Sunday, February 27, 2005

Comments at Say Anything

My comments to this article:

I'm just wondering then, how so much HIV is spreading so rapidly among straight populations?

Promiscuous sex with multiple sex partners. BBC News
What are "multiple sex partners"? Having more than one partner. Usually in the form of:
  • Infidelity - Having sex with someone other than your lover.
  • Adultery - Having sex with someone other than your spouse.
  • Bisexual sex - Having sex with both men and women (includes "three-somes" and orgies.
  • Transgendered sex - Having sex with those of the same sex who are undergoing transition into the opposite sex.
In all these cases, the sexual partner (at the time of sex) could be carrying HIV and did not disclose that information to the "straight person" (per se) or did not know they had HIV because they did not get tested in spite of their sexually active lifestyle.

AIDS IN BRAZILIn fact, I was told by an AIDS physician that the fastest growing risk group in the country is now married straight women. Upon my asking why this is so, she told me that single women are insisting on "safe sex" (they buy condoms if they can afford them) but married women aren't, although their husbands often engaged in high-risk behaviors out-side the marriage, including bisexuality.

Most sexually active folks do not get tested because of fear, for one. The anxiety of waiting for the test results is too much to think about. There are other reasons as explained by Barbados Association of Medical Practitioners that can apply to all people.
A client may decide not to test because of: false information; insufficient/ inadequate pre-test counseling; lack of social support; fear of a breach of confidentiality; fear of testing procedure; fear of stigma; cultural values; a history of past or present abuse.
Page 31 of this pamphlet, Students for International Change: HIV Education and Prevention Curriculum, suggests role-playing to address the fear of getting tested.

In fact, in Africa and Asia, the majority of infectants, of which there are millions, are heterosexual and women. See below for the African study.
According to HIV Insite: Center for HIV information, injecting drug users count for 35-80% of those infected in Xinjiang, China & 20% in Guangdong, China. Three of China's provinces are named where "HIV gained a foothold in the early 1990s among rural people who were selling blood plasma to supplement their meager farm incomes."

UNAIDS, WHO: ASIA"A rare survey of men who have sex with men in Beijing, conducted in 2001-2002, found that approximately 3% of the men were HIV-infected (almost all of whom had been unaware of their serostatus) (Choi et al.,2003)." SCARY, they didn't know.

The reason for HIV infection is not listed. Only that "There is also evidence of more widespread sexual activity among Japanese youth (reflected in the increase in the percentage of young people who have had sex by the time they turn 19 years of age)."

Papua New Guinea:
"Very low levels of condom use and wide sexual networking (amid low awareness and knowledge of HIV/AIDS) means the country could be facing a severe epidemic." [UNAIDS, Fact Sheet: Asia and the Pacific, December 2002]
Also mentioned are the sex workers and their clients: "High levels of other sexually transmitted infections indicate behavioral patterns that would also facilitate HIV transmission beyond sex workers and their clients." So in the "straight populations" I can see how the clients could give their wives and other female lovers HIV after receiving it from a sex worker.

The reason it is so common in third world countries is in large part due to the fact that there is so little availability of condoms, with little education on safe sex. Negative. Drug injection, sex workers, homosexual sex, and infidelity play the largest part according to UNAIDS, WHO. Don't sell us the lie of "little availability of condoms." I'll buy the "little education" part. Little education on HIV/AIDS and how its transmitted, that is. Nobody's really having safe sex anywhere on this planet - whether it is a third world country or not.

UNAIDS, WHO: ASIA "In Tamil Nadu, HIV prevalence of 50% has been found among sex workers, while in each of Andhra Pradesh, Karnataka, Maharashtra and Nagaland, HIV prevalence has crossed the 1% mark among pregnant women. In Manipur, meanwhile, an epidemic driven by injecting drug use has been in full swing for more than a decade and has acquired a firm presence in the wider population (UNAIDS/WHO, 2003). HIV prevalence measured at antenatal clinics in the Manipur cities of Imphal and Churachand has risen from below 1% to 5%, with many of the women testing positive appearing to be the sex partners of male drug injectors. Several factors look set to sustain Manipur's epidemic, including the large proportion (about 20%) of female sex workers who inject drugs and the young ages of many injectors (40% of male injectors surveyed in 2002 were under 25 years of age) (MAP, 2004)."

