Wednesday, May 18, 2011

Cluster of Cases of the Acquired Immune Deficiency Syndrome

Auerbach. D et. al. 1984 March. The American Journal of Medicine. Vol 76

I was sitting in a performance of The Normal Heart tonight, wondering what it must have been like to be gay in New York in the early 80s and to know that your gay friends are dying in numbers, but to have no idea why. I remembered this 1984 article in which investigators made a tentative guess that AIDS had something to do with sexual contact. At this time the scientific community was groping in the dark.  Before this, there had been a major study by the CDC (late 1981) concluding that "a large number of sexual partners was the most important risk factor among... homosexual men". It was not known that unprotected sex was how the virus is transmitted.  Actually, it was not even agreed that AIDS is caused by a virus.



Study Plan
The study was prompted when a small number of AIDS patients reported that they had had sexual contact with other patients. The original plan was to interview 19 Kaposi's Sarcoma patients from Los Angeles and Orange County and map out their sexual network. The characteristics of those patients that were linked through the network would then be compared to those of patients that were unlinked. Participants who had had sexual contact with each other less than 5 years before  getting ill were considered linked in the network (e.g. 0 and NY15 are linked in the diagram).  All the participants of the study were asked to list all the people that they had had sex with in the preceding 5 years and investigators checked these lists against each other. When a non-Californian, "Patient 0" was found to link AIDS patients from Southern California to other cities, the study was expanded to include other cities. 

Differences didn’t say anything
At the end, 40 AIDS patients (see diagram) from different cities were found to be linked and 208 were unlinked.  A comparison of the linked and unlinked patients didn't really lead to insight about the disease: linked patients "were significantly more likely to be white and to have only Kaposi's sarcoma… linked patients were significantly more likely... to have met sexual partners in bath houses, have been frequent users of inhaled amyl or butyl nitrite [poppers], and have participated in the sexual practice of 'fisting'". Other than these differences, linked and unlinked patients were similar.

Latent Period Provides Clue
It was only when they tried to estimate the latency (amount of time from infection to symptoms) that the investigators edged closer to figuring out how AIDS works.  They looked at participants that had had sex with only one other participant (there are 20, spot them in the diagram). This was so that they could accurately measure the time from that sexual contact to the first symptoms. Of these 20, they eliminated those that had had sex with the partner for a period of more than 30 days. Again, this was done so that it would be easier to measure the latent period. Only 9 patients remained that had had sex with only one other patient for a period less than 30 days.  Of those 9, 3 showed symptoms at the same time, or later than their sexual contact, and 6 showed symptoms after their sexual contact had become ill.  This supported the hypothesis that AIDS is transmitted through some infectious agent. (Had some of the 9 patients shown symptoms before the only people they had had sex with, it would be much harder to argue that the 6 were infected by their contacts).

Modest Conclusion
"Although the cause of AIDS is unknown, it may be caused by an infectious agent that is transmissible from person to person in a manner analogous to hepatitis B virus infection; thorugh sexual contact, through parenteral exposure by intravenous drug abusers who share needles, though blood products… The existence of a cluster of AIDS cases linked by homosexual contact is consistent with an infectious-agent hypothesis."



Monday, May 16, 2011

Report Card

Academic Life: B+
Keletso is a well-meaning student. He has many good intentions that generate many unattained goals. He has trouble focusing on tasks. Key obstacles to his success are (amongst others):
-The reading of novels when he should be studying
-No Parking Bar
-Naps
-Free food events
-www.hulu.com
-www.netflix.com
-www.facebook.com

Social Life: A-
Keletso has mastered the art of foregoing meals (without completely dying) in order to finance his musical-theater habit. He has discovered PBR (the American answer to black label). He knows the barmen and gogo-boys of No Parking bar by name, and he knows the name of one bouncer who doesn't i.d. him anymore. His social life is bi-winning.

Love Life: F
After having a spate of unsuccessful dates and other strange encounters, Keletso has decided to stop receiving sms's between the hours of 9pm and 9am. He has decided to re-kindle his relationship with R (an undemanding statistics package) and is about to purchase a husband pillow.  He takes immense pleasure in eating ice-cream one-spoon at a time from the freezer, and in pretending to be Patti LuPone at the 2008 Tony awards.  His new rule is that a man must be (potentially) at least as interesting as his best book in order to deserve subway time and $2.50 subway fare. Since he is not interested in long-distance relationships, his zoning rule still applies: only men north of 100th on Manhattan island are eligible.

