In Search of Death

The problem is not restricted to any one community. Cabaj's counterpart in Boston reports a similar experience with bug chasers. Dr. Marshall Forstein is medical director of mental health and addiction services at Fenway Community Health, an arm of Beth Israel Deaconess Medical Center that specializes in care for gay and lesbian patients. Forstein is on the medical-school faculty in psychiatry at Harvard University and chaired the American Psychiatric Association's Commission on AIDS for eleven years. He says bug chasers are seen regularly in the Fenway health system, and the phenomenon is growing. He adds that bug chasers can be found in any major city, though officials might be reluctant to discuss the issue either because it is unseemly or because it has escaped their notice. A spokesman for the Los Angeles County Department of Health confirms that bug chasers are known in its health system. Public-health officials in New York refused multiple requests for comment.

One standout in public-health circles is the Miami-Dade County Health Department in Florida, which is taking steps specifically to address bug chasing. Evelyn Ullah, director of its office of HIV/AIDS, readily admits that bug chasing is "a definite problem" in the Miami area, having become more common and more visible in the past few years. Miami health officials regularly monitor Internet sites for bug chasing in their community, and they keep track of "conversion parties," in which the goal is to have positive men infect negative men. The health department also is launching new outreach efforts that include going online to chat with bug chasers and others pursuing risky sex.

Cabaj and Forstein stress that more should be done, particularly on a national level. For starters, federal health officials will have to familiarize themselves with the problem. Dr. Robert Janssen, director of the division of HIV/AIDS Prevention at the Centers for Disease Control and Prevention in Atlanta, says he has never seen the Web sites that promote bug chasing and does not know of any organized efforts to spread the virus. There is virtually no research on people who intentionally seek HIV, he says, but he notes that several studies have shown a growing complacency among gay men and the population in general about the risk of HIV and a misconception that HIV infection is completely manageable. Ongoing outbreaks of syphilis and gonorrhea (which Carlos recently had) in large cities indicate a tendency to forgo condom use, he says. Recent data from the CDC show that syphilis rates among men in the United States rose 15.4 percent between 2000 and 2001, which the researchers attribute to outbreaks among gay and bisexual men in several U.S. cities. Janssen says the CDC has not addressed bug chasing in any way but might if researchers determine that it is a significant method of spreading the virus. "I'm interested that you're saying there's that much out there on the Web and that it's easy to find," Janssen says. "If we can confirm that it's happening to any real degree beyond just an anecdote here and there, we may need to address it."

What frustrates health-care professionals the most, Forstein says, is that "gay men who are doing this haven't a clue what they're doing," he says. "They're incredibly selfish and self-absorbed. They don't have any idea what's going on with the epidemic in terms of the world or society or what impact their actions might have. The sense of being my brother's keeper is never discussed in the gay community because we've gone to the extreme of saying gay men with HIV can do no wrong. They're poor victims, and we can't ever criticize them."

Furthering the epidemic doesn't bother Carlos. Bug chasing requires a great deal of self-delusion, and he easily acknowledges the contradictions in what he's doing. He notes that while he seeks HIV, he doesn't eat junk food or smoke, and that he drinks only socially. "I take care of myself," he says proudly. He also notes the hypocrisy in his doing volunteer work at GMHC, in which he tells other men to use condoms and practice safe sex, while he's hunting for partners for his secret hobby. The conflict doesn't bother him in the least.

Forstein says that attitude is disastrous for gay men. "We're killing each other," he says. "It's no longer just the Matthew Shepards that are dying at the hands of others. We're killing each other. We have to take responsibility for this as a community."

After several phone calls to work out a time, Carlos is ready to go see Richard. He's had sex with Richard about thirty times in the past year. "Knowing he's positive just makes it more fun for me," he says. "It's erotic that someone is breeding me." Richard is in the entertainment business, in his mid- to late forties.

"Lots of guys want to know who breeds them," Carlos continues. "When I have sex, I like to always make it special, a really good time, something nice and memorable in case that is the one that gives it to me."

Carlos offers, not for the first time, to have me come along and watch him and Richard have sex, but I decline. In the taxi to Richard's place, the conversation falls silent. He hasn't been tested in a couple of years, and he's reluctant to get a test now. He might very well be positive already. But as long as he doesn't know for sure, he can always hope that tonight is the night he gets the virus. Every date is potentially The One. Stepping out of the cab into the rain, I ask what he will do if he finds out one day that he has succeeded in being infected -- ending the fun of being a bug chaser. He stops, then says he might move on to being a gift giver: "If I know that he's negative and I'm fucking him, it sort of gets me off. I'm murdering him in a sense, killing him slowly, and that's sort of, as sick as it sounds, exciting to me."

[From RS 915 — February 6, 2003]