In Louise Hogarth's new documentary, "The Gift," a soft-spoken, Midwestern college youth named Doug Hitzel tearfully recalls what drove him to become a "bug chaser" -- an HIV-negative man who seeks to be infected with the virus that causes AIDS. Later, Hogarth visits a home where dozens of men are attending a "barebacking" party for unprotected sex. Interspersed through the movie are interviews with HIV-positive men who believe that prolonged use of anti-AIDS drug "cocktails" has caused them to suffer serious health problems, including heart disease.
These, Hogarth believes, are the hard realities of AIDS in America.
Her film derives its title from the term "gift givers," or HIV-positive men who give "the gift" of HIV infection, and since its debut at the Berlin Film Festival last February, audiences have viewed "The Gift" with a mixture of horror and fascination. Some have compared it to watching an accident. Others have given it a standing ovation. The movie raises questions such as: Why do so many gay men no longer fear HIV and willingly engage in high-risk sex without condoms? Why are rates rising again after two decades of prevention programs? And why do some HIV-negative men feel the need to become HIV-positive?
It arrives at a time when AIDS in the U.S. has receded from public attention, when films such as Mike Nichols' critically acclaimed HBO project, "Angels in America," confine themselves to the early years of the AIDS epidemic.
Hogarth's focus on "bug chasers" such as Hitzel is raising fears among some critics that her view is too narrow, and that when her film is seen by the public, it could give rise to a new wave of homophobia similar to the discrimination that emerged in the early 1980s when AIDS first appeared. ("The Gift" is scheduled to be shown Feb. 2 on the Sundance Channel, followed by a limited theatrical release in Los Angeles, New York and San Francisco in March before going to other cities.)
Walter Armstrong, editor in chief of POZ magazine, which has chronicled the AIDS epidemic, believes that showing the movie to a wide heterosexual audience could demonize all gay men "by suggesting that we are so perverse that we would actually want HIV."
With her winsome smile, elfin haircut and Sharon Osbourne-like features, few would imagine Hogarth, an L.A. filmmaker who herself is gay, as a lightning rod for controversy.
Yet with her blunt criticism of "AIDS Inc." -- her term for the plethora of government and privately funded agencies working to prevent the spread of HIV and AIDS -- and her dire warnings that gay men must take responsibility for their sexual conduct, Hogarth has become an unlikely crusader.
At last year's Outfest, the Los Angeles gay and lesbian film festival, she stepped onto the stage after a screening of "The Gift" to answer questions from the gay and lesbian community, as she has done countless times over the last year around the world. "Are you going into the bedroom and telling them how they should have sex and shouldn't have sex?" someone in the audience asked.
Hogarth bristled. "This isn't about going into people's bedrooms," she replies. "This is about a public health epidemic, and I think it needs to be treated like that."
"My documentary is about the large numbers of people who don't care if they get infected with HIV," Hogarth said in an interview. "... The infection rate is exploding, just exploding."
Putting the issue in focus
One of the most disturbing issues raised in the film is why young gay men would want to deliberately infect themselves with HIV. The men featured in the movie explain that they do so, in part, to fit in with their friends, many of whom are HIV-positive, because they believe that by becoming "poz," they won't have to worry about getting the virus, and because the development of anti-AIDS drug "cocktails" means the disease is no longer a death warrant.
Hogarth points to healthy-looking former Laker star Earvin "Magic" Johnson, who announced he was HIV-positive in 1991, and says he is the image the younger generation sees of an HIV-positive man.
"I think we absolutely have to get the message out that this is not some manageable thing, that you take a pill and everything is OK," she said.
Actor and gay activist Harvey Fierstein, star of the Tony Award-winning Broadway musical "Hairspray," has rallied support for Hogarth's documentary, calling it "a film of great social importance."
"I think this is a film that not only serves us now but tells us where we are at this moment," he says. "Young men seeking inclusion in the gay world, it seems, seek it sexually first, which is kind of sad considering that we have so much more. When I was a kid, that was all there was -- gay bars -- and that was it. That was how you found other gay people. I had kind of thought that in the ensuing 30 years that we had gone so far beyond that....
