This article by Myles Helfand first appeared in TheBody.com here.  

Plenty of scary headlines have made their way across the Internet in recent years, decrying the body-decaying effects of getting older and portraying the sense that HIV (or HIV meds) causes people to suffer these problems at far higher rates far earlier in their lives. And by "far earlier," some experts felt we were talking as many as 20 years earlier, according to some of the first research that explored the issue.

But the problem that often occurs with early research is that it's ... well, a bit premature in its findings. "There certainly is more of a trend for HIV-positive people to be a bit younger" when they develop certain health problems, says Amy Justice, M.D., Ph.D., a professor of medicine and public health at the Yale School of Medicine. "But when I say a bit younger, we're talking about somewhere between one and six years -- we're not talking about 20 or 30 years."

Justice should know: She is one of the world's leading researchers on aging and HIV. As the lead investigator of the massive Veterans Aging Cohort Study (VACS), it's her job to delve into one of the largest troves of information in existence and help us all better understand the ways in which HIV intersects with other health problems that emerge as we get older.

What she and her team have found is rewriting much of we thought we knew about aging and HIV. It's also helping us figure out some concrete steps we can take to prevent or treat health problems we associate with "premature aging."

A Rose by Any Other Name

To begin with, our whole approach to the idea of "early aging" misses the mark, Justice says. "If you talk to anyone who is a geriatrician -- who studies aging -- they will say this concept of 'premature aging' is a misnomer," she explains. "If you look at anyone with chronic disease, they look older than someone without chronic disease."

The problem, Justice says, is not that people with HIV are "getting older" more quickly. Instead, what happens is that HIV, like many other chronic illnesses (such as diabetes), sometimes triggers or worsens other health issues -- many of which we're naturally at greater risk for as we get older. "Are people who are sick and have HIV more frail, more likely to have problems with their health, than someone who's not? Of course they are," Justice says. "Why do we have to invoke 'premature aging' when we talk about that?"

Defining the Risk

Through her work with VACS, Justice and her colleagues have uncovered some of the most reliable information we've learned to date about the timing of various health problems in people with HIV.

Here's how the study works: More than 7,400 people living in or near eight U.S. cities are enrolled in VACS. The HIV-positive people are "matched" against HIV-negative people who otherwise have extremely similar characteristics (such as age, location and race). The study then follows these people over time and records when they develop various health complications.

A slide from a presentation given by Amy Justice at an HIV/AIDS conference in 2012. (Click the image to enlarge it.) It compares the average age at which HIV-positive people and HIV-negative people enrolled in VACS were first diagnosed with certain key health problems. ("MI" is short for "myocardial infarction" -- i.e., a heart attack.)

When comparing the HIV-positive people to the HIV-negative people, VACS has found that HIV-positive people:

• Develop kidney failure about four years earlier.
• Develop lung cancer about two years earlier.
• Develop cardiovascular disease as much as six years earlier -- but do not begin to experience heart attacks earlier at all.
• Develop liver cirrhosis about one year earlier.
• Fracture a bone due to bone weakness one year later.

This isn't the only research being done to make more accurate estimates of how much "earlier" people with HIV develop health problems. Less than two years ago, a major study funded by the National Cancer Institute found that previous estimates drastically overestimated how much earlier people with HIV develop certain cancers, because it didn't properly take people's ages into account.

But why is it that studies such as VACS manage to find such a smaller age difference than earlier studies had found? Which findings should you believe more?

Making Sense of the Research

To determine whether HIV-positive people have a "greater" risk of developing certain health problems as they get older, researchers have to compare those HIV-positive people to a group of HIV-negative people. Who those HIV-negative people are, and what measurements researchers use to examine them, makes all the difference. 

People with HIV who are visiting a Veterans Affairs hospital in Los Angeles are likely to be very different from your average HIV-negative people living in a Massachusetts suburb. For instance, they're more likely to be people of color; they're more likely to be from an inner city; and they're also just more likely to be sick in the first place, since they're the ones visiting a hospital.

Another slide from a presentation given by Amy Justice at an HIV/AIDS conference in 2012. (Click the image to enlarge it.) It shows some of the key results from a study published in the Annals of Internal Medicine that corrected earlier research which drastically overestimated how much earlier people with HIV develop certain cancers, because it didn't properly take people's ages into account.

