A Deadly Dance

JOSEPH HILBURN GOES FOR AN HIV test every six months and reads everything he can find about AIDS. He certainly doesn't want to get it. Yet that doesn't stop him from having unsafe sex two or three times a week--""more, if I'm lucky,'' he says. Though he's been doing it for years, Hilburn, 32, says he's recently noticed a change: it's much easier to find men willing to have unprotected sex. ""I've been to clubs where there's sex all over the place and they have a little fruit bowl full of condoms and it's covered with dust,'' says Hilburn, a computer analyst in a New York hospital. ""The taboo has worn off.''

Both gays and straights have struggled with the inconvenience of safe sex since the AIDS epidemic made condoms necessary more than a decade ago. But as AIDS deaths plummeted 23 percent in the last year due in large part to new drugs known as protease inhibitors (chart), a small but growing minority of gay men have begun seeking out unsafe sex again. Because of the months-long HIV incubation period, it's too early to tell if this new attitude will reverse the declines in infection rates among homosexuals. But the signs are ominous. A small study conducted by doctors at the University of California, San Francisco, and published last month in The New England Journal of Medicine found that 15 percent of the men surveyed had already engaged in higher-risk sex because they're less concerned about AIDS. Scores of America Online subscribers have adopted a phrase--bareback sex--and included it in their biographic profiles as a way to meet like-minded men. Scariest of all: a tiny but visible group of HIV-negative men are actually looking to get infected. ""The potential to roll back the last decade's worth of advances is enormous,'' says Seth Kalichman, a professor at Georgia State University. ""People are gambling with their lives.''

Barebacking got a big boost in the last few months from what has come to be called the ""morning after'' pill. The treatment, which really requires taking a potent combination of AIDS drugs for 28 days, may prevent HIV from taking root if taken within a few days of exposure to the virus. A six-year study of 710 health-care workers accidentally stuck by AIDS-infected needles found that the therapy reduced the odds of infection by 79 percent. Some private doctors have already begun prescribing the post-exposure drugs, and the Centers for Disease Control is considering recommending them for gay men, rape victims and IV drug users. Next month the City of San Francisco will begin a pilot post-exposure drug and counseling program. The morning-after regimen, though promising, is making some AIDS warriors nervous--and for good reason. Kalichman found that 26 percent of 327 HIV-negative men he surveyed this summer had already planned to use the post-exposure drugs, even though no one knows if they'll work outside the strict confines of a hospital. ""If it doesn't work,'' says Robert Janssen, deputy director of HIV/ AIDS prevention at CDC, ""you have a person infected with lethal virus for life.''

The barebacking world is most visible in cyberspace. When Brian (not his real name) stumbled into a barebacking chat room, the guys there told him hardly anyone practices safe sex now that HIV is as easy to treat as the flu. He started having sex without condoms and never gave AIDS a second thought--until two months ago, when he tagged along with a friend who was getting tested for HIV. Brian took the test, too. The result: HIV-positive. Brian is 14. ""He is devastated,'' says Reece Manley, Brian's psychotherapist.

But the phenomenon isn't confined to the dark corners of online chat rooms. AIDS groups around the country have begun to field questions about barebacking--when people bother to ask. Many organizations say calls to their HIV hot lines have dropped dramatically since 1995, perhaps a sign that people aren't worrying about the disease at all. ""There have been times when I thought there'd be a certain freedom if I seroconverted. It would be done with,'' Hilburn says. ""The biggest life adjustment would be that I'd have to take care of myself more: eat right, quit smoking, get enough sleep.''

Hard as it may be to understand, some gay men have unsafe sex because they want to get HIV--or at least skate close to the edge. Danger can be erotic, even the threat of contracting a deadly disease. And men who have had their intimacy wrapped in latex for so many years want to share something--anything--with their partner. ""I've met two people who were turned on by the idea of being infected,'' says Mark, an HIV-positive AIDS activist and frequent barebacker in New York. ""One guy kept telling me, "Give me your virus. Give me your disease'.'' There's a phrase to describe these men, too: bug chasers.

Gay-rights activists say there's a complex reasoning behind the eroticization of HIV. Like the pink triangle that was once used by the Nazis to brand homosexuals and is now a sign of gay pride, gays have sought to transform HIV from a death knell to an empowerment tool. ""If someone has AIDS or HIV, that kind of lionizes them. It's heroic, like fighting the bat- tle,'' says an HIV-negative sophomore at the University of Florida who adds that he recently gave up barebacking because he realized that it was too dangerous. ""When you get with someone who has HIV, it's like being with someone greater than you are.'' That attitude may be a perverse byproduct of the high-profile AIDS movement. ""A lot of gay men feel out of place, put down, worthless. If you're HIV-positive, everybody is generous. There's a sense of community,'' says Michael, 35, a Dallas software engineer who set up a barebacking Web site called Xtremesex. It's a place where men--more than 750 of them so far--make contact and swap stories. Michael, a dedicated barebacker who has been HIV-positive for 12 years, recently posted an essay warning about the dangers of barebacking. But he defends the practice vigorously. ""Some people hang glide or bungee jump,'' he says. ""[Barebackers] just draw the line in a place that makes others uncomfortable.''

Much of the discomfort comes from the gay community itself, where talk of limiting sexual expression is always inflammatory. Barebackers say the criticism aimed at them is unfair. People have always sought out unsafe sex, they maintain; cyberspace has just helped them talk openly. Barebackers also argue that they're primarily HIV-positive men in search of positive partners, so no one is at risk. That line doesn't fly with health advocates. ""If unsafe sex becomes perfectly OK for HIV-positive people, you've crossed the Rubicon,'' says Gabriel Rotello, author of ""Sexual Ecology: AIDS and the Destiny of Gay Men.'' ""Sliding back into behaviors from the past will have catastrophic consequences.'' The deadly regression may have already begun.