Tuesday, March 3, 2009

Q. Is there a problem with anal sex or gay sex?

Willie T. Ong, MD, writing in the column "Mind Your Body" (Philipine Star), seems to think so...

Q. Is there a problem with anal sex or gay sex?

A. Yes, according to urologist Dr. Eduardo Gatchalian. Anal sex is not advisable because the anus, including the rectum inside, is a “dirty” organ meant for the body’s waste. It’s like putting feces on the male organ. Studies show that those who engage in anal sex are prone to serious infections like HIV-AIDS, genital warts, anal warts, and HPV virus. These diseases are very easily transmitted because of the breaks in the skin of the anus. The anus is tight and wasn’t meant for sex. However, if you can’t avoid anal sex, use a condom for protection.

Anyone care to correct Dr. Ong?

1 comment:

David G Ostrow, MD, PhD said...

The methamphetamine working group of the Multicenter AIDS Cohort Study has a manuscript in press that demonstrates that approximately 2/3rds of all recent (last 9 year) of new HIV seroconversions among previously seronegative MSM in the MACS are among users of stimulants, inhaled nitrites, EDDs or combinations of those 3 sex drugs. Users of these three drugs have hazard ratios PER UNPROTECTED ANAL PARTNER 2-10 times greater than men engaging in URAS and not using any of these drugs. This is a longitudinal study and about half of the effect of these drugs is due to behavioral disinhibition, but the remainder is due to one or more of the following factors associated with poly-sex-drug use: changes in vulnerability of the anorectal mucosa to trauma, increased blood flow to the anogenital regions of both partners, selection of high risk partners who also use these same sex drugs, or other biological effects of sex drugs on the vulnerability of unprotected mucosal membranes to HIV penetration/infection. So, whatever HIV infection risk is posed by unprotected anal sex, it is increased dramatically by the use of specific vasoactive drugs. This argues against Dr. Gatchalian's simplistic reasoning that the anus is a "dirty organ" unsuitable for anal sex, but rather that specific drug use behaviors and other covariates of gay high risk sex are what render anal intercourse most efficient in HIV transmission through unprotected intercourse. Similar arguments might be applied to unprotected vaginal sex among women who use similar drugs with high risk male partners.

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