"It's 22 years since we've known how not to get AIDS. Yet, every 15 minutes, an American [who is HIV-negative] converts to HIV-positive. Somebody is doing it.... I do a commentary ... -- I'm kind of the Andy Rooney of homosexual culture, if you will -- and I did a piece on 'Why am I still doing AIDS benefits 20 years into this?' "
Indeed, the national Centers for Disease Control and Prevention in Atlanta report that an analysis of 102,590 people found with HIV in 29 states from 1999 to 2002 showed that HIV diagnoses increased 17% among gay and bisexual men and 7% among men overall. In a statement accompanying the report, CDC Director Dr. Julie Gerberding said, "Fighting HIV in America is as urgent [today] as it was more than two decades ago when the epidemic began."
Meanwhile, Los Angeles County health officials say they routinely interview persons newly found with AIDS and ask them about their sexual behavior. Among men who say they have they have had sex with men, 10% reported having 10 or more male partners in 2000, and that percentage increased to 25% in 2003.
Fierstein praises Hogarth for putting the issue in focus.
"She had a vision and she went for it," he says. "She sacrificed for it. She stood up to a lot of opposition to say, 'This is the truth.' I think this is an amazing lady."
Hogarth, who's from Fairbanks, Alaska (which she calls "the land of the individual"), is not a newcomer to filmmaking. She is founder and director of Dream Out Loud Productions, an independent documentary company and, in addition to "The Gift," has worked on documentaries dealing with human rights and poverty. She has a co-producer credit on the 1993 Academy Award-winning feature documentary "The Panama Deception," and a year later wrote, directed and produced a documentary about a battered woman trying to get of out prison titled "Ollie Mae Johnson's Petition for Clemency." In 2002, she produced a film called "Does Anybody Die of AIDS Anymore?" that she made while directing "The Gift."
Like other independent filmmakers, she fell into a financial hole to make her movie. She said she sold her home and went without a paycheck for more than 3 1/2years to produce the $125,000 documentary, shooting 80 hours of footage. She was turned down for grants, and nearly every major AIDS organization kept its distance.
"You know what people said to me?" she recalled. " 'You are so brave.' That was the quote I always heard. 'You are so brave.' Or 'You are going to get in a lot of trouble.' "
Only the AIDS Healthcare Foundation in L.A. provided support for the project: $10,000, along with an office and editing space.
"We gave our support because it's been clear for some time that prevention efforts are failing -- they are not hard-hitting enough," said foundation President Michael Weinstein. "She sacrificed a great deal to make and promote this movie. They try to portray her as a prude, which she is anything but. I think she came into this thinking that, of course, everybody would be united in this cause. I think it's been shocking to her. It's kind of gotten her dander up that she hasn't gotten more support."
Hogarth has traveled from continent to continent to screen her film, holding lengthy question-and-answer sessions with audiences to get her message out. The film has been screened at more than 100 film festivals, been shown to students at medical schools, and won the best documentary award at last year's Newfest, the New York Lesbian & Gay Film Festival.
One of the film's central characters is Hitzel who, at 19, ignored warnings about practicing safe sex and began chasing HIV in San Francisco.
Now a sophomore majoring in Spanish and mass communications at the University of South Dakota, Hitzel, who turns 22 this month, said he is HIV-positive.
In a recent telephone interview with The Times, Hitzel explained why he threw caution to the wind: "Initially, something in me said you probably shouldn't do that, but after a while, I thought [becoming HIV-positive] would make me more popular. I ended up doing it once or twice. After a while, it became apparent people would like me if I didn't have a condom."
Hitzel has become something of a poster boy for the film. Hogarth asked him to participate in her movie after reading a first-person account he wrote for POZ in February 2002, in which he discussed his "bug chasing" as a "suicide mission." He also was featured in a Rolling Stone article about "bug chasing" that drew harsh criticism last year from health experts and AIDS groups.