All of these kinds of factors -- race, location, gender, income, access to health care, average age, you name it -- can impact the risk a person has of developing a health problem. Sure, an HIV-positive black man working a low-wage job and living in an unsafe neighborhood in Los Angeles may develop heart disease many, many years earlier than an HIV-negative white man living in a million-dollar home in Weston, Mass. But is it the HIV that's to blame?

Studies like VACS try to level the playing field by comparing groups of people who are as similar as possible in every measurable way -- except that one group has HIV and the other does not. Very few studies like this exist, because finding enough HIV-positive and HIV-negative people to match in this way is extremely difficult (not to mention extremely expensive).

VACS is not the be-all, end-all of studies on aging and HIV. Researchers are constantly looking for ways to refine their studies, enroll more volunteers and make their results more reliable. But as you saw in the list above, what we've learned so far is enough to dispel some widely held myths about HIV and aging. It's also enough to give researchers some insight into how people with HIV can reduce the risk that they'll develop various health problems as they get older.

The Power to Change

"'Premature aging' -- I think it frightens the living daylights out of people," Justice says. "It suggests there's nothing you can do: You'll be 70 when you're 50, and when you're 70, you'll be 90. I don't think that's useful in clinical care."

In hopes of helping HIV-positive people and their health care providers combat this feeling of helplessness in the face of the relentless passage of time, Justice and her colleagues have developed a tool called the VACS Index Calculator. The tool, which is available online -- and even has a mobile-friendly version -- pulls together all of the research VACS has done to date and attempts to answer the question: "What are my odds of dying?"  

OK, yes, it's a terrifying concept: You check off a bunch of boxes -- age, sex, race, CD4 count, HIV viral load, liver enzymes and so forth -- and the calculator spits out a single number called your "five-year mortality risk." In other words, your risk of dying within the next five years.

But here's why the tool isn't remotely as terrifying as it seems: It's not a prediction. It's just VACS telling you, "Among the people in our study who are similar to you, this many passed away within five years." Which means you and your health care provider have the power to change those odds.

"It's a way of gauging your overall burden of disease, your overall susceptibility to further injury," Justice explains. "Whether the [cause] is treatment toxicity, HIV disease progression, diabetes, smoking, alcohol -- it reflects all of those things, in terms of looking at their injury on your major organ systems. And, by determining what else is going on in your situation, helping you pinpoint what things you might be able to do to improve it."

The VACS Index Calculator is still in development; Justice hopes over time to add features that may delve more deeply into people's behaviors and life habits, and offer some suggestions about changes they can make to reduce their mortality risk and stay as healthy as possible. She encourages people to use the tool, offer comments on how it can be made even more useful for them (there's a survey link within the tool), and discuss the calculator's results with their health care provider.

"I think the more information you can give patients directly and the more time they have to think about what questions they may have for their providers when they go to see them, the better, the higher quality, the more meaningful the interaction is, and the more likely the behaviors [that increase their health risks] will really change," Justice says.

In the meantime, Justice and her VACS colleagues -- as well as a number of other research teams around the country -- will continue their efforts to more reliably explore the real risks of HIV-positive people developing various health problems as they age.

Every life deserves a certain amount of dignity, no matter how poor or damaged the shell that carries it.”  Rick Bragg, ‘All Over But the Shoutin'

I say this with shame but when I was in my twenties, the idea of ‘old guys’ having sex with each other was pretty horrifying; it was like imagining your parents on top of each other...the stuff of nightmares! At that age, you never think about getting old yourself, or your body losing its shape and your skin resembling elephant hide and that’s the way it should be.

Nature ensures that you’re in your reproductive prime while you’re young. You are at your most attractive for as long as there’s a chance that you might procreate the species and luckily, men stay that way longer than women (ask Hollywood’s geriatric fathers!). Being gay sort of sidesteps Mother Nature because you’re not really interested in breeding new generations but still have all the desires to ‘do it’ for as long as possible. Win-win situation really and because there was never the worry of getting your partner pregnant, that’s possibly why bare-backing was the norm until the 1980’s and may be why it’s still so difficult to change old habits. Then HIV and AIDS arrived and everything changed.

