Finally, the debate is over, and we may finally know who is truly to blame for HIV!

As promised, blogger Black Informant has posted a response to my response to his response to my response to his call for a debate based on my response to a blog post he wrote about the District's new HIV numbers, thus concluding our virtual tête-à-tête. Let me begin by saying that it's been a blast, and I hope that Black Informant has a great summer and never changes.

Since Black Informant's post was to be the final one in our debate, which spanned fisting, rimming, irresponsible hedonism, and the importance of a good education, I won't respond to the points he's made here. If anyone would like to weigh in in the comments—by all means. Below, I've collected the greatest hits of Black Informant's closing statement.

"Africa is dealing with an almost completely different set of cultural issues that cannot be compared to the gay and lesbian community here in the West. The only real challenge for us Westerners is deciding whether or not we are going to take it too far in the bedroom. That is a far cry of what is taking place on the African continent."

—

"If you are an adult and of sound mind, economic position in life has NOTHING to do with self-control in the bedroom. While many of the various HIV/AIDS studies out there focus exclusively on those infected with this disease, you will be hard-pressed to find a study that focuses on those who are making the right personal choices. No matter what ethnic/economic demographic you study, the majority on this issue has managed to make the right choices and steer away from risky sexual behavior."

___

"For the sake of argument, let’s say the average cost of a pack of condoms is about $10. Do you really believe that the low income folks in your district can’t afford a $10 box of condoms? “Low income” does not mean “no income“. If people really wanted to make the right choices regarding their sexual practices, do you really think that a locked display at a local drug store would deter them? If that is the case, then cigarettes must not be selling too well in DC. The low-income population in DC may have its share of problems, but stupidity isn’t one of them.

Thanks for the discussion."

Thank you!

Welcome back to the HIV Blame Game, wherein blogger Black Informant and I debate the root causes of the HIV epidemic in Washington, D.C. Yesterday, I wrote a post arguing why the gay and lesbian community shouldn't be a scapegoat for D.C.'s HIV problem, that HIV/AIDS affects us all, and that we need to create strong educational initiatives to help stop the epidemic.

Black Informant responded—read his post here. The crux of his argument is that HIV/AIDS is spread by people, both gay and straight, "who know how to avoid STDs, yet insist on doing the total opposite," and public initiatives to further educate the public on the risks of HIV will force "society at large to foot the bill for their bad choices":

For those of us in society who not only understand the importance of practicing safe sex, but actually abide by those guidelines, HIV/AIDS is not a problem. It is only a problem for those who live by the rule “If it feels good, do it”, all the while expecting society at large to foot the bill for their bad choices. That applies to both homosexuals and heterosexuals. But as I contend in both this post and my previous one, the homosexual community, by definition has regulated itself to high risk sexual behavior and should stop hiding behind what the heterosexual community is or isn’t doing. As far as “blaming” goes, you can start with the people who know how to avoid STDs, yet insist on doing the total opposite.

I couldn't agree with Black Informant more that practicing safe sex is the best thing we can do to stop the spread of HIV/AIDS. But I have to disagree with him when he says that HIV is "only a problem for those who live by the rule 'If it feels good, do it.'"

By that logic, the largest population of irresponsible hedonists are centralized in sub-Saharan Africa. Eleven percent of new HIV cases are reserved for irresponsible hedonistic newborn babies. Fifteen million children with AIDS are orphans, surely payment for their irresponsible hedonism. In D.C., most irresponsible hedonists reside in the city's poorest areas, where even condoms are locked up to avoid irresponsible hedonists from stealing them to engage in more responsible hedonism.

The reality is this: Stating that those affected by HIV were infected through irresponsible hedonism is a way to willfully ignore a problem that does not affect you directly. Actually, being able to understand the "importance of practicing safe sex" and being able to actually "abide by those guidelines"—like Black Informant can—is a privileged position. It's not a coincidence that low-income African-Americans are most affected by HIV. Protecting yourself costs money. It costs money to educate adolescents on the importance of safe sex. It costs money to distribute free condoms to people in poor areas who are most at risk. It costs money to offer free HIV testing to an entire urban area. It costs money to come out with comprehensive studies every year that try to pinpoint the populations that are at the highest risk and arm them with the knowledge to protect themselves. It costs money to change decades-old attitude that if you're not gay, you don't have to worry about HIV.

But what's more expensive—pushing for comprehensive sex education, testing, and condom distribution for all citizens, or watching an entire segment of your population waste away from a crippling affliction? Hey, let's not pay to find out how many people have HIV, how they got it, and what we can do to prevent it. Once we declare that HIV is "not our problem," all we have to do is sit back, relax, and wait for the next generation of Washingtonians to enjoy even higher AIDS rates because we couldn't be bothered with the tax burden.

"Understanding" how to prevent HIV is not common sense. New information on HIV/AIDS comes forth all the time, and even educated, safe-sex-practicing citizens like Black Informant could use a refresher course. He writes:

Risky sexual behavior is the cause behind this jump, not “gay sex” as you are calling it. If a person chooses not to use a condom, that is a risk. If a person chooses to ingest fecal matter during sex (rimming), that is a risk.

