HIV has very low infectivity, yet there is an AIDS epidemic. Why? Promiscuous behavior increases the likelihood of HIV infection, but does not entirely explain the spread of HIV among male homosexuals.
Anal sex plays a major role in HIV infection. For instance, in a sample of 930 British homosexuals, penetrative sexual partners more accurately measured HIV risk than mere number of partners.1 The dangerousness of anal sex follows from the thin epithelial tissue that forms the rectal wall compared to the vagina, which not only has a thick wall but a muscular tube surrounding the vaginal passage, too. Rectal bleeding not infrequently accompanies anal sex. Rectal bleeding, especially bleeding from anal warts (not uncommon among homosexuals) considerably increases the risk of HIV transmission.
Some specifics of anal eroticism among homosexuals such as rectal insertion of large objects and prolonged rectal stimulation (see sexuality section) often leave tiny tears in the rectal wall (anal fissures). Upon getting anal fissures, rather than refraining from inserting objects in their rectum, homosexuals use butt plugs or rectal dilators to help accommodate penises or other objects (see here).
Homosexuals that frequent bathhouses can easily exceed the promiscuity of many prostitutes. Consider the population of all sexually active homosexual men. We can compute the average rate of homosexual contacts for this group. Within this group, a small number of homosexuals, such as those that frequently visit bathhouses, will have a rate of homosexual contact considerably in excess of the average for the entire group. Thompson has shown that an effective doubling of the average sexual contact rate among homosexuals could result from 5% of homosexuals having an activity level 7-8 times that of the less active 95% of homosexuals.2, 3, 4, 5, 6, This is the bathhouse phenomenon, which initiated the AIDS epidemic in the West.7 Click here to download a pdf file that describes a simplified model of the bathhouse phenomenon.
The bathhouse phenomenon is typically observed in big cities since homosexuals often migrate to big cities, looking for sex. For instance, New York City accounted for 20% of the AIDS cases in the U.S. during the first decade of the epidemic.8 Likewise, HIV infection was first diagnosed among Swedish MSM in Stockholm, followed by those in Malmo and Gothenburg (two major cities in Southern Sweden), as well as in the urbanized counties west of Stockholm.9
Even if white heterosexuals were as promiscuous as male homosexuals, the incidence of anal sex per sexual encounter would be considerably less because the men would not take anything into their rectum and most penetration of women would involve the vagina. Additionally, compared to male homosexuals, considerably fewer heterosexual women desire or insert penises, foreign bodies, or fists in their rectum with the frequency or duration per episode characteristic of male homosexuals; i.e., in the event of anal sex, their anorectal lining is more likely to be intact. It is obvious that white heterosexuals could not have initiated the AIDS epidemic in the First-World, and do not maintain it either. The AIDS epidemic in the West results from an unholy trinity that occurs in a minority of male homosexuals, namely that of extreme promiscuity, anal sex, and the specifics of anal eroticism that compromise the integrity of the anorectal lining. The behavior of African-Americans is related more to an endemic among themselves than to the epidemic among Americans in general.
- ^ Hunt AJ, Davies PM, Weatherburn P, et al. Sexual partners, penetrative sexual partners and HIV risk. Aids 1991;5(6):723-8.
- ^ Thompson JR. Deterministic versus stochastic modeling in neoplasia. Proceedings of the 1984 Computer Simulation Conference, Society for Computer Simulation. New York: North-Holland, 1984;822-5.
- ^ Thompson JR. Empirical model Building. New York: John Wiley & Sons, 1989;79-91.
- ^ Thompson JR. AIDS: the mismanagement of an epidemic. Comput Math Appl 1989;18:965-72.
- ^ Thompson JR. The United States AIDS epidemic in First World context. In: Arino O, Axelrod D, Kimmel M, eds. Advances in Mathematical Population Dynamics: Molecules, Cells and Man. Singapore: World Scientific Publishing Company, 1998;345-54.
- ^ Thompson JR, Tapia RA. Nonparametric function estimation, modeling and simulation. Philadelphia: SIAM, 1990;233-43.
- ^ Thompson JR. Is the United States country zero for the First-World AIDS epidemic? J Theor Biol 2000;204(4):621-8.
- ^ Thomas PA, Weisfuse IB, Greenberg AE, et al. Trends in the first ten years of AIDS in New York City. The New York City Department of Health AIDS Surveillance Team. Am J Epidemiol 1993;137(2):121-33.
- ^ Blaxhult A, Bottiger M. HIV epidemiology in Sweden from socio-geographic aspects. Scand J Infect Dis 1989;21(6):627-32.