Dangerousness of Male Homosexual Activity:

Some readers challenged my claim that there is "disproportionate and grave health danger from male homosexual activity" to men, compared to the danger from male heterosexual activity. I think this danger is tragic, and I very much hope that medical advances will lead to the danger's decreasing. All decent people should agree that it's tragic. (The bunk that we hear from some quarters about AIDS being God's punishment for homosexuality would suggest, as some wit put it, that lesbians must be God's chosen people, since their rates are apparently very low.) But it seems to me quite clear that this danger is very much there.

Reader Brian King, for instance, writes:

The fact is that male homosexuals having a one-night stand are more then twice as likely to practice safe sex then heterosexuals having a one-night stand. Given this, from a health point of view, you should think that it's preferable for a bisexual man to experiment with homosexuality, then to remain heterosexual. If the bisexual man in 2005 has sex with a male, that male has a 66% chance to demand a condom, while a female only has around a 33% chance to demand a condom. Ergo, pairing the bisexual with the male homosexual results in statistically safer sex then pairing the bisexual with the female.

Your reasoning is flawed because current STD rates are a comment on the safe sex practices of men 20 years ago. Gay men, in response to this crisis, have changed their behavior over the years. Now, gay men are the most informed people in the world about safe sex. . . .

[Quoting a study:] "From 1993 alone, nine different studies reported that two thirds of gay men were being primarily safe in locales as disparate as North Carolina, Britan, Australia, Pittsburgh, and San Fransisco. Yet, the national aids behavioral surveys surveyed heterosexual men and found: 'Among respondents with multiple partners, only 28% of men and 32% of women always use them (condoms) with secondary partners...in general, almost half the men and women with multiple partners never use condoms.' Another study compared gay and straight men and found gay condom use "twice as high.'" . . .

If gays are engaging in safe sex, that's wonderful. Nonetheless, even if one focuses on new (post-1993, and even more recent) HIV/AIDS cases among U.S. males, the majority are among gay men (if one uses means of acquisition as an admittedly rough proxy for sexual orientation). Gay men are only roughly 4% of the male population. This means that gay men are still disproportionately much more likely than straight men to get infected, by a factor of 20 or more. Even if gay men are using condoms more often, they may be engaging in riskier sexual behavior (receptive anal sex as opposed to insertive genital sex), and (probably more importantly) they're having sex with people who are much more likely to be infected. The CDC, for instance, reports that of new AIDS diagnoses among males in 2003 (which I suspect are mostly people infected after 1993), nearly 18,000 of the about 32,000 involved "male-to-male sexual contact" as the primary risk factor, and nearly 2,000 more involved "male-to-male sexual contact and injection drug use." Only a little over 5000 involved heterosexual contact as the primary risk factor. The Texas data for new HIV diagnoses (see PDF p. 12) among males in 2003 is similar: 1700 of the 3500 involved male/male sex, plus 150 more involved male/male sexual contact plus drugs as risk factors. 270 were from heterosexual contact, though another 1100 were other/risk not reported, so maybe there were more heterosexual acquisitions there.

Another reader suggests that it's a mistake to focus solely on HIV, and it's better to look at estimated lifespans — if gay male lifespans are on average the same as straight male lifespans (presumably controlling for various demographic factors), then that means that homosexual activity as actually practiced is on average less dangerous than heterosexual activity. Dr. Franklin Kameny (a leading gay rights activist of long standing) writes that "Homosexual sexual conduct is not dangerous, and its alleged danger is being MUCH over-stated and exaggerated here. As an 80-year-old gay man, sexually active for some 50 years and less so for well over a decade before that, and in good health for my age, I can certify to such lack of danger. Most of the founding fathers of the gay movement died in their 70s, 80s, and 90s."

A lifespan comparison study would be a great study to see, but I don't think it's ever been done right, and it would be very hard to do right. In the meantime, let's look again at the Texas data for (see PDF p. 12). The data suggests that there were about 50,000 HIV and AIDS cases among male homosexuals in Texas since 1980 (again, if you use method of infection as an admittedly rough proxy for the infected person's sexual orientation). The population of Texas is roughly 20 million; that leaves 10 million males; and if roughly 4% of Texans are homosexual or bisexual (working off the national percentage, that's about 400,000.

Naturally, we'd need to add to that 400,000 in some measure because of transience — there were people moving in and out of the state, and dying and being born since 1980, and since such people are counted in the AIDS and HIV cases, they should be counted in the population data as well (and unfortunately I don't know of any data that can tell us precisely how many people have lived in Texas in 1980, as opposed to those who live there now). But even if we double that, we still have a huge mortality / HIV infection rate — not at African levels, thankfully, but over 5% of all Texan homosexuals and bisexuals — and one that's likely underestimated, because presumably many people who have HIV haven't yet been tested and therefore aren't included in the HIV statistics.

So male homosexual activity does seem much more dangerous, on average, than male heterosexual activity. As I've said before, this danger is tragic. But it seems to me a grave mistake to deny this danger.