Actually, it's not. A sex act, like rimming, isn't an HIV risk just because straight people associate it with the gay community. HIV can be transmitted through four fluids—semen, vaginal fluid, breastmilk, and blood. It's okay—I didn't know that either until I got my free rapid HIV test a couple months ago, and I'm a privileged college-educated white girl.

Educating people takes time, but changing attitudes takes even longer. We need to change attitudes that encourage unsafe sex, but we also need to change attitudes that blanket moral judgments over an entire population of sufferers. Yesterday, the Pope arrived in Africa to tell the continent that condoms are making the AIDS problem worse. Categorize those who use condoms as immoral, or categorize those who don't use them as irresponsible hedonists—either way, you're shaking your hands of your responsibility to help those in need.

Yesterday, I wrote a post calling out Black Informant, a blogger who called out homosexuals for the striking new HIV/AIDS numbers in the District. The blogger then proceeded to call me out, in a post titled “Calling Amanda Hess of the Washington City Paper.” Black Informant wanted to debate. Well, here we go!

I take issue with two main assertions in Black Informant's response to the new AIDS numbers. First, that the "leading cause for this HIV/AIDS jump" in D.C. was due to high-risk homosexual activity. And second, that stepping up HIV/AIDS education efforts in the District would be both fruitless and condescending, because "folks know EXACTLY how this is caused, yet they consistently choose to do the wrong thing." That "wrong thing" goes back to Black Informant's number one—gay sex.

I disagree.

From 2006 to 2008, the number of known HIV/AIDS cases in D.C. increased by 22 percent. Three percent of the District's population is now known to be infected with HIV. But the "jump" can't be attributed to D.C.'s gay community, as Black Informant states. The study notes that "Heterosexual sexual contact is quickly becoming the leading mode of transmission among all HIV/AIDS cases, already surpassing MSM among newly diagnosed AIDS cases."

That means that over the past two years, the majority of HIV/AIDS diagnoses in D.C.—the "jump" we're referring to—were a result of heterosexual contact. Not. Gay. Sex. (Check page 57 of this PDF for those figures).

If it's not the gays, then what's responsible for the jump? Another foe of Black Informant—education. HIV/AIDS infections haven't increased 22 percent in two years—infections we know about have increased. That means:

a. People are getting tested more. Three-fifths of D.C. residents knew their HIV status in 2008. Testing efforts have significantly increased since 2006, the first time the District released a full report on its HIV status. "In mid-2006, the District became the first city in the country to implement a policy of routine HIV testing, and implemented a series of measures to encourage residents to get tested and providers to normalize HIV testing as part of routine care," the study states.

b. People are getting tested earlier. A person's CD4 count is a good indicator of how far along a patient's immunodeficiency has progressed—the more CD4 you have, the better. Only 18 months after D.C. stepped up its HIV testing program in 2005, the study found that "the median first CD4 count had risen to 332, a 50 percent increase in CD4 counts since 2005." That means that more people are getting tested for HIV/AIDS while they're still healthy, before they have signs of a secondary illness indicating an immunodeficiency (a CD4 count below 200 indicates a patient has full-blown AIDS).

c. Patients are living longer. The earlier a person tests positive for HIV, the less likely they are to spread the virus to another person. But early testing helps out the positive person, too: early testing and diagnosis gives those infected with HIV a much higher chance of survival. That's why 40 to 49-year-olds make up the largest HIV/AIDS population in the District, at 7.2 percent. The longer an HIV-positive patient lives, the higher the rate of HIV will be in the District of Columbia.

The 22 percent jump in HIV/AIDS cases is due to increased testing initiatives and medical advancements in fighting the virus. Not. Gay. Sex.

But the District of Columbia can't make people get tested for HIV. To what can we attribute the increase in testing? First of all, making HIV tests easy, accessible, and free, as they are at D.C.'s Whitman Walker Clinics. Second, normalizing the testing process through education. If D.C. residents think—like Black Informant does—that AIDS is a disease for homosexuals and sexual deviants, they're less likely to be tested, and they're more likely to pass the virus on to their partners. Continuing to spread the falsehood that HIV is a gay disease is dangerous to all residents of Washington who may be at risk.

There's an advantage to the high visibility of HIV/AIDS in the gay community—gay activists have been mobilizing since the 1980's for gay men to be tested regularly for HIV. But the visibility has also hurt other at-risk populations who think that their own behavior is "normal" enough not to subject them to the "gay" disease. Now that the rest of Washington D.C. has been proven to be as at-risk as the gay community, hiding behind homophobia will only impede our efforts to make everyone—gay and straight—healthy and safe.

Okay, Black Informant. It's your turn.

Today, I wrote a post calling out Black Informant, a blogger who called out homosexuals for the striking new HIV/AIDS numbers in the District. The blogger then proceeded to call me out, in a post titled "Calling Amanda Hess of the Washington City Paper." Black Informant wants to debate me!

"So now the ball is in your court to make a full and complete case without resorting to cut and paste arguments that deny factual evidence," he writes. "At the end, we’ll let the readers decide their own conclusions." In order to make known the seriousness with which he was calling me out, Black Informant posted my photograph.

I agreed to the challenge, under the condition that Black Informant send over a personal photo, too. He readily complied (above).

Like me, Black Informant has written extensively on both AIDS and homosexuality. We tend to come to different conclusions. I'll post my first response to Black Informant's positions tomorrow.