According to Rotello, lowering the contact rate while continuing to emphasize condoms might provide enough additional "room for error" to bring new infections below the epidemic's tipping point.
"[2] The New York Times called the book "trenchant" and "brave", saying that it "merits the attention of a broad audience";[3] The Boston Globe described it as " ... the Silent Spring of the AIDS epidemic.
"[6] AIDS activist Jim Eigo compared Rotello to right-wingers such as Pat Buchanan and Jesse Helms, writing that he "scapegoats and stigmatizes those of us who engage in multipartnerism.
"[8] Rotello was controversial for promoting the word "queer" as a catchall phrase for sexual minorities and for the phenomenon of "outing," which began at OutWeek;[9][10] he considered himself a member of the gay left.
[11] In 1992, He became the first openly-gay man to become an op-ed columnist for a major American newspaper (New York Newsday) in 1992, and used that platform to argue for gay rights and AIDS activism.
One result was "The Birth of AIDS", a cover story for the magazine Out,[14] which described the emerging scientific consensus that HIV had existed in human populations for decades before the 1980s but had not previously produced an epidemic because it required a unique set of circumstances to spread.
He wrote columns criticizing this for New York Newsday,[15] and joined a group called Gay and Lesbian HIV Prevention Activists (GALHPA), that believed that such venues should enforce safe sex or be closed.
Before World War II, most American gay men did not engage in high-risk behavior; they had fewer partners and were more inclined to have oral (rather than anal) sex.
Attendees of gay bathhouses and sex clubs might have hundreds of sexual partners per year,[23] leading to sexually-transmitted epidemics of syphilis, gonorrhea, herpes, giardia and other intestinal parasites, hepatitis A and B, Epstein-Barr virus, chlamydia, and cytomegalovirus.
Aspects of gay sexual ecology cited by epidemiologists included insertive-receptive versatility, partner concurrency, viral load, reduced immunity due to STD re-infection and substance abuse, and the role of travel.
According to evolutionary biologist Paul W. Ewald, high levels of HIV transmission among gay men produced more virulent strains of the virus.
Condoms became the primary response to AIDS prevention in the gay world after the publication of "How to Have Sex in an Epidemic", a pamphlet by Michael Callen and Richard Berkowitz.
Homophobic theories that AIDS proves the inherent "unnaturalness" of homosexuality are belied by global statistics showing that 90 percent of all cases worldwide are spread via heterosexual sex.
Well aware that his call for increased sexual restraint will be seen as reactionary and homophobic by those who cling to an orgiastic view of gay liberation, he anticipates their arguments and answers them persuasively in this impressive analysis of a pressing social problem.
"[37] In another starred review, Publishers Weekly said that Rotello's "brave, significant book deserves to be as widely read as Randy Shilts' And the Band Played On.
Ideally, Sexual Ecology will lead to more honest, rational discussion about AIDS transmission, without feeding the hellfire flames favored by anti-gay outsiders.
"[38] A Boston Globe reviewer wrote that Rotello " ... cogently rethinks the epidemic as the ecologically enabled result of HIV's biology and post-Stonewall gay sex ...
He seeks "a sustainable gay culture, one that does not destroy the very souls it liberates" with a sexual ecology that must constantly add unnatural appliances, ranging from condoms to pills to who knows what else, to keep its members alive.
This book marks a turning point, as perhaps the first major work to challenge how the dogma of gay liberation and AIDS education have sometimes blended into a potentially unhealthy cocktail of misinformation.
"[42] In his book, The Tipping Point, Malcolm Gladwell called Rotello's description of STD epidemiology in Sexual Ecology " ... one of the best lay treatments of the mechanics of a disease epidemic.
"[citation needed] Pioneering AIDS activist and GMHC co-founder Roger McFarlane wrote for POZ,Sexual Ecology blows the lid off the epidemiological closet ... Whatever the complexity of the task, the first step must be an honest assessment of how we got into this mess and what each of us can do to end it.
In Out magazine, Richard Goldstein wrote that Sexual Ecology "urges gay men to devise alternatives to promiscuity while haranguing them for failing to be restrained.
"[50] In a rebuttal to Sexual Ecology, AIDS activist Jim Eigo wrote that the book's "central argument" is that gay men should "...abandon current safer sex strategies (primary among them the condom code) and adopt serial monogamy as a communal norm."
Schoofs continued, Rotello's browbeating rhetoric, his revision of AIDS-prevention history, and his distortion of gay life add up to more than "mere" matters of style, or politics, or even truth ...
's name was derived from the work of gay historian Allan Bérubé, who described historical "sex panics" as "moral crusades that lead to crackdowns on sexual outsiders.
began a campaign of articles, posters, workshops and teach-ins to advance its views, which included discrediting Sexual Ecology as homophobic, assimilationist, and scientifically inaccurate.
The article cited Michael Warner as saying that "... promiscuous sex is the essence of gay liberation, and that any attempt to fight AIDS by changing the culture is doomed.
He predicted that as new drugs effectively treated HIV, fear would abate and condom use would probably diminish; treatment could become a form of prevention by lowering group infectivity.
It has been discussed in over 200 subsequent books and hundreds of articles and scholarly papers on subjects including epidemiology, sociology, AIDS, gay history, psychology, spirituality, ecology, and sexuality.
[71] Much of the discussion echoes the original debate, with some authors describing it as a key text on gay men and AIDS and others calling it assimilationist, inaccurate or homophobic.