Today, the need for sex is still as strong as it ever was; there just needs to be a thin film of rubber between sperm and recipient to increase safety. Now at a certain age (which was different for everyone) in generations past, the ability and maybe desire to have gratifying sex gradually faded. Performance problems and enlarged prostates made sex much more of a hurdle than it used to be and older guys retired into their hobby- or relationship-filled lives and sex became unavoidably less important.

Hello Viagra!

When I say Viagra, I include all the generic and alternative versions too (Viagra priced itself out of market domination through thinking it was the only alternative possible...ha, ha!). Whatever little blue, green or multicoloured father’s little helper men used, it rejuvenated sex lives after 50 for millions of men. Suddenly, there was a way of prolonging your sex life until your body just couldn’t take it anymore. Why hasn’t its inventor received the Nobel Peace prize!

Youngsters may not like the idea but oldies can now fuck like bunnies again and it must have lifted the spirits of countless men since it came out. Not that it’s perfect; the headaches, dry throats and other side effects can be irritating, not to mention the strain on the heart that’s already been through so much. I do wonder what the long term effects on the young will be though. These pills have been adopted by young people as a sort of security blanket and party drug; they really don’t need it but can’t afford to fail. Brilliant marketing but then again it was always a no-brainer, guaranteed success. Young guys should understand though that testosterone and hormones should be enough for decades of partying without a chemical aid; many of us ‘more mature’ guys don’t have much of a choice.

Understanding that most gay guys over the age of 50 are in the same boat should take away many of the insecurities accompanying testosterone depletion, but it won’t. Young guys think they’ve got it bad; the competition is murderous and you’re only as good as your last conquest, but older guys have a whole set of other issues to overcome when it comes to sex.

The HIV thing for instance!

Believe me; I think it’s tragic when a young guy becomes HIV positive. At this moment of time he has to live with it for the rest of his life and therefore has to join the race for potential partners with a distinct disadvantage. I wouldn’t want to be young again with HIV but statistically, a vaccine surely and hopefully has to emerge eventually (which will be small comfort, I know).

Older guys with HIV have bad memories which stay with them forever. They’ve lived with the virus for years and have filled their bodies with heavy-duty chemicals which will inevitably take their toll. They may suffer from a plethora of side effects which limit their activities, or they may have been lucky enough to live a more or less, ‘normal’ life. They may have had problems with stigmatisation which has made them nervous and unsure about profiling themselves in public and now they’re under legal pressure to disclose if they’re going to have sex. Most older men don’t have the devil may care attitude of youth any more.

None of this takes into account the guilt that many mature HIV-plussers consciously or subconsciously feel. Some feel that they don’t deserve to have partners and that throws up insurmountable barriers to relationships. Many also have body issues because the virus has left its mark physically. Weight loss; loss of fat in the face; extra fat on the stomach or shoulders are amongst the common side effects of the medication which gnaw away at people’s self worth. So if people are wary of relationships, or have lost the confidence to try to find them, many people turn to sex as a means of connecting. It’s not what you want in the best of all possible worlds but it fills a need.

Many older guys are happy with a warm embrace, or a safe pair of arms around them, or even simple tenderness; all of which add up to that physical closeness which we all crave from cradle to grave. Little wonder then that Viagra and its like gave a new lease of life to people searching for physical affirmation. At least then, the worry of failure is removed and then if you’re rejected, it doesn’t hurt so much and you can move on and try again!

That said, erection pills are not cheap and not everybody can afford them. Put that together with the fact that not everybody likes the potential side effects and you have men who need a physical connection desperately but have to accept that they will need to play a more passive role. Hide your eyes kids if this is getting too embarrassing! You may have noticed that the older the gay group is, the more likely you are to find that partners prefer to be sexually passive. That’s fantastic for the active guys, they’re like kids in a candy store and with Viagra as well, they can take their pick. However, many older guys either don’t have the energy or the potency any more to take the dominant role but they do know they want to be close and satisfy both themselves and their partners sexually; so hey, you do what you have to do!

