Oral-anal
There is an extremely high rate of parasitic and other
intestinal infections documented among male homosexual practitioners because of
oral-anal contact. In fact, there are so many infections that a syndrome called
"the Gay Bowel" is described in the medical literature.33 "Gay bowel
syndrome constitutes a group of conditions that occur among persons who practice
unprotected anal intercourse, anilingus, or fellatio following anal intercourse."34
Although some women have been diagnosed with some of the gastrointestinal infections
associated with "gay bowel," the vast preponderance of patients with these conditions
are men who have sex with men.35
"Rimming" is the street name given
to oralanal contact. It is because of this practice that intestinal parasites
ordinarily found in the tropics are encountered in the bodies of American gay
men. Combined with anal intercourse and other homosexual practices, "rimming"
provides a rich opportunity for a variety of infections.
Men who have sex with
men account for the lion's share of the increasing number of cases in America
of sexually transmitted infections that are not generally spread through sexual
contact. These diseases, with consequences that range from severe and even life-threatening
to mere annoyances, include Hepatitis A,36 Giardia lamblia, Entamoeba
histolytica,37 Epstein-Barr virus,38 Neisseria meningitides,39
Shigellosis, Salmonellosis, Pediculosis, scabies and Campylobacter.40
The U.S. Centers for Disease Control (CDC) identified a 1991 outbreak of Hepatitis
A in New York City, in which 78 percent of male respondents identified themselves
as homosexual or bisexual.41While Hepatitis A can be transmitted by
routes other than sexual, a preponderance of Hepatitis A is found in gay men in
multiple states.42 Salmonella is rarely associated with sexual activity
except among gay men who have oral-anal and oral-genital contact following anal
intercourse.43 The most unsettling new discovery is the reported sexual
transmission of typhoid. This water-borne disease, well known in the tropics,
only infects 400 people each year in the United States, usually as a result of
ingestion of contaminated food or water while abroad. But sexual transmission
was diagnosed in Ohio in a series of male sex partners of one male who had traveled
to Puerto Rico.44
In America, Human Herpes Virus 8 (called Herpes
Type 8 or HHV-8) is a disease found exclusively among male homosexual practitioners.
Researchers have long noted that men who contracted AIDS through homosexual behavior
frequently developed a previously rare form of cancer called Kaposi's sarcoma.
Men who contract HIV/AIDS through heterosexual sex or intravenous drug use rarely
display this cancer. Recent studies confirm that Kaposi's sarcoma results from
infection with HHV-8. The New England Journal of Medicine described one cohort
in San Francisco where 38 percent of the men who admitted any homosexual contact
within the previous five years tested positive for this virus while none of the
exclusively heterosexual men tested positive. The study predicted that half of
the men with both HIV and HHV-8 would develop the cancer within 10 years.45
The medical literature is currently unclear as to the precise types of sexual
behavior that transmit HHV-8, but there is a suspicion that it may be transmitted
via saliva.46
