I haven’t really been in the mood to fuck the last few days (sorta am, but sorta not), plus my dog ate the pills I use to help my dick get nice and hard and thick, so… You get something that’s not exactly a hookup story…

After my post the other day comparing smoking and HIV as problems for the gay community, I did a little more research. These numbers are as accurate as I can get them, but not perfect… They’re a lot more accurate than the numbers in my last post.

For starters, 276,000 men die from smoking related causes each year. Pile on top of that that 41.6% of gay men smoke compared to 28.6% of the general population and we’re 1.45 times more likely to smoke. So, the leap I’m taking is saying that if we’re 1.45 more likely to smoke we’re 1.45 times more likely to die of smoking related causes. So our 10% of the male population would actually be more like 14.5% of the smoking deaths.

Now, on top of that smoking accelerates the start of AIDS among people with HIV, and HIV accelerates smoking-induced emphysema, and you see the 14.5% is actually a bit low. So let’s be conservative and say 15% of male smoking deaths are gay men. That means over 41,000 gay men die of smoking related causes each year in the United States.

Taking a look at HIV… The CDC says 12,543 people died of HIV related causes in 2005 (that number is somewhat lower than the people with AIDS who die since people with AIDS can die of many other causes as well). The CDC also sas 73% of the deaths were in men. That means just over 9,000 men died of HIV, and not all of those are gay men. If we said 80% of those deaths were gay men (a guess), and rounded up (not in our favor), then about 7,500 gay men die of HIV each year.

Again, those numbers are rough estimates, but I believe I’m making assumptions that work against the point I’m trying to make, not in favor…

So when I say gay men are 5 times more likely to die of smoking related causes than HIV related cause, I think it’s actually higher than that…

Now why isn’t there the outrage and intensity of feelings about smoking that we see about HIV and barebacking?

UPDATE:

Four years after I figured out that smoking was more deadly than HIV, researchers have come to the same conclusion:

The study demonstrates the very potent hazards of smoking and also confirms that patients with well-controlled HIV are able to have longer, healthier lives than HIV patients who smoke.

In fact…

…the study found that 60% of the deaths among HIV patients was associated with smoking.

I’ve been sitting on this for a while now ’cause I’ve been busy with work and lately ’cause I figured I needed to be giving you guys more sex and less “stuff”… So since you got write-ups on no fewer than three hookups in the past 4 days, I figured it was time for me to take care of this…

A few months ago I told you about a research study about drugs and sex that was being done by CHEST which is part of Hunter College here in NYC. Well, the folks behind that study are starting a new study called “Pillow Talk” where sexually active guys login and record their sexual activity before they go to bed each night. Here’s their full blurb on the study…

The Study is called Pillow Talk. It is for sexually active NYC gay and bisexual men. We are really interested in learning about men’s sexual experiences. There are absolutely no judgments and this is not an intervention (i.e., we are not trying to change any behavior). We just want to hear your story!

Men who join the study will be asked to visit our office in Chelsea, where they will participate in a 1-on-1 confidential interview and a computer-based survey. Something new we have added to the study is a “daily diary.” Men who join the study will complete a brief online-survey about their day. They will keep this “diary” for 30 days.

There are 2 follow up appointments. We ask you to return 1-month and 4-months after joining the study. This is to get an update on you life since the last time we saw you. All told, you can earn up to $220 for full participation.

Call 212-206-7919 x 300 to screen for the study. All calls are completely confidential.

Or email research@chestnyc.org (we can answer questions briefly via email, but will ultimately ask you to call if you want to screen for the study).

This study is being sponsored by Hunter College. We have been doing research with the GLBT community for more than a decade.

You may be asking “why bother”? To me there are two really good reasons. First, the $220 isn’t bad, but more importantly it’s important that researchers understand what’s going on in our lives. Honestly, the safe sex message is failing miserably these days. Personally I don’t think that’s going to change, but I feel like we need to give “thinkers” the information they need to come up with something better than “use a condom every time”. They need to understand the lives of those of us who are sexually active in order to really understand what messages have a possibility of working.

I will always encourage guys to ditch the rubbers, fucked raw, and give and take loads. But at the same time I have no problem helping the safe sex crowd get their act together and get more grounded in reality.

If you contact them, please tell them you heard about the study from rawTOP. If you don’t want to admit to reading this blog you can say your friend “Richard” told you about the study (Richard = Dick => I’m a top… Get it?)

And just for the record – I do plan on signing up for this study. It wasn’t until today when I looked closely at the study objectives and requirements that I realized I was eligible…

UPDATE 1:

So I called a couple of days ago to inquire. They said they had about 10 minutes of questions (it took 13 minutes), and I was approved. Apparently the 30-odd guys I’ve fucked in the last 3 months qualifies me as being a big enough slut for their study… I have an appointment early next week.

