05/02/2010 05:12 am ET Updated Nov 17, 2011

Gay Marriage Will Save Lives

The nationwide furor around gay marriage has eclipsed at least temporarily the health crisis that continues to plague gay men. At the same time that we heard wedding bells and pledges of life-long fidelity from gay men in Massachusetts and elsewhere, we have soaring rates of HIV in homosexual men. One almost feels guilty bringing up the subject of sexual responsibility at a time when the gay community is waging a pitched battle to secure the right to marry. But ironically, gay marriage -- and the values any sanctioned marriage encourages -- may be one of the single most successful ways to promote safer sex.

Regardless of the immediate outcome of the marriage debate, one of the unintended consequences could be a reduction in new HIV infections. The swinging gay lifestyle of the '70s is legend. The '80s brought the endless terror of AIDS deaths. The '90s brought the miracle of the AIDS drug cocktail, and with it, complacency about becoming infected with HIV. Today, a self-destructive mixture of new designer drugs such as crystal methamphetamine and the practice of "barebacking" -- having sex without a condom -- has erased a gay community norm of safer sex that was firmly established nearly thirty years ago when the epidemic first emerged.

In the past, most everything in gay sub-culture revolved around being single and available. Long-term couples often felt like they were on the outside looking in. Slick advertising for circuit parties where men "party" for days on end became the order of the day. There was little room for marital bliss in this picture. And while the yearning for committed relationships and love often burns as brightly in gay men as in anyone else, it didn't have a lot of support. No gay wedding magazines or announcements in the newspapers. Meanwhile, many gay men became conditioned to see becoming HIV positive as a natural right of passage of gay life.

Suddenly everything seems different. It is hip to be gay and be married. In 2004, Massachusetts -- the state with the lowest divorce rate in the nation -- paved the way, and despite fear and protestations, the Commonwealth somehow survived. In the heart of the homeland, Iowa followed, joined last year by Connecticut. California also took a step closer to this goal, which resulted court rulings and the landmark federal court case, Perry v. Schwarzenegger currently before the 9th circuit court.

Now, Gay men in long-term relationships are questioning whether they should get married. Young men are seeing older men who have been in relationship for decades tying the knot. At last, the stereotype of the lonely aging homosexual is being undermined. For many, growing old with someone you love by your side seems a whole lot better than living with, and eventually dying of AIDS.

Legalizing same-sex marriage will not mean that there will suddenly be a radical change in gay male lifestyles. Much of the sub-culture will still revolve around sex. But with the faint hope of legalized marriage on the horizon here in California, there is another option that is being validated in a big way.

There is more than a little irony that the same fundamentalists who preach fidelity are so vehemently against recognizing gay relationships. From a public health point of view, health officials and epidemiologists recognize the most effective method of reducing HIV and other sexually transmitted diseases has historically been a reduction in the number of sexual partners. Logically, a public commitment to a marriage or domestic partnership should result in gay men having fewer partners. Most importantly, it will cause more gay men to protect their partners and themselves if they see a future in a committed relationship.

Politics and ideology have long been the primary obstacles to promoting safer sex. Countries that have overcome this have had great success with controlling new HIV infections. Ideological opposition to gay male relationships and honest talk about sexuality have cost an untold number of lives to be lost in this country and around the world. The current momentum to recognize gay relationships could be one of the most significant breakthroughs for HIV prevention in the gay community.

The gay community's determination to see our relationships recognized, however, should not silence our ongoing discussion of the health crisis that still exists in our community. Any fear that we might have that airing our dirty laundry will hurt our cause must be tempered with the recognition that our first and foremost obligation is to take care of ourselves. Communities that show an ability to take care of their own and address their needs are strong and earn the respect of others, even if grudgingly so.

If we as a society view the current debate about the legal recognition of gay relationships as an opportunity to protect our youth from the scourge that gay men experienced when we were young, I firmly believe this debate will not only yield new self-esteem among gay men, but it will also actually save lives.