Tolerating male homosexuals lowers HIV

Andy Francis and Hugo Mialon, both at Emory, report their latest research:

We empirically investigate the effect of tolerance for gays on the spread of HIV in the United States. Using a state-level panel dataset spanning the mid-1970s to the mid-1990s, we find that tolerance is negatively associated with the HIV rate. We then investigate the causal mechanisms potentially underlying this relationship. We find evidence consistent with the theory that tolerance for homosexuals causes low-risk men to enter the pool of homosexual partners, as well as causes sexually active men to substitute away from underground, anonymous, and risky behaviors, both of which lower the HIV rate.

That piece has recently come out in the Journal of Health Economics.

Comments

Maybe it really means god has abandoned the tolerant society and no longer sends HIV plague to kill the sinners. But maybe god has decided to use fire and brimstone to wipe out complete societies for their sins. Haiti and Iceland, to name just two, are warnings from god to repent and renounce sin.

In other words, an exogenous factor preventing the lower cost of being gay failing to supply the greater quantity of HIV as conservatives argue, so conservatives are still right - the only way to avoid dying from gay sex it to chose to be straight.

In other words, no matter what the evidence, the study isn't going to improve public policy which is driven by the many people afraid of being honest and objective about sex in any aspect.

Tom T.

The sentence is poorly worded. The HIV rate refers to HIV cases per 100,000 of total population, not rate within the gay community.

Adding low risk men to the dating pool seems to reduce the overall HIV rate.

I don't believe the gross conclusion: "tolerance is negatively associated with the HIV rate."

I think San Francisco and New York have very high tolerance, and very high rates.

From the article:
According to our estimates, a
twenty percentage point rise in the GSS measure of tolerance, which corresponds roughly to the
extent to which the measure increased from 1990 to today, is associated with a decrease in the
HIV rate of approximately one case per 100,000 population.

Also:
We additionally use state bans on gay marriage or civil union as a proxy
for intolerance.

I don't believe this is such a good proxy for social tolerance.

I'm not going to finish the article, but it seems they are discussing change of tolerance, rather than tolerance.

However, and 40,000 new infections per year -- shouldn't infecting somebody else with a disease be a crime? Who pays the health cost of these new victims of irresponsible HIV spreaders?

@ Tom Grey:

"'We additionally use state bans on gay marriage or civil union as a proxy
for intolerance.'

I don't believe this is such a good proxy for social tolerance."

Why not? The extent to which governments adopt policies based on the assumption that same-sex relationships are as deserving of support and protection as their heterosexual counterparts, reflecting popular attitudes, strikes me as a pretty good proxy for social tolerance. The only place I know of where government policy doesn't reflect public opinion in South Africa, where strongly GLBT-friendly policies co-exist with a strongly homophobic population because of that country's peculiar history.

I'm confused. I thought drug use was also related to AIDS transmission and would be an important factor in total HIV rates. There seems to be no discussion or control for this and related concerns in the paper with the sole exception of HIV through tainted blood transfusions.

"but if you believe this, it's because you want to believe it."

Or because you see it at work on a micro-foundational level. Yes, anecdotes and personal observations don't constitute statistics, but they do count for more than just wanting to believe a hypothesis.

I attended a talk by these guys on this same paper a year and a half ago. At the talk was a professor who refused to believe their results because he didn't like the idea that gay men would alter their behavior because of what some hillbilly bigots thought of them. It was funny because he was otherwise a smart, competent professor who refused to believe this work simply because it went against his politics.

Anyway, the version of the paper I read needed a little work then, but overall I thought it was solid. I haven't read what they just published, but I'm confident the results are sound.

The New York City and San Francisco anecdotes do not hold much water because within the U.S. people have a great degree of mobility. Obviously, people will flock to where people are more tolerant of their existence. Comparing the countries is a valid comparison me thinks.

At first I didn't believe Steven Landsburg's "More Sex is Safer Sex", but theory combined with empirics is a lot better than theory alone.

B.B.:

"That means those who disapprove of homosexuality are correct in saying that there is a large cultural impact on sexual expression; it is not genetically based.

You need to make up your mind on sexual orientation: genetics or environment?"

Who in the paper, or here in the comments, said that it was a simple yes/no thing like that?

Careless:

As I said above, San Francisco was one of the earliest points of entry of HIV in the United States--the first HIV-positive blood samples found date back to 1978--so it's not surprising that the virus became endemic before anyone knew that it existed. Besides, California in the early 1980s was a rather different place from California in the early 2000s, even.

As I said above, San Francisco was one of the earliest points of entry of HIV in the United States--the first HIV-positive blood samples found date back to 1978--so it's not surprising that the virus became endemic before anyone knew that it existed. Besides, California in the early 1980s was a rather different place from California in the early 2000s, even.

My point has nothing to do with the why, but with the methodology. SF being a large, gay-friendly city/region in a more average state presents a problem for them. Which is why, now that I looked at it, I see that they ran regressions without California and DC.

"I can also imagine that more sex and safer today, leads to more sex and less safe tomorrow, and higher rates later in the future."

------------

This statement strikes me as a definite possibility. The HIV rate would then have a predator-prey dynamic.

"In his groundbreaking book Sexual Ecology, author Gabriel Rotello views the [AIDS] epidemic in a new way: as part of an ecological system. Rotello's approach, while unique in the study of AIDS, is one familiar to the environmental movement. He sees the disease not as a discrete element, but as part of a system of "behaviors, thoughts and feelings that made gay culture so susceptible to AIDS."

"Although Rotello aims his book primarily at a gay audience, Sexual Ecology has a wider appeal. His chronicle follows the growth of promiscuity among homosexual men through its promotion by bathhouse owners and the gay media."

Basically, if you are going to let lots of strangers inject outside substances into your bloodstream, some of them might kill you.

Intolerance -- police raids on gay bathhouses and the like -- reduced male homosexual promiscuity up through the late 1960s. When legal suppression vanished in the most tolerant cities after the Greenwich Village Stonewall riot of 1969, a gay male culture of industrial scale promiscuity emerged, in which the HIV virus was rapidly transmitted.

Are we too brainwashed to remember what happened a few decades ago?

HIV doesn't only come from gay people and that's not where it originated. women have anal sex too. drug addicts share needles and there is very many different ways people are contracting HIV. and if you have a gay child being more accepting and teaching him to have safe sex GREATLY reduces the chances of him catching any diseases what so ever.

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