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Sexual abuse may explain high HIV rates in gay men

We must address trauma that undermines self-esteem, good judgment

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September 27 is National Gay Men’s HIV Awareness Day.

We’d been messing around since I was about 10 years old. I figured sex with him and his three younger brothers next door was just a part of our friendship, along with our hikes to Bluff Point, on Long Island Sound, and neighborhood kickball, baseball, football, and foursquare games.

Besides, I enjoyed it a lot. I never felt consciously traumatized.

It would take a 2005 HIV diagnosis to open my mind to how my experience of childhood sexual abuse, and the multiple traumas I experienced throughout my life, undermined my self-esteem and good judgment and put me in the way of the same lethal microbe that killed so many of my friends.

The American Academy of Experts in Traumatic Stress (AAETS) says that 30 percent of all male children are molested in some way. There is a well-documented correlation between sexual abuse and later promiscuity. PTSD, depression, poor self-esteem, dissociative disorders, and anxiety are among the other effects of CSA. Sexual abuse survivors often equate sexual desirability with self-worth—and use sex as an analgesic to blunt the edge of shame that is another insidious effect of CSA.

I know these things, not only from reading about them in the research literature, but because they have played out in my own life—and in the lives of so many gay men.

Behavioral scientists have wrung their hands for more than three decades trying to understand why gay men seem so disproportionately vulnerable to HIV. Recent research makes it abundantly clear that trauma, specifically from CSA, is almost certainly the long-overlooked answer.

Consider: Harvard researchers have found that up to 46 percent of gay and bisexual men who report condomless anal sex—the principal act by which HIV is transmitted between men—were sexually abused as boys.

“That is a huge number,” said Conall O’Cleirigh, a staff clinical psychologist in the psychiatry department at Massachusetts General Hospital and an assistant professor of psychiatry at Harvard. His research on gay men has found that the same mental health issues that can put someone at risk for HIV can also prevent someone living with the virus from adhering to his treatment.

In a national study of 1,552 black gay and bisexual men, O’Cleirigh and his colleagues found that men who experienced CSA—or physical or emotional abuse, or stalking, or being pressured or forced to have sex—when they were younger than 12 years old had more than three male partners in the past six months. The men who had been forced or pressured to have sex as boys were likely to have receptive anal sex.

In another study of 162 men with CSA histories, participants reporting sexual abuse by family members were 2.6 times more likely to abuse alcohol, twice as likely to have a substance use disorder, and 2.7 times more likely to report a sexually transmitted infection in the past year. Not only that, but men whose abuser penetrated them were more likely to have PTSD, recent HIV sexual risk behavior, and a greater number of casual sexual partners. Physical injury and intense fear increased the odds for PTSD even more.

“Having that history is repeatedly associated in every sample of gay men with increased likelihood of being HIV-positive,” said O’Cleirigh. He said that since CSA is “very, very common in gay and bisexual men” it appears to be one of the most significant vulnerabilities that accounts for the disproportionately high rate of HIV among gay men.

Prevention educators long have wanted to believe that handing out condoms, or, more recently, the HIV medication Truvada used as pre-exposure prophylaxis to prevent HIV infection, should suffice for men at the highest risk who engage in unprotected anal sex with partners of unknown HIV status. But increasing rates of new HIV infection among gay men—the only U.S. population with increasing, rather than declining, rates—are proof that condoms and PrEP alone aren’t enough.

The only way to arrest the spread of HIV among gay men is to address the trauma that undermines their self-esteem and good judgment.

An effective risk-reduction/health-promotion intervention that addresses the effects of childhood sexual abuse could help make gay male survivors more conscious of what they are doing and where it’s coming from in their psyche. It could also finally reduce the “hardcore” of gay men beyond the reach of more traditional prevention efforts.

At Boston’s Fenway Health, O’Cleirigh helped recruit the nearly 5,000 gay and bisexual men who participated in Project Thrive, an intervention aimed at helping gay men who experienced CSA to increase their coping skills and ability to be more present in—rather than dissociating from (a common effect of CSA)—their immediate situation, and provide specific skills to evaluate and reassess these situations.

“Treatments [counseling and therapy] are geared toward giving the men a more realistic sense of the world,” said O’Cleirigh, which is an important ingredient of resilience. “As we say to our clients, we can’t change the fact that you were abused, but you can change.”

Healed gay men protect themselves and their partners, and take their meds if they are positive.

The message for this National Gay Men’s HIV-AIDS Awareness Day should be that helping gay survivors of childhood sexual abuse to heal from trauma can profoundly reshape the way they think and make choices about sex—and about their health.

This is how new HIV infections among the “hardcore” will stop, and the surest way for those of us living with the virus to stay healthy.

 

John-Manuel Andriote is a Connecticut-based writer.

