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The
Washington
Post
Number of Partners
Doesn't Explain Gay HIV Rate
By Steven Reinberg,
HealthDay Reporter
From
washingtonpost.com on the Web, September 13, 2007
THURSDAY, Sept. 13 (HealthDay News)
-- The HIV epidemic among gay men can't be explained by their number of sexual
partners, U.S. researchers report.
More than half the new HIV infections diagnosed in the United States in 2005
were among gay men, a team at the University of Washington, Seattle, noted.
In addition, as many as one in five gay men living in cities may be
HIV-positive.
But the sexual behaviors of gay and heterosexual men in the United States may
not be as different as most people think, the researchers said.
In fact, two surveys found that most gay men have a similar rate of sex with
unprotected partners compared to straight men or women.
"Just because gay men continue to have much higher levels of HIV, we can't jump
to the conclusion that that means that they are promiscuous or that prevention
messages aren't working," said lead researcher Steven Goodreau, an assistant
professor of anthropology.
In the study, Goodreau and a colleague, Dr. Matthew R. Golden, analyzed data
from two large population-based surveys. Using those figures, they estimated how
many sex partners gay men and straight men and women have, and what number of
gay men have either insertive or receptive anal sex, or both.
The report is published in the Sept. 12 online edition of Sexually Transmitted
Infections.
"We found that even if gay men behave the same way heterosexuals do -- in terms
of sexual partner numbers -- gay men would still have a huge HIV epidemic,"
Goodreau said.
Conversely, "even if heterosexual men behaved the way gay men do, they would not
have a huge HIV epidemic," he added.
In fact, for straight men and women to experience an epidemic of HIV infection
as widespread as that of gay men, they would have to have an average of almost
five unprotected sexual partners every year -- almost three times the rate of
the average gay male, Goodreau and Golden found.
So, why the higher HIV risk for gay men? "A couple of different things
could give gay men an overall higher risk for HIV than heterosexuals," Goodreau
said.
One reason HIV remains epidemic among gay men is that anal sex is much more
conducive to the transmission of HIV transmission than is vaginal sex, the
researcher said.
"That puts gay men at much higher risk overall," he said.
In addition, HIV transmission is more easily transmitted through the penis than
via the vagina or the anus, Goodreau said. Heterosexuals tend to maintain
the same role (insertive vs. receptive), while gay men can switch roles --
making the transmission of HIV more likely, he noted.
So, for gay men and straight men who have the same number of partners and have
unprotected sex, gay men are more likely to transmit and receive HIV, Goodreau
said. "That's why you can get huge epidemics among gay men and virtually
none among heterosexual men," he said.
To end the HIV epidemic, gay men would need to have significantly lower rates of
unprotected sex than those seen among the straight men, Goodreau believes.
One expert believes the study does have its flaws, however.
"The information here is mostly based on people's reports of their own
behavior," said Philip Alcabes, an associate professor at the School of Health
Sciences of Hunter College/City University of New York. "When trying to
make use of information on self-reported sexual behavior, we have to remember
that it isn't clear that anybody tells the truth," he said.
More information
For more on HIV, visit the
U.S. Department of Health and Human Services.
SOURCES: Steven Goodreau, assistant professor, anthropology, University of
Washington, Seattle; Philip Alcabes, Ph.D., associate professor, School of
Health Sciences, Hunter College/City University of New York; Sept. 12, 2007,
online edition,Sexually Transmitted Infections
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