Not all gay men have AIDS

First posted on my other website 2009 June 22.

If you followed a link to this page, you might want to use the "Revisions" tab to find the version that was cited. I've been editing, and some of the sections might be moving around. I grew up in a conservative Chinese Christian household, but my parents were very supportive when I came out. They scheduled a visit to NJ so they could hear me sing with the New Jersey Gay Men's Chorus, where they were happy to meet my boyfriend. My mom said she remembered one of the songs because she and my father danced to it in the 1970s. They met through ballroom dance. The pastor at the old church they visited gave a sermon against same-sex marriage saying that gay men have a life expectancy of 40 years and that average healthcare costs would decrease if we did not have the problem of gay men with AIDS. I asked to talk to the pastor, who responded hoping to find common ground. I disagree with the idea that we should ban same-sex marriage because people have HIV. My guess is that we agree we can and want to reduce HIV-related suffering by helping people to make informed choices about sexual behavior. Sexual contact exchanges bodily fluids, which can transmit HIV and other infections. The most effective way to prevent sexual transmission is abstinence, but barrier protection, awareness of the HIV status of the partners involved, and promiscuity are all factors that affect risk. I believe we prevent transmission by creating an open culture that encourages asking questions, learning about the varied risks associated with different forms of sexual contact, and having conversations with partners about condom use, fidelity, and blood testing.

Links

Condoms and blood testing (a) increase safety, but (b) do not guarantee it. It's everyone's responsibility to understand both of these features. Researchers at the Centers for Disease Control and Prevention estimated relative risks associated with various sexual activities.

• Varghese, Maher, Peterman, Branson, Steketee, Sex Transm Dis. 29(1): 38--43 (2002). http://www.ncbi.nlm.nih.gov/pubmed/11773877 (Click on the Lippincott, Williams, and Wilkins link on that page to access the text).

Trying to change someone's sexual orientation is not productive. From personal experience and knowing lots of gay people, I imagine that trying to change someone's sexual orientation is probably about as effective and at least as painful as trying to force someone to change religion.

• "All major national mental health organizations have officially expressed concerns about therapies promoted to modify sexual orientation. To date, there has been no scientifically adequate research to show that therapy aimed at changing sexual orientation (sometimes called reparative or conversion therapy) is safe or effective. Furthermore, it seems likely that the promotion of change therapies reinforces stereotypes and contributes to a negative climate for lesbian, gay, and bisexual persons. This appears to be especially likely for lesbian, gay, and bisexual individuals who grow up in more conservative religious settings." American Psychological Association accessed 2009 June 23. http://www.apa.org/topics/sorientation.html#whatabout

Most gay men do not have HIV/AIDS.

• Based on CDC publications, a blogger estimated, "there are roughly 635,000 gay or bisexual men living with HIV/AIDS. This is about 12.0% of the gay male population. . . . These numbers are estimates." Box Turtle Bulletin 2008 July 31 accessed 2009 June 23. http://www.boxturtlebulletin.com/the-prevalence-of-hiv-in-the-gay-community
• You can perform a similar calculation using information from the CDC yourself. "MSM made up more than two thirds (68%) of all men living with HIV in 2005, even though only about 5% to 7% of men in the United States reported having sex with other men." Centers for Disease Control accessed 2009 June 23. http://www.cdc.gov/hiv/topics/msm/index.htm The prevalence of HIV among men is described at the CDC link below accessed 2009 June 23. http://www.cdc.gov/hiv/topics/surveillance/united_states.htm

Do all gay men get AIDS and have a life expectancy of 40 years? When I hear people say that all gay men have AIDS and have a life expectancy of 40 years, I feel I should provide a link describing the Family Research Council. I would be hesitant to cite content from the FRC as legitimate research.

• The Family Research Council cited a report as evidence that "committed" gay men have 8 partners outside the relationship each year. Their conclusion was not supported by the report because the "purpose of the study was to look at how AIDS is transmitted," so "all monogamous couples were specifically excluded from the study." Box Turtle Bulletin 2008 July 21 accessed 2009 June 23. http://www.boxturtlebulletin.com/2008/07/21/2386
• In a 2001 paper, researchers who studied life expectancy among gay men during the 1980s and 1990s note that their research has been misused by organizations such as the Family Research Council to oppose gay civil rights. The researchers described their 1997 research, "we estimated that nearly half of gay and bisexual men currently aged 20 years would not reach their 65th birthday. . . . In contrast, if we were to repeat this analysis today the life expectancy of gay and bisexual men would be greatly improved. Deaths from HIV infection have declined dramatically in this population since 1996. As we have previously reported there has been a threefold decrease in mortality in Vancouver as well as in other parts of British Columbia. . . . we do not condone the use of our research in a manner that restricts the political or human rights of gay and bisexual men or any other group." Emphases mine. Hogg, Strathdee, Craib, O'shaughnessy, Montaner and Schechter, "Gay life expectancy revisited," International Journal of Epidemiology 30(6):1499 (2001). http://ije.oxfordjournals.org/cgi/content/full/30/6/1499
• Look at the faces of the men with whom I sing on the website of the New Jersey Gay Men's Chorus. If gay men typically died around age 40, many, if not most of the chorus members wouldn't be part of the chorus. http://www.njgmc.org/

Culturally-related factors can contribute significantly to HIV transmission rates and prevalence. The transmission rate among men who have sex with men varies wildly among ethnic groups. At the order-of-magnitude level, the prevalence of HIV/AIDS in the gay male population is similar to the prevalence in the general adult populations of some sub-Saharan African countries.

• "The high numbers of new HIV infections in young, black MSM are of great concern because the number of new infections was approximately twice that of young white and Hispanic/Latino MSM of the same ages (between 13 and 29 years)." Centers for Disease Control accessed 2009 June 23. http://www.cdc.gov/hiv/topics/surveillance/resources/qa/subpopulation.htm
• " . . . HIV/AIDS does not impact the gay community uniformly. For example, African American men who have sex with men are ten times as likely to be HIV positive than white MSM." Box Turtle Bulletin 2008 July 31 accessed 2009 June 23. http://www.boxturtlebulletin.com/the-prevalence-of-hiv-in-the-gay-community

I think opposing same-sex marriage is an unproductive way to address the transmission of HIV. It might make the problem worse. The press release below describes such speculation, though I withhold comment regarding the research itself, which I have not yet read.

• "'Intolerance is deadly,' Mialon said. 'Bans on gay marriage codify intolerance, causing more gay people to shift to underground sexual behaviors that carry more risk.'" "Study Links Gay Marriage Bans to Rise in HIV Rate," Emory University, 2009 June 4 accessed 2009 June 23. http://www.emory.edu/home/news/releases/2009/06/study-links-gay-marriage-bans-to-rise-in-hiv-rate.html

Associating HIV/AIDS with gay men could lead to unnecessary HIV transmission among straight people by giving them an exaggerated sense of safety.