On February 11, 2005, the New York City Department of Health reported a case of H.I.V. infection characterized by markedly accelerated progression to A.I.D.S. and resistance to nearly all available anti- H.I.V. medications. The facts of the case are as follows: a gay male in his 40s who admitted to "countless" episodes of unprotected anal sex while using Crystal methamphetamine was infected with H.I.V. and within 4 - 20 months of being infected had progressed to full blown A.I.D.S. Testing revealed that H.I.V. virus from this man's blood is resistant to all but 2 of the currently available anti - H.I.V. medications.

Thie severity of this man's H.I.V. disease can be appreciated by understanding the following: 1. The median time from initial infection with H.I.V. to progression to A.I.D.S. is about 100 months. 2. The transmission of a strain of virus that is resistant to 1 or 2 anti- H.I.V. medications occurs in about 10% of all new infections. 3. Drug resistance strains are generally less aggressive and less infective to others.

It is not yet known why or how this man's H.I.V. has been so remarkably aggressive and simultaneously impervious to the effects of all but 2 currently available anti- H.I.V. medications. One theory put forward is that this man was infected by a new, highly virulent, "super strain". If readily transmissible, such a "super strain" could rapidly cause a devastating pandemic of immense proportions and therefore every effort must be made to confirm or disprove the existence of such a strain even though this is not the likely explanation.

One can not help but suspect that having bareback sex with "countless" men might be a factor. It is, after all, well known that for persons with H.I.V., unsafe sex can result in re- infection with H.I.V. And each time a person is re- infected, there is a 10% chance that the person's H.I.V. will have suddenly become resistant to one of a limited number of effective medicines. If there is suddenly resistance to 1 of the 3 drugs in a cocktail, then effectively the patient will effectively be taking a 2 drug cocktail. Since a minimum of 3 effective drugs are necessary to keep H.I.V. under control and prevent the development of more drug resistance, it won't be long before all 3 drugs in a cocktail will have been rendered forever ineffective. With the limited number of available anti- H.I.V. medicines, serial re- infection could be a fairly efficient way to render one's H.I.V. untreatable.

Also, as with any infection, the severity or aggressiveness of H.I.V. can be influenced greatly by its hosts overall state of health. Exercise, good nutrition, and absence of mental illness are examples of factors which can have a favorable impact on the progression of H.I.V. Not surprisingly, going without sleep or adequate nutrition for days at a time while using Crystal meth which also causes high blood pressure, impotence, heart attacks, extensive and disfiguring Staph infections of the skin, strokes, seizures, and psychosis could reasonably be expected exacerbate and intensify the effects of H.I.V. Crystal meth may also have a direct effect on the immune system, weakening its ability to fight off H.I.V. and other infections. Add all this to a little re- infection here and there and you too, could have a press conference in honor of your having gone from H.I.V. to AIDS in record time.

Will the New York case be remembered as the beginning of a new era of A.I.D.S. in the gay community, an era characterized by our lacking the courage to face our communitiy's growing problem with Crystal meth and an era characterized by our having not having enough
self respect or basic human compassion for the men we have sex with, to refrain from fucking each other without condoms? That will be up to you.