Educating men who have sex with men (MSM) about risky sexual practices holds limited promise. A disproportionate number of MSM experience sexual drive that borders on obsession-compulsion, making them largely oblivious to the risks. Besides, several sexual practices engaged in by MSM couldn't be indulged in safely. For instance, how can one rim another while avoiding the risk of parasitic intestinal infections? A condom for the tongue and oral cavity is not feasible since those into rimming are partly into the taste of the anorectal region. Rectal wash-outs (see here) prior to rimming may help somewhat, but this is typically not an available option when MSM cruise restrooms, public parks, and bathhouses. Several MSM would rather get over the fear of becoming infected with HIV, by seeking the virus from a “daddy,” otherwise anxiety will diminish their sexual pleasures. Given that the bathhouse phenomenon requires only a small minority of extremely promiscuous homosexuals, it should be clear that no educational campaigns will eliminate it, given that a substantial minority of male homosexuals continue to persist with risky sexual practices in spite of good knowledge of the risks (see here).
Consider Fig 1, which shows a young male homosexual with HIV-associated muscle wasting. He did not have AIDS at the time the photograph was taken. Several HIV-positive male homosexuals experience muscle wasting and are prescribed anabolic androgenic steroids to maintain muscle mass. As a result, HIV-positive male homosexuals often end up looking better (more muscular) than homosexual men without HIV infection, thereby attracting more partners toward themselves and spreading their HIV to others.
In the interest of public health, all bathhouses and their surrogates need to be shut down for good. One can be certain that if bathhouses and their surrogates are shut down, the displaced homosexuals will be looking for sex in public places. Therefore, one would need to crack down on MSM having sex in public places, too. The MSM arrested as a result will invariably end up having sex with others inmates. Therefore, it would be necessary to isolate them when they are not being supervised in jail. Eventually, when they are released from jail, they will go back to looking for sex in public places, and sooner or later, get arrested again. This cycle will repeat itself until a homosexual who is arrested, say, for the seventh time for violating public lewdness laws is given the choice of mandatory five years in prison with no possibility of sexual contact with another inmate or probation if he agrees to seek psychiatric treatment for sexual compulsion. This is the only way most of the promiscuous homosexuals could be made to seek treatment for sexual compulsion; educational approaches are useless since those experiencing obsession-compulsion do not have the same level of restraint that normal people do.
Fig 1: A 19-year-old HIV-positive male homosexual with muscle wasting. He did not have AIDS at the time the photograph was taken.1
- ^ A. Wisdom, D. A. Hawkins, Diagnosis in color - sexually transmitted diseases (Mosby-Wolfe, London, ed. 2nd, 1997).