- The Washington Times - Saturday, May 7, 2005

In the early 1990s during my infectious disease training program, I asked a homosexual HIV-infected patient if he told his sexual partners of his HIV infection. The patient solemnly told me “that it was a risky world.”

In a recent study more than 75 percent of HIV-positive individuals did not tell casual sex partners their HIV status. I have come to understand it is indeed a very risky world. As a physician, I warn of health risks. I believe Montgomery County Public Schools (MCPS) should do the same.

I’m concerned about the new MCPS health education curriculum which will now include the subject of sexual variations (homosexuality, bisexual, transgenderism).

In the memorandum describing the curriculum, Superintendent Jerry D. Weast said the goal of the curriculum was to let others know homosexuals could have happy and healthy lives. He implied this information was needed to promote tolerance.

I submit tolerance should be encouraged by allowing us all to recognize the worth of each individual regardless of their choices. And that in “promoting tolerance” the Montgomery County Public School system should not lose sight of its responsibility to protect teenagers and warn of health risks.

It may not be politically correct to describe ills related to homosexual activities, but it is scientifically correct. The MCPS health curriculum must tell the youth that increased number of sexual partners and risky behavior increases the incidences of sexually transmitted diseases.

This risk can clearly be documented in the homosexual population. Homosexuals account for less than 3 percent of the population. Yet in 2003 men having sex with men accounted for more than 63 percent of newly reported HIV cases in males. Gay and bisexual men account for 10 percent of all new hepatitis A infections and 15-20 percent of all new hepatitis B infections in the United States.

In recognizing risky sexual behavior, the CDC (Centers for Disease Control) recently recommended that men who have sex with men (MSM) should be vaccinated for hepatitis A and B and tested at least yearly for HIV, syphilis, gonorrhea and Chlamydia.

Dr. Ronald Stall, Ph.D., research chief for of HIV/AIDS prevention at the Centers for Disease Control and Prevention in Atlanta, has said: ” Substance abuse is pervasive among gay men and is so intricately intertwined with epidemics of depression, partner abuse and childhood sexual abuse that adequately addressing one issue requires attention to the others as well. … We have at least four epidemics going on among gay men that are associated with each other and making each other worse.” (Internal Medicine News March 1, 2004 Volume 38:5 “Drug Use Pervasive Among Gay Men.”)

Why aren’t the CDC’s MSM testing guidelines included in the Montgomery County Public Schoos curriculum? Why aren’t other maladies such as “gay bowel,” rectal cancer, increased risk of depression and drug use in the homosexual population better delineated by the curriculum?

Superintendent Weast should not describe the ills of the homosexual community as a happy and healthy lifestyle either in memorandum or by manipulating the MCPS curriculum.

Part of the current concern about the MCPS curriculum is that it does not well delineate all risks of a homosexual lifestyle. It is worrisome that CDC resources that suggest some of these risks were initially rejected by the curriculum committee (CACFLHD) and now are only partly included.

As an infectious disease specialist, I have concerns that while the curriculum outline identifies risky sexual behaviors as (1) body fluid exposure, (2) unprotected sex (3) drug/alcohol use, and (4) others, it does not clearly include other critically important risks. These include: (1) total number of lifetime partners (2) men having sex with men/rectal sex and (3) sexual relations with people who engage in risky behaviors such as drug use, multiple sex partners, rectal sex, exchange of sex for drugs, among other practices.

Encouraging risky sexual behavior undermines good health and can shorten lifespans. Yet that is exactly what the curriculum could do if it hides the health risks among homosexual men and people having sexual relations with multiple partners.

The CDC has recommended the ABC framework:

A= Abstinence first or B= Being faithful to one partner (one uninfected lifetime partner is best) and C= Correct and consistent use of condoms by those who are sexually active.

Epidemiological studies show condoms offer no protection for human papilloma virus transmission and possibly 0-50 percent protection for other sexually transmitted diseases. The studies show 87 percent protection for HIV with vaginal sex. I question why the very valuable ABC program is not clearly identified and utilized in the MCPS curriculum.

While it is indeed “a risky world,” our taxpayer dollars should not be used to encourage or normalize risky sexual behavior or to hide the results of such behavior from young people.

RUTH M. JACOBS, M.D.

Past chair

Internal Medicine

Shady Grove Hospital

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