The men who long to be HIV+ Carlos nonchalantly asks whether his drink was made with whole or skim milk. He takes a moment to slurp on his grande Caffe Mocha in a crowded Starbucks, and then he gets back to explaining how much he wants HIV, the virus that causes AIDS. His eyes light up as he says that the actual moment of transmission, the instant he gets HIV, will be "the most erotic thing I can imagine." He seems like a typical thirty-two-year-old man, but, in fact, he has a secret life. Carlos is chasing the bug.
"I know what the risks are, and I know that putting myself in this situation is like putting a gun to my head," he says. Some of that mountain music that's so popular is playing, making the moment even more surreal as a Southern voice sings, "Keep on the sunny side of life" behind Carlos. "But I think it turns the other guy on to know that I'm negative and that they're bringing me into the brotherhood. That gets me off, too."
I met Carlos in New York's Greenwich Village, the neighborhood where he usually hangs out. He is tall, with a large build, and plenty of gay men find him attractive. His longish, curly-wavy hair is jet-black with golden highlights, and his face is soft and just a bit feminine. He has a very appealing smile and laugh, and he's a funny guy sometimes. The conversation veers from the banal -- his fascination with the reality show The Amazing Race -- to his desire for HIV. Carlos' tone never changes when switching from one topic to the other.
When asked whether he is prepared to live with HIV after that "erotic" moment, Carlos dismisses living with HIV as a minor annoyance. Like most bug chasers, he has the impression that the virus just isn't such a big deal anymore: "It's like living with diabetes. You take a few pills and get on with your life." Carlos spends the afternoon continually calling a man named Richard, someone he met on the Internet. They met on barebackcity.com about a year ago, while Carlos was still with his boyfriend. That boyfriend left because Carlos was having sex with other men and because he was interested in barebacking -- the practice of having sex without a condom. Carlos and Richard are arranging a "date" for later that day.
Carlos is part of an intricate underground world that has sprouted, driven almost completely by the Internet, in which men who want to be infected with HIV get together with those who are willing to infect them. The men who want the virus are called "bug chasers," and the men who freely give the virus to them are called "gift givers." While the rest of the world fights the AIDS epidemic and most people fear HIV infection, this subculture celebrates the virus and eroticizes it. HIV-infected semen is treated like liquid gold. Carlos has been chasing the bug for more than a year in a topsy-turvy world in which every convention about HIV is turned upside down. The virus isn't horrible and fearsome, it's beautiful and sexy -- and delivered in the way that is most likely to result in infection. In this world, the men with HIV are the most desired, and the bug chasers will do anything to get the virus -- to "get knocked up," to be "bred" or "initiated into the brotherhood."
Like a lot of sexual fetishes and extreme behaviors, bug chasing could not exist without the Internet, or at least it couldn't thrive. Prior to the advent of Web surfing and e-mail, it would have been practically impossible for bug chasing to happen in any great numbers, because it's still not acceptable to walk up to a stranger and say you want the virus. But the Internet's anonymity and broad access make it possible to find someone with like interests, no matter how outlandish. Carlos surfs online about twenty hours a week looking for men to have sex with, usually frequenting sites such as bareback.com and barebackcity.com, plus a number of Internet discussion groups. Most of the Web sites use the pretense that they actually are about barebacking, which is in itself risky and controversial but still a long way from bug chasing. For the Web sites, that distinction is at best razor-thin and more often just an outright lie. "We got Poz4Poz, Neg4Neg and bug chasers looking to join the club," the welcome page to barebackcity.com, which claims 48,000 registered users, up from 28,000 about a year ago, recently said. "Be the first to seed a newbie and give him a pozitive attitude!"
