thesis at Alfred University to examining sexual decision-making and risk-taking among gay college students in the region.

About a year ago I began my research—a project I call the Rochester Sex Study—to both create a snapshot of the gay student population here and to give insight into its sexual decision-making patterns. I first began the Rochester Sex Study by interviewing young gay men in Rochester as well as Boston, New York, and San Francisco, in order to capture narrative accounts of the complexities of sexual decision-making.

Having come of age in ultra-gay Boston but having lived in New York throughout my college years, part of my quest involved getting a better understanding of how our identity as young gay men varies with our geography and the unique communities from which we come.

Interestingly, despite geographic, social, and cultural differences, I discovered that the stories of young gay men across the nation are largely the same: an almost universal desire for love and companionship, frustration over a culture that is perceived to be overly sex-centered, and sometimes, the unfortunate collision of these two realities in what may be unsafe sexual encounters.

Information from these candid interviews served as the basis for the creation of a deeply personal questionnaire assessing self-esteem and the kinds of sexual risks students in Rochester are taking, as well as the places in which they are meeting their partners and having sex.

It's not a perfect survey—many, in fact, allege that it's obscene—but it does give a general overview of how vigilant gay students are being when it comes to safer sex and allows us to look for connections between our behavior and our society.

Designing and implementing this project—while extraordinarily rewarding—has proven to be a tough lesson in recognizing how love, affection, simple human desires, and the communities in which we live can conspire to put us at risk for contracting a highly lethal disease. While it is a reality that all gay men should know and understand, it is also one that fewer and fewer of us seem to be taking to heart.

It's been frustrating to hear young people in Rochester, like elsewhere, who believe that they are safe from HIV simply by virtue of their youth. Some feel that AIDS is over or that Rochester is somehow an isolated place—and therefore safe—from the epidemic.

At the risk of sounding alarmist, the unfortunate reality is that many of the social forces in place here in Rochester make this city and its young people uniquely primed to support a new, resurgent HIV epidemic. While certainly not inevitable, it is a daunting likelihood unless more people in the community begin to truly value sexual responsibility.

Though my project is ultimately more an exercise in research technique than an attempt to reinvent public health policy, I do hope that the research provided by The Rochester Sex Study can contribute positively to local prevention efforts.

Helping to ensure that future generations of college students—and all others, for that matter—can thrive here in the Genesee Valley without ever having to face an extraordinary or endless threat of epidemic should be a top priority for us all.