"HIV is a gay disease." This is a myth that refuses to die. Misinformation, fear, ignorance and media sensationalism continue to fuel this myth in America. For every one person like me trying to tell the truth about HIV transmission, there seems to be a dozen shrieking, simpleminded, natural-born dullards with a staggering inability to grasp reality.
HIV is not a gay disease. Nope. All of us are at risk in getting HIV from unsafe sex or other modes of blood to blood contact, like sharing needles. Television talk shows and all those fundamentalist/conservative/family values groups are chock full of flaky, clueless lightweights who made up their minds twenty years ago that HIV is a product of the so-called "gay lifestyle" and it's God's wrath on homosexuals. These poor creatures are so invested in this myth that they are incapable of hearing the truth. They continue to spew their self-righteous, delusional feculence to the detriment of all humanity. They are, in fact, shameless, insidious prevaricators driven solely by their irrational loathing and fear of homosexuality.
The truth is that 16,000 people worldwide are infected with HIV every single day (World Health Organization). They are not all gay. In the United States, HIV infection rates have held steady at 40,000 per year, but recent preliminary data suggests those rates are on the rise. They are not all gay. African-American and Hispanic women together represent less than one-fourth of all U.S. women, but account for more than three-fourths (76%) of AIDS cases among women in this country (CDC Update, 6/98). Women now account for 43% of all HIV infected people over the age of 15 (New York Times, 11/98). In just over a decade, the proportion of all AIDS cases reported among adult and adolescent women tripled, from 7% in 1985 to 22% in 1997 (CDC Update, 6/98).
Further, more than 30 million people around the world are living with HIV or AIDS, and by the year 2000 that figure will reach 40 million (UNAIDS/World Health Organization, 12/97). They are not all gay. AIDS now kills more people worldwide than any other infection, including malaria and tuberculosis.
Sure, whites and people with higher incomes and insurance in the United States are gaining greater access to HIV therapies and there is a drop in AIDS-related deaths. But African-American, Hispanic and young white women are being exposed to HIV through heterosexual sex with male partners who use intravenous drugs. As a result, HIV rates are climbing disproportionately among these populations in America, and these women often do not have access to effective medical care. In Africa, Asia and India, HIV has always been and remains and overwhelmingly heterosexual disease. (Note to the purveyors of the "AIDS Is God's Wrath on Homosexuals" theory: Your deity appears to be somewhat inept at determining sexual orientation; it occurs to me that your God bears a more striking resemblance to bumbling Aunt Clara on those Bewitched reruns.)
Women contract HIV. Women get AIDS. So let's talk about what's going on. The female genital tract (vagina) is normally populated by a flora, helpful bacteria like those "active cultures" listed on yogurt containers. This flora (lactobacilli) produces hydrogen peroxide to kill invading organisms and lower the pH level in the vagina, making it less hospitable for foreign organisms. A loss of lactobacillli lowers the natural protective barriers and leads to an increased risk of infection with sexually transmitted diseases. Recent studies conducted by the American Society of Microbiology confirm this. In a study of 144 female sex-workers in Thailand, those with loss of vaginal flora were twice as likely as those with a normal balance of vaginal organisms to contract HIV. A study of 657 female sex-workers in Kenya showed that the risk of contracting gonorrhea rose by 78% in women with low levels of lactobacilli.
Maintaining a natural balance of flora/lactobacilli is beneficial to all women; it is a natural defense against STDs. However, it's difficult for a variety of reasons. For instance, taking a course of antibiotics to combat an infection somewhere else in the body often wipes out vaginal flora, often leading to a yeast infection (an inflammation that makes women more susceptible to STDs). If a woman must take antibiotics, she should also begin taking an acidophilus supplement to replace lactobacilli (even eating plain yogurt several times a day is helpful).
Another practice that has a strong negative impact on vaginal flora is douching. Numerous studies concluded douching destroys helpful vaginal flora. In fact, Dr. Sharon Hillier of the University of Pittsburgh, a founder of vaginal lactobacilli research, says, "Douching has no known medical benefit, but there is a $100 million industry out there selling perfumed water to women, and they fall for the advertising." Dawn Averitt, founder of WISE (Women's Information and Service Exchange) believes that women living with HIV should heed Dr. Hillier's advice and avoid douching.
Some other things to remember: spermicides won't kill HIV; they're designed to kill sperm. And then there's nonoxynol-9, the spermicide that does kill HIV in test tubes. Allow me to point out that vaginas are not test tubes. There is no evidence that nonoxynol-9 protects against HIV transmission outside the controlled, laboratory test tube model. In fact, several studies suggest it can actually irritate the delicate skin of genitals, thus promoting HIV infection. Nor does nonoxynol-9 seem to decrease your chances of getting chlamydia or gonorrhea. In fact, researchers see more vaginal irritation and genital lesions in women who use nonoxynol-9. I say avoid the stuff. Have your partner wear a latex condom and use a water-based lubricant that doesn't contain nonoxynol-9.
Speaking of condoms, there is an alternative for women. It's called Reality, a female condom. I don't have to tell you how many guys balk at wearing a condom, so this gives women a real choice. The Reality condom is inserted into the vagina. It comes with an explicit set of instructions and an 800 number for questions. It's a little funky looking, but well worth a try.
Finally, a disturbing survey emerged from last summer's 12th World AIDS Conference. A University of Illinois study indicated that lesbians aren't necessarily engaging in risk reduction activities. Of 82 lesbians who reported vaginal sex within a six month period, only four used a barrier. Of 18 who had vaginal sex with a man in that interval, only one-third used a condom. I can almost hear you saying, "Oh, lesbians don't get HIV or STDs." Another myth. Lesbians who share dildos or vibrators risk infection. Lesbians who engage in unprotected sex with men risk infection. Straight, bisexual or lesbian, the risk is real.