Within this online community, bug chasers revel in their desires, using their own lingo about "poz" and "neg" men, "bug juice" and "conversion" from negative to positive. User profiles include names such as BugChaser21, Knockmeup, BugMeSoon, ConvertMeSir, PozCum4NegHole and GiftGiver. The posters are upfront about seeking HIV, even extremely enthusiastic, possibly because the Web sites are about the only place a bug seeker can really express his desires openly. Under turn-ons, a poster called PozMeChgo craves a "hot poz load deep in me. I really want to be converted!! Breed me/seed me!" Carlos' profile on one Web site lists his screen name as ConvertMe, and he says he wants a man "to fill me up with that poison seed." His AOL Instant Messenger name is Bug Juice Wanted.
It's not uncommon to see people post replies to the profiles encouraging the men to seek HIV. One such comment reads, "This guy knows what he wants!! I would love to plant my seeds ) Come and join the club. The more we are, the stronger we are." A Yahoo! spokeswoman confirms that the company shuts down such sites when it receives notice that the subscribers are promoting HIV infection or any other kind of harm to one another, but the company doesn't go looking for bug chasers in its thousands of discussion groups, most established by subscribers themselves. Recently, it was easy to find two discussion groups on Yahoo! that promoted bug chasing, one called barebackover50 and one called gayextremebareback. The first discussion group was established in 1998 and had 1,439 members at the end of 2002. Yahoo! closed the group after Rolling Stone inquired about it.
Condoms and safe sex are openly ridiculed on bug-chasing Web sites, with many bug chasers rebelling against what they see as the dogma of safe-sex education; constantly thinking about a deadly disease takes all the fun out of sex, they say, and condoms suck. Carlos agrees and says getting HIV will make safe sex a moot point. "It's about freedom," he says. "What else can happen to us after this? You can **** whoever you want, **** as much as you want, and nothing worse can happen to you. Nothing bad can happen after you get HIV."
For some, the chase is a pragmatic move. They see HIV infection as inevitable because of their unsafe sex or needle sharing, so they decide to take control of the situation and infect themselves. It's empowering. They're no longer victims waiting to be infected; rather they are in charge of their own fates. For others, deliberately infecting themselves is the ultimate taboo, the most extreme sex act left on the planet, and that has a strong erotic appeal for some men who have tried everything else. Still others feel lost and without any community to embrace them, and they see those living with HIV as a cohesive group that welcomes its new members and receives vast support from the rest of the gay community, and from society as a whole. Bug chasers want to be a part of that club. Some want HIV because they think once they have it they can go on with a wild, uninhibited sex life without constant fears of the virus. Getting the bug opens the door to sexual nirvana, they say. Others can't stand the thought of being so unlike their HIV-positive lover.
For Carlos, bug chasing is mostly about the excitement of doing something that everyone else sees as crazy and wrong. Keeping this part of his life secret is part of the turn-on for Carlos, which is not his real name. That forbidden aspect makes HIV infection incredibly exciting for him, so much so that he now seeks out sex exclusively with HIV-positive men. "This is something that no one knows about me," Carlos says. "It's mine. It's my dirty little secret." He compares bug chasing to the thrill that you get by screwing your boyfriend in your parents' house, or having sex on your boss' desk. You're not supposed to do it, and that's exactly what makes it so much fun, he says, laughing.
Carlos carries another secret that he says heightens the thrill of pursuing HIV. Sometimes he volunteers in the offices of Gay Men's Health Crisis, the pre-eminent HIV-prevention and AIDS-activist organization in New York. And about once a month, he does outreach volunteering in which he goes to clubs to hand out condoms and educate men about safe sex.
Carlos should meet Doug Hitzel, but he probably never will. A year ago they might have been online buddies, both sharing a passion for HIV that few others understood. Now Hitzel understands all too clearly what bug chasing can do to a young man's life, but it's too late for him. After six months of bug chasing, Hitzel succeeded in getting the virus. He's now a twenty-one-year-old freshman at a Midwestern university, so wholesome-looking you'd think he just walked out of a cornfield.