The reason it is common in Africa is in large part due to infidelity on the male's part, forced sex when he is questioned, and the inability of the woman to practice safe sex because of male coercion as this study shows:
Exploring the Association Between HIV and Violence: Young People's Experiences with Infidelity, Violence and Forced Sex in Dar es Salaam, Tanzania (research article)This article examines the role violence plays in the sexual relationships of young people in Sub-Saharan Africa and its association with HIV. Men who were violent toward female partners also frequently described forced sex and sexual infidelity in these partnerships. Men with multiple concurrent sexual partners reported becoming violent when their female partners questioned their fidelity, and reported forcing regular partners to have sex when these partners resisted their sexual advances, thus the association between HIV and violence may be partially explained by these behaviors.
More about Africa and HIV infectants:
Research conducted in Soweto, South Africa, provided evidence supporting this association by finding that male partners who are abusive are more likely than those who are not to be HIV-positive. [Dunkle K et al., Gender-based violence, relationship power, and risk of HIV infection in women attending antenatal clinics in South Africa. Lancet, 2004, 363(9419):1415-1421.]
HIV-infected women reported significantly more sexual violence in their relationships, a larger mean number of physically violent partners in their lifetime and a larger number of physically violent episodes with their current partner.
A study conducted in Kigali, Rwanda, revealed that women with a history of sexual coercion were more likely than those without such a history to be HIV-positive. The study also found that violent male partners had elevated odds of being HIV-positive. [van der Straten A et al., Sexual coercion, physical violence, and HIV infection among women in steady relationships in Kigali, Rwanda, AIDS and Behavior, 1998, 2(1):61-73]
...Men in Tanzania, as in many other areas of the world, usually determine when, with whom and under what circumstances they have sex with their partners. [Creighton C and Omari C, eds., Gender, Family and Household in Tanzania, Brookfield, VT, USA: Avebury, 1995.] Most young women cannot freely choose safer sexual practices or refuse unsafe sexual activity, but instead must negotiate within unequal social relationships. [Holland J et al., The Male in the Head: Young People, Heterosexuality and Power, London: Tufnell Press, 1998.]
Qualitative research carried out with adolescent males in Latin America, Asia, North America and Sub-Saharan Africa suggests that attitudes that condone viewing women as sexual objects, seeing sex as performance-oriented and justifying sexual coercion as acceptable begin in adolescence. [Shephard B, Masculinity and the male role in sexual health, Planned Parenthood Challenges, 1996, 2(2):11-14]
Gay men mentality:
August 26, 1999: UNPROTECTED ANAL SEX INCREASING IN SAN FRANCISCO A study of more than 500 young gay men in San Francisco revealed that the
prevalence of unprotected anal sex rose by a third to a half in just four
years. Furthermore, about half of the men having unprotected anal sex had
partners of unknown or different HIV status. The results are published in the
current issue of the journal AIDS.
The researchers followed 510 gay men, aged 18 to 29, who were identified for
the San Francisco Young Men's Health Study (SFYMHS) in 1992. The participants
were tested for HIV and filled out a self-administered questionnaire on
numerous topics related to HIV and sexual behaviors during each study year
between 1993 and 1997.
Men who didn't know the HIV status of their partners or had a dissimilar status
were considered to be at high risk of transmission. This group made up nearly
one fourth of the total sample during the last year of the study.
with men who had the same HIV status as their partners or who practiced safe
sex, the men in the high-risk group were significantly more likely to be HIV
positive, have greater numbers of sexual partners, and have more frequent sex,

said Ekstrand. In addition, only 32 percent reported having disclosed their
HIV status to all of their anal sex partners.

The reasons for having unprotected sex differed among the different
transmission risk groups. Men who shared the same HIV status as their partners
were significantly more likely to say they had unprotected sex because they
were in love. The high-risk group reported they had unprotected sex because
condoms were unavailable, they were turned on, or they had been drinking or
using other drugs. This group was also more likely to use nitrate inhalants,
or "poppers," to enhance their sexual experience.

"Sexual expression is highly valued in the gay community," said Ekstrand.
"Gay men might think it's not that bad to become infected with HIV these days,
but in spite of treatment advances, it's still a big deal,"
said Ekstrand.
"Many of these young men have a lot to lose by getting infected."

New combination therapy treatments don't work for everyone, and for some men,
they result in terrible side effects, said Ekstrand. The emergence and spread
of resistant strains of HIV is also a danger.

...the researchers worry that
an increase in risky sexual behavior will result in higher rates of HIV
infection. Already, several US cities have reported an increase in rectal
gonorrhea, including San Francisco.
"We want to go back to the community with our findings before HIV rates follow
suit," said Ekstrand. "Unless we can find ways to help gay men devise
practical and long-term HIV prevention strategies, ongoing HIV infection will
remain a permanent problem among gay male populations."

NOTE: A copy of the AIDS journal article in PDF format can be found at under the latest issue icon.

More Gay men mentality:
BBC News: Promiscuity 'fuelling HIV spread'
The UK charity Terrence Higgins Trust expressed doubts about the ABC [abstinence, being faithful, and using condoms] strategy.

"I take the idea of promoting monogamy with a large pinch of salt," said Will Nutland, its head of gay men's health promotion.

"What has worked in Uganda doesn't necessarily translate to London.

"In some societies would people really be able to implement this, where women don't necessarily have control over their sexual encounters."
Such lack of faith. Always excuses.

Apparently there is truth in this: Gay men are a higher risk catagory.

