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risk behavior, risk behavior, risk behavior, risk behavior
6-17-2006
HIV hits Africa's rich hardest, study says
Analysis disputes long-held beliefs
By John Donnelly, Globe Staff | June 14, 2006
DURBAN, South Africa -- The richest people in Africa have higher HIV prevalence rates than the poorest, disputing commonly held beliefs that AIDS is a disease driven by poverty, according to an analysis released yesterday of recent data from eight African countries.
The study, which was presented and debated in South Africa at the third annual US President's Emergency Plan for AIDS Relief meeting, found that the poorest 20 percent of the population almost always had a lower HIV prevalence rate than the richest 20 percent. The study's author said the findings should be used to make sure AIDS prevention messages are reaching those who earn the most money.
"Poverty-driven programs are likely to have limited impact on prevention efforts when the majority of HIV-infected people are the wealthiest, not the poorest," said Vinod Mishra , director of research at ORC Macro , a Maryland-based research company that conducts detailed demographic surveys around the world.
..
Standing next to him, Dr. Alex Opio , assistant commissioner in Uganda's national disease-control department, said he was met with disbelief recently when he briefed foreign donors on the HIV prevalence data. In Uganda, the rate of HIV infection among the poorest 20 percent of women was 5 percent, compared with an 11 percent infection rate for the richest 20 percent; for men, 4 percent of the poorest were infected, compared with 6 percent of the richest.
"People wanted to stone me," Opio said of the reaction from donors. He said they didn't want to admit their programs were focused on the wrong population group. "It's in their mind-set that the poorest have the highest prevalence. They don't want to hear anything different."
The data were debated in several corners around the conference, which has attracted more than 1,100 delegates. While several raised questions about whether the findings could be extrapolated to the rest of Africa, many said the data could cause a reevaluation of whether prevention efforts were adequately reaching the relatively well-off group.
"The strategy should be geared to all population groups," said Pamela Bridgewater, the US ambassador to Ghana. If the data prove to be accurate, she said, "we would find additional strategies to reach this group."
The surveys, the most complete of their kind in Africa, included interviews with 6,000 to 18,000 people in each country and the taking of blood samples for HIV tests. Researchers did not ask people their income level, but instead registered a number of details about their residence and possessions to rank their wealth.
"The reality is that HIV prevalence is higher among the better-offs," Mishra said. "That is a fact. All those ideas that absolute poverty is at the core of AIDS are misplaced."
Bill Weintraub:
This article from the Boston Globe confirms what we've said many times.
And which UC Berkeley epidemiologist James Chin, considered one of the leading experts on AIDS in Asia, said in his poster presentation at Taipei in 2002:
HIV prevalence can only rise to the levels permitted by the prevailing patterns and prevalence of HIV risk behaviors and therefore epidemic spread of HIV cannot and will not occur in populations with low levels of HIV risk behaviors.
It is epidemiologic nonsense to ignore or to deny that there are no natural limits to epidemic HIV transmission based on the pattern(s) and prevalence of HIV risk behaviors!
Question
Why is epidemic heterosexual HIV transmission almost non-existent in most countries in the world but so prevalent in sub-Saharan African countries and to a lesser extent in several Caribbean countries and in only a few countries in South and Southeast Asia?
risk behavior, risk behavior, risk behavior, risk behavior, risk behavior, risk behavior, risk behavior, risk behavior, risk behavior, risk behavior, risk behavior, risk behavior, risk behavior, risk behavior, risk behavior, risk behavior, risk behavior, risk behavior, risk behavior, risk behavior, risk behavior, risk behavior, risk behavior, risk behavior, risk behavior
The Role of Poverty and Other Social Factors in the AIDS Pandemic
The following is a quote from a speech by Secretary-General Kofi Annan in late 2002:
" [HIV/AIDS] has exacerbated the problems of poverty, discrimination, malnutrition and sexual exploitation of girls and women"
Secretary-General Annan’s statement is right on the mark. However, too many AIDS advocates and activists believe that these factors - poverty, etc., are the basic cause(s) of HIV/AIDS!
