The risk of gay sex

AIDS is a disease that does not distinguish between race, religion, sex, or national origin. Like all diseases, it is opportunistic, and thrives when behaviors provide perfect incubation and vector situations. The promiscuity that characterized gay sex in the late 1970s and 1980s was the perfect petri dish for the disease to transition from obscure illness to world epidemic. It was never a “gay disease” — ’cause diseases do not indulge in identity politics — nor was it a “punishment from God” — which implies an intelligence directing the disease towards people of a certain identity. It was simply a disease that benefited from behaviors most common to gay men. And once it got its start, of course, it was able to find other niches — drug users, hemophiliacs, prostitutes, etc.

This little AIDS lecture is not just about history. Sadly, it’s also about the present, since gay sexual practices again seem to be strengthening for release on the general population another disease that, while not deliberately selecting people based on their sexual identity, nevertheless thrives when opportunity presents:

A new variety of staph bacteria, highly resistant to antibiotics and possibly transmitted by sexual contact, is spreading among gay men in San Francisco, Boston, New York and Los Angeles, researchers reported Monday.

The study released online by the journal Annals of Internal Medicine found the highest concentrations of infection by the drug-resistant bug in and around San Francisco’s Castro district and among patients who visit health clinics that treat HIV infections in gay men in San Francisco and Boston.

The culprit is a form of MRSA, or methicillin-resistant Staphylococcus aureus, a bug that was once confined to hospitalized patients but, since the late 1990s, has been circulating outside medical settings, afflicting anyone from injection-drug users to elementary school students. A strain called USA300 has been a leading cause of MRSA infection in this decade, and an exceptionally drug-resistant variant of it is now on the loose, researchers say.

The study estimated that 1 in 588 residents living within the Castro neighborhood 94114 ZIP code area is infected with that variant, which is resistant to six types of commonly used antibiotics. The risk of contracting this difficult-to-treat bug is 13 times greater for gay men than for the rest of the city’s population, researchers found.

“We probably had it here first, and now it is spreading elsewhere,” said Binh An Diep, a researcher at San Francisco General Hospital and lead author of the report. “This is a national problem, and San Francisco is at the epicenter.”

The germ typically causes boils and other skin and soft-tissue infections and, despite its resistance to some drugs, is still treatable by surgical drainage and several classes of antibiotics. What is unusual in this case is the high percentage of infections – up to 40 percent – occurring in the buttocks and genitalia.

Although researchers have stopped short of declaring this form of staph a sexually transmitted disease, the infections are found where skin-to-skin contact occurs during sexual activity.

I would urge gay men to remember the hard-learned lessons of the AIDS era. Then, flush with their new political identity, they rebuffed any attacks to restrain their sexual practices on the ground that those efforts were homophobic and that the only thing to be done was for the government to throw money at the disease in the hopes of a quick remedy. Sadly, AIDS was resistant to any quick remedies and the time wasted on those political battles — even as epic sexual practices flourished unchecked — meant the difference between a possibly controllable endemic disease and a worldwide epidemic disease. It also meant the deaths of tens of thousands of gay men because, politics notwithstanding, in America they were always the most likely to be the disease’s victims.

With that history in mind, the first thing for gay men to do now is to resurrect the safe sex practices that they put into place when they realized the government couldn’t save them, practices that seem to have fallen by the wayside as the AIDS specter retreated before useful, life-prolonging symptomatic treatments. Otherwise, we may find that an endemic disease that could have been fairly easily squashed will become an epidemic disease that places us back in the bad old days before antibiotics. And if you need a reminder of what those bad old days were, remember that the British poet Rupert Brookes died during WWI, not from a war injury, but from an infected mosquito bite.