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University students have a right to protest

But they must not threaten Jewish students on campus

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Students at Columbia University have set up a tent city to protest the war in Israel. (Screen capture via CBS News New York YouTube)

I support the right of students at Columbia University, and other colleges, to protest. They must understand they are protesting on private space. What I also find interesting is how many of them see their right to protest, and right to free speech. 

The First Amendment gives us a right to free speech, but it doesn’t specify what exactly is meant by freedom of speech. Defining what types of speech should and shouldn’t be protected by law, has been left to the courts. Clearly free speech has its limits. Obscene material such as child pornography, plagiarism of copyrighted material, defamation, or threats, aren’t allowed. Also not protected under the First Amendment is speech inciting illegal actions, or soliciting others to commit crimes. Private employers, and universities, are allowed to set their own guidelines as to what speech is allowed for their employees, and on their campuses. 

The debate over student protests at Columbia University is not a new one. I remember when the Student Afro Society (SAS) and the basically all-white Students for a Democratic Society (SDS), demonstrated and took over buildings at Columbia in 1968. Some were protesting the Vietnam War, others what they deemed would be a segregated gym in Morningside Heights, and Columbia’s infringement on a minority community. Both legitimate causes. Those demonstrations took a nasty turn when students took over buildings and cut off water and electricity to them. They held a sit-in, in the president’s office, and took a dean hostage. Police were called and in some cases it got violent. We are not at the 1968 stage yet in the current demonstrations, and if outside agitators don’t get involved, it may not get to that. 

I agree with some of what the demonstrators are calling for, including having Israel rethink how it is conducting this war, protection for the Palestinian people, and immediately providing them with food and medicine. I don’t agree with their call to support BDS, which is the disinvestment in Israel. BDS is a Palestinian non-violent movement begun in 2005. I also see hypocrisy in what some of the protesters are saying. While they claim Israel is committing genocide in Gaza, which many disagree with, the same people are calling for genocide against Israel by supporting Hamas. It is Hamas’s stated goal to wipe Israel off the face of the earth, “from the river to the sea.”

Calling out Israel for its tactics, is not anti-Semitic. But attacking, and calling out Jewish students on campus, telling them to go back to Poland, which we have seen on video, and making them feel unsafe, is. Then there is the totally outrageous statement, “Zionists don’t deserve to live.” made by Khymani James, one of the student leaders of the Columbia, pro-Palestinian student protest encampment. He made the comments during and after a disciplinary hearing with Columbia administrators that he recorded and then posted on Instagram. I hope the president of Columbia University will be able to negotiate an agreement with the peaceful student demonstrators, including amnesty for some of those students who were arrested, if the students agree to certain parameters for continuing demonstrations. One being they cannot make other students feel unsafe on campus. 

I find it abhorrent that House Speaker Mike Johnson has inserted himself at Columbia University, calling for President Shafik to quit. It is a totally inappropriate political stunt. The same goes for Rep. Elise Stefanik (R-N.Y.) who called for the Biden administration to revoke the student visas of all foreign students who are demonstrating. Those students came to the United States for an education, because we are a free country. If they agree to the guidelines of the university, and what is recognized as acceptable free speech, we should continue to welcome them, and allow them to voice their feelings. Again, as long as they don’t threaten others while they do so. 

I am Jewish, and a strong supporter of the State of Israel. That support has not stopped me from calling on the Israeli people to rid themselves of Netanyahu, and his right-wing government. I oppose the settlements, and support a real two-state solution. But for that to happen not only will the Netanyahu government have to go, but the Palestinian people will have to reject Hamas. I have not heard the call for Hamas to release the hostages they took, whether those hostages are alive or dead at this time. 

I strongly believe in the right to protest, and for Americans, and those here legally, to speak out. In 1969, I came to D.C. to protest the Vietnam War in front of the Justice Department and was tear-gassed. I had a right to protest in a public space. Since that time, I have participated in many demonstrations. Some around the White House supporting rights for the disabled community, LGBTQ rights, women’s rights, and in the ‘80s, demanding the government recognize, and do something about HIV/AIDS. The difference was in these demonstrations, those who disagreed were not threatened. The demonstrations I participated in, took place in public space, not the quad at Columbia University, or other university campuses, which is private space. Students who protest there must understand that. 

My hope is none of the peaceful student demonstrators at Columbia, and other institutions, those who do not threaten fellow students, are thrown out, losing the chance to earn a degree. Those students chose to go to their schools because they thought they would get a good education, and believed graduating from those schools would be good for their futures. 

Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist. He writes regularly for the Blade.

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Successful open relationships take effort

We have options as couples but they all require work

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Jake Stewart

(Editor’s note: This is the second of a two-part feature on open relationships. Click here for last week’s installment.)

Open relationships are often ridiculed as the easy way out of commitment. After speaking with Scott and Kelsey, however, it’s clear they’re anything but easy. 