So: it isn't poverty, or anything else, which drives the HIV epidemic.
It's RISK BEHAVIOR.
It's not poverty
or homosexuality
or homophobia
or depression
or low self-esteem
or anything else.
It's risk behavior.
Among men who have sex with men, the risk behavior is ANAL.
Avoid anal, and you're very unlikely to get HIV.
Move men away from anal, and HIV prevalence will plummet.
As will the prevalence of all other anally-transmitted diseases.
Yet the gay male community / AIDS Inc / ANAL Inc continues to put all its energy into condom campaigns, which are a risk reduction strategy in which it's inevitable that gay males will be infected.
This is from Crisis magazine, a Catholic publication:
Harm Reduction or Harm Elimination?
There are many common situations where the only way to save lives is to focus on harm reduction. Seatbelts in cars are a good example. The only way to prevent all deaths from car accidents is for people to stop driving. But since that’s not possible, governments do what they can to reduce the risks of driving: setting speed limits and requiring people to wear seatbelts.
There are other situations, however, where the threat of death is so serious that the risk must be completely eliminated. Consider this hypothetical situation: If 42 percent of pregnant women in the United States were, for whatever mysterious reason, suddenly dying from riding in cars, public-health officials would likely caution pregnant women
to stay out of cars. They wouldn’t just urge them to wear seatbelts.
In the case of cigarettes, Big Tobacco focused for decades on harm reduction. But when smoking was finally found to increase the risk of incurable lung cancer by a whopping 1,400 percent and to contribute to many other diseases, public-health campaigns shifted to harm elimination.
The clear public-health message became "Don't smoke," and "If you do smoke, quit." No one advised smokers simply to reduce the harm of smoking by using filters, lighting up fewer cigarettes, or eating more oranges.
When it comes to AIDS in Africa, condoms are a risk-reduction technology, much like seatbelts or cigarette filters.
"Abstain from sex if you’re single" and "Be faithful if you’re married" are risk-elimination strategies. Dr. W. Henry Mosley of the Johns Hopkins Bloomberg School of Public Health points out that "it should be intuitively obvious that if young persons abstain from sexual activity until establishing a permanent partnership, and if both partners are faithful in their sexual union, the risk of acquiring HIV is zero. Protection is 100 percent."
"When dealing with a fatal, incurable disease like AIDS, wouldn’t we all prefer risk elimination for our own kids?" Dr. Green asks.
"When dealing with a fatal, incurable disease like AIDS, wouldn’t we all prefer risk elimination for our own kids?" Dr. Green asks.
"When dealing with a fatal, incurable disease like AIDS, wouldn’t we all prefer risk elimination for our own GAY kids?" Bill Weintraub asks.
Remember, when some shitfairy asshole claims that I disparage gay men, that he is pushing condom campaigns which are guaranteed to KILL OUR GAY KIDS.
Death is the ultimate disparagement.
Telling guys to quit anal and do FROT is gay-positive, life-affirming, and life-enhancing.
Our work saves lives.
Condom campaigns kill.
BECAUSE ANAL KILLS.
That's the truth.
© All material Copyright 2006 by Bill Weintraub. All rights reserved.
Re: risk behavior, risk behavior, risk behavior, risk behavior
6-18-2006
Here's more from Crisis mag.
As soon as I have a URL I'll post it.
The article was sent to me by Dr. Edward C. Green, the Harvard U medical anthropologist who first presented the data on the success of ABC in Uganda:
Predictably, the Catholic Church has been sharply criticized for opposing condoms -- the "C" component in the Ugandan [ABC] approach -- promoted to prostitutes, homosexuals, and injection-drug users.
But the Church teaches that all persons are made in God’s image and deserving of love. For individuals in concentrated epidemics, condoms still fail.
In 1989, the Journal of Sex & Marital Therapy revealed the dirty little secret of epidemic control: If homosexuals use condoms, they won’t necessarily be safe as individuals, but at least the rest of society will be protected. And some experts now doubt that condoms reduced HIV rates among gay men in San Francisco:
"One careful study showed that for ‘receptive’ men during anal sex, it made little or no difference whether their partners used a condom or not," says Harvard's Dr. Green. "The truth is, condoms are even less effective in anal sex than in vaginal sex."
