Exporting Our Morality

As the world moves toward a global AIDS policy that will affect every heterosexual on the planet, our country is still hammering on homosexuals. Every day I watch the great river of AIDS news coverage, and on the average I still see more talk about gay risk than straight risk go floating by. It seems like moralistic anti-gay outrage is needed to fuel heterosexual AIDS awareness.

On its Web site, the CDC has a whole subpage devoted to women who have sex with women (WSW). When you follow the link, you find little of any significance. The CDC admits that it's really hard to find U.S. cases of female AIDS that have woman-to-woman sex as the sole risk factor. But they try! The agency says:

"Through December 1998, 109,311 women were reported with AIDS. Of these, 2,220 were reported to have had sex with women; however, the vast majority had other risks (such as injection drug use, sex with high-risk men, or receipt of blood or blood products). Of the 346 (out of 2,220) women who were reported to have had sex only with women, ninety-eight also had another risk -- injection drug use in most cases. Women with AIDS whose only reported risk initially is sex with women are given high priority for a follow-up examination. As of December 1998, none of these investigations had confirmed female-to-female HIV transmission. A separate study of more than one million female blood donors found no HIV-infected women whose only risk was sex with women."

Translation: After twenty years of the epidemic, there is no evidence that WSW sex is a dire health threat to the United States. So much for all those claims that "the gay lifestyle is unhealthy."

Other public-health sectors also stay obsessed with that same "medical moralism" about gay and bisexual sex. Yet our current national statistics (if we can believe them) clearly suggest that young heterosexual men are higher-risk, especially if they are black and Latino.

According to recent CDC figures, new AIDS cases declined for more populations, but the number of cases actually increased nationally among women (by two percent) and heterosexuals (by nine percent). Women account for over fifteen percent of cumulative AIDS cases nationally, and 21 percent of cases reported between July 1996 and June 1997. AIDS-related deaths among men fell by 25 percent, deaths among women only dropped by 10 percent. But AIDS-related deaths dropped much less quickly among African-Americans, Latinos, heterosexuals and injection drug users as compared to whites and men who have sex with men.

Most startling of all: The CDC estimates that nearly 50 percent of all new infections are now related to injection drug use. Fifty percent!

This being the case, why are some public-health and media operatives still so quick to go for the item or statistic about unprotected sex that includes the word "gay"?

San Francisco is a good example of a city where the Department of Public Health insists on a gay positioning for its AIDS scene, despite statistics that prove otherwise. According to the "Overview of Health Statutes," released last month by the SFDPH, there was an 83.9 percent decline in gay and bisexual AIDS cases between 1990 and 1999. So why is the SFDPH spending CDC money on a prime-time TV prevention campaign aimed at local gay men? How about using some of that money to reach the 50 percent who use IV drugs? Or those women or young heterosexual men at risk out there? A campaign like this may convince the moralistic crowd that "something is being done about the gay menace to American health," but it won't deliver the numbers that the right kind of campaign targeting drug users could deliver. Yet CDC funds are evidently available to repeat this gay campaign in other cities.

Public-health officials are sucking in their breath at reports that a new, more nasty strain of HIV is around -- one that is nonresponsive to protease inhibitors. According to the reports, one in five HIV-positive people now have the new strain. "It's a dangerous situation," said Brian Byrnes, director of education with the AIDS Action Committee of Boston. But so far the only worries I've seen in the news were about gay men catching this strain. Not about women or young heterosexual men. Or those 50 percent drug users.