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Would there be an HIV problem if we eliminated anal sex? Whether men on men or men on women. Your figures of one in 1000 or 2000 for vaginal sex are pretty long odds. What are the odds in anal intercourse? T-cells are dense in the lower digestive tract, so transmission is very likely, much more so than in vaginal sex. Why is there such resistance to discussing the most likely vector? There is an incredible desperation to blame heterosexual sex as being equivalent to homosexual anal sex as a vector. It isn't. Cut out the buggery and you will essentially eliminate HIV.