October #106 : Topsy-Turvy - by Richard Kim

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Table of Contents

Crime no. 69

Who’s Afraid of HU?

Six Nights in Bangkok

Their Patients, Their People

Thar She Blows!

HU Handbook

Top Black MDs

Heartbreak Hotel

Quilt Trip


No PEP Rally


Show & Tell



Pos & Neg

Meth-od Actor

West Denial Virus

Bangkok Big Top


Private Parts

Forbidden Grapefruit

Quick Study: Prostate

Alzheimer’s Drug Does HIV

Body Eclectic: Lungs

Get Flu-ent

If You Knew Sushi


Trip or Treat

Scared Straight

Hitched & Bewitched


Most Popular Lessons

The HIV Life Cycle


Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV

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October 2004


by Richard Kim

Are tops the new bottoms for HIV risk?

Butt pirates, beware. In a study of 64 HIVer men who have sex with men, University of Washington researchers unexpectedly discovered more virus in rectal secretions (saliva-like fluids from membranes down under) than in either blood or semen. The study, published July 1 in The Journal of Infectious Diseases, reported average viral-load counts 25 times higher in booty swabs than in cum shots from guys not receiving HIV meds.

While stunned by his data bombshell, the lead reasearcher Richard Zuckerman, MD, cautions against drawing conclusions about bottom-to-top infection rates, since the study did not examine transmission. “Although HIV levels in rectal secretions are higher,” Zuckerman said, “the insertive partner is exposed to the secretions for a shorter period of time than the receptive partner, who may be exposed to semen long after intercourse.”

A 1999 transmission study reported that bareback catchers risked infection rates 4 to 14 times higher than pitchers’—a stat supporting longstanding anecdotal reports that condomless topping was relatively unrisky. Zuckerman says more studies are needed to examine how other factors may increase viral loads and infectivity. “These data are intriguing, but really bring home the message that HIV transmission is complex and in the future prevention will need to be addressed in a number of ways. Currently, condom use is the most important means we have.” Now that’s an indisputable position.

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