Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.
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The San Francisco Examiner - Thursday, Aug. 14, 1997
Larry D. Hatfield of the Examiner Staff
"They're looking for ways to convince themselves it's OK," says UCSF psychiatrist Dr. James Dilley of gays slipping back into dangerous sex habits. "But the bottom line is still a poor choice."
Dilley, executive director of the AIDS Health Project, emphasized that the majority of the gay men surveyed still practice safe sex. "It's not like everybody has completely lost their mind," he said.
The Health Project conducted the survey among men who said they had unprotected anal intercourse within the last year.
Although there were only 54 men in the survey, Dilley said it showed that gains in AIDS treatments also have a downside in that the gains can make prevention efforts more difficult.
"It shows that AIDS service providers have an additional task in front of them," he said. "That is to make sure that people in the community understand that while it's understandable that people might take the good news that is out there about new treatments as a reason to no longer behave safely, that is not the answer.
"The important message is that people need to remain safe regardless of new treatments that are out there."
Dilley and fellow researchers William J. Woods and William McFarland reported on their survey in a letter to the editor in Thursday's edition of the New England Journal of Medicine.
Willing to take a chance
They said 26 percent of the men surveyed said they are now less concerned about becoming HIV positive because of new treatments. Thirteen percent agreed that they were now "more willing to take a chance" of getting infected and 15 percent said they had already done so.
Four of 22 men responding to a separate questionnaire reported that at the time of their high-risk sexual encounter, they had the thought that they could take the new preventative AIDS drugs if they were exposed to HIV.
Dilley said the increase in risk-taking was related to the successes of protease inhibitors now being used in treatment to slow the infection in many men and, in some cases, apparently suppressing the AIDS virus.
But, he cautioned, while the new class of drugs have been helpful in some cases, it is also true that the new treatments are difficult to take, not everyone can take them and not everyone responds to them.
"Morning after' treatment
The survey was taken before publicity about the availability of a postexposure treatment program - a so-called "morning after" treatment - being developed at San Francisco General Hospital.
Citing a need for increased education to discourage people from using the new drugs as a rationale for unsafe sex, Dilley said in a telephone interview, "We're talking about a difficult task . . . Gay men in particular, who have been through the epidemic, who have grown up in it, who have lost friends to it, who have the difficulty of having to remain safe all the time, are looking for ways to convince themselves it's OK.
"It's not."
The Health Project provides a range of services for HIV negative gay men. "Those folks who are having difficulty maintaining safe sex behaviors, they should be sure to call us," Dilley said. "It's completely understandable that people wish that drugs and treatment are going to eradicate HIV and make it possible to go back to the way it used to be.
"But that is not the case."
The Health Project's number is 476-3902.
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