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Rise in Sexual Diseases May Signal Return of Unsafe Sex

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The latest gonorrhea statistics only go through 1998, so no one knows what has happened since, Laurence says. Preliminary data from 1999, however, show that the disease may once again be on the decline.

Recent studies have shown that 50% of gay men and 50% of women in high-risk groups use condoms all of the time, and that 20-30% of gay men and high-risk women use condoms often, but not always, Laurence says. High-risk groups mainly include people with multiple sex partners and those who use IV drugs.

"That's still a high number, [but] there are pockets of people in San Francisco, particularly young gay men, who feel that HIV is not in their population," Laurence tells WebMD.

According to Laurence, their attitude is: "'Well, I can practice safe sex for 30 to 40 years, or do exactly what I want, get infected, live 10 to 15 years without any signs or symptoms of the disease, then take protease inhibitors or whatever drug is available at that time. So why should I be celibate or good when I can take risks and the worst thing that can happen is that I shave a few years off my life?'"

But protease inhibitors -- the antiviral drugs that interrupt the way HIV uses a healthy cell to make more virus -- are not miracle drugs, he says. They only work half the time, and people can develop resistant strains of the virus, Laurence says.

Also, he says, despite some misconceptions, the AIDS crisis is far from over.

As of the end of 1999, an estimated 33.6 million people worldwide were living with HIV/AIDS, according to the National Institute of Allergy and Infectious Diseases in Bethesda, Md. Worldwide, approximately one in every 100 adults aged 15-49 is HIV-infected, and in 1999 more than 7,500 people aged 15-24 became infected with HIV every day.

"We have heard about the rise of certain STDs in the gay community anecdotally, and we are concerned because it means that people are not using condoms, and this may be a precursor to more HIV/AIDS cases," says Marty Algaze, spokesman for the Gay Men's Health Crisis in New York. "We know that people are letting their guards down because they feel that the AIDS crisis is over because of the new medications."

He tells WebMD that the new thinking may be that the worst that can happen is that a person goes to the doctor's office and is put on medication to treat HIV/AIDS. But "even though there are treatments, there is still no cure for HIV/AIDS," he says.

"Our biggest concern is for young gay men, who did not have all their friends die of AIDS, who think they can act recklessly and engage in risky behavior like anal intercourse without a condom," Algaze says. "That's a big mistake."

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