Rectal Secretions from "Men who have Sex with Men" Contain More HIV than Blood or Semen

Bill Weintraub

Bill Weintraub

Rectal Secretions from "Men who have Sex with Men" Contain More HIV than Blood or Semen


Rectal Secretions from "Men who have Sex with Men" Contain More HIV than Blood or Semen

Levels of HIV RNA in rectal mucosa secretions from men who have sex with men (MSM) are higher than those in blood and semen, according to a study presented in the July 1st edition of The Journal of Infectious Diseases. The results suggest that "unprotected" insertive anal intercourse may involve exposure to higher levels of free virus than previously believed, even where the receptive partner's plasma viral load is undetectable on HAART.

In contrast to previous studies, which have examined HIV levels in rectal biopsies (tissue samples) or swabs from the anus in men with suppressed viral loads, this study looked at secretions from the rectum in a group of men with varying degrees of viral suppression and antiretroviral drug exposure.

"HIV RNA was often found at high levels in rectal secretions, even in men receiving antiretroviral therapy, and paired HIV RNA levels in rectal secretions were greater than those in either the blood or seminal plasma among HIV-infected MSM," state the authors. "Furthermore, antiretroviral therapy had a greater direct effect on levels of HIV in seminal plasma than in rectal secretions."

The investigators recruited 64 HIV-positive MSM from sexually transmitted disease clinics in Seattle, USA, and Lima, Peru between December 1999 and January 2001. Twenty-seven (42 percent) of the men had been on a stable antiretroviral regimen for at least 30 days, and the remainder were drug-naive.

HIV viral loads were measured two to three times over four weeks in swabs taken from the rectum, and in the blood and semen. Because the samples were diluted at different ratios, the lower limit of detection was not equal in the three samples (rectal secretions: 8000 copies/ml; blood: 400 copies/ml; semen: 800 copies/ml). However, the authors used a mathematical correction to estimate the distribution of viral loads in samples below the limits of detection.

Overall, HIV viral loads were higher in rectal secretions (median 91,200 copies/ml) than in blood (median 17,400 copies/ml; p < 0.05) or semen (median 3550 copies/ml; p < 0.05).

Nevertheless, HIV viral loads in the blood were correlated with those in the rectum (p < 0.001) and the semen (p < 0.001).

A similar pattern of viral loads was observed in the men who were taking antiretroviral therapy. Rectal secretions contained a median of 3980 copies/ml, compared with 200 copies/ml in blood (p < 0.05) and 1000 copies/ml in semen (p < 0.05). Ten (37 percent) of 27 rectal samples from these men had detectable viral loads, nine (35 percent) of 26 blood samples, and eleven (55 percent) of 20 semen samples, a much higher level than observed in most other studies, the authors note.

In the men who were not taking antiretroviral therapy, HIV viral loads differed significantly among all three samples, with rectal secretions containing the highest viral loads (median 316,000 copies/ml), compared with a median of 63,100 copies/ml in the blood and 12,600 copies/ml in semen (p < 0.05 for all comparisons). These men also had higher rates of detectable viral loads in the rectum (35 [95 percent] of 37 samples; p < 0.05), and blood (37 [100 percent] samples; p < 0.05), but not in the semen (28 [78 percent] of 36 samples; p = 0.08).

[Journal of Infectious Diseases, 6/1/04;, 6/16/04]


Re: Rectal Secretions from "Men who have Sex with Men" Contain More HIV than Blood or Semen


I can't believe that in the year 2004 we are still so blind to the truth, anal sex KILLS.

I live in Toronto, where the rise in new HIV cases, year over year, is shocking. It's not from the lack of education regarding HIV/AIDS, quite the opposite since millions are spent each year for that very purpose.

HIV/AIDS is now an acceptable and profitable industry, other wise the worldwide case numbers would be dropping, but they are not.

Gay men in particular seem to have fallen into this false sense of security regarding anal sex and HIV/AIDS. The unbelievable number of gay/bisexual men who are engaging in unprotected anal sex (bare backing) leaves me dumbfounded. AIDS kills, thereís no masking that fact or even entertaining the thought that life with AIDS is somehow, just a normal part of m2m sex. That's so completely warped; it leaves me shaking my head.

The colorectal tract is a potential breeding ground for pathogens. Thankfully our body (when healthy and HIV -) protects us from harmful infections/diseases. If you want proof of that just look at how cholera is spread, via fecal matter in water.

The notion that a condom is the answer is ridiculous. Yes, it will help lower the risk of contracting HIV/AIDS, it doesnít eliminate it though. A change has to take place in the gay community, turning away from anal sex and towards genital on genital sex or FROT.

