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AIDS biggest killer of men in SF

Oct 20, 2006

Hey Dr. Bob, thanks so much for all of your wonderful help and support. I just read over the article that recently went up on the site about AIDS being the biggest killer of men in SF. In addition to your clinic, do you do any work with prevention education, especially among gay men? I'm all for gay rights, equality, etc. but I sometimes get a little cynical when I hear that gay men are still disproportionately getting infected with this disease here in the US and other developed parts of the world. What gives? I think gay men need strong role models that don't just focus on sex and pleasure bc it's their "right" to sleep around with whoever they want. Sorry for ranting, but sometimes I really wonder why, in a place like SF, where there was so much pain and tragedy associated with the disease, people knowingly put themselves at risk and/or have no self-control over their dicks. Now, I know that most cases worldwide are heterosexual, but that's to be expected since the vast majority of the world is straight. It just seems like gay men are not trying to break down the stereotype that all they do is have sex and are completely irresponsible with their sex lives. It's very frustrating. What are your thoughts?

Response from Dr. Frascino


This is a complex topic and a full discussion of the issues related to this tragic phenomenon is beyond the scope of this forum. What I will point out is that the notions that all gay men do is have sex and that they are completely irresponsible with their sex lives are indeed stereotypes. And like most stereotypes, they are untrue. You are correct: the vast majority of folks infected with HIV worldwide are heterosexual. I should also point out that unprotected sex is at least as common, if not more common, in the heterosexual population as in the gay population. So why do gay men still account for a disproportionately large percentage of total as well as new HIV infections? Primarily because HIV is more prevalent in the gay community, so someone having unprotected sex is more likely to have an HIV exposure in the gay community than in the straight community. Next, anal sex is a more efficient way to transmit the virus than vaginal sex. And finally, there are other contributing factors, such as the crystal methamphetamine craze in the young gay community. Crystal meth lowers inhibitions and increases the likelihood of unsafe sexual practices. These are only a few of the factors involved. Added to this is our failure to provide appropriate HIV-prevention information to specific target populations. Dubya's abstinence-only sex education policies are fueling the epidemic while pacifying his evangelical rightwing base. Take a read-through Michelle Goldberg's "Kingdom Coming." It's very "enlightening" and scarey!

Dr. Bob

thrush and testing
add on to my earlier question/statement...

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