The dangers of acquired immune deficiency syndrome, AIDS, have led some public officials to consider and sometimes carry out drastic measures to decrease the risks of spreading the disease, including closing bath houses and threatening to quarantine sexually active AIDS patients.
But, as even the Centers for Disease Control admits, we cannot simply legislate away this disease through external forces. Internal changes in the people at risk -- particularly homosexual men -- are also essential.
Promiscuity is central to the problem. Every homosexual male -- unless he has spent the last three years in Antarctica -- knows that promiscuity increases the risk of becoming infected with AIDS. But mere knowledge has never been known to alter radically a person's behavior. As a physician, I know intimately the absurdity of telling people to stop smoking, to change eating habits, or to change sexual practices without also telling them how to do so.
What can be done to diminish promiscuity? First, homosexual men, on an individual basis, may want to allow their fears of AIDS to become more prominent.
Although many gay men have altered their life styles significantly (some even choosing celibacy), it still appears that heterosexual groups are more "hysterical" than the gay community about the threat of AIDS. This hysteria has forced homosexual organizations to focus their fears more against the actions of, say, the "Moralists" than the disease itself.
But recognition of one's legitimate fears, and then turning these fears into some vague action, is not enough. Homosexual men may want to equip themselves with "strategies" and "belief systems" that encourage ongoing relationships rather than promiscuity.
To find these strategies, they may need to look at a complex human behavior such as promiscuity rather broadly -- and perhaps simplistically. Studies (The Kinsey Institute, Gagnon and Simon) have shown, for example, that sexuality develops quite differently in young men as compared to young women. In fact, young women in their teen-age years are preoccupied almost solely with the idea of "a relationship." Young men, in contrast, are focused almost singlemindedly on having sex.
By the time men and women reach their late twenties and early thirties, a meeting of the minds has usually taken place: Men have evolved to a point of having a genuine interest in an ongoing relationship, and women have generally developed more of an interest in sex for sex's sake (if done at least in the context of an ongoing relationship).
This process may be purely a biologically mandated evolution divorced from environmental influences, but I doubt it. From my years of studying human nature as a psychiatrist, I believe that a heterosexual woman helps to turn a man toward an interest in a long-term relationship (with sex literally seducing a man into changing his values); and, in parallel fashion, a heterosexual man can reinforce for a woman the pleasures of sexuality.
In contrast, homosexual men do not ordinarily have the profound influences of the other gender in their adolescent and adult sexual life. Their drives and instinctual desires -- every bit as great as heterosexual men's desires for "pickups" of women -- are simply directed toward other men.
In the original work of Kinsey, he and his associates found that homosexual men manifested their sex drives by having sexual relations with far more partners than did heterosexual men. And, in turn, heterosexual men had dramatically more partners than both heterosexual women and lesbians. (Lesbians actually had about the same number of sexual partners as heterosexual women -- a fact that reinforces the point that gender, not homosexuality, is the crucial variable in promiscuity.)
Admittedly, the fear of AIDS has changed these patterns to a large extent; but these patterns may need to change further as the HTLV-3 virus spreads among homosexual men. Conceivably, both heterosexual and homosexual men may wish to adopt the line, "Stop! Wait! I'm really more interested in getting to know you than in simply having a one-night stand" -- a message that, in the past, often came more naturally from women than from men.
Older homosexual men -- in their forties or fifties -- may ultimately recognize the value of an ongoing relationship. Perhaps, as one approaches the end of one's life, a desire for close affiliation becomes a stronger drive than that of promiscuous sex.
But what of the young homosexual men who are at the greatest risk of contracting AIDS? Somehow, they must find ways of being profoundly influenced by people whose long-term relationships they admire, whose relationships can be a model for them. Gay men may wish to model themselves after heterosexual or homosexual women who have made a long-term relationship a major priority in their lives. Likewise, older homosexual men who have committed themselves to an ongoing sexual relationship with another man can serve as crucial models.
Unfortunately, the "stereotypical" homosexual man has often been ridiculed for his effeminate gestures. Ironically, however, for survival in the age of AIDS, many homosexual men may want to and need to adopt the beliefs and perspectives of women -- particularly a belief in the overriding importance of a monogamous sexual relationship. Gender-specific gestures are irrelevant at this point in history: What matter most are the belief systems and strategies by which a human being can lead a long and satisfying life. Indeed, at the end of the 20th century, we all may want to revise Alan Jay Lerner's lyrics from "My Fair Lady" and ask: "Why can't a man be more like a woman?"