Thursday, February 25, 2010

How much autonomy does an individual over have over their body?

Believe it or not, there are actually people who actively strive to contract HIV/AIDS. The story of Carlos, one such "bug chaser," is chronicled in a 2003 Rolling Stone article entitled: "Bug Chasers: the men who long to be HIV+." Although news from 2003 isn't necessarily groundbreaking today, the implications of what these bug chasers consider their right to contract a potentially terminal illness are applicable in any discussion of the triumph of individual autonomy versus public health.

Carlos, a 30-year-old gay male from New York City, claims that the actual moment of HIV transmission is "the most erotic thing [he] can imagine." While Carlos acknowledges that he knows "that putting myself in this situation is like putting a gun to my head," he maintains that he still wishes to "be initiated to the brotherhood."Like most bug chasers, Carlos believes that with today's HIV-related treatments, having HIV/AIDS is only a "minor annoyance," like living with diabetes-just take a few pills a day, and you'll be fine.

The internet has served as the primary meeting place for those who are hoping to become infected with HIV-"bug chasers"-and those who are willing to give it to them-"gift givers." Author Gregory Freeman writes, "While the rest of the world fights the AIDS epidemic and most people fear HIV infection, this subculture celebrates the virus and eroticizes it." The anonymity and widespread use of the internet enables these like-minded individuals to meet and engage in casual sex without the use of a condom. "Safe sex" and the use of condoms are often ridiculed on web forums for bug chasers and gift givers, who say that "condoms suck" and "constantly thinking about a deadly disease takes all the fun out of sex."

Many work to contract HIV because they figure after becoming infected, "nothing worse can happen to you," the chase is exciting, they figure they'll contract it anyway, or they like the idea of doing something the general public considers crazy and wrong.
Freeman's article also introduces Doug Hitzel, a 21-year-old freshman at university in the Midwest who contracted HIV after six months of bug chasing. Now that he is HIV positive, Hitzel hates taking his medication each day, and finds his disease a barrier to forming new relationships. Hitzel is embarrassed to have ever pursued HIV, but wishes to tell his story to discourage any bug chasers. He takes most issue with the idea of HIV transmission being erotic. He says, "How about you follow me after I start new medications and you watch me throw up for a few weeks? Tell me how erotic that is."

Reportedly, public health officials, anti-AIDS and Gay and Lesbian associations generally tend to deny that bug chasing is more than just an aberration. Dr. Bob Cabaj, director of behavioral-health services for San Francisco County, thinks it could still have significant impact. He says, "It may be a small number of actual people, but they may be disproportionately involved in continuing the spread of HIV. A small percentage could be responsible for continuing the infection."

This article, besides being a very interesting read, brings up the question of how far individual autonomy should be taken when it infringes upon the well-being of the public's health. Most would argue that people should have control of their bodies, but do they have the right to actively pursue a disease? If so, do they have the right to transmit it to other individuals, willing or not? At what point should public health officials interfere?

References: Freeman, Gregory A. "Bug Chasers: the men who long to be HIV+." Rolling Stone 24 Feb. 2003. Web. 25 Feb. 2010.

Brooke Evans is a contributing writer on public health for TuftScope Spring 2010.
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