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Perry’s pet peeves

BY SCOTT STIFFLER | Plop a prolific researcher down in the middle of a diner in the middle of the afternoon and put an omelet in front of him. Then let the tape recorder roll and ask him to map out the everyday frustrations that come with the territory of having one’s work — often years in the making — interpreted, misinterpreted, demonized, analyzed and otherwise used by others who rarely ask for his opinion on the best policies and programs to come from all that number crunching.

By the time you’re done, he’s got one cold omelet — and you’ve got 5,000 words to whittle away at. What you find, almost from word one, is that the amiable and sober Perry N. Halkitis (PhD. MS) becomes passionate and animated when asked for what one assumes must be a laundry list of things that piss him off. Your instincts are right. That list turns out to be almost as long as his job title (Associate Dean for Research and Doctoral Studies; Professor of Applied Psychology and Public Health; Director, CHIBPS, at The Steinhardt School of Culture, Education, and Human Development, New York University).

For just over a year now, Halkitis has been writing for Chelsea Now — in order to give this much-cited researcher a forum to air his opinions on what policies should come from studies and surveys regarding the sexual behavior of gay men.

Scott Stiffler: So, Perry, what’s pissing you off lately?

Perry Halkitis: Well, what’s not pissing me off? I’m gonna say that the thing that’s pissing me off most is the lack of an organized voice in the gay community. You know, the ‘80s were scary, right? They were terrifying; especially if you were a young gay man — if you were any gay man — but at least we came together.

Scott: Yeah, nothing makes you a savvy coordinator quite like all your contemporaries dropping like flies.

Perry:  Exactly. Right. So we had a reason, we came together, something great happened there. I miss that. That’s what I want and that’s what’s pissing me off. Some might argue that it can’t — that it’s not happening now because a generation has died, right? Plus, I think there is a belief that being HIV-positive is not the horrific reality that I witnessed when I was in my ‘20s. In the 1980’s, death was all around us. It’s not what young men are seeing today. So I think that partially contributes to the rise in risky sexual behavior — but I also think there’s a lack of knowledge. We’re doing a study right now of 18-year-olds. It’s amazing to me how many of them don’t know that they shouldn’t be using Vaseline, that they should be using water-based lube. Many of them don’t know the difference between an antibody test and a viral load test. I’m 48-years-old, but I’m training my guys in a research center, so I’m preparing the next generation of scholars to go out into the world. I want that sort of kind of unified organized voice, where gay men come together and fight for something important and good. It seems splintered to me right now.

Scott: Have we lost that Stonewall zeal and rage because we’ve got a certain amount of rights and it seems like we’re past the plague years? Are we just comfortable enough because we have just enough rights?

Perry: In my opinion, we don’t have rights. Even in the best organization in the whole world. My university is a great university. They acknowledge same-sex relationships. They provide health care — but I’m still taxed on my partner’s healthcare, in a way a straight person would not be taxed. I raise this issue all the time as one that’s unequal and unfair, yet nothing moves along.

Scott: Well, taxes aren’t exactly a sexy, unifying issue — for the community or the general population. Most states don’t even protect us from workplace discrimination, yet everybody’s getting worked up about the right to marry.

Perry: Right. I think gay marriage is an important issue. I’m not gonna deny that. I do believe the fact that hate crimes continue to happen in this country, that people can get fired or denied rights and housing because of sexual orientation, and the fact that we have an HIV epidemic that continues to escalate in the gay population are more important issues. Yet we seem to have latched on to this marriage thing, as if nothing else exists. That’s strange to me. And we didn’t even do it right. I think that if the folks fighting for marriage were smart enough, they would’ve made it a civil rights issue from day one.

You know, the academic in me wants to say, ‘Well, if we fight for our right to be married, then we reduce discrimination, so everything else gets better as a result of that.’ But that’s so far removed…I don’t even want to call it ‘marriage.’ I want to call it something else, that’s ours. Instead of doing something that ‘they’ do.

Scott: And maybe there’s an element of assimilation, of self-loathing? I don’t ever want to be married or monogamous or have children, do you?

Perry: I didn’t think about marriage either — until two years ago. And I decided to do it. I never had wanted to have kids, but I respect people who do. Part of my identity as a gay man was that I wasn’t going to have those things. But I think there’s this need — you’re right — for some gay men to fit into the norm, thinking that if they do, their lives are going to be better. Which we know is not true.

You know, it’s interesting to see that while the 30- and 40- year olds are getting married, my 20-year-olds are not so keen on that, on the marriage thing.

Scott: Have they said why?

Perry: They speak to some of the issues we’ve addressed already, like the heteronormative nature of it, and how it sort of constricts their identity. So I think you’ve got a generation that got married and had babies and moved to Jersey, right? And now you’ve got a new generation coming up, who are in their late teens and early 20’s, who are like, ‘Wait a second. We’ve sort of given up part of who we are in doing this.’ I think that the 30- and 40-year olds felt that in order to get ahead, in order to get our rights, we had to assimilate. And I think now, the younger generation is feeling, ‘We’ve lost something in that process.’ That’s what’s different with this generation. That makes me proud, and that makes my thinking, when I do my work, fresh. They push my buttons all the time.

Scott: Speaking of button-pushing, we’ve been so busy bad-mouthing gay marriage we haven’t even started in on the things that piss you off about your profession. Mull that over while you have some of that omelet and we’ll start the tape recorder up again in a few minutes.

