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Missive #11


AIDS: The Non-Issue, or
Yes, It IS Somebody Else’s Problem

By John Ross

Copyright 2003 by John Ross.  Electronic reproduction of this article freely permitted provided it is reproduced in its entirety with attribution given.

I was corresponding with a friend the other day, who has been a teacher for almost 40 years.  He enjoys my columns and was amused by a website I had referred to in last week’s offering.  The site archives pornography from days past, back to the late 1800s.  I linked to it to make my point that “morals” today aren’t any worse than they were in generations past.  My friend commented that in visiting the site, he noticed “no mention of the glories of pre-AIDS sex, when going bareback was far less hazardous.”

    The comment surprised me.  My friend is a math professor, and like every math professor I have ever known, is a rational, logical person.*  I told him that for straight males, things are no different now than they were in 1975, and that I had been considering doing a column about this very issue.  When I gave him the condensed version of my piece, his comment was “VERY interesting!   I hope you write it up, but add substantial documentation.”

    This is a weekly column, not something that’s going to determine my educational degree, so I’m not going to have the kind of numerical data here that a fellow going for summa cum laude would include in his hundred page Senior Thesis.  However, I will try to address all the various issues my friend brought up.

    First and most importantly, there are only two things that carry the AIDS virus: Infected blood and infected semen. 

    For all of the hand-wringing the tabloids put out when Rock Hudson kissed Linda Evans on Dynasty in the early ’80s, right before he announced he had AIDS, you don’t get AIDS from kissing.  You don’t get AIDS from shaking hands with people who have AIDS, or by using the same restroom facilities.  You don’t get AIDS from attending a picnic with HIV-positive guests and being stung by the same mosquito. (My “documentation” for this is that in largely gay communities with lots of mosquitoes, the incidence of AIDS in small children (who weren’t born with it) is the same as the places in America where there are few gays and no mosquitoes: zero.)

    To get AIDS, either infected blood or infected semen must be admitted into an uninfected person’s bloodstream.  AIDS has ravaged the male gay community because A) a small but results-influencing number of gay men have lots of partners (over 100 new ones a year in some cases) and B) the sexual activities that some of these very active men practice (such as fisting, and the simultaneous use of amyl nitrate) often cause tiny breaks in the soft tissue inside the rectum.  This provides a sure path for infected semen to enter the healthy partner’s bloodstream during the next anal sex session. 

Note:  I do not know what percentage of gay men fall into this “very active with many new partners” category.  I believe it varies by age and locale, but is in general a small fraction of the gay community.  The important fact is that a small number of high-activity members of a group can have a huge effect on the overall results.   Read the book The Tipping Point to learn about how small numbers of people can cause epidemics (not just medical ones) when those people have widespread influence. 

    Whether or not you find the subject unpleasant, these are facts.  To repeat, to get AIDS, either infected blood or infected semen must be admitted into an uninfected person’s bloodstream.  If the uninfected person is a heterosexual male, the only way he can get AIDS is from:

1. Blood transfusion in a country that does not screen blood adequately; 
2. Sharing needles with an infected IV drug user;
3. Having surgery where an infected surgeon cuts himself while operating and the surgeon’s blood gets in the open wound;
4. Engaging in some kind of sexual activity with an infected female partner where her blood somehow gets into her partner’s bloodstream.

    Since 1, 2, and 3 are not at issue here, that leaves number 4.

    First we need an infected female partner. This means probably an IV drug user.  Most SWFs you meet have never even thought about shooting up, but check the arms if you meet a girl with the Kate Moss look, or if you gravitate towards skanky women.  If the woman doesn’t shoot drugs, then we need her to have an infected male partner (either an IV drug user, or a truly bisexual man) who engages in rough enough sex with her to have caused a tear somewhere on her body that semen contacts. VERY few men play for both teams, and most women I meet aren’t at all interested in having rough sex with junkies or gay guys, but it’s still possible.  (No, I don’t have any numbers, but I would give very high odds that if you tested every single woman that you see in the next month who is wearing business clothes, 100% of them would come up HIV-negative.)

    So, for the sake of argument, assume we find an infected female that a clean, sober, straight man would want to have sex with (which is not completely impossible. (Rebekka Armstrong comes to mind.)  Now we need to figure out some way to get the infected woman’s blood into her male partner’s bloodstream. This is the tough one. I can’t think of any sexual practice I’ve EVER engaged in that could even possibly have had this result.  Can you?

       This is unscientific, but look into your own knowledge base:  Do you or did you ever know someone who died from hypoglycemia? (I knew one.)  How about a person struck by lightning? (Two for me.)  A person paralyzed in a vehicle accident? (Two again.)  Someone who died in the first Gulf War? (One.)  A person who died while he was swimming by being run over by a speedboat? (One.)  Killed in the crash of a commercial airliner? (Two.) How many non-IV-drug-using heterosexuals do you know with AIDS? I’ve never known a single one.**  So, logically, I should be more worried about being hit by lightning, being run over by a speedboat, or dying on a commercial flight than I should fear contracting AIDS from a woman. 

    More to the point, although I’ve never met a man who got AIDS from a female sex partner, I have known (and known of) quite a few men who were injured (and in two cases, killed) by a female sex partner through physical means.  The rational single man shouldn’t worry that the next hottie he spends the night with might have AIDS and give it to him–he should worry that she might be crazy and stick a kitchen knife in him while he’s asleep some night after she decides she’s upset with him for some imagined slight.