Sometimes older gay men look at themselves in the mirror and rack their brains for ways to turn back the years, so that they can feel more self-confident in social situations. Dying hair, plastic surgery, dressing young, going to the gym, wearing sexy underwear, even arriving with wads of cash are all well-known and well-worn strategies. Now who am I to say but I really think that guys look better and more attractive if they just be themselves and don’t turn to artificial aids. For every pot there’s a lid and there’s definitely a market for the older guy who just looks after himself and walks into a bar with a little confidence in his demeanor. We really don’t need to try too hard because we’ll be seen through in a blink of an eyelash; you only have to listen to the gossip in a bar to be sure of that one. You don’t have to strut your stuff in peacock feathers then but you don’t have to be afraid of the acres of un-wrinkled and muscular flesh either. Then again, if you feel better trying to change your physical appearance, who’s to say that’s wrong either?

Hopefully, most older guys have found their life partners, or soul-mates, or even good friends before the sand in the hourglass has run out and don’t need to trawl the internet, or the bars any more. There are many older HIV-positive men though, who have lost their partners, live alone and don’t have so many friends around anymore. They very often see their own futures in a very negative light. The TV and internet porn can only provide so much solace and the need for a warm body next to theirs becomes more and more important as they realise they’re unlikely to find another Mr. Right at this stage. A Mr. Right Now is a viable option and when it happens it can provide at least a temporary relief from the daily grind. It can also serve to emphasise the emptiness too but maybe better those fleeting encounters than none at all. 

Never underestimate the drive for intimacy. If you have HIV and are of a certain age, your world can suddenly become very small. I know you won’t believe it for a minute but the next time you curl your lip at an older guy looking needy in the bars, baths or wherever, spare a thought for his motives because before you know it, you’ll be in that situation too.

Disclaimer time: before you jump to conclusions, this article is not autobiographical, although various things do apply to my situation. As an older, gay man with HIV, I’ve watched what my peers do and how they behave over the years and have both learned and ignored the lessons. Also, before somebody gets annoyed that I’m tarring all older men with the same brush, I should point out that nothing I say here applies to everybody; there are always exceptions.

I happened to walk past the mirror the other day...er...actually, no I didn’t; there was nothing coincidental about it. I approached the mirror as I do most days, determined to find every blemish that had dared to raise its head and ruin my day.

You’d really think that a 60’er wouldn’t give a damn any more wouldn’t you? Unfortunately, we may be sixty plus but us baby-boomers are still romping around Woodstock...in our minds! Anyway, today for the first time for some time, I really saw myself and it wasn’t pretty!

 Now, I’ve got a great bathroom mirror which hides a multitude of sins but if I want the truth I have to go into the spare room and look at the mirror there. That piece of glass is a ‘mirror, mirror on the wall’ which has been injected with truth serum! After looking; really looking, I suddenly realised that after you hit a certain age, you look older in dog years and the body ages even faster than the face!

Why is that even an issue? I’ve had a life, done some stuff, been good, been bad, you know the story and should really accept that nature slows you down for a reason. However rational that may be, the mirror still has the power to shock and re-awaken the vanity genes.

Men have always been slightly smug about the female need to look like super models and have sniggered at that weakness in the female character we always suspected was there. How could they fall for the hype? I know, stereotyping much! Yet any intelligent person can see that the beauty industry is exploiting people’s vanity?  Lesbians resisted for a while until the advent of fashion for dykes; upon which they rushed out, bought Versace and lip gloss and completed the cycle. Men would never feel the need to cover up our blemishes or fluff up the image...or so we thought, until we tumbled into the same trap!  In our case it has been called the Adonis Complex and the Ad men have finally won!

Yes okay, the male menopause probably exists and yes, we probably go through monthly hormonal cycles of behaviour and emotions and we’re used to having penis envy thrust down our throats, so to speak and accept that real men cry and that it’s okay to share with our emotionally retarded drinking buddies? However, do we really have to give in to that thing which has reduced healthy teenage girls and boys to anorexic waifs, driven people into the arms of wealthy plastic surgeons and made fortunes for fashion designers the world over? I’m afraid so. We men, young and old, have become vanity victims!

After years of trying to develop acceptable toiletries for ungrateful males who used their Old Spice and Brut to scour the toilet bowl (some of course didn’t but you could always smell them coming well in advance!), our vanity was used against us and Cosmetic Ken was created to join airbrushed Barbie on the billboards. Heterosexual women were finally convinced that they had to drag their husbands’ sagging bodies into the 21st Century and a whole new gleaming set of products was born.

