In early February, reports of an HIV "superstrain" came out of the New York City Health Department. The subject in question, a 40-something gay man, had a strain of HIV which advanced within four months into full-blown AIDS. Since then, the individual’s health has only responded to one of 21 available drugs. Not since the early 80’s, when HIV/AIDS was first named, had medical officials seen someone deteriorate so quickly. Soon thereafter, many public health officials were careful to state that although there wasn’t necessarily a new “superstrain” on the loose, more research had to be conducted to determine the virus’ severity in terms of its progression and extent of infection.

Thusfar, the response by AIDS social service providers has been complicated. The New York Times announced the discovery about the virus with the headline, “Report on new form of HIV brings alarm, not surprise.” This lack of surprise was partially fueled by an expectation on the part of researchers that a drug-resistant strain of HIV could emerge. Social service providers had also began to document the problem of “safer sex message burn-out,” in addition to the rising role that crystal meth plays in risk factors for HIV. Initially, however, some activists considered starting quasi-vigilante efforts—including disrupting Internet chat arranging for sexual liaisons for example, or confronting participants at sex parties.

What this means for the gay community, however, is a potential crisis that it must actively confront. While worldwide the HIV pandemic is generally caused through heterosexual sexual transmission and intravenous needle sharing, in the United States HIV has largely been limited to MSM (men who have sex with men) behaviors. HIV’s history is a narrative that continues to dominate gay culture and consciousness, but less so in the past 15 years with the advent of life-prolonging HIV treatments. Social service providers have already documented the rise of sexually transmitted infections (STI’s) in young people 18-24—who never had to live through the onslaught of deaths their older mentors did—to indicate the decrease in urgency they might feel about the disease.

Furthermore, with a new strain that is still so little understood, and in a political climate that has been—let us say, slightly less than enthusiastically supportive—of research in traditionally marginalized populations (drug users, sex workers, transgenders, and gay men), no one can predict what kind of backlash could occur towards the gay community.

While it probably will not do much good to panic about an isolated case of a drug-resistant HIV (about which we still know very little), these investigations are significant because they point to the future of HIV prevention and treatment: that is, addressing the underlying causes of STI’s. Today this means crystal meth usage, the culture of partying, and public health campaigns which apparently don’t register on the radar as strongly as they used to. The Centers for Disease Control have also initiated new prevention methods focusing on positive individuals, which emphasize testing and partner notifications/counseling. For HIV-positive peoples, this also means a call-to-action to protect themselves and their partners from superinfections.

One of the major continuing challenges of HIV work is preventing a disease which carries weighty stigmas, both for its affected populations and transmission methods. How to effectively address the socio-economic-physical causes of HIV in a compassionate manner, while maintaining the assertive overtone needed in prevention messages, requires a delicate balance. In the face of this aggressive strain, APAIT will have to adjust once again.