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A medical question. I've often heard it said that one is far more likely to contract HIV as a result of gay sex than straight sex. Is this statement true purely as a result of the incidence of HIV infections in the gay male community (i.e. the proportion of gay men who have HIV is vastly higher than the proportion of straight people) - or is there also a mechanical component that makes the virus more likely to spread via certain sexual activities than others? That is to say, supposing Alice and Bob both have HIV, and they've both had it for the same duration, neither are taking PReP. Is Carl more likely to contract HIV as a result of having anal sex with Bob than as a result of having vaginal sex with Alice? Moreover, if Carl had anal sex with Alice, would he have the same risk of contracting HIV as he would if he had anal sex with Bob? Lastly, does it make a difference who the receptive partner is - is Carl more or less likely to contract HIV from Bob if he's the bottom than if he's the top, or does it make a difference?
The mechanical elements are a major part of it, but the social element is probably larger. I just finished And the Band Played On, which was excellent, and I have an effortpost in my head about the characters that pop back up like bad nickels.
But something that runs through the early years of AIDS is the process by which they kept trying to shut down, or at least soften the activity in, Bathhouses in SF and NYC and other cities, and they didn't do it. There is simply no hetero equivalent, none, for that kind of normalized, regular, random, high partner count sexual activity outside of a brothel. Not all gay men used the bathhouses, but basically all knew people who did.
While there are heterosexuals who engage in that kind of sexual athleticism, they tend to cluster together: whores and whoremongers, rock stars and groupies, etc. So for a random heterosexual, you're fairly comfortable that your partner has no connection to that kind of thing. For a random homosexual in the 1980s, unless you're talking to a virgin the odds are that he's no more than a few degrees of sexual separation from the bathhouses.
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