For gays of course, the whole process started much earlier and the well-toned, muscular hunk has never been out of fashion. Somehow though, in the fifties, sixties and seventies it all seemed much more innocent – those who sweated and worked that body, achieved what they wanted but the vast majority of us were still quite happy to parade around with what Nature had given us. Often a moustache and a cowboy shirt was enough to satisfy our needs to look macho swish. Nowadays though, if you can’t compete in the body-beautiful stakes, you can’t take your shirt off in the club or on the beach, much less join the ‘pecs’ parade! The drive to be Adonis has enlisted the help of the chemicals industry (never a stranger to gay society) and the innocence is gone. Never mind that steroids can shrink your genitalia and render you impotent; they can also make you sterile, which might concern Mr and Mrs Nuclear Family but has never really bothered us, has it? What is really frightening is the sheer size of the industry that has built up around the workout ethic and the fitness frenzy. ‘It’s all about the money, money, money!’ We won the battle to get homoerotic images into advertising but lost the war because we got sucked in! Duh!

There is a serious side of course. A whole generation of boys, gay and straight, and gay men of any age, is experiencing the angst, which their sisters have known about for centuries. Previously rare, the male anorexic is becoming a major problem and penis envy has been replaced by body envy. Gyms have sprung up like mushrooms and the number of home-fitness systems, as shown every day on Tele Sales programmes, is mind-boggling. We read horror stories of men carefully removing the nuts from their rough muesli and haunting supermarket aisles reading every word on the labels, seeking sugar-free and cholesterol-light. Diabetic food sales have never been so high! It can’t be healthy!

Actually, all people fall into three physical groups: Ectomorphs, Mesomorphs and Endomorphs.  The Mesomorphs have it easiest; they‘re the ones with rectangular bodies, an upright posture, thick skin and thick hair. They only need to play at working out and they develop muscles in all the right places. Thank God they turn to fat in later years! Ectomorphs are thin, have flat chests, are tall but stoop-shouldered and are supposed to have bigger brains, which is a fat lot of use when you’re trying to attract some Hercules across the dance floor! Endomorphs have the round, soft bodies; the underdeveloped muscles; the overdeveloped digestive system; have trouble losing weight and have the hardest job of all! So, for at least two thirds of the gay male population, this new body culture has been greeted with horror because no amount of working out, weights, or hormones will ever give us the body they say we should have. We have to do the best we can with the physique we were born with but there’s always someone better, someone to secretly envy! Oh come on, we all do it! The tragedy is that we give in to the temptation of that Wonder product which promises to let us achieve our dreams. And only $ 199,00!! Have your credit card at the ready!

For those whose idea of a full workout is drinking standing up, there’s always the scalpel! Cosmetic surgeries across the civilised world are reporting booming business from men! We apparently have more money than sense, so the face-lift and liposuction are within financial range and men are flocking to the chic clinics to have it done. Nobody tells them of course, that you have to go into hiding for at least three months afterwards, endure pain and infections and just pray that it all looks good at the end and no, I’m not talking from experience but I’m not knocking it either...it’s a cruel world if you’re getting sand kicked in your face!

Finally, before your insecurities cause you to rush off to dust off the weights and start pumping, consider this: In 1998 in the United States, there were over three thousand suicides of men between the ages of fifteen and twenty five, who suffered from Body Dysmorphic Disorder. Yes it has a name and is thought to affect 1-2% of the population in the western world! Of that 1 to 2%, between 20% and 22% have suicidal tendencies. That may not seem much but we’re talking about 1-2% of the whole population who are clinically depressed by body issues and you might safely assume that it’s somewhat higher in the LGBT sector.

Obsession with physical appearance amongst gay men has become the single greatest reason for visiting the psychiatrist and in San Francisco for instance, plastic surgery operations on men outnumber those on women by three to one. Well, who’s surprised but it does make you think! Are gay men always going to be suckers for the latest trend? Is this obsession with physique here to stay and for people with HIV, is it a reaction to the potential the virus has for wrecking the body? We like to think that we set the trends, not follow them but the beauty industry is quite happy to indulge our delusions.

