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Studies re: HIV transmission in Gay men

May 12, 1997

Having been a volunteer in the late 1980s for the N.Y. Blood Center study on sex-practices and HIV transmission amongst Gay men, I am wondering how many other similiar studies have been done since the emergence of AIDs and to what degree they arrived at conclusions similiar to the N.Y. study - namely that HIV transmission amongst Gay men appeared to be almost exclusively the result of passive, anal intercourse? I am aware of a few that do support this conclusion, and suspect that most do so also. However, I am confused as to why the message to Gay men on transmission remains so confusing. Unprotected anal intercourse remains a preferred sexual practice amongst a very high minority of Gay men in my experience (maybe even majority). I believe this is so because no one in the Gay sex-education establishment is sufficiently familiar with the studies or sufficiently confident of their capacity to simplify the message for the general gay male population. I feel a great disservice is done to the Gay male community by not advising them straightforwardly and SIMPLY that nearly all of the scientific studies done suggest unambiguously that unprotected anal intercourse is the way gay men transmit HIV. I believe that if the message was simplified, more younger gay men would Get It. It seems to me that the unambiguous message of the unqualified dangerousness of unprotected passive anal intercourse for gay men is often lost and obfuscated by meandering and unfocused discussions of possible sexual transmission practices and issues (saliva, oral, etc.) for which which there seems to be very little scientific evidence suggesting a risk of transmission. I believe that if gay men were SIMPLY and CLEARLY advised that the scientific evidence overwhelming suggests that unprotected passive anal intercourse is how gay men contract HIV, and that gay men who avoided the practice ran little risk of contracting HIV, a more substantial percentage of gay men (particularly less educated and younger gay men) would willingly change their sexual behavior accordingly and the incidence of HIV transmission would noticeably decline. In any event, I do not think any harm would come from so simplifying the message.

Response from Mr. Sowadsky

Hi. Thank you for your question. There are many myths regarding transmission of the HIV virus. For example, it is a common myth that giving oral sex to a man is low risk for HIV and other Sexually Transmitted Diseases (STD's). WRONG! There have definitely been cases of HIV transmission through giving oral sex. There have been numerous reports in the medical literature linking giving oral sex and HIV infection (but the risks from receiving oral sex are very low!). And there have definitely been cases of transmission of other STD's (like Gonorrhea), through giving oral sex. Giving oral sex is not low risk! But it is less of a risk as compared to intercourse. So giving oral sex is risky, but intercourse is even riskier.

Another common myth is that the insertive partner during intercourse (either vaginal or anal) is low risk for HIV and other Sexually Transmitted Diseases. WRONG! There have definitely been cases of transmission of HIV and other STD's, where the insertive partner became infected from the receptive partner. Over 15 years of worldwide data have shown that the insertive partner during intercourse is at high risk of HIV infection. During intercourse (vaginal or anal), the insertive partner is at high risk, and the receptive partner is at even higher risk. Note that when the other partner is infected, neither partner is at low risk.

Let's look at HIV transmission in greater detail. To understand why both partners are at risk of infection during intercourse, we need to review the basic requirements for HIV transmission to occur.

In order for infection to occur, 3 things must happen:

Requirement #1) You must be exposed to pre-cum, semen, vaginal secretions, blood, or breastmilk, AND

Requirement #2) The virus must get directly into your bloodstream through some fresh cut, open sore, abrasion etc., AND

Requirement #3) Transmission must go directly from 1 person to the other very quickly.....the virus does not survive more than a few minutes outside the body.

Let's now apply this information to anal intercourse specifically. In regard to the receiving partner:

Requirement #1:

Lesbians and most recent stats on HIV risk

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