WHAT WOULD MAKE THE COUNTY OF LOS ANGELES DECIDE to run out and purchase a half million condoms? Ninety-three individuals diagnosed with syphilis, to be exacts--93 cases that also led to the spending of 560,000 county dollars, an educational billboard campaign and the appearance of roving Department of Health vans blood-testing citizens on the streets. Yet 414 syphilis cases were diagnosed last year, and never did Supervisor Zev Yaroslavsky--the sponsor of this year's campaign--stand up to motion for a countywide safe-sex crusade. Why now? Because while not one of last year's documented syphilis cases involved a gay man, all 93 individuals testing positive this year were men who have had sex with men (MSMs), and more than half of these men were also HIV-positive.
SAFE SEX IS WANING AMONG SOME OF L.A.'S GAY MEN. WILL A RESURGENCE OF HIV BE NEXT?
WHAT WOULD MAKE THE COUNTY OF LOS ANGELES DECIDE to run out and purchase a half million condoms? Ninety-three individuals diagnosed with syphilis, to be exacts--93 cases that also led to the spending of 560,000 county dollars, an educational billboard campaign and the appearance of roving Department of Health vans blood-testing citizens on the streets. Yet 414 syphilis cases were diagnosed last year, and never did Supervisor Zev Yaroslavsky--the sponsor of this year's campaign--stand up to motion for a countywide safe-sex crusade. Why now? Because while not one of last year's documented syphilis cases involved a gay man, all 93 individuals testing positive this year were men who have had sex with men (MSMs), and more than half of these men were also HIV-positive.
"Obviously, we are at a much higher risk of HIV transmission in the middle of a syphilis outbreak," says the Department of Health's Peter Kerndt. "Right now we're running 100 percent above average for MSMs with syphilis--the visible part of this outbreak.
Thus all those Yaroslavsky-sponsored condoms being distributed to the county's bathhouses and gay sex clubs, with varying response. "Without the cooperation of club owners, who have always been distrustful of the county's motives," says AIDS Project Los Angeles director Craig E. Thompson, "this campaign will be hard. But we believe the county's response has been sensible." Whether free bath house condoms will change the sex practices of L.A.'s gay population is another matter.
APLA cites a study of West Hollywood-gay men conducted by USC's Annenberg School that found men who were optimistic about the success of HIV treatment regimes engaged in higher rates of unsafe sex. "Now that AIDS is not necessarily a death sentence," says one Department of Health investigator, "young gay men have become a lot more lax in their sex practices."
But it's not just young men caught up in the current vogue of "barebacking." The average age of individuals in the recent syphilis outbreak is 36: men who would have come of age during the AIDS meltdown of the 1980s--and who belong to this century's most sex-educated generation. Individually, these men admitted to as many as 70 sexual partners--most of them anonymous--in the months that followed the outbreak's inception, in late March.
"This syphilis outbreak," says a county official, "tapped into something we all knew would happen--a population prone to HIV has stopped its safe-sex practices."
Syphilis has always been a "canary in a coal mine" for HIV. In San Francisco in the late '70s, the syphilis rate among gay men was 92 times the national population's. What followed were the plague years of the '80s, when as many as 13,000 cases of HIV were being diagnosed annually in L.A. alone.
"In 1989," says APLA's Thompson, noting the education campaigns that rose out of the '80s, "L.A.'s numbers dropped to about 2,000 newly diagnosed, cases a year, and they have stabilized there ever since."
And while Thompson was hoping for a drop to a new low of 1,600 diagnosed HIV cases this year, the Department of Health's assumption is that a syphilis outbreak could presage a new HIV outbreak.
And not just in L.A., either. Thompson worries about HIV spreading nationally due to the increasing popularity of so-called circuit parties. These gatherings of as many as 20,000 gay men--some 9,000 attended Palm Springs's White Party last April--are notorious for random orgies of up to 100 men, where barebacking, as well as the ingesting of such drug cocktails as Viagra-Ecstasy, are common.
The magazine Circuit Noize lists more than 50 North American circuit parties through Thanksgiving this year. The parties draw gay men from across the country, and "because travel to these parties can be expensive," says Thompson, "they tend to weed out younger men, attracting men who are around 38"--essentially the same age as the L.A. syphilis vector. "The circuit party phenomenon will be an important factor in this outbreak," says Kerndt, who, like Thompson, knows how quickly a new round of HIV in L.A. could become the nation's.
Whether that will happen is unknown. In June, county health officials declared the syphilis outbreak contained, with no new cases reported since the first week of April. Yet the Department of Health has also just about run through its county-sponsored funds, meaning the first high-profile safe-sex campaign in years aimed at L.A.'s gay population is as good as over. Once the billboards disappear, the county's victory could turn out to be short-lived.
"There is real consciousness in L.A.'s gay community at the moment," says a county investigator. "The irony, however, is that 2,000 new cases of HIV a year wasn't enough" to spur L.A.'s renewed safe-sex campaign. "It was something as easily cured as syphilis that did it."
COPYRIGHT 2000 Los Angeles Magazine, Inc.
COPYRIGHT 2000 Gale Group
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