The AIDS virus first appeared in King County in 1982, a year after cases had first been reported in other US metropolitan areas. It was known to spread primarily amongst openly gay white men, which the health department was able to profile and strategically educate through tailored initiatives.
However, AIDS proved to be a complicated virus to prevent because of its inherent intersectionality and intimacy. Even though people were aware of the risks, many gay men reported dissatisfaction with the county’s requests for abstinence because they saw hook-up culture as a large part of their homosexual identity. To stop would be to stifle self-expression. Additionally, due to stereotypes about who was vulnerable to AIDS, many other groups were at risk without realizing it.
One particularly hard-to-protect group for the King County Health Department was the population of men who have sex with men but don’t identify as gay. In this article, I will explore how the County attempted to creatively target this group using a series of interviews conducted by the Aids Prevention Project in 1990. This study identified what behaviors put these men at risk and how to reach them according to factors such as race, incarceration, marriage status, political affiliation, and more. The study consolidated same-sexually active men who don’t self-identify as gay into five groups, each with different sub-identities, behaviors, and unique methods of outreach, outlined below.
The first group of men the report labeled were “New Age Men,” which included men who have sex with men for political reasons. They often identified as communists, anarchists, socialists, or democrats, and the Health Department planned to check the number of third-party voters to get an estimate on the size of this population. Open to any experience, they tended to dislike labels, have close emotional relationships with men, and deny that same-sex behavior between friends was risky. Due to their political affiliations, the report stressed that they may be distrustful of mainstream institutions and the county would have to get creative to reach them.
Another group included all “Coming out/closeted Men” who hid their sexuality to protect their job or reputation. Fear of being caught guided their decision-making, so these men purposely avoided participating in gay culture, and in turn, seeking AIDS resources. One particularly interesting way the County reached this population was by teaching gay men to educate their partners who may not be out.
Similar to the group above, the report included a category of “Bisexually active men with a hetero identification.” This primarily included men who used intercourse as a “sexual outlet,” and were often married and unfulfilled by their wives, housed in all-male institutions, or people with numerous sexual partners regardless of gender. For this group, the plan was a mass media approach with a focus on danger to wives.
Incarcerated men in institutions such as King County Jail and Walla Walla and Monroe prisons were also at high risk of contracting AIDs due to lack of condom availability and high drug use. The report also mentioned that they often “didn’t see their partners as men” and therefore didn’t identify with gay labels. Same-sex relationships often occurred in jails out of a need for survival, so the county felt unable to intervene without offering resources or protection.
The last category of men in the report was those who exchanged sex for money, drugs, food, and housing. This group included prostitutes in Pioneer Square and a large population of street youth in the International District. An estimated 50% of street youth were same-sex active and sometimes got paid more for unprotected sex. Like many in the incarcerated group, they pursued same-sex relationships out of a need for survival, making it difficult for the county to blindly preach safe sex without addressing their other needs. Additionally, this group was more likely to feel powerless, have low self-esteem from internalized racism, and be less likely to speak up about condom use. On how to reach this population, the report merely said “Approach: ?,” indicating the struggle to reach all vulnerable groups, particularly minorities.
Within each of these categories, the report also expanded on other important demographics, such as race, age, and region. Though it used some condescending language when referring to other ethnic groups, it brought up some important points about cultural differences. For example, Black people were less likely to see themselves at risk because AIDS was known as a “White man’s disease.” Additionally, Native American communities had an open attitude about sexuality while not identifying as gay, and a pattern of reduced condom use and access.
Age was also an important factor in vulnerability. Youth education was a priority to the county, but they learned that knowledge of AIDS was not enough protection; emotional strength is necessary too. Many high school-aged kids feared or had experienced rejection, making them overly eager for validation, even when it required risky behavior. The report included one illuminating quote about the decision-making process of teens: “If someone loves me, it might be worth the risk.” In addition to education, the report specified that teens should be approached through counseling, increasing self-esteem, and encouraging control over their bodies.
In 1996, as the AIDS epidemic finally showed signs of slowing, Dr. Robert Wood, the Director of the HIV/AIDS program for King County, left an enlightening quote. “I think it has been beneficial for society to have had to struggle with a very serious disease for which there is yet no cure or preventative vaccine. [Instead of relying on medicines], HIV control has had to rely on…behavior change, targeting socially disparate and disadvantaged communities.”
AIDS was more than just a virological crisis; it had numerous social and political ramifications as well. A combination of complex socioeconomic, racial, and emotional factors required the county to find creative ways to prevent it while remaining sensitive to all identities.
This post was written by Archives Intern Nina Kibria. To learn more about King County’s response to the AIDS epidemic, check out our exhibit Responding to AIDS.
Be First to Comment