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Safe Sex Messages Seem To Be Falling Short

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It's been the HIV prevention message for decades: just practice safe sex. But there's evidence that message isn't getting over, especially with young gay men.

— About 50,000 Americans become infected with HIV every year. That number hasn’t changed much in more than a decade.

The Centers for Disease Control says most of these infections are among men who have sex with other men, and bisexuals.

In this second of our three-part series on HIV in San Diego, we look at whether safe sex messages may be falling short.

If you’re looking for a good time in Hillcrest, you can’t go wrong with Urban Mo’s Bar & Grill.

30 Years Of AIDS In San Diego

Since the first cases of AIDS in 1981, the disease has killed nearly 7,300 people in San Diego County. In this three-part series, KPBS Health Reporter Kenny Goldberg recounts the epidemic's early days, explores how safe sex messages may be falling short, and looks at a unique effort in San Diego that's trying to take HIV testing door-to-door.

Since the first cases of AIDS in 1981, the disease has killed nearly 7,300 people in San Diego County. In this three-part series, KPBS Health Reporter Kenny Goldberg recounts the epidemic's early days, explores how safe sex messages may be falling short, and looks at a unique effort in San Diego that's trying to take HIV testing door-to-door.

The place always seems to be jam-packed, even on a weekday afternoon.

There’s good food here. People are friendly.

Mo’s is advertised as gay restaurant. In fact, there’s a jar of condoms at each door.

Chris Shaw has operated Mo's since 1992.

"It’s kind of like, you know, you grab a mint at most restaurants. Here, you can grab a condom."

Shaw said sexual practices were different 20 years ago.

"If you didn’t cover it up," Shaw recalls, "I wouldn’t sleep with anybody, right? That’s the way it used to be. It was considered, you know, more of a sin. It was disgusted if you didn’t wear a condom or practice safe sex back in the 90s."

Shaw said lately, it seems like gay men just take too many chances.

"It just makes you mad," Shaw said. ".Just that they’re so young, they have such a life ahead of them, and that they were so stupid, and not practicing safe sex. And all it is is a condom. Just put a condom on. You can have all of the sex you want, just cover it up."

Just use a condom.

That’s been the message since the AIDS epidemic began.

But there’s evidence the message isn’t getting over. Today, most new HIV infections in the U.S. are among people under 30.

A young man we'll call Gio became infected with HIV three years ago, when he was 21.

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HIV Among Gay, Bisexual And Other Men Who Have Sex With Men (MSM)

HIV Among Gay, Bisexual And Other Men Who Have Sex With Men (MSM)

HIV among Gay, Bisexual and Other Men Who Have Sex with Men (MSM)

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He remembered the encounter.

"For me, in my mind at the time was that, I was, I was enjoying myself at the time," Gio said. "I mean, I was having a good time. I didn’t think about the potential risks involved. ¬I was too busy feeling good. Ha, ha. Honestly."

Gio says condoms just weren’t part of his scene.

"It wasn’t something that was stressed in my peer group, practice safe sex," Gio recalled. "My friends were just like, have sex."

UCSD’s Jim Zians has been doing research into human behavior for more than a decade. He’s worked on a number of studies involving gay men.

Zians says the hope was that widespread condom use would drive HIV infection rates down considerably.

"Anyone can protect themselves by using condoms. It’s kind of like a decision you make to go to the gym and get in shape," Zians pointed out. "But when you look at the population and try to make these dramatic changes, it just hasn’t happened."

Trying to change human behavior on a broad scale is enormously difficult.

Just look at the obesity epidemic. We all know what we need to do to stay healthy. But how many of us do it? And how much does our culture contribute to the problem?

Terry Cunningham has been trying to halt the spread of HIV for nearly 30 years. He’s the chief of the San Diego County Health Department’s HIV, STD, and Hepatitis branch.

"What do you have to do to get the information out there that you need to protect yourself and protect your sexual partners?" Cunningham sighed. "Why this isn’t happening I don’t know."

Here’s the situation: The Centers for Disease Control says one in five gay men in America is HIV positive. That means at best there’s inconsistent condom use. And there’s no technological solution like an AIDS vaccine on the immediate horizon.

UCSD’s Jim Zians said it’s not a pretty picture.

"It’s going to be very challenging to lower these rates anytime soon, without some sort of huge transformational, cultural change in the environment," Zians explained. "And I don’t know anyone who’s able to advocate exactly what that would be."

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