Hitzel's experience started when he moved from his home in Nebraska to San Francisco with his boyfriend. When that relationship broke up, Hitzel was at the lowest point in his life, and alone. He sought relief in drugs and sex, as much of each as he could get. At first, he started out just not caring whether he got HIV or not, then he found the bug-chasing underground and embraced it. He was sure he'd get HIV soon anyway. He thought he would always feel exactly like he did then; he was certain that ten, twenty, thirty years later he'd still be partying every night. It lasted only six months -- then Hitzel got sick with awful flulike symptoms and lost a lot of weight. A doctor's visit cleared him of hepatitis and other possible problems, but the clinic sent him home with an HIV test he could do himself. Hitzel waited before doing the test and decided to go home to Nebraska, to give up the bug chasing and the rest of the life that was killing him. Once he got home, he did the test and found out he was positive. He now wakes up each day with a terrible frustration that's just below the surface of his once sunny demeanor. He hates the medication he has to take every day, and he realizes that HIV affects nearly every part of his life. While he was bug chasing, Hitzel couldn't imagine ever wanting to be in a relationship again. But now that he's getting his life back in order, he realizes that being HIV-positive can be a roadblock to new relationships.
"Whenever I have to deal with things like medication, days when I'm really down," Hitzel says, "I have to look myself in the mirror and say, 'You did this. Are you happy now?' That's the one line that goes through my head: 'Are you happy now?' " He says it with a snarl, full of anger. "Some days I feel really angry and guilty. I'm pretty much adjusted to the fact that this is my life, but about forty percent of the time I look at myself and say, 'Look what you've done. Happy now?' "
Looking back on it, Hitzel says he was committing suicide by chasing HIV, killing himself slowly because he didn't have the nerve to do it quickly. Hitzel is ashamed and embarrassed that he actually sought HIV, but he's willing to tell his story because he hopes to dissuade others who are on the same path. He gets angry when he hears bug chasers talking in the same ways he talked a year earlier. The mention of "bug chasing" and "gift giving" sets him off.
" 'Bug chasing' sounds like a group of kindergartners running around chasing grasshoppers and butterflies," Hitzel says, "a beautiful thing. And gift giving? What the hell is that? I just wish the terms would actually put some real context into what's going on. Why did I not want to say that I was deliberately infecting myself? Because saying the word infect sounds bad and gross and germy. I wanted it to be sexualized." He's particularly angered by the idea of HIV being erotic: "How about you follow me after I start new medications and you watch me throw up for a few weeks? Tell me how erotic that is."
Though he's older, Carlos lives a life that has a lot in common with Hitzel's in San Francisco. Carlos estimates that he has had several hundred sex partners throughout his life, and he routinely hooks up with three or four guys a week, all of them HIV-positive or at least uncertain about their status.
That's a common trait among bug chasers, says Dr. Bob Cabaj, director of behavioral-health services for San Francisco County and past president of both the Gay and Lesbian Medical Association and the Association of Gay and Lesbian Psychiatrists. Cabaj (pronounced suh-bye) calls bug chasing "a real phenomenon." Some bug chasers are more likely to have a defeatist attitude, to think they'll eventually get HIV anyway, whereas others are more likely to add the element of eroticizing HIV, Cabaj says: "For kids who have had a really hard time fitting in or being accepted, this becomes like a fraternity."
As a public official, Cabaj is familiar with how the topic makes people uncomfortable. Most AIDS activists prefer to deny that the problem exists to any significant extent, he says: "They don't want to address that this is a real ongoing issue."