    Need another example from your own universe? Teen pregnancy is rampant, particularly in the inner city, so the kids are obviously having lots of unprotected sex. AIDS cases? Ask the health care professionals involved with these high school students about the actual data.  They will tell you the only AIDS cases they see are the children who have had it since birth, drug users, gay males, and once in a while the female sex partners of same.  

    But what about men who see prostitutes? you ask.  Well, if the prostitute is a call girl, she almost certainly takes excellent care of her most valuable asset (her body) and wouldn’t dream of doing any drug stronger than a glass of wine or a joint.  You won’t find her in her spare time shooting up–go look for her in the gym or Tae Bo class.  She won’t take on any man as a new client if he looks like he might be a druggie, and she will insist upon condom use with even the healthiest-looking customers unless she knows the client very well.  Gay men don’t hire call girls for $200 an hour, gay men prefer other gay men, many of whom need only the barest indication of interest to be agreeable to free sex.  A call girl is not going to be HIV-positive.  A crack-addicted streetwalker is another matter, of course, and if you troll the ghettos for these women, some (maybe most) of them are going to have AIDS.  But again we are back to the question of how is their blood going to get into your bloodstream?  I don’t say it’s impossible, just that it’s difficult to imagine the transmission route.  There is real danger, of course, if your preference for “female” professionals involves pre-op transsexuals performing anal sex on you.  This his how adult film director and performer John Stagliano says he became HIV-positive in Brazil, from a “gorgeous Brazilian he-she.”  Call me old-fashioned, but I believe such practices fall outside the “heterosexual” stipulation I made earlier.

    But what about Africa and Haiti? I hear you cry.  AIDS is rampant there, and they aren’t all gays or drug users.  The huge proportion are heterosexuals, right?  These countries are different from the United States, as are the transmission methods.  In Africa, an entire village may be inoculated with a single needle.  You may not believe this, and think that surely the information about how AIDS is spread must have ended this practice by now, but it has not.  Second, many if not most of the poor in Africa and Haiti have open wounds and sores on their bodies, including on their genitals.  In these cases, heterosexual sex can easily transmit the virus, to and from either gender. 

    There have been calls in the media for Americans to help with the education of Africans regarding how to stop spreading the AIDS virus.  In Africa it is widely if not universally believed that a man with AIDS can be cured by having sex with a virgin.  Even Newsweek has reported this sad (and ironic) fact.  Given this kind of belief system, suggesting that it is the duty of Americans to educate Africans about AIDS strikes me about like advocating shooting out all the streetlights so the sun won’t come up in the morning.

    For those of you who want to read some recent medical literature on this issue, http://www.hopkins-aids.edu/publications/report/may00_1.html is a VERY interesting report that somewhat downplays the fact that male circumcision may drastically reduce the female-to-male transmission of AIDS.  In a study of 187 uninfected men in one village in Africa whose partners had AIDS, 29% of the 137 uncircumcised men in the group became infected, while NONE of the 50 circumcised men did, after having sex with their infected female mates over a period of FOUR YEARS.  Circumcision is almost certainly another critical factor in explaining the very low female-to-male transmission ratio in America.

    This might seem like an excellent way to slow the spread of AIDS in Africa, but [from the article] “In his accompanying editorial, Dr. Cohen suggests that ‘countries where HIV infection is endemic or epidemic might well consider promoting circumcision for its public health benefits. However, the promotion or institution of a procedure that has profound cultural implications, risk of complications, and benefits that are realized only decades later, represent a formidable public health and political challenge.'”  Translation: You’re shooting out the streetlights again.

    Bottom line, the practice of unprotected sex for the average straight American male is fraught with various perils (gonorrhea, chlamydia, genital warts, herpes, and unwanted pregnancy, to name a few) but these are exactly the same risks as in the pre-AIDS days. For the straight male, nothing is new.  AIDS is a non-issue, from a personal risk standpoint.  (My point here is not that female-to-male AIDS transmission never occurs, but rather that it is much less common than plenty of other things we risk every day that don’t cause us to lose any sleep.)

    Most men and women either already understand this, or immediately grasp it when it is explained to them.

    I know a lot of men and women who regularly have unprotected sex. Many of the men are over 40 and have had vasectomies, so the pregnancy issue is gone. Most of the men I know don’t engage in one-nighters but prefer serial monogamy.  They’ll stay with the same woman so long as her behavior is acceptable.  Their reasoning is that if they get chlamydia etc. from their partner they’ll know about it before having sex with anyone else, and get corrective medical attention.  I cannot find fault with this logic.  To take the opposite extreme, I know straight people (of both genders) in their twenties and early thirties who have lots of sex partners, including lots of one-time “hook-ups,” and have been doing this for over a decade.  Guess what?  None of them are HIV-positive, either.  I know this because an AIDS test is required these days for the insurance that these people have.

   It may have once been an arguable strategy to tell the public that “everyone” was at risk of getting AIDS, to get more funding/support for research, but it’s just not true.  This may not be Politically Correct, but it’s the truth and an awful lot of men and women are behaving accordingly.

John Ross 9/7/2003

*At least where anything involving numbers are concerned.  I’ve known some math profs with some pretty strange beliefs in other areas.

**I once met a man who received tainted blood in a 1983 transfusion following a gunshot wound, but that isn’t relevant to the discussion at hand.

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