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studies, such as the Multicenter AIDS Cohort Study (MACS) of 4,954 gay men,'" have proven beyond all reasonable doubt that in homosexual men the only significant sexual act related to becom- ing HIV-antibody-positive is receptive anal intercourse. Thus, in gay men, AIDS may be likened to the non-infectious condition, pregnancy. It is acquired by the passive partner but is not trans- mitted to the active partner. Significantly, the MACS also showed that once a homosexual man becomes HIV-positive, progression to AIDS is further deter- mined by the amount of passive anal intercourse sustained after "infection". This is contrary to all that is known about infectious diseases. Infection, not repeated infections, causes disease. Indeed, the Royal Australasian College of Surgeons (RACS) con- siders HIV-positive surgeons to be "infectious" and that they "should not perform invasive procedures or operations", but "they may provide these services to patients who have the same infection".'* studies, such as the Multicenter AIDS Cohort Study (MACS) of transmitted infectious agent found its way into the promiscuous 4,954 gay men,'" have proven beyond all reasonable doubt that in _ portion of the gay male population in certain large cities in the homosexual men the only significant sexual act related to becom- United States in the late 1970s (as is widely accepted), and given ing HIV-antibody-positive is receptive anal intercourse. Thus, in the facts that prostitutes are frequented by bisexual men and that, gay men, AIDS may be likened to the non-infectious condition, at the very earliest, "safe" sexual practices date from 1985, one pregnancy. It is acquired by the passive partner but is not trans- would have expected HIV/AIDS to have spread rapidly through mitted to the active partner. prostitutes and thence to the general community. However, the Significantly, the MACS also showed that once a homosexual prevalence of "HIV" antibodies amongst prostitutes is almost man becomes HIV-positive, progression to AIDS is further deter- entirely confined to those who are drug users. Virtually all other mined by the amount of passive anal intercourse sustained after prostitutes have not been, and are not becoming, HIV-positive. "infection". This is contrary to all that is known about infectious In September 1985, 56 non-intravenous drug using (IVDU) diseases. Infection, not repeated infections, causes disease. prostitutes were tested "...in the rue Saint-Denis, the most notori- Indeed, the Royal Australasian College of Surgeons (RACS) con- ous street in Paris for prostitution. More than a thousand prosti- siders HIV-positive surgeons to be "infectious" and that they tutes work in this area... These women, aged 18-60, have sexual "should not perform invasive procedures or operations", but "they intercourse 15-25 times daily and do not routinely use protec- may provide these services to patients who have the same tion." None was positive.'"* infection".'* In Copenhagen, 101 non-IVDU prostitutes, a quarter of whom "suspected that up to one fifth of their clients were homosexual or Heterosexuals bisexual", were tested during August-October 1985. The median The largest and best-conducted studies in heterosexuals, includ- numbers of sexual encounters per week was twenty. None was ing the European Study Group, ''* showed that, for women, the positive." only sexual practice leading to an increased risk of becoming In 1985, 132 prostitutes (and 55 non-prostitutes) who attended a HIV-antibody-positive is anal intercourse. The unidirectional Sydney STD clinic were tested for HIV antibodies. The average transmission of "HIV" observed in number of sexual partners (clients and OECD countries is supported by lovers) in the previous month was Nancy Padian's 10-year study of het- The "overwhelming" evidence 24.5. When an estimate was made to erosexual couples (1986-1996). from studies both in homosexual separate clients and lovers, the medi- There were two parts to this study: an number of sexual contacts per year one cross-sectional, the other men and heterosexuals is that rose from 175 to 450. The partners prospective. . - oe . of only 14 prostitutes (11%) used In the cross-sectional study, "The HIV/AIDS is not bidirectionally condoms at all, and 49% of their part- constant per-contact infectivity for sexually transmitted. ners used condoms in fewer than 20% male-to-female transmission was of encounters. No women were HIV- estimated to be 0.0009 [1 in 1,111)", | In the whole history of medicine Ff positive.» The risk factors for the women were: there has never been such a The same Australian clinic repeat- (i) anal intercourse; (ii) having part- edly tested an additional 491 prosti- ners who acquired this infection phenomenon. tutes who attended between 1986 and through drug use (Padian says this means the women may also be IV 1988. Of 231 out of the 491 prosti- tutes surveyed, 19% "had bisexual drug users); (iii) the presence of STDs (antibodies to their non-paying partners and 21% had partners who injected drugs. causative agents may react in an "HIV" antibody test)'*” Of the Sixty-nine per cent always used condoms for vaginal intercourse HIV-negative male partners of 82 HIV-positive female cases, with paying clients, but they were rarely used with non-paying only two became HIV-positive—but under circumstances that partners. Condoms were rarely used by those clients and/or part- Padian considered ambiguous. ners for the 18% of prostitutes practising anal intercourse." No In the prospective study, starting in 1990, 175 HIV-discordant women were HIV-positive. couples were followed for approximately 282 couple-years. At At the time of this report, a decade into the AIDS era, the entry to the study, one third used condoms consistently and, in the authors commented that "there has been no documented case of a six months prior to their last follow-up visit, 26 per cent of cou- _ female prostitute in Australia becoming infected with HIV through ples consistently failed to use condoms. There were no serocon- sexual intercourse" (italics ours). Yet, these investigators from versions after entry, including the 47 couples not using condoms the Sydney Sexual Health Centre concluded that "there are still consistently. Based on the 2 in 86 men who became HIV-positive | many women working as prostitutes in Sydney who remain seri- in the early study, the risk to a non-infected male from his HIV- ously at risk of HIV infection".'” positive female partner was reported to be in the order of 1 in In Spain, of 519 non-IVDU prostitutes tested between May 9,000 per contact. From this statistic one can calculate that, on 1989 and December 1990, only 12 (2.3%) had a positive test, average, a male would need to have 6,000 sexual contacts with an which was "only slightly higher than that reported five years ago infected female to achieve a 50 per cent chance of becoming HIV- in similar surveys". Some prostitutes had as many as 600 partners positive. If sexual intercourse were to commence at age 20 and a month, and the development of a positive antibody test was average three times weekly, this would occupy a lifetime.*''° directly related to the practice of anal intercourse. The authors also noted that "a more striking and disappointing finding was the - Female Prostitutes low proportion of prostitutes who used condoms at all times, The notion that HIV is a virus which "does not discriminate" is despite the several mass-media AIDS prevention campaigns that also markedly inconsistent with the data obtained from studies of have been carried out in Spain"."” female prostitutes. Even if by some unknown means a sexually Similar data from two Scottish studies,'” the 1993 European + Female Prostitutes The notion that HIV is a virus which "does not discriminate" is also markedly inconsistent with the data obtained from studies of female prostitutes. Even if by some unknown means a sexually 44 = NEXUS men and heterosexuals is that HIV/AIDS is not bidirectionally phenomenon. AUGUST — SEPTEMBER 1999