When I asked about bug chasing, leaders of groups such as Gay Men's Health Crisis in New York, the San Francisco AIDS Foundation, the Stop AIDS Project, and the Gay and Lesbian Alliance Against Defamation weren't interested in providing much education or increasing public awareness. To the contrary, most were dismissive of the issue and some actively dissuaded me from writing the article at all. A spokeswoman for the Stop AIDS Project, Shana Krochmal, characterized bug chasing as "relatively minor acting-out" and aggressively encouraged me to drop the article idea altogether, saying the issue is "not big enough to warrant a trend story." Krochmal cautioned against focusing on "just a bunch of really vocal guys who want to continue this image of being reckless, hedonistic gay men who will do anything to get laid. I think that does a disservice to the community at large." The San Francisco AIDS Foundation labeled the issue "sensational" and would not provide further comment. GLAAD spokeswoman Cathy Renna was more helpful, saying she had heard enough about bug chasing to be concerned, emphasizing that her group's focus would be whether people use bug chasing as an easy way to disparage all gays and lesbians as sex-crazed and reckless. "The vast majority of the gay community would be just as surprised and appalled by this as anyone else," she says.
At GMHC, where Carlos is one of more than 7,000 volunteers, spokesman Marty Algaze calls bug chasing "one of those very underground subcultures or fetishes that seems to have sprung up in recent years." The assistant director of community education at GMHC, Daniel Castellanos, acknowledges that bug chasing exists but claims there's not much need to discuss it because it involves such a small population. But would he try to talk a bug chaser out of trying to get HIV? "If someone comes to me and says he wants to get HIV, I might work with him around why he wants to do it," he says. "But if in the end that's a decision he wants to make, there's a point where we have to respect people's decisions."
Cabaj, the San Francisco psychiatrist, says those arguments sound familiar. Then, without being asked, he adds, "But I don't know if it's an active cover-up." He pauses for a moment, then continues, "Yeah, it's an active cover-up, because they know about it. They're in denial of this issue. This is a difficult issue that dredges up some images about gay men that they don't want to have to deal with. They don't want to shine a light on this topic because they don't want people to even know that this behavior exists."
Public-health officials also tend to dismiss the bug-chasing phenomenon, he adds, assuming that it is just an aberration practiced by a few, nothing more than a curiosity. Cabaj adamantly disagrees, though he admits numbers are very hard to come by. Some men consciously seek the virus, openly declaring themselves bug chasers, he says, while many more are just as actively seeking HIV but are in denial and wouldn't call themselves bug chasers. Cabaj estimates that at least twenty-five percent of all newly infected gay men fall into that category.
With about 40,000 new infections in the United States per year, according to government reports, that would mean around 10,000 each year are attributable to that more liberal definition of bug chasing. Doug Hitzel says he fits that description. Though he now says he was a bug chaser for six months, he explains that he would not have admitted it to anyone outside the subculture, and he sometimes even lied to himself about what he was doing. Even if you consider only the number of self-proclaimed bug chasers and not the overall group of men seeking HIV, Cabaj still sees cause for concern because of the way one bug chaser's quest can spread the virus far beyond his own life. "It may be a small number of actual people, but they may be disproportionately involved in continuing the spread of HIV," he says. "That's a major issue when you're talking about how to control the spread of a virus. A small percentage could be responsible for continuing the infection. The clinical impact is profound, no matter how small the numbers."
The problem is not restricted to any one community. Cabaj's counterpart in Boston reports a similar experience with bug chasers. Dr. Marshall Forstein is medical director of mental health and addiction services at Fenway Community Health, an arm of Beth Israel Deaconess Medical Center that specializes in care for gay and lesbian patients. Forstein is on the medical-school faculty in psychiatry at Harvard University and chaired the American Psychiatric Association's Commission on AIDS for eleven years. He says bug chasers are seen regularly in the Fenway health system, and the phenomenon is growing. He adds that bug chasers can be found in any major city, though officials might be reluctant to discuss the issue either because it is unseemly or because it has escaped their notice. A spokesman for the Los Angeles County Department of Health confirms that bug chasers are known in its health system. Public-health officials in New York refused multiple requests for comment.
One standout in public-health circles is the Miami-Dade County Health Department in Florida, which is taking steps specifically to address bug chasing. Evelyn Ullah, director of its office of HIV/AIDS, readily admits that bug chasing is "a definite problem" in the Miami area, having become more common and more visible in the past few years. Miami health officials regularly monitor Internet sites for bug chasing in their community, and they keep track of "conversion parties," in which the goal is to have positive men infect negative men. The health department also is launching new outreach efforts that include going online to chat with bug chasers and others pursuing risky sex.
