CDC, anal sex, and risk

Related to a couple of previous posts, I thought it would be helpful to review what The Centers for Disease Control (CDC) has to say about anal sex and risk.

Can I get HIV from anal sex?

Yes. In fact, unprotected (without a condom) anal sex (intercourse) is considered to be very risky behavior. It is possible for either sex partner to become infected with HIV during anal sex. HIV can be found in the blood, semen, pre-seminal fluid, or vaginal fluid of a person infected with the virus. In general, the person receiving the semen is at greater risk of getting HIV because the lining of the rectum is thin and may allow the virus to enter the body during anal sex. However, a person who inserts his penis into an infected partner also is at risk because HIV can enter through the urethra (the opening at the tip of the penis) or through small cuts, abrasions, or open sores on the penis.

Not having (abstaining from) sex is the most effective way to avoid HIV. If people choose to have anal sex, they should use a latex condom. Most of the time, condoms work well. However, condoms are more likely to break during anal sex than during vaginal sex. Thus, even with a condom, anal sex can be risky. A person should use generous amounts of water-based lubricant in addition to the condom to reduce the chances of the condom breaking.

Working with clients, I provide this information and accentuate the risks involved. This is true for men and women, no matter what their erotic orientation.

For information purposes, Laumann et al found that 25% of men and 20% of women reported anal sex. Among gay and bisexual men, 76% of the survey respondents had experienced insertive anal intercourse and 82% receptive. This was in 1994, I suspect the numbers are higher among straights now.

To me, this means that straights need the CDC information and some gays do not engage in anal sex (although they need the information as well). Assumptions that all gay males do this routinely, while often correct, are not always true. Frequency of such activities and with whom are important factors for health care professionals to ask about and they are the determinants of disease, not sexual attractions per se. My view is that sexual promiscuity in gay men owes more to being male than being attracted to the same sex. Of course, this is not proven but it fits my clinical experience and observations better than assuming the reverse.

There are people of both sexes and all sexual orientations who are at high risk for acquiring and spreading STDs. These individuals often have significant emotional needs and profit from interventions that are individually suited to their needs.

Take away point: People who do not manage their intimate lives well are at higher risk for disease and emotional distress than those who do.

  • Jimmy Gatt

    HIV is bogus.

    HIV does not cause AIDS.

    AIDS is not a sexually-transmitted disease.

    AIDS is not a conspiracy theory; it is merely bad science run amok.

    I WILL NEVER HAVE AN HIV TEST EVER!

  • anon

    Jimmy, I’d suggest that, firstly, it’s not at all helpful to simply assert an opinion about the cause of AIDS without supporting it with evidence or argument, and secondly, this website is not a particularly good place to have a discussion about the cause of AIDS anyway.

  • Jimmy Gatt

    Anon,

    My assertion is merely the entrance into a much larger discussion. Of course I can support my assertions with loads and loads of evidence. Furthermore, I am able to discuss that evidence with critical analysis.

    The fact is that AIDS is so ingrained in our culture that merely stating “HIV does not cause AIDS” is more offensive than claiming that Jesus is not the son of God. AIDS has full support of both the Left and the Right (but for different reasons).

    I understand that you think that this website is not a good place to have a discussion about the cause of “AIDS”. I believe that this website is not a good place to promulgate the orthodox view of AIDS without a skeptical view being expressed as well.

    If you’re interested in discussing this with me, then I am happy to share with you everything I know. If you listen to me with an open mind, then I will convince you never to have another “HIV test”. It is long and complex, but it is necessary.

    Sincerely,

    Jimmy Gatt

  • Ivan

    Is sexual promiscuity in gay men *only* because they are men, or is there much more to it?

    Ivan.

  • Ivan

    Dr Throckmorton,

    My question is for you :)

    Ivan.

  • http://www.wthrockmorton.com Warren Throckmorton

    I do not think this blog is a very good place to debate the basic issues of HIV/AIDS. I know they are not the same thing but there are pretty good scientists that are spending lots of time and money on the issue. This is not my field, I have to trust what I read on this and try to be discerning. If Jimmy would like to put up some links to material supporting his position, that would be fine but I do not want to get into point – counterpoint here in the comments section of this post.

    One reaction I have is that I cannot imagine what would be wrong with having an HIV test.

    Ivan – I have known many gay or ex-gay clients who were not promiscuous that I tend to think that there is not a bathhouse compulsion that accompanies same sex attraction. But on the other hand, I think men in general are just more wired toward sexuality than women. Research supports this across cultures.

  • Ivan

    Why among gay men, but not among straight men? This is my question. I understand having a wife is part of this, but surely it is not the defining factor for a monogamous man?

    Ivan.

