On 30 November 2000 the Government voted to lower the age for consent for anal sex from 18 to 16, by invoking the Parliament Act to overrule the House of Lords and pass the 'Sexual Offences (Amendment) Bill'. Less than a month later, research released at a British Psychological Society conference suggested that many homosexuals are tired of constant warnings about their sex lives and feel empowered by rebelling against them (The Times, 20 December 2000). An earlier survey of 10,000 UK homosexuals showed that 45% had had unprotected anal sex; two thirds of these did not know the HIV status of their partners. This February it was announced that new HIV infections had hit a record UK high in the year 2000 (BMJ 2001; 322:260).

The health risks of anal sex are well documented but poorly publicised. The delicate columnar epithelium of the rectum makes it highly susceptible to syphilis, gonorrhoea, HIV and other viral infections predisposing to anal cancer. Anal squamous epithelial lesions are now found in 36% of HIV positive gay men (Sex Trans Dis 1997; 24:14). Furthermore breakage and slippage rates for condom use in anal sex are 32% and 21% (respectively six and three times higher than for vaginal sex)(AIDS 1998; 12(5): 495-503).

But whilst doctors would consider it negligent not to warn their patients of the health dangers of smoking, excessive alcohol, poor diet and lack of exercise; most are reluctant to highlight the dangers of anal sex. Nor does the health of its homosexual citizens appear to be a leading priority for government.

The Bible is clear that homosexual acts are wrong and their associated high health risks should come as no surprise. No one is saying that as Christian doctors we should judge our homosexual patients or deny them good medical care. But, as well as being vehicles of God's mercy and compassion, Christian witness also involves being informed in an atmosphere of ignorance and misinformation and speaking the truth about risks to health. Even at the cost of incurring the wrath of the politically correct. If we remain silent, we share the blame.