[emphases mine]
Dr. Green is correct.
The study he refers to is Buchbinder, which we reported on last year, and in which it was crystal clear:
Anal with a condom was only ONE percentage point safer than anal without a condom:
HIV seroincidence was 1.55 per 100 person-years (95% confidence interval: 1.23-1.95) over 18 months of follow-up. On multi-variable analysis using time-dependent covariates, independent risk factors for HIV seroconversion were increased number of reported HIV-negative male sex partners (adjusted odds ratio (AOR) = 1.14 per partner, population attributable risk (PAR) = 28%), nitrite inhalant use (AOR = 2.2, PAR = 28%), unprotected receptive anal sex with an HIV unknown serostatus partner (AOR = 2.7, PAR = 15%) or HIV-positive partner (AOR = 3.4, PAR = 12%), protected receptive anal sex with an HIV-positive partner (AOR = 2.2, PAR = 11%), lack of circumcision (AOR = 2.0, PAR = 10%), and receptive oral sex to ejaculation with an HIV-positive partner (AOR = 3.8, PAR = 7%). Having a large number of male sex partners, nitrite inhalant use, and engaging in receptive anal sex explained the majority of infections in this cohort and should be targeted in prevention strategies for MSM.
[emphases mine]
I know that's a lot of scientific jargon to wade through, but the point is that in Buchbinder, receptive anal WITH A CONDOM was a significant risk factor:
"While unprotected receptive anal (URA) was higher risk than protected receptive anal (PRA), even PRA was found to put MSM at significant risk."
Let me spell it out:
Anal WITH A CONDOM was just one percentage point less risky than barebacking.
Barebacking, the "population attributable risk" was 12%.
WITH A CONDOM, the "population attributable risk" was 11%.
That's why Buchbinder said: "even PRA [PROTECTED receptive anal] was found to put MSM at significant risk."
Furthermore, as Dr Green says, ""The truth is, condoms are even less effective in anal sex than in vaginal sex."
Anal is a lot harder on the condom -- for one thing.
Crisis mag:
In 1989, the Journal of Sex & Marital Therapy revealed the dirty little secret of epidemic control: If homosexuals use condoms, they won’t necessarily be safe as individuals, but at least the rest of society will be protected.
Why would that be so?
Because the condom failure rate for vaginal, which is far gentler on the condom than ANAL, is 20%.
INEVITABILY, guys who use condoms get infected.
They are collateral damage in the war to preserve anal and promiscuity.
And some experts now doubt that condoms reduced HIV rates among gay men in San Francisco:
[Dr. Green] adds that even in Thailand, where HIV rates plummeted after prostitutes began requiring condoms, "the decline in HIV prevalence during the mid-1990s may have been due to a high percentage of men not going to prostitutes and not having multiple partners."
That's correct.
And there's evidence that something similar was true among American MSM in the 80s and 90s:
that partner reduction and the choice of non-anal alternatives were MORE IMPORTANT than condoms in reducing HIV prevalence.
There's growing evidence that the condom code, not just in Africa, but here at home, was a FRAUD.
Crisis mag:
the Church teaches that all persons are made in God’s image and deserving of love. For individuals in concentrated epidemics, condoms still fail.
I'm not a Roman Catholic, but I understand the point.
No one deserves to be given a second-best "treatment."
No one.
Not even gay men.
We know that condoms fail.
We know that a certain percentage of gay men using condoms faithfully will seroconvert anyway, and that most other gay men won't use them correctly or consistently.
They too will seroconvert.
That's why seroconversion rates among gay men keep rising.
If we love these men, and don't want to see them "disparaged" or destroyed, shouldn't we be doing all in our power to get the word out to them about a better way to go?
One which is mutually and directly genital, very hot, and carries virtually no risk of HIV infection?
Stay tuned Frot dudes.
And
© All material Copyright 2006 by Bill Weintraub. All rights reserved
AND
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