Journal of the Plague Years: 1981—2008

It is “possibly transmitted by sexual contact,” hedged Sabin Russell, the San Francisco Chronicle medical writer, last month—though “researchers have stopped short of declaring this form of staph a sexually transmitted disease.”

Because if they did, then they’d have to call the common cold one, too!

Somewhere, Laurie Garrett is screaming.

Back at the gay center: “That study in San Francisco didn’t have any behavioral data,” said Melissa Marx of the New York City Department of Health’s communicable disease bureau.

But the city does now. The
New York study, in interviews with people with MRSA, did not show that people with MRSA were more likely to have had more sexual partners or to have had more sex acts.

Nor were they more likely to have sex in bathhouses.

And they were not more likely to use drugs—except for crystal meth.

The preliminary results did suggest that men with MRSA were slightly more likely to have had sex at a private party in the past year. The city expects that that is related to their (preliminary!) finding that people with MRSA were also less likely to shower or wash immediately after sex.

The study, so far, shows one concrete thing.

It is that people who spend time with other people are more likely to give each other their communicable diseases.

In sticking to this point, Marx skirted the dreadful problems of epistemology that afflict reporters (and researchers!) when making sense of data.

And as for the gays, well. There is one other thing the study might show. It is far more likely that community-acquired MRSA in New York City is a disease of crystal meth users. It is being identified as a gay disease because crystal meth is epidemic among gay men.

In other words, it’s all the wrong way around. Crystal meth users in New York are not the Amish on rumspringa in a Delaware trailer park you see on 60 Minutes. They are, disproportionately, affluent young gay men.

In another, much smaller study, presented in 2004, researchers interviewed 12 gay men in New York with MRSA. Eleven of them had used crystal meth in the previous three months.

Do 11 out of 12 gay men use crystal? Of course not. Eleven out of 12 gay men with MRSA did!

Also, 11 of them shaved their body hair. No anal sex needed for transmission!

Dr. Marx had some just-crazy recommendations.

“We suggest you avoid using crystal meth,” she said.

And if you go to a sex party?

“Maybe bring your own towel,” she said. The condoms, of course, go without saying—unless you’re talking about that other gay plague.

“B.Y.O.T.!”

These rules were perhaps too simple for the crowd—aging bad boys, yesterday’s sex radicals. The first question she got from the audience was from a man who wanted clarification on staph’s affection for warm, wet places.

“Would you include someone shooting a load on you?” he asked. Dr. Marx didn’t flinch, but I did.

Journal of the Plague Years: 1981—2008