(As Published in the March/April 2002 Edition of HIV Plus Magazine)
John D. Moore, MS

In a clear sign of trouble on the horizon, raw has become fashionable for many young gay men. Pointing to the computer, Chris, a self-described fitness enthusiast, explains that "raw means condomless sex. It's the rage!" As the instant messages continue to arrive, some contain invitations to group sex parties where condoms are optional and drugs are plentiful. "At these parties," Chris says, "nobody asks your status-nobody cares. We just play raw and have a good time. I'll probably go to one tonight."

Some of the messages contain terms in what has become part of the everyday vernacular for Chris. "See these letters BB and PNP?" Chris asks. BB means bareback, and PNP means party and play."

In a testament to the need for stronger, widespread messages that speak pointedly about the truth of HIV infection and anti-HIV medications, Chris adds, "All my friends do it. Those new drugs," he says referring to antiretrovirals, "keep you from dying, and if you do get HIV, you don't have to worry about playing safe anymore." Pointing toward his computer again, he remarks, "Look at this guy's profile! He is 28 years old, works out every day, is into raw, and thinks he's HIV-negative! Sounds like a match!"

This trend toward condomless sex is not restricted to gay men. Kristine, a 23-year-old straight female living in a blue-collar Chicago suburb, offers her input. "AIDS? Do straight people get that? When I hook up with a guy, the last thing we talk about is rubbers! None of my girlfriends make a guy wear them. In fact, I can't remember the last time a guy pulled one out. One guy told me he doesn't like them because it doesn't feel right." Kristine goes on to say, "And with the Internet, you can basically find sex without a problem."

It is thought the Internet has contributed to this movement toward unsafe sex. Quinn Tyler Jackson, Ph.D., an author and researcher who has followed societal changes relating to interpersonal technologies, says, "There is clearly a link between access to the Internet and the sexualization and personal boundary setting of youth, and this very likely carries from keyboard to daily life choices. If there were no link, why have I spent the past six years helping develop software that controls the use of computers by youth-even those standing in full view in public libraries?"

A similar view comes from Mark Simpson, project coordinator for the nonprofit agency Better Existence With HIV, based in Evanston, Ill., a Chicago suburb. "The Internet has made connections possible for the purposes of sex in a less threatening environment," he says. "The false story being told on the Net is that HIV basically is no big deal anymore and having it is glamorous."

Simpson, who conducts HIV prevention outreach at schools, bathhouses, and bars, has struggled to fight the problem. "There was a time at outreach events when we ran out of condoms," he says. "We couldn't pass enough of them out. Now nobody wants them, and offering them meets resistance. People are thinking this thing is cured, and they are tired of living in fear."

It is particularly poignant to learn that the raw-sex rage has moved from the Internet into the mainstream. "Where there once was a subculture of people on the Internet engaging in this activity," says Simpson, "it has now spread to such a degree that I fear unsafe sex has become the norm for many people."

The problem may be more widespread than suspected. "There is no sense of urgency anymore," Simpson says. "Younger people are clearly not getting the message. With the proliferation of drugs, including GHB, crystal [meth], and ecstasy, people are throwing caution to the wind and mixing unsafe sex with dangerous drugs. Recently I conducted an outreach at a bathhouse and spoke with a guy who was no older than 25. He told me he wanted to get HIV because he thought it would place him with the in crowd. This guy thinks getting HIV is chic! I wish some of these kids could come to the hospital and see the people I see lying in a bed dying from AIDS."

According to a four-year government study, there is cause for concern. In September 2000 the Centers for Disease Control and Prevention released surveillance data analyzed from 25 states with integrated HIV and AIDS reporting systems. According to the data, young people (ages 13-24) accounted for a much greater proportion of HIV infections than AIDS cases. The data also showed that even though AIDS incidence was declining, there was no comparable decline in the number of newly diagnosed HIV cases among youth. Trying to head off a possible crisis, the CDC recommends sustained prevention efforts for young gay and bisexual men and increased efforts by community-based programs. For some, there is concern as to whether these recommendations will ever be acted upon with Tom Coburn's appointment as cochair of the Presidential Advisory Council on HIV/AIDS.

Meanwhile, back at the Internet caf the ignorance about HIV lives on as well. Says Chris: "The HIV genie is out of the bottle, and people just don't fear it anymore."

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JM020501

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