A Johns Hopkins University professor of public health recently published a letter to the editor in the more liberal of the two main Jamaican national newspapers[1] in which he took issue with facts put forth in a commentary, “Tell Men Who Have Sex With Men The Truth,”[2] written by a friend of mine, a pediatrician and medical university instructor in Kingston.  Jamaica is the flagship nation of the British Commonwealth for the Caribbean and Latin America. It is under extreme pressure from the UK, UN, and USA to loosen both its anti-abortion/pro-life and anti-sodomy (“anti-buggery,” in local parlance) laws.  Insofar as I have had a few items published in both major national papers of Jamaica, and being asked my Jamaican colleagues to do so, I submitted the following letter to both the Jamaica Gleaner and the Observer. I struck out there, but I present below what I sent in.

“Professor Chris Beyrer’s recent commentary admitted that HIV was “spread efficiently through unprotected (condomless) anal sex” but also claimed that “the risks are similar for women and men” who engage in the practice, and put forth that calling anal sex unnatural would be akin to “arguing that vaginal sex is ‘unnatural’ since it can efficiently transmit” other sexually acquired infections. He concluded that “making condoms and lubricants widely available and cheap” reduces STI risks and that “(p)unitive and hostile policies” increase HIV risks.

The premise that anyone practicing anal sex gets the same results, be it men having sex with men (MSM) or men having sex with women (MSW), glosses over the reality that over 90% of MSM have anal sex while far fewer MSW/WSM do so. MSM on average start younger and have more partners than MSW. Consequently, the type and quantities of pathogens (bacterial, viral, fungal, and parasitic) found in the rectum of MSM on average varies greatly from that of WSM practicing anal intercourse.  The comparison to vaginal STI communication is bizarre, both in failing to divulge just how efficiently STIs are spread through anal sex (it’s not just HIV), and in ignoring that the rectum is made to expel waste while the vagina is designed for intercourse and childbirth.  Disregarding natural function is done at one’s own peril.

Condoms have been given throughout the world by various agencies for over 40 years. They are available and cheap. In 2009 Edward Green of Harvard’s AIDS Prevention Research Project noted, “We have found no consistent associations between condom use and lower HIV-infection rates” since, in part, splashing condoms around tends to increase the high-risk sexual behaviors, thus magnifying the condom failure rate.  But even in the AIDS hot bed of sub-Saharan Africa, Uganda dramatically reduced its HIV transmission rates using an “ABC” program (A – Abstinence pre-marriage; B – Be faithful to your spouse; and C – Condoms as a back-up with a failure rate), not by liberalizing sodomy laws or ramping up condom distribution.

I concur that punitive medicine is bad medicine, but embracing homosexual practice seems a failure thus far.  Regarding homosexual practice, Canada, Scandinavia, the Netherlands, and Belgium have supportive government policies, celebratory liberal churches, and a public coerced into silence by “hate-speech” codes. Their HIV, STI, and other health statistics for MSM do not support Professor Beyrer’s premise.

Treating each other with respect and compassion is a priority, but encouragement of harmful practices is not.  The negative health consequences of same-sex sexual behavior are formidable and inherent to the practice.  Acceptance and celebration of it doesn’t help, and dismissing this reality is no less a judgmental response than is pointing it out.”

Andre Van Mol, MD