In his brutally honest, groundbreaking and iconoclastic book, Sexual Ecology, gay American author Gabriel Rotello warned the gay communities of the danger they were in if it became known in society at large what was already common knowledge in their own communities, namely the fact that gay men were deliberately engaging in unsafe anal penetrative sex despite two decades of sexual education warning against this practice. Rotello warned that society would withdraw their support, funding and compassion for men who had knowingly become infected.

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So awesome and irrefutable were the arguments presented by Rotello that a campaign of vilification against him was orchestrated by the very same British and American sex educators whose conflicting and unclear advice drove much of the unsafe sex taking place in the UK and US gay communities.

His book was attacked by one of the UK's leading gay sex educators, in a conversation with Cass Mann, as "daring to tell the truth about what gay men do to people who must never know". Rotello's book consequently did not have the impact it should have as copies were mysteriously removed by outraged persons from the gay non-fiction racks and stuffed elsewhere where they would be lost to browsers.