Over the decade and a half that HIV has been with us, prevention programs built around information about the virus have reduced its transmission -- a victory of the head over the body's thirsts. At Larkin Street Youth Center and at Health Initiatives for Youth, the experts say that new cases of HIV infection have significantly slowed, even among the homeless youths who are at risk in so many ways. But still there are youths out there on the street, hustling and shooting and grasping at a world that drives past them, who have not been tested. Who don't want to know. It is here, on the edge of what is known about how to help people help themselves, that the perfidies of HIV, and the human heart, come ever more into view.
When it comes to HIV and AIDS, "people like to make it simple. But when they make it simple, they blame."
That's Antigone Hodgins of Bay Positives speaking. Growing out of a support group for young people with HIV, Bay Positives' sunny, plant-filled storefront office in the Lower Haight now has job announcements, counseling groups, and referrals for its 140 members.
"I think that prevention has to come from many different avenues," 27-year-old Hodgins is saying. "All those social issues that are surrounding these young people and make them so vulnerable need to be addressed in order to stop the virus."
At the San Francisco AIDS Foundation, Prevention Director MacArthur Flournoy agrees. Reaching the people who have not yet been reached isn't easy, he says. "It's not just a matter of using the health belief model or the theory of reasoned action. It is much more sophisticated and complicated than that," he says. "We need much more sophisticated answers." To get those answers, the foundation is currently conducting a survey of injection-drug-using youths to try to find out what approach works best for them.
But even so, problems remain. Beds at drug-treatment programs are limited, and unless youths are HIV-positive, placement can take three to four weeks, Larkin Street's Michael Kennedy says, which can be an eternity to a young person on the streets.
And while it might be tempting to do so, it is unwise -- and untruthful -- to consider that young homeless people are the only ones in need of some enlightenment.
Because when you come right down to it, the rigors of life in Polk Gulch are not only a matter of the youths on the streets. Like all sex workers, the youths of Polk Gulch -- whatever their reasons for being on the street, and whatever their life choices and compulsions may be -- are not working by themselves. In all of this, the forgotten part of the equation is the customer, the man with the white headlights and red taillights who finds what he's looking for in the young men who stand on the street corners, waiting.
Queer youth activist Eric Ciasullo is in favor of legalizing prostitution. He is also in favor of safe sex. But combining the two -- especially in a society where queer sexuality is stigmatized, leading to feelings of shame and disaster -- is difficult, in that the johns are a hidden society, one whose community consists of them and their car and the youths they've picked up.
"There is an economic incentive on the streets to have unsafe sex. You treat this young person who is cold and on the street as a commodity," Ciasullo says. "To reinforce those circumstances in his life to reach sexual pleasure I find to be extremely selfish."
"We're not creating a climate of emergency around this," he says. "We are doing a pretty good job locally of acknowledging the need for lots of money and lots of professional intervention. But still, we don't want to offend people."
Although that's not something Stephen is worrying about. On a rainy Thursday night, he is sitting at a Polk Street cafe, dropping Hershey's Kisses into his cup of coffee and smoking a cigarette. He's smiling and talking -- a story about how, this afternoon, he told one of his regular customers to get lost. The man wanted to pay just $10 for oral sex without a condom, Stephen is saying. "I told him no," Stephen says. "But he'll be back. He can't stay away."
"Most of these tricks out here are just drug addicts like us, but their drug is sex," he says, stirring his coffee, watching the rain. "It's like a drug for them. They have to have their boy."
The names of the homeless young men interviewed for this story have been changed. Research assistance by Liza Goodwin.
