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Valiant Dancer
Forum Goalie
USA
4826 Posts |
 Posted - 05/10/2005 : 07:23:17 [Permalink]
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quote:
Originally posted by Dude
quote:
CDC have a few recent studies from 2001 which indicate that homosexual men are far and away the leader in new cases of AIDS/HIV.
What those tables show is that male/male sexual contact is the second most likely way to contract HIV in 2003 (32%). Other/non-specified takes the top honors(35%). With heterosexual contact falling in at 18%.
Are we reading the same tables?
The first one says that of the 32 states that collect data, over 50% of new AIDS cases in males are through male to male sex.
The second says in males, other/not specified is 31% and male to male sexual contact is 46% with an additional 3% male to male sexual contact with IV drug use.
The third indicates 22% of males of all races have an other risk factor not reported or identified and 48% of males have male to male sexual contact as a risk factor with an additional 5% having both male to male sexual contact and IV drug use.
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Nothing in there indicates level of sexual activity or number of partners. I suspect (no evidence to back this one up) that if they broke it down into monogomous relationships vs non, then the numbers from male/male and hetero sexual contact would be very close to one another. That is my hypothesis anyway. Not sure if there is any evidence out there to support it or not. Will look.
In all cases, one of the partners had to be infected to begin with. The particular risk factors directly relate to the facilitation of bodily fluid to blood transfer of blood bourne pathogens.
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Anyway, I am not suggesting that there be no pre-donation screening, just that the screening should be based on a solid analysis of the evidence. If my hypothesis bears up, then the questions should be more concerned with level of sexual activity, number of partners, and use of protection... as opposed to who your partner is.
The CDC did a study (I'll try to find a link to it) which indicated that anal sex caused a higher percentage of prophalactic breakage (The condom companies refer to such on their packaging) than vaginal sex. In addition, the study noted a risk factor of anal tearing during anal sex, thereby opening up a direct blood pathway. Without the existance of genital sores or another STD to facilitate fluid to blood transfer of blood borne pathogens, the anal tearing becomes a primary risk factor.
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If the idea is to protect recipients, then the questions should be as effective as we can make them yes?
Then there is the issue of honesty. Especially with the ammount of anti-gay sentiment being feuled by the neocon and fundamentalist rightwing. People want to donate blood for many reasons. To help others, to return a little to the community, etc. If they feel they will be discriminated against they may well just lie on the questions.
They've been asking these same questions for well over a decade. (I first was asked in 1989 for blood donation)
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Our specimen screening process for blood and tissues seems to be pretty good. Only 87 cases in 2003 of transmission.
The pragmatist in me says if it isn't broke, don't mess with it. And from the view of protecting people it seems we are doing fairly well.
But. We always have a shortage of blood. If the system could be improved to safely introduce more safe donations, then it is something we should do.
As beskeptigal points out, a blood substitute would be a good start. The blood banks have cronically been short for well over a decade. And they responded with developing technology which increased the shelf life of blood from a few weeks to 6 weeks. |
Cthulhu/Asmodeus when you're tired of voting for the lesser of two evils
Brother Cutlass of Reasoned Discussion |
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Dude
SFN Die Hard
USA
6891 Posts |
Posted - 05/10/2005 : 11:56:25 [Permalink]
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quote:
Are we reading the same tables?
You posted the link, just look at the one that covers ALL cases, male and female. The "other" catagory is higher than the male/male sex category. And, when you combine the male and female tables together, the % for heterosexual transfer closes in on the % for male/male.
My entire point is that screening for sexual behaviors like number of partners would be a more effective way than a blanket rejection of gay men, assuming that my hypothesis was correct anyway. The idea being to get more donated products available, in the safest way, to the people who need it.
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As beskeptigal points out, a blood substitute would be a good start. The blood banks have cronically been short for well over a decade. And they responded with developing technology which increased the shelf life of blood from a few weeks to 6 weeks.
There are several under developement, might even be one in clinical trials currently...
Well, found this from 2003:http://news.bbc.co.uk/2/hi/health/3207291.stm
And another that has undergone phase 3 clinical trials: http://www.allp.com/Oxygent/ox_fact.htm
Interesting stuff. But many years from significantly reducing the need for donated blood.
