For different reasons I recently re-read Joan Shenton’s Positively False (1998; an updated version is in publication) and a review I wrote in 1996 of five HIV/AIDS dissident works (Lauritsen, Poison by Prescription  and The AIDS War ; Fumento, The Myth of Heterosexual AIDS ; Root-Bernstein, Rethinking AIDS: The Tragic Cost of Premature Consensus ; Ellison & Duesberg, Why We Will Never Win the War on AIDS ). That brought home how compelling was the evidence, already very early in the AIDS era and from a considerable variety of viewpoints and phenomena, that HIV is not the infectious cause of AIDS.
Root-Bernstein in particular — as befits the immunologist that he is — pointed out how many reasons there can be for immunedeficiency. Any number of challenges can weaken the immune system: infections of all sorts, drugs, blood transfusions, age that is too young or too old; and the opportunistic infections that characterized 1980s-AIDS had long been observed — albeit rarely — as resulting from those conditions. Data from antibody surveys revealed that Africans and gay Americans had typically been exposed to a considerably greater number of different infections than had heterosexual Americans; and immune systems are weakened especially by multiple and concurrent challenges. If AIDS and “HIV-positive” both (independently) reflect immunedeficiency, here is cogent reason why Africans and gay men have been and continue to be the prime victims.
Semen is “One of the oldest identified alloantigens known to cause immune suppression . . . if it obtains access to the bloodstream or lymph”. Receptive anal intercourse risks such access, and such intercourse in both women and men was early identified as a risk factor for AIDS (p. 115 in Root-Bernstein).
That last point offers a possible, at least partial answer to the troubling, unresolved question, why “HIV-positive” continues to be more prevalent among even those gay men who never indulged in the “fast-lane” lifestyle of drug abuse and extraordinary promiscuity that brought about the initial “AIDS” “epidemic”. Systematic data are lacking, but there are a handful of anecdotes of gay men being “HIV-positive” and healthy for decades but then becoming more or less suddenly ill with some sort of “AIDS-like” symptoms. Perhaps a consequence of a long-standing but sub-acute weakness of the immune system? It is frustrating in the extreme that these anecdotes lack full information about all aspects of the individuals’ health histories and of what diagnostic attempts attending doctors may not have made: one knows that, quite routinely, doctors take an “HIV-positive” test as providing all the diagnosis they need.
That the fast-lane life bears primary blame for the 1980s epidemic seems clear enough. Larry Kramer’s novel Faggots and the documentary Where Ocean Meets Sky describe the scene quite graphically. Josef Sonnabend cautioned his gay clients during the 1970s that their continuing behavior would bring drastic consequences. Gordon Stewart saw AIDS-like symptoms among (heterosexual) drug abusers in the 1960s (Hodgkinson, AIDS: The Failure of Contemporary Science  p. 103 f.).
It may be difficult to appreciate the impetus that led a small proportion of gay men to such self-destructive behavior unless one obtains some inkling of the intense persecution gay men routinely experienced, and the correspondingly intense sense of relief brought by so-called “gay liberation” following the “Stonewall” events of 1969. Among the books that have opened my eyes a bit about those things are Edmund White, States of Desire and City Boy. I recommend them highly, also Dennis Altman’s AIDS in the Mind of America and The Homosexualization of America; and Early Homosexual Rights Movement, 1864-1935 by John Lauritsen and David Thorstad. I’ve mentioned often before that Andrew Sullivan’s Virtually Normal is for me the most cogently reasoned argument I’ve read, deservedly credited for priming the road toward marriage equality.