I’m not quite sure why the appointment is going to take 3 hours, but that’s how long they say it will be. It’ll be interesting to see what they do with me for 3 hours! No wonder they pay you $225 to be part of the study…

UPDATE 2:

I went in today for the initial interview it took 3 hours like they said it would. They first went over the different sex, alcohol and drug use I had had in the past 90 days (looks like I had sex with over 50 guys thanks to IML and going to the bathhouse in Montreal). Then we had a general discussion of sex, and then there was an hour long computer survey. So pretty straightforward, and they paid $40 for the three hours.

Now for the next 30 days I do a daily online survey (get paid $40 if I complete all 30 days), then there’s a 4(!) hour follow up interview for which I get paid $45, and then another interview something like a month after that (another $40 I think…)

The important part is that the people there really are really non-judgemental. It was a woman (young) who interviewed me. I could tell she’d heard it all before and had no problem with my answers (and I was reall pretty honest and frank with her)… So I can say from personal experience that you won’t have a negative experience if you go…

In case there was any doubt, a new study out today confirms that HIV acts quickly. The idea that it lies dormant is now fully debunked.

“It was stunning to see how quickly the immune system was affected,” said Haynes, who is the lead author on the study.

To deal with the shrinking window, clinicians can check for the presence of HIV more often, but the potential for catching cases early enough for intervention looks bleak. The earliest and most infectious stage of HIV has vague and practically unnoticable symptoms.

“It looks like HIV does a lot of damage very early on,” Haynes said. “Now we feel that the opportunity to intervene most effectively may range from about five to seven days after infection.”

Doctors are going to have to start screening patients for the HIV virus even if they come in with what seems like a headache or a common cold, Leone said.

Why they say 5 to 7 days when the window for effective PEP has been 72 hours for a while now, I don’t know…

The upside is that good HIV tests should be able to detect infection much more quickly. Which means you don’t have to wait 3 months to be sure you’re neg. It also means that if your doctor does a blood draw and tells you to come back in two weeks – by then it’s too late to do anything about it. That may be fine for routine checks, but it’s not OK when you think you just got infected.

It seems like there’s been a lot of discussion of bug chasing on this blog recently. The “Neg 4 Neg” gangbang bottom taking a poz load, the bug chaser going on a sex vacation in SF and wanting as many loads as possible, and so on… I’m wondering whether I’ve gone too far. Not sure if I’m 100% comfortable with the public image I’m projecting. I mean it’s all happening and on one hand it’s sort of like news reporting… But there’s also an element of facilitation and eroticizing guys becoming poz and that’s where it gets to be a bit “dark”.

So I’m wondering what you guys think of it? Am I going too far? Should I step back and lighten things up a bit? Tell me what you think… The poll has answers that sorta cover the gammut, but feel free to add something under “other” or better yet – leave a comment on the post…

Oh yeah – I’m not going to feel obliged to do what the poll results say, but I will definitely take them into consideration…

UPDATE: It’s pretty clear where the poll results are going… While about 1 in 5 of you want it to go darker, the vast majority want it to stay the same and preferably lighten up a bit. What’s telling is that the “lighten up” percentage has been going up as the days drag on. In other words, the occasional readers may be put off a bit by the heaviness of the blog. The argument for staying the same is that this is my life and it won’t be all that interesting if I censor it.

So, to that end… I’ll change how I right about things, but not so much what I write about. In other words, those of you who like it dark will need to read between the lines. I’ll put all the details in there (neg4neg gangbang, etc.), but won’t dwell so much on the risk factor. Here are a few examples…

The bug chaser visiting San Francisco wanting loads – I’d just leave out the bug chaser part and say a bottom is on vacation wanting as many loads as possible. It would completely change the nature of the post – if you wanted to read the other related posts you could figure out the details…

There will still be occasional updates on HIV and AIDS research – that won’t change. I may think twice about some of the stories however… For example, I’m not sure how important the “HIV Strikes Quickly” story really was.

The story about three sides of a stealth breeding gangbang – I’d do it with less detail and more as a cautionary tale (neg bottoms who take anonymous loads will wind up getting poz loads).

The story of what a bug chaser is thinking as he makes the decision to take all loads instead of being “neg4neg”… That one would be done pretty much the same way. There are some things I think just need to be expressed unedited.

When I talk about my hookups I usually just stick to the facts of what happened – so no change will be needed there…

There’s a new study out that looks at the mortality rates of people who are poz. Curiously they declare that HIV is “no longer fatal”, but then they go on to say how it will shorten your life…

There’s obviously a lot of young bug chasers out there. If you’ve ever wondered how they’ll fair long term – the study answers that…

The study said that “despite” these positive results, an HIV-positive person starting Cart treatment at the age of 20 will on average live another 43 years, to 63. A 20-year-old HIV-negative person in a high-income country can expect to live to around 80, a difference of nearly 20 years.

I assume “Cart” is the same as HAART (the “drug cocktail”).

I’ve said for a while now that the only safe sex message that I can see working is “stay neg – enjoy your retirement”. That’s basically what’s going to happen with the guys who are getting pozzed young. Provided they do what a good doctor tells them to do, they’ll live a decent life, and then start having medical problems when they should be retiring. The part of their life they’re going to miss out on are “the golden years”.

