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Homosexual Demography: Implications for the Spread of AIDS

Journal of Sex Research, Nov, 1998 by Christopher Hewitt

Before the viral cause of AIDS was known or detectable, behavioral
research had shown that being sick with AIDS or showing laboratory
signs of immune deficiency was associated with (1) a large number of
different sexual partners; (2) receptive anal intercourse; (3) the use
of bathhouses for sexual contact; (4) frequent infection with sexually
transmitted diseases, particularly gonorrhea, syphilis, and enteric
parasites (p. 11).

Gay liberation in the 1970s was accompanied by an explosion of gay
sexuality, especially in tolerant cities such as New York and San
Francisco, where gays concentrated. The director of the New York City
Department of Health describes the situation as follows:

By their own reports, many men had large numbers of sexual partners
annually, often numbering in the hundreds and even in the thousands.
Frenetic casual and anonymous sex was widespread among homosexual and
bisexual men. Bathhouses, back rooms of bars and clubs, and other
public settings such as erotic bookstores and movie "heaters were, in
effect, wide open. Sexual practices such as anonymous group sex,
sado-masochistic fantasies enacted with physical trauma, penetration of
rectal orifices with penises, fists, and blunt objects - all of these
practices and more were accompanied by extremely high rates of sexually
transmitted diseases and set the scene for the rapid transmission of
HIV once it appeared in the late 1970s. Rates of rectal and oral
gonorrhea in males soared (Joseph, 1992, p. 98).

But what of the other groups of men who had sex with men? How likely
were they to become infected, and to infect their female partners?
Situational homosexuals are a very low risk group, in part because they
have sex with men only intermittently. Most important, if Humphreys
(1970) is correct, they rarely engage in the most dangerous behaviors,
such as receptive anal intercourse. They are also unlikely to transmit
the HIV infection to their wives since they rarely have sex with them,
which is why they resort to sex with other men.

Repressed gays, if they completely repress their desires are, of
course, at no risk at all. Hunt (1974) reported very low annual
frequencies of five to six encounters among closeted homosexuals. Bell
and Weinberg (1978) found, however, that some married gays take several
years before leaving their wives, and during this time they often have
sex with men. The median length of marriage was 3 to 5 years, but 25%
lasted more than 10 years. Since there is generally an inverse
relationship between homosexual and heterosexual activity, with the
frequency of marital sex declining dramatically by the last year of
marriage, this considerably reduces the risk of the husbands infecting
their wives.

The concept of experimenting with homosexuality is somewhat ambiguous,
and may include anything from a single occasion to repeated activity
for two or three years. Homosexual experimentation usually involves
only a few experiences, if we accept the 1970 Kinsey survey data
(Klassen et al., 1989). Therefore, these young men are unlikely to
become infected, although any that are seem likely to transmit the
virus to their subsequent female partners.

In the early period, bisexuals were likely to have a high risk of
becoming infected and, since they also had an active heterosexual life,
were very likely to infect their female partners. However, behavioral
changes among this group, after they became aware of AIDS, are very
marked. One study comparing sexual behaviors among bisexuals in 1983
and 1988 found a dramatic decline in the number of same-sex partners,
anonymous sex, and group sex. Most important, those reporting that they
never engaged in receptive anal sex rose from 32% in 1983 to 82% in
1988 (Weinberg, Williams, & Pryor, 1994).

By paying attention to the social and behavioral differences between
men who have sex with men, rather than treating homosexuality as a
single phenomenon, it is possible to estimate more precisely the likely
spread of HIV among different groups of men, and from these men to
their female partners.(3)

(1) The survey was carried out by Teichner and Associates, who "started
with the premise that it would take 4,000 calls to reach 400 gays, both
nationally and in the Bay Area. That was based on the idea that 10
percent of the population is gay--the generally accepted figure
resulting from Alfred C. Kinsey's groundbreaking studies in the late
1940s. Instead, it took close to 27,000 calls to find the 800 people
needed to make both gay samples statistically significant" (Hatfield,
1989, p. A20). Since in the Bay Area sample, 10% acknowledged being
gay, this implies that 23,000 calls (27,000-4,000) had to be made to
find 400 gays nationally, or that the rate was 1.7% for both sexes
combined. Adjusting for the higher numbers of male homosexuals compared
to lesbians found in the survey (287 vs 113), this suggests a rate of
2.4% for men and 1.0% for women.

(2) The data on the age distribution of self-identified gay men in the
survey was provided by the New York Times.

(3) See Hewitt and Peverly (1996) for a computer simulation of the
sexually-transmitted spread of AIDS within the United States, that
divides the population into different categories on the basis of their
sexual behavior.

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