NOTE: Five minutes later, after some scandalous off-record conversation:

Scott: When you started writing for us, you remarked that you do all this research and it’s cited everywhere, and people use it for various purposes. And those people weren’t coming to you and saying ‘Well, how does this research translate into policy, what’s your opinion?’ To what extent are you asked that question? You know, and how regularly, and when they ask it, do they actually take that advice?

Perry: I feel like in academic circles I’m asked that question. For example, I serve now on the Center for Disease Control (CDC) HIV and STD Advisory Panel. May was my first meeting, I was appointed at the beginning of the year, at the new term.

Scott: Better late than never, huh?

Perry: I’ve been doing this sort of work since I was director of research at Gay Men’s Health Crisis (GMHC) in 1996.

Scott: Has there always been such a gap between the folks doing the research and the ones who take that research and create policy from it?

Perry: Well there’s often a disconnect between science and policy, right? That’s true in education, and I think it’s true in HIV prevention. I wish that folks on the front line reached out to me more so that I can help them think through their programs and their strategies. Some agencies like GMHC and Harlem United do. But I wish it would happen more often. Because that’s really why I’m doing this work.

Scott: So how are you being treated by the CDC?

Perry: It’s just been a few weeks since the Advisory Panel met for the first time. But I will tell you that I felt that it was a forum in which my thoughts and ideas were heard.

Scott: So there’s hope? But what about the medical field in general?

Perry: I’ve been arguing lately that HIV prevention — and HIV health — has to be embedded within the larger framework of gay men’s health. That means that doctors have to open to a conversation about our sexuality, about our alcohol use, about any other substance use, about discrimination. All that has to be part of the package. Right now, when we train people in disciplines, we put them in silos. So they lose the big picture — and I think we have to constantly fight to break outside those silos, to make our work much more meaningful. Of course, you want doctors to be trained in the best techniques and the best treatments possible — but you also have to train them in the reality of people’s lives, to be embedded in social contexts informed by policy; to ask when they say to a young person, ‘Use a condom now for the rest of your life,’ how that does or doesn’t make sense in that person’s mind.

And I think that’s the difference between a biopsychosocial model as compared to what many physicians espouse — which is called a biomedical model. For me it’s about more than the transmission of pathogens and viruses.

I went to a new health care provider in the fall, who had to do my whole history. So we went through all the ridiculous questions and he got to the question about drugs. He said ‘Do you do drugs?’ and I said ‘No,’ He said, ‘Do you drink?’ and I said, ‘Yeah, well you know, now and again.’ And he said, ‘So socially, right?’ and I said, ‘Does that mean that if I go with my friends five nights a week and I come home drunk out of my mind, that’s socially and that’s okay? Shouldn’t you really be asking me how many times I’ve come home drunk in the last month? Isn’t that a better question?’ And I just ruffled his feathers. He didn’t know what to do.

And that’s what I’m thinking about when I’m saying biopsychosocial. I’m thinking outside the box. What does that mean, ‘social drinking’? That’s a stupid question, right? We have these stereotypes about how we define addictions.

The other thing that pisses me off is always wanting to have a simple solution to a problem. You know, five years ago, the simple solution to the HIV epidemic was: Get rid of meth. Come on, right? Come on. We know that with gay men, this was just going to be another drug that was going to pass, right? There are always substances. Alcohol’s probably the worst of them, and the one that’s never really talked about. But meth was sexy. It was the like the new shiny toy that we were going to focus on. If we could get rid of meth, we would get rid of the HIV epidemic. How ridiculous is that?

Scott: Yeah, with meth it was like ‘Oh, those promiscuous sexy gays, with their meth, you know? That explains the infection rates.’

Perry: Right — if they weren’t doing meth, they wouldn’t… ‘They’re bottoming cause they want to bottom. Meth just makes the bottoming easier for them. That’s what’s happening, right?’ But it’s not like every man who does meth is gonna seroconvert.

Scott: Wow. That omelet hasn’t gotten much of a workout since we’ve been on meth…on the meth topic, that is. Anything else getting your goat?

Perry: Other things that piss me off are the inconsistencies in the treatment of gay men’s health. I raised this with somebody in a class recently, where the lecturer was talking about the use of Gardasil — a medication that can prevent the acquisition of Human Papillomavirus (HPV). And HPV has been implicated in anal cancer; certainly cervical cancer, we know. But anal cancer in gay men, particularly HIV-positive gay men, but gay men in general. You’ve seen those ads by the Department of Health, where it’s like ‘If you get HIV, it’s more than just HIV…’ Okay.

So they do that. But at the same time, they don’t provide Gardasil to men who have sex with men. They only provide it to women, because it’s more cost-effective for them than it is to do it for men. How does that make sense? If you’re gonna put an ad out that says ‘You’re at risk for anal cancer,’ and you’ve got this medication, and you’re not giving it to this vulnerable population, then how do these two lines of thinking come together? They don’t come together. That sort of stuff pisses me off. You’re making me scared to death, yet at the same time, we are not immunizing young gay men with Gardasil. Why? Because it’s not ‘cost-efficient?’ Because while you have 100% certainty that HPV can cause cervical cancer, you only have 89% that it can cause anal cancer? 89% seems like a pretty good reason to me. I think they’re talking out of both sides of their mouths when they do that. That pisses me off.