Hitzel's use of the drug crystal meth during his "bug chasing" in San Francisco is not explored in the film. Had it been, critics believe, it would have shown how complex the issue of why gay men engage in unprotected sex really is. (When smoked, injected or ingested, crystal meth becomes a powerful stimulant that puts the user in an alert, pleasurable state.)
"I don't really talk [in the film] about the fact that there were a lot of drugs in my life at that point," Hitzel said. "I was into crystal meth, but I would never blame what I did on crystal meth, because I still fully take responsibility for my choices. But I think that at that point, honestly, when you are doing drugs and things, your health runs down. I was so sick. It messes with how you feel. I didn't have much of a fight in me anymore."
"Our most serious concern with the film was that it didn't address the issue of substance abuse to the extent that we see it every day in our work," said Shana Krochmal, a spokeswoman for San Francisco-based Stop AIDS Project, a community-based organization that does HIV prevention work with gay and bisexual men.
Hogarth said she deliberately left crystal meth and alcohol use out of her film "because I don't really believe that is the issue. This film is about taking responsibility for your life. You have to realize, medicine isn't going to save us, the doctor isn't going to save us and the good aliens aren't coming."
She used the phenomenon of "bug chasing" and "gift giving" as hooks to draw people to the film, she said, and to discuss larger issues such as why gay men are having unprotected sex in large numbers.
And it's that strategy that has drawn the most criticism.
POZ editor Armstrong noted that his publication first explored "bug chasing" in 1999, when it appeared that the phenomenon might spread havoc in the gay community, but now believes that those fears proved unfounded.
"That's not to say that unsafe sex and infections among gay men are not huge," he said. "They are serious problems that we need to deal with. I just think the 'gift giving' and 'bug chasing,' as sensational as they are and interesting as they are, aren't really a public health or social problem. It's just a tiny group of people."
Perry Halkitis, a research psychologist at New York University who has conducted extensive studies on health issues in the gay community, called the film "shortsighted, uni-dimensional and sensationalist."
"Clearly we know unsafe sex among gay men is on the rise again," he said. "[But] she's clearly got an agenda, and this movie is about her agenda. It's not a well-rounded, objective representation of what is going on."
Halkitis said gay men engage in sex without condoms for a variety of reasons that have nothing to do with "bug chasing," and those reasons can be linked to other issues such as drug use or mental health.
Although Hogarth does not dispute that "bug chasers" might be few in number, she contends that the number of gay men who engage in unsafe sex is a gross illustration of the failure of AIDS prevention in America. "It's not the immaculate infection," she said. "The main way the disease is being spread is by HIV-positive people having unsafe sex."
Kim de St. Paer, who conducts anonymous HIV testing and counseling at the Laguna Beach Community Clinic, said working on the front lines of HIV testing has convinced her that "bug chasing" is a more serious problem than experts realize.
She recalled one "bright, intelligent" 19-year-old man at the clinic who told her he had had unprotected sex with men he knew were HIV-positive. "He shared needles with men he knew were positive," she said. "Clearly he was 'bug chasing.' He was seeking it. He stopped caring about his life. He felt very empty and alone inside."
'People are not afraid'
Hogarth said the film has been a "real journey" for her personally. Like many, she has seen friends die of the disease but came to the project believing the illness was manageable.
In the early years of the epidemic, she said, prevention deliberately showed "what it looked like to be infected. We didn't know how to prevent it."
Once gay men knew who was HIV-positive and negative, "we stopped doing prevention the way we had done it before, because we didn't want to hurt the feelings of people who were positive and take away their hope, and that kind of prevention made [HIV]-negative people feel guilty.
"When the new drugs were introduced, we had great hope and we continued to put out a very positive message. Nobody knew the epidemic would last this long. And now, because of the glamorization of the disease, people are not afraid of the disease. They think they are just going to take a few pills and then there will be a cure. We need to start telling the truth about what it truly means to be infected with a disease for which there is no cure."
Robert Welkos can be reached at Robert.email@example.com.