"I know what the risks are, and I know that putting myself in this situation is like putting a gun to my head," he says. Some of that mountain music that's so popular is playing, making the moment even more surreal as a Southern voice sings, "Keep on the sunny side of life" behind Carlos. "But I think it turns the other guy on to know that I'm negative and that they're bringing me into the brotherhood. That gets me off, too."
I met Carlos in New York's Greenwich Village, the neighborhood where he usually hangs out. He is tall, with a large build, and plenty of gay men find him attractive. His longish, curly-wavy hair is jet-black with golden highlights, and his face is soft and just a bit feminine. He has a very appealing smile and laugh, and he's a funny guy sometimes. The conversation veers from the banal -- his fascination with the reality show The Amazing Race -- to his desire for HIV. Carlos' tone never changes when switching from one topic to the other.
When asked whether he is prepared to live with HIV after that "erotic" moment, Carlos dismisses living with HIV as a minor annoyance. Like most bug chasers, he has the impression that the virus just isn't such a big deal anymore: "It's like living with diabetes. You take a few pills and get on with your life." Carlos spends the afternoon continually calling a man named Richard, someone he met on the Internet. They met on barebackcity.com about a year ago, while Carlos was still with his boyfriend. That boyfriend left because Carlos was having sex with other men and because he was interested in barebacking -- the practice of having sex without a condom. Carlos and Richard are arranging a "date" for later that day.
Carlos is part of an intricate underground world that has sprouted, driven almost completely by the Internet, in which men who want to be infected with HIV get together with those who are willing to infect them. The men who want the virus are called "bug chasers," and the men who freely give the virus to them are called "gift givers." While the rest of the world fights the AIDS epidemic and most people fear HIV infection, this subculture celebrates the virus and eroticizes it. HIV-infected semen is treated like liquid gold. Carlos has been chasing the bug for more than a year in a topsy-turvy world in which every convention about HIV is turned upside down. The virus isn't horrible and fearsome, it's beautiful and sexy -- and delivered in the way that is most likely to result in infection. In this world, the men with HIV are the most desired, and the bug chasers will do anything to get the virus -- to "get knocked up," to be "bred" or "initiated into the brotherhood."
Like a lot of sexual fetishes and extreme behaviors, bug chasing could not exist without the Internet, or at least it couldn't thrive. Prior to the advent of Web surfing and e-mail, it would have been practically impossible for bug chasing to happen in any great numbers, because it's still not acceptable to walk up to a stranger and say you want the virus. But the Internet's anonymity and broad access make it possible to find someone with like interests, no matter how outlandish. Carlos surfs online about twenty hours a week looking for men to have sex with, usually frequenting sites such as bareback.com and barebackcity.com, plus a number of Internet discussion groups. Most of the Web sites use the pretense that they actually are about barebacking, which is in itself risky and controversial but still a long way from bug chasing. For the Web sites, that distinction is at best razor-thin and more often just an outright lie. "We got Poz4Poz, Neg4Neg and bug chasers looking to join the club," the welcome page to barebackcity.com, which claims 48,000 registered users, up from 28,000 about a year ago, recently said. "Be the first to seed a newbie and give him a pozitive attitude!"
Within this online community, bug chasers revel in their desires, using their own lingo about "poz" and "neg" men, "bug juice" and "conversion" from negative to positive. User profiles include names such as BugChaser21, Knockmeup, BugMeSoon, ConvertMeSir, PozCum4NegHole and GiftGiver. The posters are upfront about seeking HIV, even extremely enthusiastic, possibly because the Web sites are about the only place a bug seeker can really express his desires openly. Under turn-ons, a poster called PozMeChgo craves a "hot poz load deep in me. I really want to be converted!! Breed me/seed me!" Carlos' profile on one Web site lists his screen name as ConvertMe, and he says he wants a man "to fill me up with that poison seed." His AOL Instant Messenger name is Bug Juice Wanted.