Unprotected sex is high risk sex:
Aidsmap|Unprotected Sex says even having anal sex with oil-based lubricated condoms is risky. It is also risky to use condoms that have spermicides with nonoxynol-9. Are these the first things people check in regards to their condoms (if they even choose to use one) when they are turned on, "in the heat of the moment", inflamed with passion, or drug-induced?

This same link also says that even if you're HIV-positive, taking anti-HIV drugs and have an undetectable viral load in your blood (that sounds pretty new meaning to "are you loaded?"), then you may still have enough virus in your semen or vaginal fluids to pass on HIV. I especially like this statement:
You should also be aware that in some countries including certain states of the USA you are legally required to disclose your HIV status to sexual partners. In the UK people have been recently been sent to prison after infecting their sexual partners with HIV.
That practice should be put into place in the U.S.of A. It will cause people to take extra precautions, to think twice, to consider the cost of jail versus disclosing the information to a partner/getting checked out just in case.

As for this statement within that Aidsmap link...
There is growing evidence that it is possible to be super-infected with a new strain or strains of HIV, which may either be more aggressive than or resistant to anti-HIV drugs. This could lead to the failure of treatments that might otherwise have been effective. This applies to both men and women.
...this has already proven true here.
"This case is a wake-up call. First, it's a wake-up call to men who have sex with men, particularly those who may use crystal methamphetamine," [New York City Health Commissioner Dr. Thomas] Frieden said in a statement.
"Certainly CDC is alarmed by the apparent intersection between two dangerous conditions -- multidrug resistance and apparent rapid progression," said Jessica Frickey, a spokeswoman for the Centers for Disease Control and Prevention's National Center for HIV, STD and TB Prevention.
"The patient is a male in his mid-40s who reported multiple male sex partners and unprotected anal intercourse, often while using crystal methamphetamine (crystal meth). He was first diagnosed with HIV in December 2004 and appears to have been recently infected," the New York Health Department said in a statement.

The AIDS virus mutates easily and patients often develop strains that resist the drugs they are taking. Such strains of multidrug-resistant virus can also be passed to newly infected patients, and several groups have reported on HIV patients who have drug-resistant infections before they take any of the cocktails of medications used to control the virus.

Dr. Susan Little and colleagues at the University of California San Diego found in 2002 that drug-resistant HIV was affecting as many as one in five newly infected people in the United States.
New York officials say more than 88,000 New Yorkers are infected with the AIDS virus, which has no cure, and estimates 20,000 more are infected and do not know it.
Great. Which is more reason to put into practice what the UK is doing: jail those who infect others. Why? How about: Why not? Bring those -- who are accountable for the choices they make with their lives and lifestyles -- into accountability for the results of their choices as well. If you choose to practice sexual immorality in any form and contract some horrible virus or STD infection AND continue to have sex with others knowing the risk of your behavior, but not disclosing it to your partners, then you should pay for the crime. To rob another's life, intentionally or unintentionally, requires a form of payment. "Sorry" doesn't bring back the life of a person. And the argument that "neither does putting the person in jail" comes from a debased mentality. Payment is required. "Sorry," but that's just how it goes.

The new aggressive strain was discovered Feb. 11 in New York. As a result of this finding:
Medline Plus: Urging a major shift in U.S. policy, some health experts this week began recommending that virtually all Americans be tested routinely for the AIDS virus, much as they are for cancer and other diseases.

Merck Source - New HIV Strain May Progress Quickly

Plenty of information I hope.

This is not about discrimination, Nicholas.

The only resolution I can propose to protecting the blood supply is to:
  1. continue to ban gay men from donating blood (wise decision based on all the information out there due to high risk behavior and the mentality in that population group)
  2. promote education on HIV/AIDS to children in grade school & how it is contracted through
    • drug injection
    • infidelity
    • promiscuity
    • unprotected sex
    • risky sex (i.e. anal intercourse, rimming)
  3. and go through with the policy of having everyone screened for HIV/AIDS since there seems to be a fear to get tested.
Make it just like screening for cancer - make the patient aware based on a little information given to the medical personnel (i.e. are you sexually active?) and then routinely test for it.

As for my statement earlier, “If the population of straight people who donate blood suddenly increased by a sizeable margin, the risk of HIV getting through the blood banks would increase," that is just common sense. If you have a larger population donating blood, there is likely going to be more HIV going into the testing phase because there would probably be more infected individuals donating. Think about it.

There is apparently no way to find out if someone has AIDS unless you trust they are telling you the truth before you have sex with them...and you CHOOSE to ask if they have anything you may contract.

The third option would probably be a better measure for protecting the blood supply. Those who are HIV-negative could be given the "official O.K." to donate blood.

But donating blood is a choice. It cannot be forced on anyone.

And when you make a choice to harm yourself (i.e. drug injection, unprotected sex, multiple sex partners), you are also inadvertantly harm others.

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