  • http://www.patheos.com/blogs/warrenthrockmorton/ Warren

    Factors that seem to relate to promiscuity are religious affiliation, gender, disordered childhood, drug/alcohol abuse and opportunity. Religious people are less promiscuous so a prediction based on this would be that religious gays would be less promiscuous. However, I have seen no research on this. Hmmm, something that needs done?

    Having a wife or a partner who demands fidelity as a condition of allowing access to intimacy is a huge part of this. Women are valuable constraints on men in many ways, this one being one of them.

    Now, inasmuch as child abuse and family disruption associate more with homosexuals (there is a weak effect, but a real one in my opinion), some of the variance could be explained by this developmental factor – but not all or even most, in my opinion.

    Now, put together these factors in a person: male, no or weak religious beliefs, disordered background, and access to others who are similar in these factors and it should be no surprise that sex would become sport. Toss in some drugs/alcohol as fuel for the fire and you have a conflagration.

    Putting promiscuity off on homosexuality as the sole factor cannot be supported, in my opinion.

  • http://www.exgaywatch.com Timothy Kincaid

    Warren,

    That would be the “Men Are Dogs” theory? :)

    I don’t disagree that those factors all may be relevant to promiscuity. And while I think that heterosexuals (both men and women) are far more promiscuous and homosexuals (both men and women) are far less promiscuous than is believed and claimed by anti-gay activists, I do agree that the CDC risk factors should definitely be considered. And it is probably true that of the four groups, homosexual men probably are the most promiscuous (though this certainly cannot be considered a defining characteristic).

    Incidentally, the CDC fails sometimes in accurate information by erring on the side of caution. While it is true that HIV can be contracted through the urethra, the actual instances of this are very very few. (I’m looking for a source on just how few but it’s hard to narrow down the search).

    Research shows (http://www.sciencedaily.com/releases/2005/01/050124004711.htm) that the most significant factor in those who seroconvert by being the active member in penetrative sex (anal or vaginal) is circumcision. This, supposedly, helps explain why Africa and Asia have such huge rates of infection in heterosexual populations.

  • http://www.exgaywatch.com Timothy Kincaid

    Jimmy Gatt,

    I value your opinions on HIV to exactly the same extent that I value your opinions on “the gay community”.

  • Ivan

    Would you agree with this paper Dr Throckmorton – It sounds like you may be saying something similar to this:

    Bailey, J. M. (1999). Homosexuality and mental illness. Archives of General Psychiatry, 56, pp. 883-884.

    Ivan.

  • http://www.exgaywatch.com Timothy Kincaid

    I guess another form of prevention of the contraction of HIV/AIDS would be to convert to Conservative Judaism.

    Yesterday the movement decided to allow the blessing of same-sex commitment ceremonies and allow gay rabbis — but disallow anal sex between men.

  • Jimmy Gatt

    Warren stated:

    “I cannot imagine what would be wrong with having an HIV test.”

    I cannot imagine what is RIGHT about an “HIV test”:

    1. There is no such thing as an “HIV test”. There is no test that can detect HIV. What are called “HIV tests” actually test for antibodies.

    2. Antibodies are promiscuous and cross-react with other antigens. The AIDS church has admitted that cross-reactivity of antibodies can yield false positives.

    3. The “AIDS tests” admit that there is no gold standard for HIV, and, thus, no established standard for determining the presence or absense of HIV in human blood. The reason there is no gold standard is because HIV has never been isolated. Presense of reverse transcriptase does NOT count as “isolation” because RT is not unique to retroviruses.

    4. The results of the “HIV test” are interpreted according to risk group. A “positive” test for a black man may bery well be a “negative” test if it were to have come for a white woman.

    5. The proteins that are claimed to come from “HIV” could not have because there is no gold standard. They are merely assumed to have come from HIV.

    6. The “HIV proteins” have stayed the same despite the virus having “mutated” many, many, many times.

    7. The “HIV test” is actually a combination of ELISA, ELISA + WB, or two ELISAs, depending on where you are geographically. A “postitive” result in one location might well have been “negative” if it were followed up with a “confirmatory” WB test.

    8. The “HIV proteins” that indicated a “positive” test are not standardised in the WB. A “positive” WB test in the USA may vey well be “negative” in Australia.

    9. The 99.999% accuracy readings are bogus because the “accuracy” is determined by repeating the same test over and over again and declaring it “accurate” if it gives the same result. The only real way to determine accuracy is to compare the test against the gold standard. There is no gold standard becase HIV has never been isolated.

    And, despite all of this that I can rattle from MEMORY, the “HIV test” is used as the basis of telling someone that they are going to die a slow, painful death along with having their name added to a federal registry.

    DO NOT HAVE AN HIV TEST!


CLOSE | X

HIDE | X