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Ignorance is preferable to error; and he is less remote from the truth who believes nothing, than he who believes what is wrong.
-- Thomas Jefferson
"god :: the last refuge of a man with no answers and no argument." - G. Carlin
Hope, n.
The handmaiden of desperation; the opiate of despair; the illegible signpost on the road to perdition. ~~ da filth |
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Valiant Dancer
Forum Goalie
USA
4826 Posts |
Posted - 05/10/2005 : 13:06:01 [Permalink]
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quote:
Originally posted by Dude
quote:
Are we reading the same tables?
You posted the link, just look at the one that covers ALL cases, male and female. The "other" catagory is higher than the male/male sex category. And, when you combine the male and female tables together, the % for heterosexual transfer closes in on the % for male/male.
My entire point is that screening for sexual behaviors like number of partners would be a more effective way than a blanket rejection of gay men, assuming that my hypothesis was correct anyway. The idea being to get more donated products available, in the safest way, to the people who need it.
I'd have to disagree with your methodology. Since the male to male transfer is impossible for females, their numbers have to be viewed seperately. 33% of all AIDS cases are in females, this is enough to skew results for male to male transfer. Most of the new cases (45%) in females are of other origin which is more than the ones by heterosexual contact (40%) or IV drug use (14%).
Number of partners is a sticky situation. It is one thing that people will generally not discuss, but a valid risk factor.
I found the reference (although no tables or specific percentages) for my assertation that anal sex is more risky than vaginal sex.
http://wonder.cdc.gov/wonder/sci_data/misc/type_txt/sgrpt.asp
Under the subheading "Unprotected Sex Is Dangerous"
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Cthulhu/Asmodeus when you're tired of voting for the lesser of two evils
Brother Cutlass of Reasoned Discussion |
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Dude
SFN Die Hard
USA
6891 Posts |
Posted - 05/10/2005 : 15:46:22 [Permalink]
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quote:
I'd have to disagree with your methodology. Since the male to male transfer is impossible for females, their numbers have to be viewed seperately.
When looking at the overall picture, you have to consider all methods of transfer. Heterosexual contact must include stats from males and females.
The only place where the male/male transfer is an important statistic is if you are examining only men who contract HIV. Then yes, among meny only, the most common method for transfer is male/male sexual contact.
When placed in the overall context, all cases of transfer being considered, the male/male transfer is lower than the "other/non-specified" category.
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I found the reference (although no tables or specific percentages) for my assertation that anal sex is more risky than vaginal sex.
Not arguing that point. But it would be false to think that only male/male sexual contact involves anal sex. This can/does occur in heterosexual relationships as well. Granted it is probably more common, per % of population, in male/male than in hetero. Overall, considering the number of hetero vs male/male orientations, it seems likely that the actual number of anal sex encounters is going to be higher in the heterosexual area. I doubt there is any way to verify that because of the nature of the topic, but it seems to be a common sense conclusion.
Again, I think that sexual orientation is not the best criteria to screen people. The Sub-Saharan areas of Africa are a great example of this. Some places have 70% HIV infection of the adult population. Promiscuity and unprotected sex are the root cause, not gay men.
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Ignorance is preferable to error; and he is less remote from the truth who believes nothing, than he who believes what is wrong.
-- Thomas Jefferson
"god :: the last refuge of a man with no answers and no argument." - G. Carlin
Hope, n.
The handmaiden of desperation; the opiate of despair; the illegible signpost on the road to perdition. ~~ da filth |
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Valiant Dancer
Forum Goalie
USA
4826 Posts |
Posted - 05/11/2005 : 07:27:42 [Permalink]
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quote:
Originally posted by Dude
quote:
I'd have to disagree with your methodology. Since the male to male transfer is impossible for females, their numbers have to be viewed seperately.
When looking at the overall picture, you have to consider all methods of transfer. Heterosexual contact must include stats from males and females.
The only place where the male/male transfer is an important statistic is if you are examining only men who contract HIV. Then yes, among meny only, the most common method for transfer is male/male sexual contact.
As the question on the blood donation form only applies to males, I find it reasonable to concentrate on HIV infection rates for males only.
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When placed in the overall context, all cases of transfer being considered, the male/male transfer is lower than the "other/non-specified" category.
