This commentary offers a critical perspective on the New York (USA) case of a rare HIV strain, which was reported in 2005. In brief, New York City's health department announced in a press release that a man in his 40s had been newly infected with "3-DCR HIV", a strain of HIV resistant to drugs from the 3 main classes of antiretrovirals (ARVs), and was experiencing rapid disease progression. The man was diagnosed with HIV in December 2004, having previously received a negative test result in May 2003. However, the man subsequently had unprotected anal sex with multiple male partners, often after taking the recreational drug methamphetamine.

In this commentary, Michael Carter examines the US media response to this case, drawing on examples from the popular press to illustrate the media's failure to base reports on careful study of the facts and review of the scientific evidence. Carter argues that the arrival at quick conclusions, and provocative, moralistic reactions to the case, may in part be explained by the current (conservative) moral climate in the United States with regard to sex and sexuality. He suggests that this trend in news reporting may, then, deserve further scrutiny.

Excerpts from the commentary follow:

On both sides of the Atlantic, the media have been quick to pick up on the
story, warning of a new, 'impossible' to treat strain of HIV, and the
consequences of promiscuous sex and drug use.

But is the alarm generated by this case really justified?

In actual fact, very few details are available. Information about the man's case is provided not in an article in a medical journal where the facts have been verified by other doctors and researchers, but in a press release which contains scant information...

...New York City did not provide details of the condition leading to the man receiving an AIDS diagnosis. Once again, it appears journalists did not bother to ask, although in their report the New York Times did state that the man had experienced weight loss, and had a high viral load. Neither of these symptoms necessarily indicates rapid HIV disease progression, indeed, both can be indicative of the early stages of HIV infection...

Not all media reports accepted the New York City press release at face value. In the UK, The Observer quoted Roger Pomerantz of Thomas Jefferson University in Philadelphia who said "every medical centre in a major metropolitan area will have a case like this. You've got to really prove something before you go on CNN and scream about a super-strain." They also contacted Dr Barry Evans of the UK Health Protection Agency who urged caution, and said he was waiting for the case to be published in a medical
journal before reaching any conclusions.

HIV prevention messages have been reiterated due to this case. The City's Health Commissioner Thomas Frieden calling it a "wake-up call to men who have sex with men"...and called on gay men to take action to prevent the "devastation" that drug resistant HIV could cause. Concern has also been expressed about the apparent use of methamphetamine by the man...

Sections of the media have used the case as an excuse to revive a tone of moral panic reminiscent of the early days of the HIV epidemic. The New York Times reported that the man's case had implications for "promiscuous gay men" and sent a reporter to the Big Cup gay coffee shop in the city's Chelsea district to find that younger gay men who had not had the "searing" experience of seeing friends die of HIV were reporting "complacency" due to the success of antiretroviral therapy. A report in their February 14th edition, found that gay men using the internet to seek sex in the city were paying little attention to the warning of the "new" strain, despite the fact that the man is thought to have met some of his partners on-line.

There is no mention in any of the media reports of research which has found that the recent syphilis outbreaks affecting gay men across the US and Europe have an epidemiology separate from HIV. Nor is there any reference to research actually looking at the sexual behaviour of gay men since the advent of effective anti-HIV therapy which has found little evidence of the complacency suggested by some reporters.

Perhaps the reason for the reaction to this case and its reporting lies not in its medical significance, but in its importance to current US debates on comprehensive or abstinence-only HIV prevention.