ST Forum: Figures speak for themselves: Practising gays have higher risk of HIV (May 15, 2007)

Wednesday, May 16, 2007

ST Forum

May 15, 2007

Figures speak for themselves: Practising gays have higher risk of HIV

I REFER to Mr Siew Meng Ee's letter, 'Doctor using selective material to justify own conclusion' which was written in response to my letter, 'Homosexuality: disease or immutable trait?'. I thank him for his views that he has expressed.

Let me clarify what I have written. It is true that not all people who contract Aids are homosexuals and not all homosexuals have Aids.

Let's look at the statistics from the US' Communicable Diseases Centre (CDC) - in the year 2005, there were 45,669 cases of newly-diagnosed Aids cases of which 18,938 were from male-to-male sexual contact.

This means that 41.5 per cent of cases of Aids were transmitted by male-to-male sexual contact.

The estimated number of cases diagnosed through 2005 (this means the number of people at the end of 2005 having HIV) is 988,376.

The estimated number of this same group of people having Aids through male-to-male sexual contact is 454,106. This means that of the 988,376 diagnosed cases of Aids in the US, 45.94 per cent of these cases were contracted through male-to-male sexual contact.

The number of homosexuals in the US has been estimated to be 2.8 per cent ('the most widely accepted study of sexual practices in the United States is the National Health and Social Life Survey which found that 2.8 per cent of the male, and 1.4 per cent of the female, population identify themselves as gay, lesbian or bisexual.

See Laumann, et al, The Social Organization of Sex: Sexual Practices in the United States (1994).

This amounts to nearly four million openly gay men and two million women who are identified as lesbian.

This means that 2.8 per cent of the population in the US accounts for 41.5 per cent of the new cases and of the number of HIV cases in the States, 2.8 per cent of the population accounts for the 45.94 per cent of the people having Aids. When relative risk is calculated, this means that a person who engages in male-to-male sexual contact has a 2,400 per cent higher chance of getting Aids.

If we look at the Singapore figures for 2005, 2.8 per cent of the population accounted for 31 per cent of the new cases of HIV infection, 2.8 per cent of the population accounted for 22 per cent of the number of people diagnosed with HIV.

I believe the figures speak for itself, that practising homosexuals have a far higher risk of HIV with its numerous complications and increased mortality.

There are two main reasons for this.

1) The rectum is physiologically unsuitable for anal intercourse. Its fragility leads to increased risks of trauma during anal intercourse, accounting for the increased risks of infection, both bacterial and viral including HIV.

2) Homosexuals are sexually more promiscuous.

A 1978 study found that 75 per cent of homosexual white males claimed to have 100 male sex partners, 15 per cent 100-249 male sex partners, 17 per cent 250-499 male sex partners, 15 per cent 500-999 male sex partners and 28 per cent more than 1,000 male sex partners (Alan P. Bell et al, Homosexuality: A Study of Diversity among Men & Women pg 308 Table 7. New York 1978).

In a local publication, People Like Us: Sexual Minorities In Singapore, gay activist Alex Au Wai Pang wrote frankly about homosexual sexual values being different from that of heterosexual males. Both of Mr Au's articles in the book talk frankly about how many homosexuals are more promiscuous than their heterosexual counterparts.

With regard to whether homosexuals can change their sexual orientation, this is an issue that arouses the emotions of all concerned. As gay activists see it, if someone can change his or her sexual orientation, then homosexuality can be considered a lifestyle choice and thus does not qualify to be considered as a protected class under the law.

As why Dr Robert Spitzer's study was quoted, some background information as how this study came about is useful. Dr Spitzer is one of the most renowned psychiatrists in the US, who is called the father of DSM.

In fact, he was one of the key psychiatrists in deciding that homosexuality should be removed from the DSM. However, in the early 2000s, during an APA meeting, Dr Spitzer met some picketers who claimed that they had changed their sexual orientation.

Intrigued, he decided to do a study as, at that time, his view was that homosexuals could not change their behaviour.

He genuinely wanted to know if some homosexual men and women could change from homosexual to heterosexual, and that he wanted science to guide him. Certainly, with more than 275 publications to his credit, this esteemed scientist at Columbia University was more than able to conduct such a study.

With the limitations that are inherent to all such studies, Dr Spitzer employed the best rigours available for such research protocols.

His sample size was larger than those in previous studies. He was very detailed in his assessment and carefully considered the affective components of the homosexual experience.

Any bias in interview coding was virtually eliminated by near-perfect interrater scores. He limited his pool of applicants to those reporting at least five years of sustained change from a homosexual to a heterosexual orientation.

His structured interview clearly described how the participants were evaluated. His entire set of data is available for scrutiny by other researchers.

If his study methods are considered flawed, then all the original research material used by APA to justify the original change in classification is also flawed using the same argument.

Dr Spitzer's conclusions are simply this: Based on his study, there is evidence to suggest that some gay men and lesbians are not only able to change self-identity, but are also able to modify core features of sexual orientation, including fantasies.

His study was not designed to give the percentage of homosexuals that have changed. Dr Spitzer felt the percentage was low as it was difficult to find subjects willing to be interviewed.

One of the few rational, scientific commentaries on the Spitzer study was offered by Scott L. Hershberger. Dr Hershberger, a distinguished scholar and statistician, elected to respond in a Commentary to the Spitzer research (Hershberger' s article was published in the same issue of the Archives of Sexual Behavior as the Spitzer study was) by conducting a Guttman scalability analysis. This is a scalogram to determine whether or not reported changes occur in a cumulative, orderly fashion.

Dr Hershberger' s conclusion: 'The orderly, law-like pattern of changes in homosexual sexual behaviour, homosexual self-identification , and homosexual attraction and fantasy observed in Dr Spitzer's study is strong evidence that reparative therapy can assist individuals in changing their homosexual orientation to a heterosexual orientation.

'Now it is up to those sceptical of reparative therapy to provide comparably strong evidence to support their position. In my opinion, they have yet to do so.'

The Schidlo and Schroeder study, funded by the National Lesbian & Gay Health Association, was originally titled 'Homophobic Therapies: Documenting the Damage.'

The title was later changed to 'Changing Sexual Orientation: Does Counseling Work?' because they found that some people reported benefits to reorientation therapy including a change of sexual orientation. Biasness will be an issue as the aim of the National Lesbian & Gay Health Association is to prove that homosexuals are normal and healthy and reparative therapy is harmful.

There are thousands of testimonies of homosexuals who have changed their orientation. Even in Singapore there are testimonies of homosexuals who have changed their sexual orientation.

The point is that even if one person can change, then homosexuality is not an immutable trait and we should not deny anyone the right to change.

Dr Alan Chin Yew Liang