Now where did I put those dumbbells?

"I’m not an object, or an idea or an abstract lifestyle, or visible proof of a disease; or any other dehumanizing concept, yet that’s how everyone is summed up and evaluated."

I think I need to put this post in some sort of context, or else you’re going to get the wrong idea about me (more of that in a minute).

I’m sitting here in front of the laptop, with my back aching, feet pulsing, calves tingling, muscles full of lactic acid and neck hurting. I haven’t mentioned that the soles of my feet feel as though someone has dowsed them in petrol and set them on fire. As a matter of fact, there aren’t many parts of my body that aren’t screaming, ‘put an end to it; grab the f...ing pill box!’ You may think I’ve just got home from the gym, or been pounding the roads while training for a marathon, (if only!) but the fact is that these are my off-and-on, daily and nightly neuropathy symptoms. It’s the torture that almost turns me to religion because at least then I could understand I was being punished for my sins.

That said, life goes on and no, I’m not suicidal or particularly feeling sorry for myself (well sometimes maybe a little bit); it’s just the way it’s turned out for me in the same way that life’s slapped so many other people with unexpected wet fishes. Meh; it’s not heroism or stoicism either; you get on with it because you don’t have a choice! The trouble is that society won’t just let you get on with it. You have to be given a label and then be responded to accordingly; people get upset otherwise.

Christopher Plummer‘s got a lot to answer for; winning an Oscar for coming out joyously as a senior and then promptly and heroically popping his clogs. So now I can’t even be a grumpy old man any more, I’m now supposed to be thrilled to be sixty plus and living out my golden years as if there was no tomorrow. Well stuff that for a lark! As far as I’m concerned it’s just another label, another tag to hang around our necks which is supposed to determine how we live and justify our existence.

I’ve built up a lifetime full of labels... but not in the sense that Paul Smith or Armani rock my geriatric boat (can’t afford them sadly): I’m just plastered with labels that’s all and I hate it! I’m covered in damn sticky notes, each of which is carrying someone else’s description of who I am and I can’t even see myself under them anymore. Let me list a few and then maybe you’ll see what I mean.

According to who’s looking, I can be a gay man; unemployed; HIV-positive and with lung problems and arthritis. I’m a senior; daddy (silver or otherwise); bear (but only because of the unwanted extra kilos inaction has given me). I’m an ex-pat Englishman; ex-teacher; ex-tennis player; failed author (pretty much); enforced couch potato and blogger about neuropathy and HIV. Neuropathy, that came from either the medication or the virus or both, has dumped more labels on me, so that now I’m to all intents and purposes slowing down to a snail’s pace; with constant variable pain; can’t walk too far anymore and rapidly losing muscle strength. Tell me you haven’t already come to several conclusions as to who I am! Yet these are labels; not mine by choice but things people need to use to describe me. If I stood in front of you, smiled and didn’t say a word, half of them wouldn’t apply because they’re not really visible without further clues.

I’m not an object, or an idea or an abstract lifestyle, or visible proof of a disease; or any other dehumanizing concept, yet that’s how everyone is summed up and evaluated.

In an age where image is everything and your FaceBook profile determines the parameters of who and what you are; labels are pretty much essential keys to your fitting into society. Even if you don’t promote yourself with keyword descriptions, someone else will happily do it for you; so most people learn to put the best spin possible on themselves; in order to avoid stereotypes and pre-judgements from outside. I thank my lucky stars that I’m not a twenty-something gay person any more – those poor kids just have so much to live up to! The problem is that although the intensity and ensuing stress levels are off the chart in 2012, it was probably always the way and it’s not for nothing that people pin a label on you within twenty seconds of meeting. It’s probably an adrenalin-based survival technique. Animals have learned to evaluate a stranger pretty quickly to avoid becoming a quick snack. Unfortunately then, because it’s nature’s way, there’s not a damn thing you can do about it.

