Washington Blade - December 27, 2002
Lou Chibbaro Jr.

Former Congressman Tom Coburn, a Republican from Oklahoma, informed the 35-member Presidential Council on HIV/AIDS that he has scheduled time during the panel's upcoming meeting in January to discuss the 1997 book, 'Sexual Ecology: AIDS and the Destiny of Gay Men.' Gay writer and political activist Gabriel Rotello wrote the book.

Coburn, a medical doctor, informed the panel that he would open a discussion on the book and the issues it raises about gay male sex practices and the AIDS epidemic during a council discussion on HIV prevention.

Coburn has been a longtime critic of promoting condom use as an effective means of curtailing the spread of HIV. Citing the potential for condoms to fail due to breakage or misuse, he has called on those at risk for HIV to practice monogamy and sexual abstinence as the most important ways to prevent infection. Coburn has also been a longtime opponent of gay civil rights, receiving a zero rating from the Human Rights Campaign, a national gay rights group, for his congressional voting record on gay issues.

Rotello, contacted at his home in Los Angeles, said he has no objections to Coburn's decision to use his book to discuss HIV prevention. But he said he is concerned that Coburn will minimize or ignore the proposals he outlined in his book to encourage coupled relationships among gay men, such as the legalization of same-sex marriage and government support for domestic partner benefits.

"These are the things that are needed to encourage gay men to cut down on the number of partners, which puts them at risk," he said.

Brent Minor, an openly gay member of the council, known as PACHA, said the assignment of Rotello's book raised eyebrows among some council members.

"Some of us were wondering if Dr. Coburn planned to use this book to make gay men look bad," said Minor, who was appointed by President Clinton and re-appointed by President Bush.

Rich Tafel, outgoing executive director of the national gay group Log Cabin Republicans, said he was pleased that Coburn asked commission members to read the Rotello book, saying it presents an "accurate, scientific" account of the start of the AIDS epidemic that is instructive to finding ways to end the epidemic.

"It's not the prettiest picture of gay men," Tafel said. "It's not 'Will & Grace.' "

Coburn did not return a call by press time.

Rotello said he contacted Coburn on Dec. 23 after learning from the Blade of Coburn's book assignment. He said Coburn praised the book for its insight into the transmission of HIV among gay men but indicated he could not support Rotello's recommendations about government support for gay relationships.

"He said he was a Christian conservative and did not believe the government should be taking those positions," Rotello said. "He said he can't take a position that endorsed homosexuality."

Rotello's book, which has been lauded by epidemiologists and attacked by some gay activists, explores the reasons gay men were hit the hardest by the AIDS epidemic in the United States and Europe when AIDS first surfaced in the early 1980s. Among other things, he describes in graphic detail the sexual practices some gay men engage in to place them at risk for HIV.

Three legs of epidemic

Saying he conducted extensive reviews of epidemiological literature and scientific studies of the path of sexually transmitted diseases, Rotello reported in his book that epidemics of sexually transmitted diseases come about when a threshold in the rate of transmission is reached.

He reported that the threshold consists of three "legs." The first is the prevalence of a disease in a given population group; the second is the "infectivity" or the degree of certainty that the virus or other germ can be transmitted in a single sexual act; the third leg consists of the number of sexual partners among members of a population group.

When any combination of these legs is reduced to drop the infection rate below the threshold, he recounts epidemiologists as asserting, a disease ceases to be an epidemic and begins to fade away.

Rotello said that by the time gay men learned of the threat of AIDS, a vast number of them were already infected with HIV, the virus that causes AIDS, and little or nothing could be done to lower that leg of the epidemic.

He said the infectivity, or mode of transmission, was found to be high among those who engaged in anal intercourse. Condom use, in theory, he reported, was one way to reduce "infectivity."

But the most prominent of the three legs, he reported, was the large number of sexual partners that many of the gay men hit by AIDS had during the 1980s and beyond. He refers to that phenomenon as "multiple partnerism," saying he prefers that term rather than the term "promiscuity."

Although Rotello said condom use is a key factor in curtailing the spread of HIV among those who use them faithfully, he noted that not enough gay men use them consistently to lower the threshold enough to end the epidemic among gay men in the United States.

He points to studies of gay male population groups in cities such as New York and San Francisco that show rates of condom use rarely exceed 65 percent. He reports that extensive and "saturated" promotional campaigns by gay-run HIV clinics and AIDS prevention groups consider it a "success" when their interventions result in an increase in condom use from 55 percent to 65 percent.

"In some places in Europe, the same condom use rate was enough to bring the disease below the threshold," he said. The reason, he said, was that gay men in those locations had far fewer sex partners than their counterparts in the U.S.

"It's interesting that Dr. Coburn has taken such an interest in the sex lives of gay men," said Michael Cover, spokesperson for D.C.'s Whitman-Walker Clinic. "I would refer him to the numerous scientific studies that present overwhelming scientific evidence that latex condoms stop the transmission of HIV and save lives," he said.

Lou Chibbaro Jr. can be reached at lchibbaro@washblade.com.

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