'It is time to give specific attention to [the health needs of] gay-identified men,' Eric Rofes told the more than 300 men and a handful of women attending the Gay Men's Health Summit 2003. It met May 7-11 in Raleigh, NC.
'We are not leaving it to Time magazine, we are not leaving it to the CDC or the Department of Health and Human Services to be the only ones calling the shots' on gay men's health issues, he said. 'We want to see community-based responses and actions ... . This is about our voice and about being heard.'
Rofes, one of the guiding forces behind the gay men's health movement, described it as 'decentralized, anarchistic, and neo-tribal. We do this and think there is power in it.' It seeks to expand health concerns beyond HIV and beyond a purely medical paradigm.
The Summit brought members of the community together at the national level 'in a rich dialog' about those issues, with the aim of stimulating further discussions in communities across the nation. Two earlier gatherings had taken place in Boulder, Colo., in 1999 and 2000.
Rofes advocates replacing the current 'HIV-centric paradigm' of gay men's health with a more holistic one. He criticized public health officials for framing problems of syphilis infections and methamphetamine use within a context of HIV. 'Crystal addiction is a problem in and of itself, not just because it can lead to the spread of HIV.'
He urged an 'exit from the crisis paradigm' that shaped programs in the mid-1980s, but that is no longer applicable today. And he challenged the men to move from 'deficit-based models' to 'assets-based' approaches that build upon their strengths.
'Shame and guilt are the health hazards,' not specific sex practices and cultures, said Rofes. Racism, sexism and homophobia have health consequences.
He embraces a 'big tent vision of community, respecting diverse ways of organizing sex and relationships.' He urged them to 'launch efforts that are not overtly or covertly sanitizing, sanctimonious, or moralistic.'
What are the meanings of anal sex, penetration and the exchange of semen, Rofes asked? He argued that 'sexual acts have different meanings' to different people, depending upon the values that each attaches to them.
The Summit embraced questions such as those in a variety of sessions, along with more practically oriented matters such as working with hard-to-reach populations with effective HIV-prevention messages.
Rofes said the community has to grapple with the issues of responsible sexuality, but he offered little guidance as to what that might look like.
During comments from the audience, one man said, when you talk about health, you are talking about values; there is no way to avoid it.
Christopher Smith, an AIDS educator from Tucson, Ariz., threw out the ultimate challenge on that subject. He asked, 'Do we have the courage to say to our funders, 'We taught you everything that we know, and we were wrong.''