Close, Single, and Infectious

A deadly meningitis outbreak is targeting the gay community. Are hookup apps to blame?

A patient receives a free meningitis vaccine from Dr. Wayne Chen at the AIDS Healthcare Foundation pharmacy on April 15, 2013, in Hollywood, Calif.
A patient receives a free meningitis vaccine from Dr. Wayne Chen at the AIDS Healthcare Foundation pharmacy on April 15, 2013, in Hollywood, Calif.

Photo by Kevork Djansezian/Getty Images

The first thing you see when you open the app Grindr are men—or rather, parts of men. Faces and torsos confront you in tiny boxes, accompanied by spare descriptions (height, weight) and a crucial factor: physical proximity. One user might be 50 feet away, another 200; expand your range, and you can find a man far across town. Like what you see? Message to meet up. Whether you’re looking for sex, a date, or even just a friend, apps like Grindr can give you the perfect match.

Something else they can give you, according to the New York City Department of Health: meningitis.

A new strain of the disease has been spreading in New York City, targeting the gay community. In the past three years, 22 people have been infected with the bacteria. Seven died. All of them were men who have sex with men. And all of them used hookup apps link Grindr, Scruff, and Adam4Adam.

In response, the Health Department has officially tied the meningitis outbreak to the use of smartphone apps, warning all New York users to get vaccinated. Citing smartphone technology has proven a controversial move, with some in the gay community accusing the department of tacit homophobia and sententiousness.

They’re wrong. The department is seizing upon the only lead it has and using the same technology—hookup apps—to spread awareness of the outbreak. The strategy might seem suspect in light of the government’s hideously homophobic early response to the AIDS crisis. But this time around, there’s a key difference: The Health Department is on the gay community’s side. And it may have already begun saving lives.

The scariest thing about New York’s meningitis outbreak is its erratic spread. Typically, a meningitis outbreak is confined to a discrete physical location, like a dorm or a military barracks. The bacteria spread through social contact—anything from sharing a drink to sex—which is inevitable in a close, confined space. These traditional outbreaks are fairly easy to contain: High-risk individuals can be identified, vaccinated, and treated in a hurry, halting the spread of the disease.

The recent outbreak, in contrast, has taken place throughout New York City. Its victims are connected not by place but by activity—same-sex intimacy. And that intimacy is often facilitated by technology.

“In New York City, if you were to grab 100 gay men and say, ‘let me see your phone,’ the chances are they all have [a hookup app],” says Dr. Demetre Daskalakis, the incoming medical director of the Mount Sinai AIDS Program (and an intrepid gay health activist). “It may or may not be a direct driver of this infection. But it is a marker for people who are socializing in a network where the disease can be transmitted.”

That’s why in March, about 18 months after the outbreak began, the city’s Health Department has officially designated all users of such apps “high risk” and advised that they get vaccinated, possibly through the city’s free program. (Users with HIV are at especially high risk: Twelve of the 24 victims have been HIV-positive.)

“In the days of bathhouses, people were certainly having anonymous sex,” says Dr. Jay Varma, the deputy commissioner for disease control at the New York City Health Department. “But you had a location as an identifying characteristic,” so at-risk individuals could be tracked down with relative ease. But with the digital bathhouse of hookup apps, there’s no such identifying characteristic. And the apps don’t store records of the encounters, either—a privacy perk for users but a frustration for public health experts.

Despite the prominent role these apps have played in the outbreak, the Health Department has been careful not to judge their users—“we’re not warning people not to use them,” says Varma—or to criticize casual sex as a safety risk per se. It’s easy to understand why the department is treading lightly around the topic of gay sex. The LGBT community remains haunted by the AIDS crisis of the 1980s, particularly the government’s callous disregard for its victims. At the time, AIDS was thought to spread only through gay intercourse, a topic about which the Republican administration was dismayingly squeamish. Larry Speakes, Ronald Reagan’s press secretary, joked about AIDS in October 1982 in response to a serious question (“I don’t have it. Do you?”), and Reagan himself did not discuss the disease publicly until 1985. The government’s startling apathy toward AIDS victims was likely a direct result of Reagan’s homophobia: The president had run on a vehemently anti-gay platform, and, as his Surgeon General C. Everett Koop would later concede, he knew he would gain no political capital by helping gays. According to Koop, the administration actually issued an AIDS gag order, preventing Koop from discussing the disease during the first four years of its spread.

When New York’s Health Department cited hookup apps as a meningitis risk factor, some in the gay community saw history repeating itself. Why should the department single out men who have sex with men? Everyone, gay or straight, is technically at risk for the disease, and the fact that it’s affecting the gay community is a random stroke of bad luck. (According to Daskalakis, it might just as easily have hit the Hasidic community.)

It’s this focus on same-sex intimacy that rings alarm bells for Stephan Adelson, general manager of Adam4Adam, a gay dating and hookup company. Adelson believes the Health Department’s actions are simply another example of medical bias toward the gay community. “They seem to point blame for risk behaviors towards the technology used for communication,” Adelson says, “rather than at the behaviors that have negative health consequences.” He acknowledges that there have been “some small examples of collaboration” between public health officials and gay social networks, but claims that “there are many more examples of provocation.”

Anyone familiar with the AIDS crisis—and the government’s attendant abdication of responsibility to citizens it deemed unworthy of help—could understand Adelson’s reservations. But many of his competitors are taking an opposite view. Varma notes that most app companies have been “incredibly helpful” in working with the government to curb the disease and extremely open to collaboration. One app, Manhunt, helped the department distribute emails to members in the New York area notifying them of the outbreak. Another, Scruff, carries a link to the department’s warnings about meningitis and other public health hazards. And Grindr—the most popular hookup app—displays for all New York–based users a banner ad warning about the meningitis outbreak.

A screenshot of a health advisory in the Grindr iPhone app

Why would these companies collaborate openly with the Health Department after it officially implied that their apps fostered the spread of meningitis? “It’s enlightened self-interest,” says Varma. “They don’t want people who use their apps to die—they want them to keep using them.”

Whether you call it self-interest or altruism, those pragmatic maneuvers may have prevented the meningitis outbreak from rising to the level of a crisis. No new cases have been reported since February, and though some outbreaks die off on their own, Daskalakis is optimistic that the collaborative public health campaign may be playing a role in defeating the disease.* Notably, throughout the outbreak, hookup apps have remained as popular as ever—which doesn’t bother public health experts.

“If we eliminated all of these technologies,” says Varma, “would STDs go away? No. If not Grindr, some other evolution, technological or sociological,” would spur the behavior that leads to diseases like meningitis. “People are going to have sex—gay, straight, whatever. Our perspective is always trying to focus on healthy sexual behaviors.”

The Health Department, in other words, isn’t discriminating against gay men. Meningitis is.

This article arises from Future Tense, a collaboration among Arizona State University, the New America Foundation, and Slate. Future Tense explores the ways emerging technologies affect society, policy, and culture. To read more, visit the 
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Correction, May 30, 2013: This piece originally said the New York outbreak of meningitis is caused by a virus. Though some forms of meningitis are viral, this outbreak is a bacterial infection. (Return to the corrected sentence.)