Michael Fumento's "The myth of heterosexual AIDS"

Perhaps now that AIDS has leveled off we don't need this book any more. But every now and then the old misinformation resurfaces: A TV commercial shows a white mid-Western girl speaking soberly of the one sexual adventure that will now cost her life. It can happen to ANYONE. Use a condom.

MYTH: Everyone is at risk.

Everyone is not at equal risk.

The vast majority of those who contract AIDS in the U.S. every year are either men who have unsafe sex with men or IV drug users or their sexual partners ( CDC AIDS Report table 3). The risk is racially biased too. Blacks and Latinos now constitute the majority of new cases, according to CDC data . This appears to be because they are more likely to be involved in needle-sharing IV drug use ( CDC AIDS Report tables 4 and 10, Myth p 133). Quite apart from the issue of truthfulness, denying that some groups are at greater risk means denying them the extra resources they need.

MYTH: AIDS is growing in the U.S.

The overall incidence has remained roughly constant since 1990, at about 50,000 new cases per year, ( CDC AIDS Report , fig 6; the jump in 1993 is due to a widening of the CDC's definition of the disease).

MYTH: It's safer to be married than dating

AIDS is a weak little organism that has a hard time surviving the treacherous leap to a new host. It can only make it under specially favorable conditions, such as in blood transfusions.

Fumento actually argues that the female-to-male transmission rate is so low (probability about 1/1000, New York Times "Science Times", June 10 1997), that monogomy is not necessarily any protection for men.

[Note, however, that the presence of other STDs can greatly increase the transmission probability.]

Some AIDS math

Consider a nice guy Paul and his swinging single brother Stevie.

Paul gets married. He picks a wife from a population with probability p of being HIV-positive. They have sex three times a week (transmission probability r, about 1/1000).

Pauls probability per year of being infected: 150 p r . (For the mathematical reader: it is really 1-(1-pr)^150, which is approximately 150pr because 150r is much less than 1.)

Over to Stevie. He dates quite a bit, drawing partners from the same population as his brother's wife, so they are HIV-positive with probability p too. The typical unattached but sexually active heterosexual man has sex about once a month (Myth, p 61), but let's say Stevie is a stud, and gets lucky every weekend.

Stevie's probability per year of being infected: 50 p r (as before, the exact formula is 1-(1-pr)^50, which is approximately 50pr).

The point: if you don't know your partner's HIV status, you are at the same risk from them as if you would be if they were a different person each time you have sex. Paul does have one advantage, though. He can eliminate his future risk if his wife takes an AIDS test.

MYTH: AIDS research is underfunded in the U.S.

AIDS research gleans 10 times as many grant dollars per attributable death as heart disease and cancer (Myth p327).

The problem with Fumento

The problem according to Fumento is that almost no AIDS money goes where it would do most good: into the education and rehabilitation of IV drug users, and the encouragement of safe sexual practices among members of high risk groups. Blanket propaganda tends to frighten the anxious, and dilute the resources available for those really at risk.

The problem with Fumento's book, apart from its title, is that he does not address the question of what kind (if any) of education or rehabilitation is likely to work for high-risk groups, particularly IV drug users.

Fumento's real interest, it turns out, is not in AIDS itself, but the alarmist response to it. As time goes on, and the predicted explosion of AIDS among the tax-paying middle class fails to materialize, the credibility of the alarmists will evaporate. This may already be happening. However, Fumento cannot resist closing with his own dire warning: there are many viruses out there, and next time the alarmists may be right.

For CDC Statistics see the CDC Aids surveillance report (Table and figure references are to the Year-end 1995 Edition, Vol.7, No.2)