Then again it was just a few years ago that they said the average life expectancy after becoming poz was around 23 years. Now it’s up to 43 years for these guys. Given how well medical science is doing it will probably go higher. And that’s the point… People from my generation and before are telling the young guys how crazy they’re being but they’ve forgotten how radically things have changed. It used to be that someone who was poz for 5 years was a “long term survivor”… It’s not like that anymore.

[Fine Print: These are averages – you may be on the low end of the average. If you don’t get tested and don’t know you’re poz you will be on the low end of the average for sure and will die way before you should. So GET TESTED and know your HIV status!]

Then you think about the guys like the bug chaser who’s in San Francisco this week who are in their 40s and turning poz. Their life expectancy after infection is shorter than 43 years, but still – if you got pozzed in your upper 40s and lasted say 30 years (I’m pulling that number out of my ass), then you’ve still lives a pretty full life. They’re making a choice that will undoubtedly lead to complications, but they’re not completely insane like some people would lead you to believe.

In related news… There’s a study out in The Lancet that says that the Swiss statement (that it’s safe for sero-discordant straight couples to fuck without rubbers) is wrong. They do a mathematical model that shows that there will be HIV infections as a result if the Swiss statement is followed.

Here’s the problem. The Swiss statement is based directly on empirical data. The new study is a mathematical model, and it would appear the empirical data the Swiss have access to does not fit with the Aussie’s mathematical model. If you know anything about statistics you know the closer you are to real-world observations, the better your results will be. The data source is always suspect. So it looks like the mathematical model may be in trouble, though it is getting published in one of the top peer-reviewed journals so you’d think it couldn’t be that bad. Then again, I think there are people who want to see the Swiss discredited.

The point is, the discussion about the Swiss statement is far from over.

A discussion on bareback porn on another site got me thinking… Barebacking is a lot like smoking. It’s addictive and it can kill you. So how does it compare?

According to UNAIDS/WHO, 21,000 people died of AIDS in North America and 12,000 in Western and Central Europe. That’s 58 people a day in North America and 33 a day in Europe. By comparison the CDC reports that 418,000 people die just from cigarette smoking every year in the United States alone. That’s 1145 a day.

I get that some of the people who are dying every day of AIDS acquired HIV by barebacking. But I bet the people who are bothered by young guys barebacking don’t think twice when the same guys light up a cigarette… I’m not trying to say they’re being willingly hypocritical – personally I think society is having a moment of group think where the big killers don’t get the attention they deserve and smaller ones that are seen as somebody else’s problem get all the attention. HIV is a popular one ’cause people see it as avoidable. But smoking deaths are avoidable too and kill so many more people. But HIV is seen as something that affects unpopular minorities like gay guys and drug addicts so it gets focused on.

On the other side of the coin, as a community this does affect us greatly and it’s something we need to come to grips with. Personally I think one of the huge issues is how ineffective the safe sex message is these days. It needs a total rethink but it’s such a touchy subject people don’t want to touch it with a 10 foot pole. Some people will cry foul if the message is anything but “use a condom every time”. On the other hand I’ve seen guys get addicted to barebacking in a monogamous relationship and then not be able to quit barebacking when the relationship ends. So who knows what the message should be. I know I don’t know…

But for me, as with smoking, it comes down to personal choice. People choose to smoke and some die as a result of that choice. Likewise people choose to bareback and some die as a result of that choice. The difference of course is that the damage from smoking builds over time where with barebacking the damage happens all of a sudden and you don’t know when that will be. So a teen could smoke for a year or two and stop without much consequence. But if they bareback it’s an all or nothing game. The damage may have been done by the time they decide to stop.

Just as we don’t bar people from smoking, we can’t bar them from barebacking. But society has put limits on things like advertising of tobacco and alcohol, and the sale of those products. The issue is what limits, if any, are appropriate for barebacking?

Some people have suggested a system similar to straight porn where there’s an industry sponsored non-profit testing agency who monitors all the models. But I don’t know whether that would even work in our case since so many models are poz or like me – neg and don’t mind fucking poz guys.

Personally, I think the important thing is that the guys in bareback porn do so with informed consent. That they understand the risks and consequences. If they do, then it’s all OK in my mind… The question is how do you know some Eastern European guy who doesn’t speak your language had decent sex ed in high school? The concept of informed consent is great. The implementation is a bitch…

UPDATE

I was thinking about this a little more… Canada has about 10% of our population, so let’s guess that 19,000 people in the US died of AIDS. Let’s also guess that 75% of them were gay (I think that’s actually a higher number than what’s true), so that would mean about 14,000 gay guys died of AIDS last year. Now, if we’re 5% of the population (10% of the men), then that means if the entire US were made up of gay men then 280,000 of us would have died of AIDS. That 280,000 number is comparable to the 418,000 that died of smoking.

Those are really rough numbers, but the bottom line is that it appears smoking kills more gay men than HIV/AIDS. Think about that for a moment. Smoking is a bigger problem for our community than HIV. I wish someone could get hard data to prove that, but with high rates of smoking in the gay community, I’m almost certain it’s a true statement.