Vulnerability of men having sex with men to AIDS

OFTEN I read news items in the Inquirer about the increasing incidence of HIV infection in men having sex with men. I remember listening a few years ago to a lecture on HIV and AIDS and the advances in their treatment by a professor from Harvard University. The lecture was attended mostly by physicians and paramedical workers. A young woman behind me whispered to a friend what MSM means and was told it meant men who have sex with men.

AIDS, or acquired immune deficiency syndrome, is the full-blown illness of HIV infection. It remains incurable to this day and death is inevitable. The illness was first reported in a 1981 issue of the New England Journal of Medicine, the world’s No. 1 medical journal from Harvard University. In the beginning, and for years after that publication, those afflicted with AIDS were ostracized and shunned by society. Why is it prevalent among men having sex with men?

Men who engage in receptive coitus are the most vulnerable. The ano-rectal mucosa, in contrast to the cornified vaginal epithelial cells, is naturally more resistant to the virus and in addition less conducive as a culture medium, unlike the rectal epithelial cells. The same is true of the buccal mucosa where bacteria, viruses, fungi, parasites and the like pass each day, but we do not get sick unless our natural resistance is down.

Men who engage in fellatio become more susceptible to the HIV virus if they have inflammation or breaks in their mucosa, especially in times when their immunity is low. Not all men who engage in homosexual relations assume the active (masculine) role. Many obviously gay men and some more beautiful enough to qualify in a beauty contest may not be passive in their sexual preferences. Some may want the heterosexual male to assume the feminine role and therefore the receptive position or do the fellating. This is where conflict may arise because the straight man who may be a rent boy may refuse and at times vehemently even when the financial consideration is multiplied. A fight may ensue and occasionally you read in the papers the details of the savage beating or even murder of a man.

–ALBERTO DAYSOG JR., MD, 2274 Roxas Boulevard, Pasay City 1300