I've met almost nothing but resistance in chat rooms and in face to face discussions with other gay men about turning away from anal sex. Most consider it to be the final "act", itís more final then they truly realize. On the flip side though, I've also had the opportunity to have some really good conversations with single and partnered gay men who feel the same way we do, that FROT is the way they achieve climax, oneness, release, LOVE.

Honestly, I canít understand how anyone could find pleasure in sticking their nose up another guys butt and licking it, EWWWWWWWWWW.

So how do we start to change the behavior, change the culture? Well I think Bill's right when he commented on not watching "traditional" gay porn, that's a big step. Refusing to rent/buy gay porn, be it video/DVD/magazines or websites, that glorifies anal sends a powerful message, MONEY AND PROFIT SPEAK LOUDLY.

As we all know "traditional" gay porn almost ALWAYS ends up with at least one guy being nailed up the butt. They portray anal as being so pleasurable so sexy, right, I guess those grimaced faces, clenched teeth and fists, those grunting noises are supposed to be a turn on, I think not; it's called old fashioned pain.

I don't care how many guys say, "oh it feels so good when it's done right". Well what about the times when it's not done right, that is my response, one I'm getting tired of asking

So how do we change this tide of death and destruction? Well this site is an excellent example. We become engaged in making a positive change in the community's where we live and the folks we call friends. Like any change it begins at home, in your life.

Now I have to stop at this point and confess that I have not made a donation to this site; that is terribly wrong of me and I will do so.

Write or email Production Company's (Alliance Atlantis as an example), Publishing Houses, letting them know you're tired of seeing all this anal; you want to see some real action, FROTTAGE. Believe me, your complaints are read and reviewed. The more they get the better the chance of change.

After you start doing this you actually get a real motivation and you change yourself in the process; that's been my experience at least.

Anyway that's my rant for today. I really do feel strongly that if we combine our "voices" the deafness of the culture will subside and positive change will be made.


Bill Weintraub

Re: Rectal Secretions from "Men who have Sex with Men" Contain More HIV than Blood or Semen


Hey David,

Thank you for all your very supportive and wonderful posts.

You're the one person in here who doesn't need to make a donation -- you've done far more than your share out in the world for the Alliance and all Frot Men.

And you're absolutely right "that if we combine our "voices" the deafness of the culture will subside and positive change will be made."

However, in this instance I would urge Frot Men to direct their voices in a slightly different direction:

Still towards a cultural messenger, but a different messenger.

So let's talk porn and videos and what's the most effective use of your letter-writing and other activist time.

This question of porn comes up a fair amount.

Of course, people are free to write to whomever they wish, but pornographers and other purveyors of erotica aren't in it for the good of mankind: they do it strictly for the money.

And the reason there aren't Frot videos is that there's no or very little money to be made.

I know; as does Mart Finn, who has a "commercial" cocktocock site; as does EROS V, who put together BlackDicksRubTogether and other sites.

Collectively the three of us have about 12 years experience in Frot, and here's what we know:

The market is miniscule.

I'll explain why in a moment, but first let's talk about the actual costs of making a video.

Currently, X0 man says he wants 20 people to give him $5000 (yes, that's 20 x $5,000 = $100,000) to "invest" in a dick2dick film.

He also says that he would keep the money in an "off-shore account" to be sure of no government interference.

Reality: While of course one could spend $100,000 or $500,000 or even a cool million on a dick2dick vid of some sort -- you'd never earn your money back on it.

Furthermore, I don't know what he thinks the government may do, but out here in California, the porn industry is coddled by the state, which needs the tax revenues the industry generates.

Translation: you don't need to move money off-shore.

Unless you're planning on leaving it there.

Or maybe taking it somewhere else.

Now, what does it actually cost to make a video?

Not $100,000.

I discussed this with Joe Kramer, a PhD sexologist who is an internationally recognized expert on erotic massage and masturbation, who has given workshops literally all over the world, and who has made no fewer than 10 erotic massage and masturbation videos, aimed at both men and women, which he markets on high-end websites like Playboy dot com.

According to Joe, whom I've known for years, with whom I studied, and whom I trust, and who, like me, has been an out gay man working always under his own name for more than 30 years, it costs no more than $12 to 15,000 to make a professionally shot and edited vid/DVD with 8 "models" / "actors."

We last talked about this at length two years ago, and by now I'd be certain it costs even less, because so much can be done on home PCs.

So why aren't I running out to make these vids?

First of all because I don't have $12,000.

But even if I did, the market's too small.

Here's why:

The people who are able and most likely to buy a male-male porn vid, are gay men.

They have surplus income, and they don't have wives.