Kelsey reflected on the ups and downs of being open in the past. “Younger me definitely needed it,” Kelsey said. “At the same time, drama came with it as well.”

While Scott and their partner have been together for nine years, it took four before they decided to open their relationship. “It came from the desire for the two of us to meet boys together,” said Scott. “Then we had some really terrible threesomes.” 

Drama. Bad threesomes. Yikes – these aren’t exactly selling points for being open. But their experiences underscore something important: open relationships, like all relationships, are actually quite hard. Couples considering openness shouldn’t trick themselves into thinking it will make things easier. In reality, they take a lot of work. 

For Scott, those really terrible threesomes led them to opening up further, but with established boundaries. “We came up with ground rules. Use protection. No spending the night at somebody’s house, etc.”  

Since Scott and their partner are happy in their relationship, these rules seem to work even if they’ve shifted over time. “Being in an open relationship comes down to being really good at communicating with your partner,” they added. “It’s about communicating and checking in to see where your partner is.”

Open relationships should be for the right reasons 

As open relationships began taking off, observers were skeptical for good reason. “In the past, people were just cheating,” said Kelsey. Another comment from Scott echoed this. “I’ve seen open relationships and it felt like one partner was being taken advantage of by the other.” 

It turns out there is a fine line between sexual exploration and free passes. While some open relationships walk that line well, others – not so much.  

In all fairness, now more than ever it’s difficult to remain monogamous, and one culprit is the rise of accessible hookup culture via social media. Apps like Tinder, Grindr, and dare I say Instagram are facilitating secret sexual connections never seen before. They ushered in a new era of cheating into relationships, alongside a bit of excessive stalking as well. 

So, to avoid an atmosphere of mistrust and pain, a natural evolution for couples is to change the rules altogether. Cheating can’t be cheating if it’s allowed, right?

However, once it is allowed, I wondered why these people don’t cut the strings altogether and be single. In response, Chad made an interesting point: people aren’t just afraid of being cheated on – they’re afraid of the appearance of being single as well. We live in flashy times where our online image means everything. The dream is not necessarily having a partner, but showing the world you have a partner. Without that, you otherwise appear lonely. 

So, do open relationships ease the pain of cheating and perceived loneliness? As a proud lone wolf I’m not the best person to assess, but based on my observations I can say this: being open works for some couples, but by no means is it a fast pass to being happy. Understanding why you want one is just as important as discovering how to make one work. 

With all this said, the undeniable risk – and perhaps downside – of a monogamous coupling is the higher chance of cheating outright. Unfortunately, that’s something Chad knows all too well. 

Preferring monogamy is still OK

Chad had dated someone for two years before they married for five. Then, just over a year into the pandemic, his husband informed him he was dating someone else. They separated a few days later. 

For Chad this was painful, as it is for anyone, gay or straight, who’s gone through something similar. But when I asked him if this experience shaped his outlook on what he’s looking for, his response came as a bit of a surprise: 

“It has not changed my view for or against open relationships,” he said. “I learned a lot in my marriage. It takes a lot of love, trust, and communication, which at times can feel like work. It also takes two; one can’t carry the relationship. I want to date someone who wants to be in a relationship with me.” 

My heart swells hearing that, for even after experiencing the deepest kind of hurt, Chad searches for his one and only. Why? Because for him, the love he’s looking for is worth the wait. It’s a beautiful sentiment that makes so-called hopeless romanticism the raddest feeling in the world sometimes. 

More importantly, Chad doesn’t let fear alter his view on love, and to me that’s the most important lesson of this article. Love always comes with risks, and lowering your standards to reduce them never really pans out, does it? The best we can do is to be ourselves. 

By the way, this is a lesson I should also apply. My main hesitation toward an open relationship is that I’m a jealous bitch, and I fear that jealousy will never go away. Yet this can be hard to admit when everyone around you is propping up a culture where open is supreme and jealousy is immature. 

When I brought this up to Kelsey, she pushed back with a simple question: “Do you think jealousy is a bad thing?” 

This caught me off guard. “I’m not sure,” I replied. “Do you?” 

“Jealousy is a natural, human emotion,” she said. “It’s what you do with it that matters.” 

So, maybe my goal is not to suppress my jealousy but rather be upfront about it. If it’s part of me, I should own it, then ideally find someone who loves me regardless.  

Changing your mind is OK, too

In gay man speak, I was a top for my first seven years before I embraced bottoming. For some, they’d be shocked to hear it. Yet maybe no one should be surprised, for as we all know sexuality is fluid, and this applies to more than just your orientation. Your sexual preferences can shift over time, too, and this will inevitably affect your relationships. 

This was the case for Scott and their partner. “When we first started dating, we did not want to be open,” they mentioned, “but as our relationship grew, we decided to reevaluate that.” Meanwhile, Kelsey went the opposite direction – she was open back in the day but chooses to be closed now. 

