In Search of Death

Though he's older, Carlos lives a life that has a lot in common with Hitzel's in San Francisco. Carlos estimates that he has had several hundred sex partners throughout his life, and he routinely hooks up with three or four guys a week, all of them HIV-positive or at least uncertain about their status.

That's a common trait among bug chasers, says Dr. Bob Cabaj, director of behavioral-health services for San Francisco County and past president of both the Gay and Lesbian Medical Association and the Association of Gay and Lesbian Psychiatrists. Cabaj (pronounced suh-bye) calls bug chasing "a real phenomenon." Some bug chasers are more likely to have a defeatist attitude, to think they'll eventually get HIV anyway, whereas others are more likely to add the element of eroticizing HIV, Cabaj says: "For kids who have had a really hard time fitting in or being accepted, this becomes like a fraternity."

As a public official, Cabaj is familiar with how the topic makes people uncomfortable. Most AIDS activists prefer to deny that the problem exists to any significant extent, he says: "They don't want to address that this is a real ongoing issue."

When I asked about bug chasing, leaders of groups such as Gay Men's Health Crisis in New York, the San Francisco AIDS Foundation, the Stop AIDS Project, and the Gay and Lesbian Alliance Against Defamation weren't interested in providing much education or increasing public awareness. To the contrary, most were dismissive of the issue and some actively dissuaded me from writing the article at all. A spokeswoman for the Stop AIDS Project, Shana Krochmal, characterized bug chasing as "relatively minor acting-out" and aggressively encouraged me to drop the article idea altogether, saying the issue is "not big enough to warrant a trend story." Krochmal cautioned against focusing on "just a bunch of really vocal guys who want to continue this image of being reckless, hedonistic gay men who will do anything to get laid. I think that does a disservice to the community at large." The San Francisco AIDS Foundation labeled the issue "sensational" and would not provide further comment. GLAAD spokeswoman Cathy Renna was more helpful, saying she had heard enough about bug chasing to be concerned, emphasizing that her group's focus would be whether people use bug chasing as an easy way to disparage all gays and lesbians as sex-crazed and reckless. "The vast majority of the gay community would be just as surprised and appalled by this as anyone else," she says.

At GMHC, where Carlos is one of more than 7,000 volunteers, spokesman Marty Algaze calls bug chasing "one of those very underground subcultures or fetishes that seems to have sprung up in recent years." The assistant director of community education at GMHC, Daniel Castellanos, acknowledges that bug chasing exists but claims there's not much need to discuss it because it involves such a small population. But would he try to talk a bug chaser out of trying to get HIV? "If someone comes to me and says he wants to get HIV, I might work with him around why he wants to do it," he says. "But if in the end that's a decision he wants to make, there's a point where we have to respect people's decisions."

Cabaj, the San Francisco psychiatrist, says those arguments sound familiar. Then, without being asked, he adds, "But I don't know if it's an active cover-up." He pauses for a moment, then continues, "Yeah, it's an active cover-up, because they know about it. They're in denial of this issue. This is a difficult issue that dredges up some images about gay men that they don't want to have to deal with. They don't want to shine a light on this topic because they don't want people to even know that this behavior exists."

Public-health officials also tend to dismiss the bug-chasing phenomenon, he adds, assuming that it is just an aberration practiced by a few, nothing more than a curiosity. Cabaj adamantly disagrees, though he admits numbers are very hard to come by. Some men consciously seek the virus, openly declaring themselves bug chasers, he says, while many more are just as actively seeking HIV but are in denial and wouldn't call themselves bug chasers. Cabaj estimates that at least twenty-five percent of all newly infected gay men fall into that category.

With about 40,000 new infections in the United States per year, according to government reports, that would mean around 10,000 each year are attributable to that more liberal definition of bug chasing. Doug Hitzel says he fits that description. Though he now says he was a bug chaser for six months, he explains that he would not have admitted it to anyone outside the subculture, and he sometimes even lied to himself about what he was doing. Even if you consider only the number of self-proclaimed bug chasers and not the overall group of men seeking HIV, Cabaj still sees cause for concern because of the way one bug chaser's quest can spread the virus far beyond his own life. "It may be a small number of actual people, but they may be disproportionately involved in continuing the spread of HIV," he says. "That's a major issue when you're talking about how to control the spread of a virus. A small percentage could be responsible for continuing the infection. The clinical impact is profound, no matter how small the numbers."