Contrary to what is still being drummed into us from every side, it is becoming clearer and clearer from a dispassionate reading of the evidence that AIDS poses little or no risk to the general, or heterosexual, population. Yet those of us who have been trying to spread the good news have been met not with sighs of relief but with anger and with scurrilous attacks.
Mostly this response has come from homosexual pressure groups and their liberal sympathizers. But now one such liberal sympathizer, and a prominent one at that, has broken ranks on the question of whether AIDS is or will prove to be as much a threat to heterosexuals as it has already been to homosexuals.
The name of this liberal dissenter is Dr. Robert E. Gould. Dr. Gould is both a psychiatrist and a gynecologist, and he also serves as chairman of the Committee on Gay and Lesbian Issues and as a member of the Committee on AIDS of the New York County branch of the American Psychiatric Association.
It would normally be a safe bet that anyone with credentials like these would take the position that we are all equally at risk from AIDS. But writing in (of all magazines) Cosmopolitan, Dr. Gould begins by asserting flatly, and in his own italics, “that there is almost no danger of contracting AIDS through ordinary sexual intercourse.”
The reason he gives for arriving at this conclusion are both biological (the fact that the vagina is “very inhospitable to the AIDS virus”) and epidemiological (the fact that there are so few documented cases of heterosexual transmission).
So far as the epidemiological evidence goes, Dr. Gould challenges the standard notion that 4 percent of the people in this country who have AIDS caught it from normal sexual intercourse. The true proportion of heterosexually transmitted cases, he demonstrates, is closer to 2 percent and may well be even lower — conceivably as low as zero.
But what about Africa, where, we keep hearing, the majority of cases are heterosexually transmitted? Having worked with African nurses on sex education, Dr. Gould believes that many of the cases attributed to conventional intercourse there were actually caused by anal sex, “which is often used as a means of preventing pregnancy.” The others, he thinks, were related to certain personal and medical practices peculiar to the regional culture and of no relevance to the situation here.
Dr. Gould of course recognizes that AIDS can be contracted by nonsexual means, especially the sharing by drug addicts of unsterilized needles. But, he maintains, the only sexual practice that carries with it the risk of AIDS is being penetrated anally (regardless of whether the recipient is a man or a woman).
In his opinion, indeed, the disease cannot even be contracted through “recurrent sexual activity with a person who carries the AIDS virus” — provided such activity does not include anal intercourse. On this point, Dr. Gould probably overstates, since there is at least some evidence, which he does not mention, indicating that transmission can occur through repeated conventional intercourse with an infected partner. On the other hand, the same evidence suggests that the odds of becoming infected even in this way are very slight.
In general, then, Dr. Gould confirms those of us who have been insisting that people who engage only in normal sexual intercourse are no more likely to get AIDS than to be struck by lightning.
Dr. Gould quite naturally concludes his article by raising the question of why, “when there is so little likelihood and no solid proof” of AIDS spreading through normal heterosexual intercourse, “so few experts are saying so.” His answer is that researchers, gay organizations, and public-health officials all fear that to acknowledge “just how risk-free conventional heterosexual intercourse actually is” would be to jeopardize public support for the funding necessary to find a cure for AIDS.
Dr. Gould seems to consider this an honorable motive. I disagree. I think it is a scandal of major proportions that we should be misled by scientists and public-health officials on a matter of such importance. I also think that nothing could be more destructive than to politicize issues of public health. We will pay heavily for these breaches of trust and integrity.
As for Dr. Gould, in him the fear of jeopardizing support for AIDS research has given way to a greater fear: that “the false alarm” over AIDS will undo all the work he and others have done in the past 25 years to liberate us all from the “old feelings of guilt, sinfulness, and immorality” that (so he imagines) formerly made it difficult “for any of us to enjoy sex.”
Compared with the threat to the great “enlightenment” we achieved through “the tumultuous 1960s and the sexual revolution of the ’70s,” even AIDS seems relatively insignificant to Dr. Gould. “I don’t mean,” he writes, “to underestimate or downplay the horror of AIDS. . . . Still, this killing of our sexual selves, I feel, may prove more destructive in the long run than the AIDS virus itself.”
Dr. Gould is thus driven by the realization that he, as an evangelist of the sexual revolution, has no interest in bolstering the campaign to persuade us that we are all at risk from AIDS.
But if ideological interest explains why he has chosen to oppose this campaign, it says nothing one way or the other about the case he makes in opposing it. That case must stand or fall on the evidence. And what the evidence shows even to some of us who have very different ideological interests (and who also suspect that people may just possibly have enjoyed sex even before the 1960s) is that there is almost no chance of contracting AIDS through normal sexual intercourse.