Even Chad remains open to being open. “I’m not opposed to an open relationship, but I feel like it would take more work. I just don’t see myself starting a relationship open. The first few years there is a lot of learning about each other.” 

In a world of shifting preferences, the best we can do is reflect on what we want and be honest about it. Life is a process of discovering who we are, and damn is it messy. So, perhaps I should cut some slack to the couple trying things out. And perhaps they can cut me slack for not understanding their rules. 

For the couples: remember, a solid relationship is not only about meeting the needs of your partner, because your needs matter, too. The best relationships, open or closed, strive to find that balance. 

For those still searching: remember that love is more than just that thing, that connection, that spark. In fact, love is so complex that the “spark” is just one of many factors, alongside timing and how you want to be loved, that come together and form an imprint as unique and special as the person you want to be with.

In this sense, open and closed relationships aren’t diametrically opposed but rather complimentary, a sort of yin and yang where both become better because the other option exists. Today, we have options as couples, and that’s significantly better than abiding by rules because we assume that’s how it must be.

And that feels right. Because regardless of whether you’re more a Chad or a Scott, the truth is: I feel lucky to have both.  

(Writer’s note: A big thank you you to Chad, Scott, and Kelsey for allowing me to share their stories.)

Jake Stewart is a D.C.-based writer and barback.

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Fact: The next president will be Biden or Trump

One candidate is clearly better for the future of the world

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(Washington Blade file photos by Michael Key)

Like it or not, the next president will be either Joe Biden or Donald Trump. In our system, third-party candidates are simply spoilers, they don’t win. The last time a third-party candidate won was 1856. It has been 36 years since a third-party candidate even got more than 5% of the vote. So, it’s time to face reality and choose; for your future, do you want Biden or Trump? 

I was prompted to write this column because I see the media interviewing young people about who they want as their president. I have great respect for the young people of today. In many ways, they are smarter than my generation was. But it’s clear, some don’t fully understand the presidential election process. I hear many complain about Biden, and then follow that up and say they will never vote for Trump. Some then say they will vote for a third-party candidate. They need to understand their third-party candidate will not win, but their vote could help elect Trump. I hate to say it, but in 2024, voting for a third-party candidate is the equivalent to flushing your ballot down the toilet. 

I am an unabashed Biden supporter. I see the great things he has done, including: getting us through the fallout from the pandemic, passing an infrastructure bill, forgiving billions in student loans, ensuring our economy is the best in the world with more than 13 million jobs created, and increasing wages. He supports unions, being the first president to walk a picket line with the UAW. His administration is working to deal with climate change. He is fighting for a woman’s right to control her own body and healthcare, and supports full equality for the LGBTQ community. In this dangerous world he has kept our troops out of war.

Then there is Trump. To be clear; I see him as a racist, sexist, misogynistic, homophobic, pig. OK, so maybe I don’t have strong feelings about him. Trump has been found liable for sexual assault and has been indicted on 91 counts. He proudly claims credit for having taken away control of their body and healthcare from women, when the justices he appointed ended Roe v. Wade. He supports states making decisions on abortion, and we see what recently happened in Arizona. He is a climate change denier and is opposed to wind and solar power. He wants to give more tax deductions to the rich and to corporations, while opposing any increase in the minimum wage. He opposes equality for the LGBTQ community, refusing to endorse the Equality Act. He opposes student debt relief.

You may see these candidates differently, and that is OK. But if you like one more than the other, fear one more than the other, or just aren’t enamored by either, you must still make a choice and vote for one of them. Staying home is abrogating your civic responsibility, and especially if you would never vote for Trump, understand your staying home helps him. 

Young voters, like all voters, should take the time to do the research on both candidates. Then match what you find as close as possible to what you want to see as your future. If you want student loan relief, equality for the LGBTQ community, women having control of their body and healthcare, equal pay for women, efforts to ameliorate the impact of climate change, then clearly Trump is not your candidate. 

I hear some young people say they won’t vote for Biden because of his positions on the Israel/Hamas war. I, too, have called for Israel to recalibrate how they fight this war. But I ask you to look again at Trump’s history of attachment to Netanyahu, even going so far as relocating the U.S. embassy to Jerusalem. If you want a chance for the Palestinian people to live in peace and prosperity, for Israel to remove their settlements from the West Bank, your chance of having that happen is clearly better with Biden than Trump. Don’t let your emotions today, cloud the reality of the future.

Yes, Biden is old, but so is Trump. He apparently can’t even stay awake at his own trial having nodded off two days in a row.  So, since one of them will be president, with no third-party candidate having a chance, I urge you to look at them again, in a realistic way. Then make your choice. I think you may come to the same conclusion I have. Though not perfect, and no one is, Biden is the better candidate for your future, and for the future of the world. 

Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist. He writes regularly for the Blade.

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