Sunday, May 8, 2011

This time I am ready. I punched the address of the place in my mom’s GPS thingie which I will borrow for the night. I called ahead to check whether Buzerant will have a New Years Eve party. I have shaved and done the make-up thing. I went for striking eyes: dark brown liner, black mascara and gold eye shadow but really, I look exactly like I do without make-up (my sister points out). That’s fine, the important thing is that I feel made up: it’s like wearing good tight-fitting underwear (gotta work the arsenal).

The last time I tried going to Buzerant – the only gay nightclub in Bloemfontein – I anxiously drove across Bloemfontein town a few kilometers out the other side. After what seemed like hours on a narrow road lit only by my headlights, I made out a sign saying “Orange Grove” –the name of the farm Buzerant is on. I turned into the creepy gravel driveway. There was a large pad-lock on the gate at the end. Beyond the gate, an abandoned-looking house; dark and quiet except for the feint sound of dogs barking. Top of mind were the facts that I am Black, I am Gay and that this is the Free State – my mom had reminded me of these at 21h45 when I left the house.

For a few seconds I entertained the idea of a secret entrance or a secret password – maybe I was to flash my headlights in a certain sequence, or perform some dance – probably from a Broadway musical. This was after all, one of the first gay clubs in the country - it started in the 1980’s when things were a bit more difficult than they are now. There must have been secrecy about the club and some way to screen out undesirables. Maybe they just carried on in the same way – except now they have a website with the club’s address and contact telephone number. When common sense regained control I jumped back in the car and drove back to civilization.

This time I am prepared. I have everything I need – except a friend to take along. I spoke to the contact person earlier. He sounded very welcoming – I’m sure my blackness came through over the phone. If my blackness didn’t come through then certainly my mother’s did – she happened to grab the receiver in her room as I grabbed it on the other phone. Awkward. Not the idea that I am finding out details for a gay club, my mom knows about Buzerant already, but the suspicion that I am replacing my ex (for two weeks now) with a mature Afrikaans hunk of burning love – the caller. Loving me must be difficult for her.

There is a risk of being beaten up for being black and alone…. fags don’t know how to fight though, who are they gonna beat up? not me…. Yoh, but my friend Richard told me about vicious fag-on-fag violence at stargayzers…. no, that only happens when people are in drag – not gonna happen tonight… what if I encounter gay right-wingers though ….hmm never saw a gay right-winger around here, only hairdressers and musicians – I can take them… what about the dykes? … sjo, it would be over for me if I pissed one off… but I am black, I should be able to work a knife… but living in the ‘burbs has robbed me of knife combat experience… aah well, at least I would die in an interesting way.

As planned, I arrive an hour after the club opens. I did not want to arrive at opening time because that would seem desperate. As a teen self-help book advised me a while ago, you should not arrive too late at a party because by then cliques will have already formed. Additionally, all the beautiful people will have already paired, leaving the desperate and the drunk. Further, it is better to be early than it is to be late in Bloem: the right-wing (hetero) Afrikaner youth are usually held up at Wiesbaden (another club just outside town) until at least midnight. This is when they sing their old national anthem (apparently). I have not heard of a black person who entered that place and left without receiving a good smack.

After updating my Facebook status and SMSing people happy new year’s – delay tactics, I psych myself up and walk towards the entrance… on my own. I sigh cynically when I see the bouncer. I really dislike bouncers, they are always vol kak. I spot one of those black and yellow handheld metal detectors on the table behind him. Expecting to be just about strip-searched (in an unpleasurable way) , I put on my angry black man face and prepare a witticism (something not too insulting, I don’t want him to donder me, I just want to feel cleverer). The bouncer waves the detector around quickly and lets me go; he didn’t even give me the customary pat on the inner thigh, not that I really wanted one tonight – but sometimes a girl just wants to know that SOMEONE will touch his inner thigh. The bouncer smiles and says “welcome”. Hao. Is this a trick? What the fuck is this? Anyways, I move on.

I get inside and start the most difficult stage – the one where you lurk at the walls alone and sober. I make a beeline for the bar, I may be alone but I don’t have to be sober. “Can I have a Castle?” It arrives quickly and I get working on it immediately. This gives me a prop… something to do with my right hand. I lean against the bar on my left elbow, cross my left foot over my right and balance all my weight on my right foot. Now that I am doing something with each of my limbs, I will seem less awkward. I can get on with the business of people watching more cool than creepy.

