|
Hi CDC,
Your page at http://www.cdc.gov/hiv/pubs/faqs.htm does not cover an important and controversial subject, which I believe it should cover. Your own statistics indicate that the race of one's sexual partner (especially Black or Negro) is a significant risk factor in the transmission of HIV. I have been following your HIV/AIDS Surveillance Reports for several years, and there is a consistently higher risk (a factor of about 14) that a heterosexual Black male will have HIV than is the case for a heterosexual White male. A public service agency should report that fact. There is no need to overly politicize it, of course, but it is irresponsible and dangerous to the public health not to report it. Although the statistical evidence is in your Reports, few people will do the work necessary to understand the extent to which their risk increases when they choose a Black sexual partner. Please amend your FAQ page accordingly, and in your other publications you should indicate the racial risk factors for sexually transmitted diseases, including AIDS, explicitly and as prominently as other risk factors are indicated. Jerry Abbott jna55@hotmail.com |
|
Dear CDC/HIVNET,
Thank you for your reply to my earlier statement that the CDC should report race as a risk factor in HIV infection. I believe that your position should be reconsidered. You are right insofar as you said that individual behavior determines the risk for that person. What your position neglects is a means by which potential future sexual partners of that person can assess his or her own risk of becoming infected. HIV infected persons are not always honest about their condition, and some of them might conceal the facts in order to have a good time. A woman, whom a bisexual man solicits for sex, has no easy way of ascertaining the accuracy of his statements about his HIV status or about his past sexual activities. By the time she learns that he is HIV positive, she might have contracted the infection herself. It should be sufficient for her to know that he has a bisexual orientation. She should not require a detailed knowledge of how many partners he has, or the frequency he has sex with them. Her risk of getting HIV from sexual contact with a bisexual man should be posted in a prominent way by the CDC. While it is certainly true that bisexual men are not all equally at risk for getting HIV, that some bisexual men engage in high-risk activities more commonly than others do, a concern for the health of heterosexual women should prompt the CDC to underscore the risk to a woman of having sex with "bisexual men" in general. Likewise for race. A woman can often surmise a man's bisexual orientation by the way he looks at other men or by the comments he makes in regard to other men. Race is even more immediately apparent, of course, but the obviousness of race is irrelevant to the question. A Black man, like a bisexual man, might falsify his sexual history in order to have a good time. A woman, whom a Black man solicits for sex, has no easy way of ascertaining the accuracy of his statements about his HIV status or about his past sexual activities. By the time she learns that he is HIV positive, she might have contracted the infection herself. It should be sufficient for her to know that he is Black. She should not require a detailed knowledge of how many partners he has, or the frequency he has sex with them. Her risk of getting HIV from sexual contact with a Black man should be posted in a prominent way by the CDC. While it is certainly true that Black men are not all equally at risk for getting HIV, that some Black men engage in high-risk activities more commonly than others do, a concern for the health of non-Blacks should prompt the CDC to underscore the risk to a woman of having sex with Blacks in general. The principle involved is well-understood in the medical profession; it is the reason that all persons in a group suspected of infection are placed in quarantine until the exact status of each of them can be determined by thorough testing. A suspected group can be as large as a country, and in the case of plague, cholera and yellow fever it is accepted practice to target whole countries for quarantine, regardless of the individual behaviors of each person involved. Yet HIV, which leads to an incurable condition more likely to be fatal than any of those other diseases, is not treated with the gravity that it warrants. HIV easily justifies the quarantine of suspect groups, and it more than justifies the publication of risk factors associated with sexual contact with a randomly drawn member of someone in a suspect group. The failure to publish those risk factors, let alone to take the proper quarantine measures, has a political motivation. A responsible public health agency should be above politics. Jerry Abbott jna55@hotmail.com |