That’s one of the reasons why you still can’t really spin being HIV-positive as being a good thing. I would argue that even many young gay people see being HIV positive is the 21^st century equivalent of having leprosy and God help you if you run into a Santorum sycophant or a Mullah Mary! Thirty years on, HIV is still largely in the closet, just behind the LGBT kids who are terrified of sticking their heads above the barricades. ‘It Gets Better’ is a noble concept and great inspiration for coming out but much easier said than achieved. Have you seen that silly computer game ‘Whack a Mole Gopher Bash’!

Polarisation in society increases exponentially with economic crisis and during those times, being publicly different is not always a safe option. What really shocks me as an older gay man (plus labels) is the attitude of young gay people to both their elders and to people who are HIV+. You only need to look at gay social network forums, to see how viciously judgemental and harsh ‘our own’ kids can be.

For example; a couple of years ago there was a scandal in the Netherlands concerning sex parties with positive guys who drugged some of their guests and then injected them with contaminated blood. Labels were attached before anybody knew details of the case. On the face of it, looking at the bare facts, nobody could justify that sort of behaviour in any possible way and the media had a field day. However, a couple of months later, the men were given prison sentences and the always pragmatic Dutch shrugged their shoulders and moved on to other news stories. The rest of the population had also been shocked at the details but nobody had actually died and yes, there are bad people in the world but in a country where ten years is a reasonably severe sentence for murder, the fourteen years the chief culprit got was seen as an appropriate punishment. That wasn’t the reaction of the gay youth on the forums though. At least three quarters wanted the guilty men hanged, shot, or at best chemically castrated and many responses were so violent and video-game aggressive, it was truly shocking. Across the gay forums it continued for months, merciless demands for the death penalty or worse. This was a general reaction from gay people under thirty, not just a few extremists. You could call it ignorance, or a lack of perspective or maybe a sense of guilt that this had happened within their own social group but it’s a sign of the times.

I’m not justifying what went on in that case, far from it but if only we waited until we knew more before pinning the label on the donkey! No wonder politicians can wrap us around their little fingers...they live for labels! Being gay clearly does not necessarily make you tolerant. When extremists, both political and religious, on the right wing of American politics; or religious fanatics in Africa, or Islamic Sharia law promoting imams, or Russian state-backed, city mayors, actively encourage this sort of polarisation of society to gain votes, you get a funny feeling about how gay people with HIV may well be viewed in the near future. ‘Gay’ plus ‘HIV’...if you’re neither, the labels are loaded enough!

I’m probably doing much the same thing with this article. For every label there’s a counter-label so my generalisations may appear to be equally clichéd. I should really only talk from my own position and my own labels.

As an LGBT person, I think that how you view being gay and HIV positive in the western world in 2012 very much depends how old you are. The older man or woman will often say that things were better in ‘the old days’, because they were better for them! They were younger, they could still turn heads and their bodies still defied gravity. I look at the gay scene now and wonder if I have any connection to it at all, but that’s because it’s time for new generations to have their days in the sun. However, I can’t say I like the gay nation very much sometimes. It rejects its old and infirm far too easily, expecting them to fade away quietly and not clog up the passageways in the saunas or appear ghost like in the woods at night.

His first experience of a contemptuous look is a marking point in a man’s life! It’s also so easy to claim the moral high ground by protesting that we’re the HIV generation; we’ve watched our friends suffer then die; we’ve seen the bars empty of a whole host of the most wonderful men and we’ve survived! ‘So what!’ seems to be the current answer from many of the newly emerged butterflies on the street who begin to wonder if the conspiracy theories are true and if it ever really happened. Don’t they realise? No, of course they don’t and the truth is they have to find out for themselves because the generation gap is as strong a divide in gay society as amongst heterosexuals.

The tragedy is that from now on everybody will be judged by their labels whether self-attached or stamped on their foreheads; the 140 characters of their Tweet, or their profile updates and friends on FaceBook. It’s going to become harder to ‘find yourself’ (forgive the cliché, I’m an old hippy), establish your true identity and be satisfied with the person you are because you’ll eventually and inevitably end up disappointing yourself and others because you can’t live up to the ridiculously high expectation labels any more.

Sometimes, I’m glad I don’t have my whole life stretched out before me any more...I could never, ever be David Beckham and can he even live up to the size of his Armani label! Maybe my labels do define me and maybe I need to accept that other people are going to judge me according to my illnesses, or my age, or my social status but I don’t like it and I never will!