It's not uncommon to see people post replies to the profiles encouraging the men to seek HIV. One such comment reads, "This guy knows what he wants!! I would love to plant my seeds ) Come and join the club. The more we are, the stronger we are." A Yahoo! spokeswoman confirms that the company shuts down such sites when it receives notice that the subscribers are promoting HIV infection or any other kind of harm to one another, but the company doesn't go looking for bug chasers in its thousands of discussion groups, most established by subscribers themselves. Recently, it was easy to find two discussion groups on Yahoo! that promoted bug chasing, one called barebackover50 and one called gayextremebareback. The first discussion group was established in 1998 and had 1,439 members at the end of 2002. Yahoo! closed the group after Rolling Stone inquired about it.
Condoms and safe sex are openly ridiculed on bug-chasing Web sites, with many bug chasers rebelling against what they see as the dogma of safe-sex education; constantly thinking about a deadly disease takes all the fun out of sex, they say, and condoms suck. Carlos agrees and says getting HIV will make safe sex a moot point. "It's about freedom," he says. "What else can happen to us after this? You can **** whoever you want, **** as much as you want, and nothing worse can happen to you. Nothing bad can happen after you get HIV."
For some, the chase is a pragmatic move. They see HIV infection as inevitable because of their unsafe sex or needle sharing, so they decide to take control of the situation and infect themselves. It's empowering. They're no longer victims waiting to be infected; rather they are in charge of their own fates. For others, deliberately infecting themselves is the ultimate taboo, the most extreme sex act left on the planet, and that has a strong erotic appeal for some men who have tried everything else. Still others feel lost and without any community to embrace them, and they see those living with HIV as a cohesive group that welcomes its new members and receives vast support from the rest of the gay community, and from society as a whole. Bug chasers want to be a part of that club. Some want HIV because they think once they have it they can go on with a wild, uninhibited sex life without constant fears of the virus. Getting the bug opens the door to sexual nirvana, they say. Others can't stand the thought of being so unlike their HIV-positive lover.
For Carlos, bug chasing is mostly about the excitement of doing something that everyone else sees as crazy and wrong. Keeping this part of his life secret is part of the turn-on for Carlos, which is not his real name. That forbidden aspect makes HIV infection incredibly exciting for him, so much so that he now seeks out sex exclusively with HIV-positive men. "This is something that no one knows about me," Carlos says. "It's mine. It's my dirty little secret." He compares bug chasing to the thrill that you get by screwing your boyfriend in your parents' house, or having sex on your boss' desk. You're not supposed to do it, and that's exactly what makes it so much fun, he says, laughing.
Carlos carries another secret that he says heightens the thrill of pursuing HIV. Sometimes he volunteers in the offices of Gay Men's Health Crisis, the pre-eminent HIV-prevention and AIDS-activist organization in New York. And about once a month, he does outreach volunteering in which he goes to clubs to hand out condoms and educate men about safe sex.
Carlos should meet Doug Hitzel, but he probably never will. A year ago they might have been online buddies, both sharing a passion for HIV that few others understood. Now Hitzel understands all too clearly what bug chasing can do to a young man's life, but it's too late for him. After six months of bug chasing, Hitzel succeeded in getting the virus. He's now a twenty-one-year-old freshman at a Midwestern university, so wholesome-looking you'd think he just walked out of a cornfield.
