"Now, if the so-called life-style theory of AIDS is correct, one important implication is that AIDS should not be a new syndrome. It is not. I am one of only a handful of scientists who have bothered to search intensively through the back issues of medical journals for odd cases that match the CDC surveillance definition of AIDS. So far I have found hundreds of such cases, extending back to 1872 (the date when the first opportunistic disease associated with AIDS was identified). I have also scoured the medical literature for data relevant to changes in life-style risks associated with immunosuppression. What I have found is very provocative.

"Whereas the Kinsey report of 1948 indicates that the average homosexual man had a sexual encounter no more frequently than once a month, by 1980, the advent of gay bars and bath houses had increased this average to dozens per month. Gay AIDS patients have often had thousands of sexual partners. Medical reports of complications arising from AIDS-associated high-risk activities such as anal intercourse and fisting are first mentioned in the medical literature only at the beginning of the 1970s, and become increasingly frequent thereafter. From 1960 to 1980, the rates of syphilis triple, gonorrhoea quadruple, and diseases related to 'gay bowel syndrome' quadruple. These increases were found only among gay men, but not among heterosexual men or women.

"From 1960 to 1980, hepatitis-B cases rose 10-fold, in part due to sexual transmission in gay men, and in part to IV drug abuse. Arrests on opiate-related drug charges rose nearly 20-fold during the same period. There is, then, no doubt that AIDS was preceded by medically evident changes in life-style among those groups at highest risk for AIDS, and these changes are such that not only HIV, but the entire spectrum of immunosuppressive agents mentioned above became increasingly prevalent in these groups.

"These data indicate to me that HIV is not sufficient to explain the manifestation of AIDS or its recent appearance. Many other factors are also at work. It is a tremendous mistake to base our policy decisions concerning AIDS on an exclusive HIV basis. Far from undermining current drug prevention and safe sex programs, the recognition of non-HIV immunosuppressive factors in AIDS suggests that these programs are failing because they are too narrow. AIDS will only be understood when we begin to explore the ways in which anal sex, infections, drugs, blood products, anesthetics, antibiotics, and malnutrition interact. At present, we know almost nothing about such interactions. Since increasing evidence from the laboratories of the discoverers of HIV indicates that HIV needs immunosuppressive co-factors to be active, such studies are clearly needed. In the meantime, those who wish to avoid contracting AIDS should avoid all potential causes of immunosuppression, not just HIV. And those who are HIV-positive but not ill may find that if they, too, avoid the lengthy list of immunosuppressive co-factors, they too will stay healthy."