- NEW YORK (Reuters
Health) - Only a small percentage of new HIV infections among homosexual
men are linked to 'high-risk' unprotected anal sex, researchers report.
This suggests that 'lower-risk' practices, such as unprotected oral sex,
may now be driving the epidemic.
- "It is important to communicate clearly that these
practices are not without risk,'' according to investigators led by Dr.
Eric Vittinghoff of the University of California, San Francisco, and the
San Francisco Department of Public Health. Their findings are published
in the August 1st issue of the American Journal of Epidemiology.
- More than 10,000 new HIV infections continue to be recorded
among US gay and bisexual men every year. Previous studies have identified
unprotected receptive anal intercourse as posing the highest risk for HIV
transmission among gay and bisexual men. Other practices, such as protected
receptive anal sex and unprotected receptive oral sex, are assumed to be
of lower " but not zero " risk.
- Vittinghoff's team examined the sexual histories of 1,583
sexually active homosexual and bisexual men living in San Francisco, Denver,
or Chicago in 1992-1994. All of these men regularly provided the investigators
with detailed reports on the nature and frequency of their sexual contacts.
- Forty-nine of the men seroconverted (became infected
with HIV) over the course of the study period.
- According to the researchers, "unprotected receptive
anal intercourse accounted for only 15% of all reported sexual activity''
among newly infected men. "Providing that subject reporting was accurate,
this implies that a majority of new infections took place via other types
- Unprotected receptive anal sex remained the riskiest
of sexual contacts among homosexual men, with a per-contact risk for HIV
infection of 0.82% when performed with partners infected with HIV.
- The investigators point out that this risk is double
that of being stuck with a needle used previously by a person infected
with HIV. Furthermore, cumulative risks of infection linked to unprotected
anal sex can increase to very high levels as the number of contacts rise.
"Prevention messages must continue to emphasize the importance of
avoiding this type of contact,'' the authors conclude.
- Other sexual acts carry a lower - but still significant
- risk, according to the researchers. Risks for condom failure mean that
the use of a condom during receptive anal sex reduces per-contact infection
risks to 0.18%, not zero. Unprotected receptive oral sex, as well as protected
and unprotected insertive anal sex, were each associated with a 0.06% per-contact
risk of HIV infection, according to the authors.
- Vittinghoff and colleagues speculate that "as (these)
lower-risk practices become more common, they may play a larger role in
propagating the epidemic.''
- SOURCE: American Journal of Epidemiology 1999;150:306-311.
- From Gordon Tibbles <firstname.lastname@example.org 8-4-99
- The question not being asked, nor being reported upon
is the related medical treatment for parasitic and fungi infestations spread
during anal and oral sex. Which are subsequently treated with antibiotics
to the extent that these infestations no longer respond to the prescriptions.
Many of these individuals also have immune systems ravaged by drug and
alcohol abuse. It is not HIV that causes AIDS. AIDS is the end result
of opportunistic diseases attacking an already weakened system. AIDS is
not a disease, but rather a catchall for a number of debilitating afflictions
arising from the aforementioned activities and treatments.