Hitzel's experience started when he moved from his home in Nebraska to San Francisco with his boyfriend. When that relationship broke up, Hitzel was at the lowest point in his life, and alone. He sought relief in drugs and sex, as much of each as he could get. At first, he started out just not caring whether he got HIV or not, then he found the bug-chasing underground and embraced it. He was sure he'd get HIV soon anyway. He thought he would always feel exactly like he did then; he was certain that ten, twenty, thirty years later he'd still be partying every night. It lasted only six months -- then Hitzel got sick with awful flulike symptoms and lost a lot of weight. A doctor's visit cleared him of hepatitis and other possible problems, but the clinic sent him home with an HIV test he could do himself. Hitzel waited before doing the test and decided to go home to Nebraska, to give up the bug chasing and the rest of the life that was killing him. Once he got home, he did the test and found out he was positive. He now wakes up each day with a terrible frustration that's just below the surface of his once sunny demeanor. He hates the medication he has to take every day, and he realizes that HIV affects nearly every part of his life. While he was bug chasing, Hitzel couldn't imagine ever wanting to be in a relationship again. But now that he's getting his life back in order, he realizes that being HIV-positive can be a roadblock to new relationships.
"Whenever I have to deal with things like medication, days when I'm really down," Hitzel says, "I have to look myself in the mirror and say, 'You did this. Are you happy now?' That's the one line that goes through my head: 'Are you happy now?' " He says it with a snarl, full of anger. "Some days I feel really angry and guilty. I'm pretty much adjusted to the fact that this is my life, but about forty percent of the time I look at myself and say, 'Look what you've done. Happy now?' "
Looking back on it, Hitzel says he was committing suicide by chasing HIV, killing himself slowly because he didn't have the nerve to do it quickly. Hitzel is ashamed and embarrassed that he actually sought HIV, but he's willing to tell his story because he hopes to dissuade others who are on the same path. He gets angry when he hears bug chasers talking in the same ways he talked a year earlier. The mention of "bug chasing" and "gift giving" sets him off.
" 'Bug chasing' sounds like a group of kindergartners running around chasing grasshoppers and butterflies," Hitzel says, "a beautiful thing. And gift giving? What the hell is that? I just wish the terms would actually put some real context into what's going on. Why did I not want to say that I was deliberately infecting myself? Because saying the word infect sounds bad and gross and germy. I wanted it to be sexualized." He's particularly angered by the idea of HIV being erotic: "How about you follow me after I start new medications and you watch me throw up for a few weeks? Tell me how erotic that is."
Though he's older, Carlos lives a life that has a lot in common with Hitzel's in San Francisco. Carlos estimates that he has had several hundred sex partners throughout his life, and he routinely hooks up with three or four guys a week, all of them HIV-positive or at least uncertain about their status.
That's a common trait among bug chasers, says Dr. Bob Cabaj, director of behavioral-health services for San Francisco County and past president of both the Gay and Lesbian Medical Association and the Association of Gay and Lesbian Psychiatrists. Cabaj (pronounced suh-bye) calls bug chasing "a real phenomenon." Some bug chasers are more likely to have a defeatist attitude, to think they'll eventually get HIV anyway, whereas others are more likely to add the element of eroticizing HIV, Cabaj says: "For kids who have had a really hard time fitting in or being accepted, this becomes like a fraternity."
As a public official, Cabaj is familiar with how the topic makes people uncomfortable. Most AIDS activists prefer to deny that the problem exists to any significant extent, he says: "They don't want to address that this is a real ongoing issue."
When I asked about bug chasing, leaders of groups such as Gay Men's Health Crisis in New York, the San Francisco AIDS Foundation, the Stop AIDS Project, and the Gay and Lesbian Alliance Against Defamation weren't interested in providing much education or increasing public awareness. To the contrary, most were dismissive of the issue and some actively dissuaded me from writing the article at all. A spokeswoman for the Stop AIDS Project, Shana Krochmal, characterized bug chasing as "relatively minor acting-out" and aggressively encouraged me to drop the article idea altogether, saying the issue is "not big enough to warrant a trend story." Krochmal cautioned against focusing on "just a bunch of really vocal guys who want to continue this image of being reckless, hedonistic gay men who will do anything to get laid. I think that does a disservice to the community at large." The San Francisco AIDS Foundation labeled the issue "sensational" and would not provide further comment. GLAAD spokeswoman Cathy Renna was more helpful, saying she had heard enough about bug chasing to be concerned, emphasizing that her group's focus would be whether people use bug chasing as an easy way to disparage all gays and lesbians as sex-crazed and reckless. "The vast majority of the gay community would be just as surprised and appalled by this as anyone else," she says.
