The Washington Blade - August 13, 1999
Lisa Keen

The researchers surveyed 2,189 Gay and bisexual men in three cities (San Francisco, Chicago, and Denver) every six months over a period of two years to determine what sexual practices they engaged in and whether the men had become HIV-infected. Specifically, the researchers were looking for men who were engaging in high-risk sexual behaviors, and they eventually analyzed data from 1,583 men.

Of these 1,583 men, 49 men (3 percent) began testing positive for HIV infection during the course of the study. The researchers then compared the sexual practices of these men to the men who did not test positive.

What they found was that the men who tested positive were much more likely to have been the passive partner in anal intercourse without a condom and with a partner they knew to be HIV-positive. Fourteen percent of the men who tested positive were bottoms in unprotected anal sex with HIV-positive partners, compared to only 1 percent of the men who did not test positive.

Forty-five percent of the men who tested positive said they had been bottoms in unprotected anal intercourse with a partner whose HIV status they did not know, compared to 27 percent of the men who did not test positive.

But what interested the researchers more was the fact that, if 45 percent of the men who tested positive were likely infected through sexual practices known to have a high risk, then 55 percent become infected through "other types of contact."

"Provided the [participants'] reporting was accurate," noted the researchers, "this implies that a majority of new infections took place via other types of contact, which may have included episodes in which condoms were used but failed."

The most common sexual practice engaged in by the group of men who became infected was anal intercourse with a condom -- as either the top or bottom partner. Following that, the most common sexual practices were anal intercourse as the top partner and not using a condom, and being the receptive partner in oral sex in which the insertive partner did not use a condom.

Applying a number to quantify the risk of each practice, the researchers identified anal intercourse as the bottom with a top partner known to be HIV-infected and not using a condom (the highest risk) at 0.82 percent per contact. (The study's authors noted that nine men became infected after only one or two contacts of unprotected anal intercourse as the bottom.)

The same intercourse with the top using a condom was identified at 0.18 percent per contact. Being the receptive partner in oral sex in which the top does not use a condom was identified at 0.04 percent per contact, a risk that was the lowest for all sexual practices but "not without risk."

The study is reported in the Aug. 1 issue of the American Journal of Epidemiology.

In brief ...

KIDNEY DISEASE IN AFRICAN AMERICANS: A study from Wake Forest and Emory universities this month concluded that the much higher incidence of kidney disease among African Americans with HIV (compared to other races with HIV) is probably due to "an inherited susceptibility" to renal disease for those patients, and not to HIV or its treatments. The researchers found 201 African Americans with HIV and kidney disease and compared them to 50 African Americans with HIV but no kidney disease. They discovered that 28 percent of those who developed kidney disease had close relatives with serious kidney disease as well. But among those without kidney disease, only 6 percent had close relatives with kidney disease. The full report appears in the August issue of the American Journal of Kidney Diseases.

COGNITIVE HELP: Researchers in New York and Baltimore reported in the July 22 issue of the journal Neurology that a drug used to treat acute pancreatitis might help treat AIDS-related mental impairments. The researchers -- at the University of Rochester, Columbia University, and Johns Hopkins University (in Baltimore) -- administered the drug, known as lexipifant, to 30 patients who were suffering from mental impairment as a result of their HIV infection. They found that the patients taking the drug saw improvement in their mental functioning, especially in verbal memory. A separate study reported, in an earlier Neurology, that effective suppression of HIV might reduce the incidence of dementia and neuropathy in people with HIV.
990813
WB990804

The Washigton Blade, Inc., 1408 U St., N.W., 2nd Floor, Washington, D.C. 20009-3916

Copyright © 1999 - The Washinton Blade. All rights reserved. Republication or redistribution of The Washington Blade content is expressly prohibited without the prior written consent of the Blade. The Washington Blade shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon.  The Washington Blade