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I found the reference (although no tables or specific percentages) for my assertation that anal sex is more risky than vaginal sex.
Not arguing that point. But it would be false to think that only male/male sexual contact involves anal sex. This can/does occur in heterosexual relationships as well. Granted it is probably more common, per % of population, in male/male than in hetero. Overall, considering the number of hetero vs male/male orientations, it seems likely that the actual number of anal sex encounters is going to be higher in the heterosexual area. I doubt there is any way to verify that because of the nature of the topic, but it seems to be a common sense conclusion.
As it refers to actual numbers, I would say that anal sex is more prevalent in hetero couples. As percentage of population, it is more prevalent in homosexual couples.
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Again, I think that sexual orientation is not the best criteria to screen people. The Sub-Saharan areas of Africa are a great example of this. Some places have 70% HIV infection of the adult population. Promiscuity and unprotected sex are the root cause, not gay men.
I in no way was blaming gay men. It just so happens that the Surgeon General, the CDC, and many activist groups have done an excellent job in informing the population of America about the dangers of HIV and preventative measures. This is not so for the Sub-Saharan areas of Africa where ignorance of the nature of HIV is very prevalent even being propagated by some tribal shamans/medicine men who have suggested sex with a virgin will cure them of AIDS.
In the US, promiscuity is common, but unprotected sex is being curbed through educational processes. Since it is effective in combating the spread of HIV, the primary cause then has to switch to specific risk factors which facilitate the transfer of the virus.
Personally, I'd like to see questions such as the following
1) Have you ever had unprotected anal sex?
2) Have you had more than 3 sexual partners in the past year?
Some people might get bent, but fuck em', this is mor important than not offending some prude's sensibility.
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Cthulhu/Asmodeus when you're tired of voting for the lesser of two evils
Brother Cutlass of Reasoned Discussion |
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beskeptigal
SFN Die Hard
USA
3834 Posts |
Posted - 05/11/2005 : 13:21:08 [Permalink]
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I haven't had time to look over your stats here but wanted to remind everyone there is a difference between prevalence and newly acquired infection rates which I see some of the stats above refer to.
Also, once again, HIV is not the only problem. There was a time when a large percentage of gay men were engaged in 'bath house' activities involving hundreds of partners in succession. Just as having used IV drugs at any time in the past still has the holdover risk of Hepatitis C now, the blood bank, since the HIV epidemic with its long incubation period, has included risk of unknown disease in their screening programs.
There actually is a small number of transfusion associated cases of hepatitis today that are unexplained. The cases have not caused significant disease so far. At one time it was thought a viral organism called Hepatitis G was the cause but that has now been ruled out, I believe. No one knows whether or not to worry about the Hepatitis G virus since it doesn't seem to cause transfusion associated hepatitis. |
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tomk80
SFN Regular
Netherlands
1278 Posts |
Posted - 05/11/2005 : 17:13:39 [Permalink]
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| Another thing which is important to note is not only the percentage of cases atributed to a certain group or type of behavior is important. What's equally important is how big that group is. Even if the percentage of cases attributed to people having heterosexual sex was equal to then percentage attributed to people having male homosexual sex, the last group would still have an increased risk, as it is (as far as I know) a minority group in the population. |
Tom
`Contrariwise,' continued Tweedledee, `if it was so, it might be; and if it were so, it would be; but as it isn't, it ain't. That's logic.'
-Through the Looking Glass by Lewis Caroll- |
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Dude
SFN Die Hard
USA
6891 Posts |
Posted - 05/11/2005 : 17:35:43 [Permalink]
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quote:
Even if the percentage of cases attributed to people having heterosexual sex was equal to then percentage attributed to people having male homosexual sex, the last group would still have an increased risk, as it is (as far as I know) a minority group in the population.
I think there is a stronger correlation to certain behaviors than to sexual orientation.
So, if you are going to break things into groups, it would make more sense to set up the groups based on the high risk behaviors rather than sexual orientation.
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Ignorance is preferable to error; and he is less remote from the truth who believes nothing, than he who believes what is wrong.
-- Thomas Jefferson
"god :: the last refuge of a man with no answers and no argument." - G. Carlin
Hope, n.
The handmaiden of desperation; the opiate of despair; the illegible signpost on the road to perdition. ~~ da filth |
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