"If I got HIV, I would accept it, and just move on with my life," he says. "I would look for people who have it as well, and get in that community."

Though Butler is not representative of his generation, his lifestyle shows that barebacking is not exclusive to men who are avoiding transmitting or receiving the disease by practicing risk-reduction strategies.

Whether it's the city's responsibility to step in is a different question — something it has grappled with at length during the last 30 years.


Claude Wynne has no problem with people going to sex clubs. He just wants them to wear condoms.
J.P. Dobrin
Claude Wynne has no problem with people going to sex clubs. He just wants them to wear condoms.
Gehno Sanchez doesn’t think 
monitoring for condom use will fly at his Cockpit parties.
J.P. Dobrin
Gehno Sanchez doesn’t think monitoring for condom use will fly at his Cockpit parties.

Back when little was known about HIV/AIDS, gay men congregated at bathhouses for anonymous sex. As awareness of the disease increased in the early 1980s, and the public learned that it was mostly concentrated among the gay population and spread through sex, the bathhouses became an obvious target for debate.

Ultimately it was San Francisco Public Health Director Dr. Mervyn Silverman's decision to keep the bathhouses open or shut them down. He waffled for more than a year. "By the thousands, gay men continued to go to the baths, and by the thousands, they would later die," wrote Randy Shilts in his 1987 novel And the Band Played On.

Dr. Silverman's main concern was not putting the Health Department and gay community at odds. He wanted consensus.

Those who wanted the bathhouses closed said it was a no-brainer: If gay men were having high-risk sex in bathhouses, then bathhouses presented a public health hazard that Dr. Silverman should use his authority to close.

Bathhouse advocates took offense to the department sticking its nose in their business. The bathhouses symbolized the sexual freedom and civil liberties that men gained in San Francisco.

Finally, toward the end of 1984, after attempts to post safe sex education messages in the bathhouses failed, Silverman ordered their immediate closure. A court countered that they could stay open, but would have to follow regulations that included monitoring for and expelling people having unprotected sex, and eliminating private rooms with locked doors. Between HIV/AIDS and the new rules, the bathhouses swiftly lost their appeal and went out of business. Silverman resigned. Attempting to regulate gay sex was shaping up to be the stuff of political suicide: damned if you do, damned if you don't.

More sex clubs followed the bathhouses in the mid-1980s. They met considerably less resistance. In 1990, a group of concerned individuals formed the Coalition for Healthy Sex to draft a set of minimum standards for sex clubs and parties. The hope was that the guidelines would be made law, when and if the sex clubs were required to have special business licenses. The rules ranged from general to specific: condoms at all times; frequent monitoring; no locked rooms; and no shared use of sex toys, to name a few.

In 1996, a proposal to license sex clubs flopped — there simply wasn't enough political support. Several members of the Coalition withdrew their endorsement. SFDPH adopted the standards anyway, but only as voluntary guidelines. While the department still attempts to check that they are followed, there is no penalty for a breach.

Today, Wynne says he feels alone in his efforts to call the department on its lack of firm policy. Gone are the days when a man punched him in the face for suggesting the bathhouses remain open as long as condoms were required. His attacker had just lost a friend to AIDS. Wynne could have done without the assault, but says he wishes more people were passionate about the issue — or at least talking.

With San Francisco upending its approach to eliminating HIV/AIDS, that might happen sooner than he thinks.


A week after the Folsom Street Fair, the national Road to AIDS 2012 town hall meeting made its first stop in San Francisco on its way across the country. The issues discussed here at City Hall would inform what the global HIV/AIDS community will talk about in July 2012, when the U.S. hosts the International AIDS Conference for the first time since 1990.

The Bay Area panelists, including Dr. Colfax, began with one of the big talking points: 2011 marks the 30th anniversary of the first reported HIV cases in the U.S., and while more people are surviving with the illness, there are still thousands of newly infected people every year.

This reminder, coupled with the country's first-ever National HIV/AIDS Strategy from the Obama administration, signals a renewed determination to stamp out the epidemic. Released in 2010, Obama's strategy first acknowledges that U.S. citizens don't regard HIV/AIDS with the same urgency as before, and examines how traditional prevention approaches have grown stale. "We must also move away from thinking that one approach to HIV prevention will work, whether it is condoms, pills or information," it says.

San Francisco released its own ambitious plan along the same lines: reduce all new HIV infection rates, and new infections among men who have sex with men, by 50 percent by 2015. With funding cuts on the way, the city is forced to zero in on which methods yield the best results and are most cost-effective.

As a result, the new local strategy calls for more emphasis on testing and treating people, just as the national strategy recommends. The city is attempting to test thousands more people each year; knowing their HIV status decreases the likelihood that they will inadvertently transmit the disease. According to a U.S. Centers for Disease Control and Prevention survey, in 2008, 23 percent of men who have sex with men in San Francisco had HIV, and 19 percent of those infected did not know they had the disease.

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