All the usual fixtures are present. There is an old, invisible man to my right sitting in a corner. He is of my lean build but slightly taller. He is dressed well-enough. Actually, everyone seems to be dressed well-enough. Less label-mongering narcissism than I am used to seeing. He came alone like I have. He seems pleasant. I am tempted to feel pity, but I am in the same boat as he. There is another older man dancing predatorily at the edge of the dance floor. I feel pity for him, no, I think its empathy. Loneliness is no stranger to me.

There is a raised platform in the middle of the dance floor – for people who need to be seen. Many more fag-hags here than I am used to. Shame, they will end up sitting here at the bar with me when the fornication begins. Coming to think of it there are more women than I am used to seeing. The last time I saw this many lesbians was at the GAT party in Cape Town (a fortnightly “Sokkie” replete with trestle tables and langarm dancing). It just so happens that Kurt Darren is playing and people are langarm-ing at this stage. Coincidence? I think not. There must be some link between lesbian-ness and propensity to langarm. Will investigate later.

A quick race survey confirms my suspicions: I am the only black person in the room, and one of three people who are not white. It’s like under-16 hockey all over again. Wait, there is another black gay. Yay! I feel like going up to him and saying, “Dumela Rra, ke itumeletse go gobona fa!” Let me drink a bit more before I do that.

My eyes dart from face to face on the dance floor, looking for someone familiar… or a lascivious glance. Wouldn’t it be sweet if I recognised someone from my high school? I would be so scandalized! Alas. I stop at the white guy dancing opposite the other black gay. That white boy dances well hey. He makes me feel inadequate - fuck him (please?). Actually, all these (white) people are dancing well … what the fuck?! All my people have is BEE and dancing skillz (yes, that’s skills with a “z”). Selfish!

I catch the gaze of a cute blonde to my right at the bar. He is with his clora (means “coloured” in gayle language … I think) faghag. Hmm… are we going to play furtive glances or sultry seductress? I think furtive glances – I don’t have enough booze in me to play seductress.

The music switches from Kurt Darren and Kurt Darren-like numbers to Lady Gaga. Raa Raa Ma Ma Maa Gaa Gaa Ooh la laaaaaa. It’s such bullshit that I remember how that “song” goes.

“Hi, you need to pri-tend you know me”.

Ha ha! It’s blonde guy to my right.

“Hello… ok…”

What a pick-up line… I am thoroughly picked up though, and that’s ok. I knew that the eyeliner would work out for me. The furtive glances did their job also. I give myself a secret high-five and instinctively reach for my phone to do a facebook status update. Common sense prevails. My picker-up and I make awkward chit-chat over the blaring Lady Gaga. He has to (or chooses to) lean in very close to be audible. He invites me back to hang with him and his fag-hag. He had told me that he pretended to his lady friend that he knows me – this is why he asked me to make like I know him. When I asked him why he is trying to get away from his friend, he said he actually was not trying to do that at all. This makes no sense, but I did not want to enquire further. That would just lead to unnecessary cock-block.

We head to the dance floor and the music switches from Lady Gag to Brenda Fassie – “Vul’indlela”. Noo…. what? In the F.S! This is crazy. I start dancing my little heart out (that investment in beer is starting to yield returns). Over my right shoulder, some people are beginning to get in formation for *drumroll*…. THE ELECTRIC SLIDE – or at least a South African version. For the uninitiated – the electric slide is line dancing for black people. There is an electric slide moment in every African-American romcom – it is usually at the end when all the characters have made up. It is (apparently) a favourite at weddings. Anyways I was just so excited I forgot about my picker-up and got into formation. Bloem lesbians rock hey.

I get back to my newly found clique not wanting them to forget about me, leaving me stranded again. My picker-up, aka hot Afrikaans guy is dancing in earnest – he is very cute doing it. It’s amazing to me how fluid the groupings on the dance floor seem to be. People just come join our circle and dance, and leave, or stay. I meet some of cute blonde Afrikaans guy’s acquaintances – all very warm and unbitchy (well, at least at this stage of the night).

Very quickly, we get to the countdown. 3… 2… 1… “Happy New Year!”…. hugs and kisses and lots of smoke (from the smoke machine – uber cool) and flashy lights and new year’s music and hugs and laughing. Happiness!

A complicated story begins to unfold with my picker-up… slight bitchiness ensues. To be shared another time.