At GMHC, where Carlos is one of more than 7,000 volunteers, spokesman Marty Algaze calls bug chasing "one of those very underground subcultures or fetishes that seems to have sprung up in recent years." The assistant director of community education at GMHC, Daniel Castellanos, acknowledges that bug chasing exists but claims there's not much need to discuss it because it involves such a small population. But would he try to talk a bug chaser out of trying to get HIV? "If someone comes to me and says he wants to get HIV, I might work with him around why he wants to do it," he says. "But if in the end that's a decision he wants to make, there's a point where we have to respect people's decisions."
Cabaj, the San Francisco psychiatrist, says those arguments sound familiar. Then, without being asked, he adds, "But I don't know if it's an active cover-up." He pauses for a moment, then continues, "Yeah, it's an active cover-up, because they know about it. They're in denial of this issue. This is a difficult issue that dredges up some images about gay men that they don't want to have to deal with. They don't want to shine a light on this topic because they don't want people to even know that this behavior exists."
Public-health officials also tend to dismiss the bug-chasing phenomenon, he adds, assuming that it is just an aberration practiced by a few, nothing more than a curiosity. Cabaj adamantly disagrees, though he admits numbers are very hard to come by. Some men consciously seek the virus, openly declaring themselves bug chasers, he says, while many more are just as actively seeking HIV but are in denial and wouldn't call themselves bug chasers. Cabaj estimates that at least twenty-five percent of all newly infected gay men fall into that category.
With about 40,000 new infections in the United States per year, according to government reports, that would mean around 10,000 each year are attributable to that more liberal definition of bug chasing. Doug Hitzel says he fits that description. Though he now says he was a bug chaser for six months, he explains that he would not have admitted it to anyone outside the subculture, and he sometimes even lied to himself about what he was doing. Even if you consider only the number of self-proclaimed bug chasers and not the overall group of men seeking HIV, Cabaj still sees cause for concern because of the way one bug chaser's quest can spread the virus far beyond his own life. "It may be a small number of actual people, but they may be disproportionately involved in continuing the spread of HIV," he says. "That's a major issue when you're talking about how to control the spread of a virus. A small percentage could be responsible for continuing the infection. The clinical impact is profound, no matter how small the numbers."
The problem is not restricted to any one community. Cabaj's counterpart in Boston reports a similar experience with bug chasers. Dr. Marshall Forstein is medical director of mental health and addiction services at Fenway Community Health, an arm of Beth Israel Deaconess Medical Center that specializes in care for gay and lesbian patients. Forstein is on the medical-school faculty in psychiatry at Harvard University and chaired the American Psychiatric Association's Commission on AIDS for eleven years. He says bug chasers are seen regularly in the Fenway health system, and the phenomenon is growing. He adds that bug chasers can be found in any major city, though officials might be reluctant to discuss the issue either because it is unseemly or because it has escaped their notice. A spokesman for the Los Angeles County Department of Health confirms that bug chasers are known in its health system. Public-health officials in New York refused multiple requests for comment.
One standout in public-health circles is the Miami-Dade County Health Department in Florida, which is taking steps specifically to address bug chasing. Evelyn Ullah, director of its office of HIV/AIDS, readily admits that bug chasing is "a definite problem" in the Miami area, having become more common and more visible in the past few years. Miami health officials regularly monitor Internet sites for bug chasing in their community, and they keep track of "conversion parties," in which the goal is to have positive men infect negative men. The health department also is launching new outreach efforts that include going online to chat with bug chasers and others pursuing risky sex.