But as we all know, Frot Men are a tiny minority of gay men -- who are themselves a minority.

Mart knows it, I know it, EROS V knows it: as of now, there just aren't a lot of gay men who think outside that anal box.

They exist -- and to say that gay men all do anal or that the "a" in g-a-y stands for "anal" is a lie, and a slander upon all those gay-identified men like myself and my late lover who don't do anal sex.

But the number of men within the gay community who don't do anal is still relatively tiny.

And those are the guys you need and would rely on to buy that video.

There are, however, a comparatively large number of guys who are bi or straight-identified who are into cock2cock.

Problem: almost ALL of them are married, and the last thing they want in their DVD collection is a copy of Cockrub Confidential.

Because it would destroy their marriage.

That's why our donor premium on this site is *on-line* access to Mart Finn's wonderful CockToCock Stories Vol 1.

Because most of our guys don't want a hard copy of those stories -- it would compromise them.

Well, you may say to me, why can't you shoot a vid and make it available for downloading over the web for a fee.


As soon as I did that, the vid would be copied and sent out all over the net.

No matter how good my encryption was, someone would break the code -- and that would be it.

And if you think that the average Frot Guy is more honest about stuff like this -- think again.

People regard material on the net as free -- they don't believe they should have to pay for it.

So: given the way the population of men into Frot breaks down -- a relatively tiny number of gay-identified men, and a much larger number of bi and straight-identified men -- you cannot make money.

You might break even, but in my view, you will lose money.

And that's why I have not done what X0 man is doing, and asked you to "invest" in something -- because it's a bum investment.

If someone out there wants to spend $10,000 on a Frot vid as a labor of love -- we can talk.

But if you ask me, "Is this a good investment?" I'd say -- NO -- you're throwing your money away.

And in terms of a big porn studio doing this:

Why would they?

Like I say, they're not philanthropists.

The gay money is in anal.

The straight money is in straight sex -- including anal.

Of course, they might make a vid with a couple frot scenes and a lot of anal scenes, but then all you've got is a vid reinforcing the notion that frot is foreplay, and that only anal matters.

The one thing you can be sure the porn studios will not do is make a "liberating" pro-Frot movie.

Because that would undercut all the other vids they've made, and in which they have a big investment.

So that's where the matter sits.

Further, I want to emphasize to you guys that you do NOT need more pornography.

There's far too much porn in our lives.

What you need is real connections with real people.

Making those connections is a lot more work than watching a video.

But the pay-off is a lot higher.

It's the difference between empty sex and true love guys.

And you all know the difference.

Finally, if you're going to do a letter-writing campaign, what I urge you to do is write to your local AIDS Service Organization (ASO).

I've spent a year working with AIDS anthropologists and epidemiologists and some people in Congress on the issue of how ASO money is spent, and they're in the process of making a big push in the direction of Fidelity (partner reduction), and, maybe, non-anal alternatives too.

Now, as most people know, the Bush admin *at present* is reluctant to have anything to do with appearing to endorse "gay sex."

But, yesterday, for the first time, the President actually endorsed condoms when part of an "ABC" (Abstain, Be Faithful, Use a Condom only as a last resort) program.

That was significant.

In the meanwhile, the Bush admin and Congress have been pushing the ASOs very hard to come up with AIDS prevention programs which actually prevent AIDS -- or lose their funding.

At present the ASOs are the primary manufacturers of messages about sex among gay men, and, unlike pornographers, their concerns go beyond money.

In addition, the ASOs are greatly respected in the gay community, where they are perceived as professional, scientific, and caring.

I urge you to write to your local ASO, saying you want to see far more emphasis on non-anal alternatives, including Frot, in HIV prevention programs.

And give them the URL of What's Hot About Frot:

Getting the ASOs behind Frot would really make a difference.

And it's just a question of emphasis.

Less emphasis on "use a condom every time," more emphasis on partner reduction and non-anal sex.

That's a moderate program, which, given the intense pressure they are under from the Republican congress, the ASOs may well respond to.

So: when you ask a pornographer to make a cock2cock video, you're asking him to lose money.

And that's not why he's in business.

Nor does he care about "safe sex."

But the ASOs do.

They've been misguided in my view, but, under pressure, they are beginning to come around.

If you have only one letter to write, write it to your local ASO.


Re: Rectal Secretions from


Thanks Bill.

Your thoughtful and thought-provoking insight into current "gay culture" points me in the right direction.

You're right; targeting the "gay porn industry" would be like p-ssing in the wind.

Off goes a letter/email to the Aids Committee of Toronto "ACT", sort of an ironic acronym. Let's ACT with the conviction to make change, not perpetuate the problem!



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