Yes, I'm gay. I probably was since the day I was born. On my 21st birthday, I sort of had my debut. I came out to my parents. A little drama from mom, and some indifference from dad. An above-average coming out. Almost perfect.

Nine years later, two weeks before my 30th birthday, I found out... I'M HIV POSITIVE.

And so my story begins... I'm BACK IN THE CLOSET.

Saturday, October 31, 2009

Pyramid Scheme?

I think we all know the common but mistaken notion that HIV is a gay-only disease. Lately, even the Department of Health came out with statistics showing that HIV infections among MSMs, or men who have sex with men, have been increasing in the Philippines. Could it be the fact that Filipinas are more conservative that makes heterosexual transmissions less likely? Or could it just be that more homosexuals are getting tested than heterosexuals? Or it is just one complicated pyramid scheme?

Conservatism and unknown HIV statuses will be difficult to quantify. But since the philosopher and the scientist in me have been acting up again, I’m so tempted to try to figure out some idea as to why HIV is linked to homosexuals. So banking on pure logic, let me try to analyze.

For this analysis, let me zero in on sexual transmission. And for both heterosexual and homosexual acts, let me focus on insertive sex, meaning vaginal and anal sex, since these are considered higher risk acts as compared to oral sex and other forms. Let me also make the assumption that the people involved are not consciously protecting themselves from HIV. Also, let’s factor in the statistics that say that the possibility of an insertive partner passing the virus to a receptive one is ten times more likely as compared to the other way around.

Imagine starting out with one HIV-positive male at the top of a heterosexual pyramid. He has two choices, vaginal and anal sex. It may be safe to assume that vaginal sex is the more common practice, especially in a relatively conservative society such as that of the Philippines. And because of the potential of pregnancy, heterosexual encounters, unless done within the context of a relationship at least, will more likely be protected. As such, that lowers the chance of the top level male passing it on to the second level female, unless in cases of the less common unprotected anal sex or pregnancy-prone unprotected vaginal sex.

On the other hand, starting out with one HIV-positive male at the top of a homosexual pyramid, assumed in this case to be insertive as well, leaves him with no choice but anal sex. And with no risk of pregnancy, and the assumption of not consciously protecting themselves from HIV, he does not have any other reason to use protection. Let’s just say, if he really couldn’t stand the idea of a fudgy banana then he wouldn’t be go anywhere near that place.

So at this point, all factors considered, including the fact that anal sex is more risky because of the absence of natural lubrication in the anus versus that of the vagina, making the anus more prone to lacerations due to friction which then become possible sites for exchange of bodily fluids, it seems that there is a higher chance in the homosexual pyramid for the HIV to be passed to the second level as compared to that of the heterosexual pyramid.

From the second level of the heterosexual side, the infected female will always be a receptive partner, primarily because she has nothing to insert. Second level males on the homosexual pyramid, on the other hand, can be purely receptive, or able to swing between being a receptive and an insertive partner, more commonly termed as versatile. Thus, at minimum, the infected second level male on the homosexual side will be as efficient in transmitting the virus as an infected second level female on the heterosexual side. But, should the infected second level male on the homosexual side suddenly turn insertive, the chances then multiply ten times.

Am I making sense? Are you still with me? Or have you nosebled to death?

Anyways, if we go further down the pyramids, it should make sense that further transmission of HIV in the homosexual one will indeed be more likely. Could this analysis be a logical explanation to the higher risk of transmission of HIV among homosexuals? I don’t really know.

Now I’m not saying everyone should turn heterosexual to make it less likely to contract HIV. Nor am I saying that everyone should confine themselves to oral sex so they will be completely excluded from either of my pyramids. Because any which way you look at it, no matter how small of a risk a sex act is, it is still a risk. Even if you say that there’s only a one-in-a-million chance, I say you just might be that unlucky one. Comprende?

So, now tell me, are you willing to take that risk?

- republished from Positivism's Ka-Blog!


Ming Meows said...

masyadong mataas ang explanation. ang masasabi ko lang, mahaharot po tayo. yun lang.

Niel Camhalla said...

Do you have the statistics of women having multiple partners? That could also be a factor for a lower rate of heterosexual transmission.

"...the Department of Health came out with statistics showing that HIV infections among MSMs, or men who have sex with men, have been increasing in the Philippines."

I thought that this was because the major efforts for AIDS prevention campaign was directed mainly towards the female sex workers, hence lowering the rate for heterosexual transmission. I think it's time to direct some of that effort towards education of the gay community. But that could be a challenge especially in the closeted gay community.

PinoyPoz said...

@Meowie: Hahaha! Oo mas simple explanation mo!

@Neil: We have to keep in mind though that it is not just about multiple partners. Unprotected sex is unprotected sex, no matter how many you did it with. Neither is the at-risk heterosexual community confined to female sex workers. :-)

Manech said...

I think the permutations within homosexual relationship is a big factor. Consider 200 groups of people, half of which are completely heterosexual (male and female), while the other half completely homosexual. Just imagine how many possible couples the hundred gay guys can have as oppose to the fifty straight men and women.

Simply put, since, on our end, anybody can theoretically screw around with everybody else, the chance of infecting and being infected is higher.

And this kinda scared me a little.