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Yvonne Abraham

Still much to be done as AIDS Walk turns 25

By Yvonne Abraham
Globe Columnist / June 6, 2010

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There’s no way Steve Spinale should be positive.

He’s only 26. We’ve known about HIV since before he was born. Gay communities have recognized unsafe sex as Russian roulette for his entire lifetime.

He understood the risks.

And yet the slight, dark-eyed student was sitting in a citrus-walled room at a South End drop-in center Thursday afternoon, talking about the day last June when he was tested for the virus.

“I knew it would be positive,’’ he said softly. “I was educated about it growing up. I made my decisions.’’

If guys like Spinale are contracting HIV 29 years after the disease was first diagnosed, we’ve still got a major problem.

Since 2000, we’ve managed to halve the number of new HIV infections in Massachusetts, from 1,200 a year to under 600. But while infection rates have been slashed in other high-risk groups — injection drug users, for example — they haven’t budged among men who have sex with men, according to state figures.

For eight years, new infections have been stuck in the mid-300s in the state’s gay community. That’s one every day.

Why? It’s partly lousy sex education, and public health policy that’s still unaccountably squeamish about condoms.

It’s partly that younger gay men didn’t see the most horrific stage of the epidemic, when legions died awful, visible deaths that scared others into better protecting themselves. And treatments over the last 15 years have made HIV seem more like a chronic disease than a deadly one. It’s also harder to reach gay men with prevention messages now that many socialize online rather than in the bars where condoms and counseling were plentiful.

But Spinale says none of that mattered to him. The only thing that did came into his life outside a theater district dance club two Octobers ago: Crystal meth.

“The first time I smoked meth, I remember feeling, ‘This must be what happiness is,’ ’’ he said. The drugs made him forget everything. Not just the depression and anxiety for which he hadn’t been able to afford medication. Not just his stalled career.

When he was high, he forgot all he had learned about taking care of himself and others. He threw himself into sex with the same abandon he brought to meth.

But then Spinale’s sister became pregnant, and “I started to see myself how my niece would see me,’’ he said. He was done.

“Off the drugs, your head clears,’’ he said. “Then you have to take responsibility.’’

He knows some people have no sympathy for somebody who contracted HIV as late as 2009. “They’re like, ‘Oh, well, you did it to yourself,’ ’’ he says.

Maybe. But blaming Spinale won’t make his disease any less harrowing for him and his family. It won’t make his treatment any less costly. It won’t change the fact that people are continuing to get infected with a potentially fatal disease, even though we’re supposed to know how to prevent it.

Spinale wasn’t the first meth user to walk into the drop-in center on Columbus Avenue, and he won’t be the last: Director Michael Shankle says he sees lots of men who test positive after smoking the drug and throwing caution away.

He also sees men who had temporary lapses in judgment, just as straight men and women do. And people who are still clueless about how the disease is transmitted, fretting about kissing or sharing toothbrushes.

We should be way beyond all of it.

As proof that we’re not, thousands of people will gather at the Hatch Shell this morning for the 25th annual AIDS Walk, which raises money for AIDS Action, the outfit that runs Shankle’s drop-in center and other prevention and support programs for people with HIV and AIDS.

It will be a beautiful sight and, after 25 years, a profoundly depressing one.

Yvonne Abraham is a Globe columnist. She can be reached at abraham@globe.com.

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