On AIDS, gay men, and sex

[Random Gal]

I have seen a number of FSTDT entries lately regarding a World Health Organization study regarding AIDS.

Apparently, the HIV infection rate is up lately among men who are having sex with other men, and as a result the WHO is recommending that all such men start taking anti-retroviral medications as a precaution. The responses are a predictable condemnation of homosexuality from the fundies.

The response is unwarranted, certainly. But that's not what I want to discuss.

There is a stereotype being promoted not just by the fundies, but by the WHO, and what seems like every anti-fundie commentator as well. This stereotype is that "gay male sex" and "anal sex" are one and the same. The only difference in how these groups approach the issue is their differing beliefs in how HIV is spread.

The fundies, and the health organizations believe that HIV is spread much more easily by anal sex than by other forms of sex. The people trying to counter the fundies do not share this belief and cite other methods of contamination as a defense. Yet I believe the point is correct; anal sex risks contact with blood more often than in most other sex acts, which makes spreading HIV easier.

However, where everyone, not just the conservatives but the liberals as well, fails, is in assuming that gay male sex is anal sex. The behavior listed by the WHO and regarded as worthy of banning blood donations by the Red Cross as well, is gay male sex. Anal sex is the real risky behavior and the one that should be listed in both cases above, but it isn't. And incidentally, the fundies are partially right in calling for a particular type of sexual behavior to be discouraged; they are only wrong in that anal sex should be discouraged instead of homosexuality.

While it is true that gay/bi males tend to contract HIV more often than other groups, it is because gay/bi males tend to have more anal sex, not because they are gay/bi males. (This is also why lesbians are the lowest-risk group for HIV; they are the least likely to have anal sex) It is not exactly helping matters either that many gay men equate being gay with having anal sex as well.

I am a bisexual man who has chosen not to engage in anal sex (largely because of its inherent risks), yet I am unfairly considered part of a high-risk group because I am assumed to be taking part in a risky behavior due to my orientation. I should also note that heterosexuals who have anal sex should also be considered a high-risk group, but there is no call for a ban on blood donations by them.

(as a side note, I do not believe anal sex should be illegal, merely discouraged, and not because it is inherently immoral, which it isn't, but only because it is a health risk)

[Ultimate Paragon]

I always found that suspicious too.

[Cataclysm]

And is anal sex by heterosexual couples any less risky? I heard that they aren't restricted from donating blood because the percentage with AIDS is lower, so even though the risk of transmission is the same. Either way, the policy shouldn't make exceptions.

[Søren]

Bug chasers.

Just leaving that there.

[Nemo]

I'm hardly an expert on human sexuality here, but it seems like frequent, irresponsible sexual encounters are more to blame here. I remember a few years back, a friend and I were discussing how the drinking age of 21 might actually be encouraging irresponsible drinking in young people. Partially, this stems from people not being taught how to drink responsibly. And partially, it would stem from them having to hide their drinking, and then going overboard when they do manage to do it. The same could apply to same sex encounters; many gay individuals are shamed, and as such live secret lives in which they are more prone to excess.

What are your thoughts on this guys?

[Sylvana]

I thought medicine had removed the concept of "gay" and "heterosexual" sex from transmission discussions.
To my understanding they have become quite specific with the terminology. The WHO might just be behind on the new terminology.

HIV prevalence comes and goes. As HIV incidence increases we begin larger HIV awareness campaigns. These campaigns work, and the incidence of HIV decreases. As the incidence of HIV decreases people start feeling the campaigns are more of a nuisance and so they stop being as careful, which in turn leads to another increase in HIV infections. Those committing the higher risk actions would see the greatest jump in infections. Unfortunately that is generally male on male anal sex in most first world countries. In third world countries it is male on female vaginal sex.

Nemo is right though in some regards. People who have something to hide tend to engage in high risk activities. As s result they are less likely to get tested, out of fear and shame. They shouldn't feel shame but they do because society views such activities as shameful. As s result they never discover their own infection, and their activities can generally result in them passing it on before finding out. Additionally, in the first world, far too many people particularly white middle class, live in a delusion that HIV is something that happens to gays, other people, or poor people, and never them. Hence they engage in unprotected sex leading to their own infection.

[Random Gal]

I thought medicine had removed the concept of "gay" and "heterosexual" sex from transmission discussions.
To my understanding they have become quite specific with the terminology. The WHO might just be behind on the new terminology.

When I donate blood at the Red Cross, they still ask "Are you/have you had sex with a male who has had sex with another male, even once, since 1977?" and will not allow people to donate if the answer is yes. Their definition of sex includes oral sex in addition to anal and vaginal.