 |
 | Home | Contact Us | FAQ | Search & Site Map | Link to Us |
 | Sign In | Join | Other 45 Sites in Network |
Medical Forum / Diseases and Disorders / AIDS / October 2006by Joseph Shapiro. About 1 million Americans have HIV -- but an estimated 25 percent do not know they have it.
by Joseph Shapiro CDC to Recommend Routine AIDS Screening by Joseph Shapiro Audio for this story will be available at approx. 7:30 p.m. ET All Things Considered, September 21, 2006 In a major shift in U.S. health policy, the Center for Disease Control will issue recommendations to make HIV screening a routine part of getting health care. The changes means that when patients see a doctor or go to a hospital, they will be asked if they've been tested for HIV and, if they haven't, asked to be screened or tested. About 1 million Americans have HIV -- but an estimated 25 percent do not know they have it. The new policy is meant to get medicines to that sector of infected people, to both extend their lives and cut the further spread of HIV. NPR's Joseph Shapiro reports on the new policy and goes to a clinic in Washington, D.C., where routine testing is already practice. http://www.npr.org/templates/story/story.php?storyId=6119310 by Joseph Shapiro "Don Saklad" <dsaklad@nestle.csail.mit.edu> wrote in message > In a major shift in U.S. health policy, the Center for > Disease Control will issue recommendations to make HIV > screening a routine part of getting health care. > > http://www.npr.org/templates/story/story.php?storyId=6119310 > by Joseph Shapiro ``````````````````````````````````````````````````````````````````````````````` CDC Backs HIV Test for All Between 13-64 Sep 21 12:01 PM US/Eastern By MIKE STOBBE AP Medical Writer ATLANTA All Americans between the ages of 13 and 64 should be routinely tested for HIV to help catch infections earlier and stop the spread of the deadly virus, federal health recommendations announced Thursday say. The U.S. Centers for Disease Control and Prevention said HIV testing should become about as common as a cholesterol check. Nearly half of new HIV infections are discovered when doctors are trying to diagnose a sick patient who has come for care, CDC officials said. "We know that many HIV infected people seek health care and they don't get tested. And many people are not diagnosed until late in the course of their illness, when they're already sick with HIV-related conditions," said Dr. Timothy Mastro, acting director of the CDC's division of HIV/AIDS prevention. "By identifying people earlier through a screening program, we'll allow them to access life-extending therapy, and also through prevention services, learn how to avoid transmitting HIV infection to others," he said. The announcement was hailed by some HIV patient advocates and health policy experts. They said the guidelines could help end the stigma of HIV testing and lead to needed care for an estimated 250,000 Americans who don't yet know they have the disease. "I think it's an incredible advance. I think it's courageous on the part of the CDC," said A. David Paltiel, a health policy expert at the Yale University School of Medicine. The recommendations aren't legally binding, but they influence what doctors do and what health insurance programs cover. Some physicians groups predict the recommendations will be challenging to implement, involving new expenditures of money and time for testing, counseling and revising consent procedures. Some physicians also question whether there is enough evidence to expand testing beyond high-risk groups, said Dr. Larry Fields, the president of the American Academy of Family Physicians. "Are doctors going to do it? Probably not," Fields said. But the recommendations were endorsed by the American Medical Association, which urged physicians to comply. "This is important public health strategy to stop the spread of HIV," Dr. Nancy Nielsen, a Buffalo, N.Y.-based physician who sits on the AMA's governing board, said in a statement. Previously, the CDC recommended routine testing for those at high-risk for catching the virus, such as intravenous drug users and gay men, and for hospitals and certain other institutions serving areas where HIV is common. It also recommends testing for all pregnant women. Under the new guidelines, patients would be tested for HIV as part of a standard battery of tests they receive when they go for urgent or emergency care, or even during a routine physical. Patients wouldn't get tested every year: Repeated, annual testing would only be recommended only for those at high-risk. There would be no consent form specifically for the HIV test; it would be covered in a clinic or hospital's standard care consent form. Patients would be allowed to decline the testing. CDC officials have been working on revised recommendations for about three years, and sought input from more than 100 organizations, including doctors' associations and HIV patient advocacy groups. The CDC presented planned revisions at a scientific conference in February. Since then, the CDC has strengthened language on informed consent to make sure that no one is tested without their knowledge, and emphasized the need for doctors to provide information on HIV tests and the meaning of positive and negative results. http://www.cdc.gov/mmwr Don Saklad wrote... > About 1 million Americans have HIV -- but an estimated 25 > percent do not know they have it. > > The new policy is meant to get medicines to that sector of > infected people, to both extend their lives and cut the > further spread of HIV. Lie. It will tend to extend their lives, but that translates as so many more new HIV infections in the extra years the drugs let them live. Knowledge of one's HIV status does not appear to make them care any more about infecting others with a deadly disease, so earlier testing will do nothing. But interestingly, the calls for increased testing seem to be coming from the left and of course the testing can't possibly be effective in controlling the spread of the virus unless it is combined with quarantine. While the left would typically be horrified at such a violation of the individual's civil rights by, they realize that unless something is done there will be much less public money available for their various other social causes. Therefore, I consider this proposal to be a prelude to routine mandatory testing in the near future. I'm almost wondering if it is worth the goal if it means having to ally with the totalitarian left. >From www.drdach.com: This new CDC recommendation to routinely test the entire low-risk population is a BAD IDEA. It is similar to the program for routine testing of military recruits in which 0.4 per cent are found to be HIV positive and otherwise healthy. This program is probably uncovering the subpopulation of "Elite Controllers" which are the subject of a current MGH clinical study. These are HIV Positives who are otherwise healthy and have never take anti HIV drugs over many years of good health. According to the CDC, there are a quarter of a million HIV positives in the population who are unaware of their status because they have never been testing and are otherwise healthy. Many of these are probably elite controllers who will do quite well without drug treatment. The problem with finding all these Elite Controllers and revealing their HIV status is that they would then be given anti-HIV drugs such as AZT and protease inhibitors which are known to be highly toxic and cause serious medical problems such as liver failure and Stevens Johnson Syndrome. The risks involved in HIV drug treatment for Elite Controllers is clearly greater than the theoretical risks of Kaposi's Sarcoma or Pneumocystic Carinii pneumonia which are never found in the Elite Controller group. I am a Board Certified MD with 25 years of clinical experience diagnosing and treating AIDS, and I urge all physicians to oppose this CDC proposal which is simply BAD Medicine for the people of our country. If these measures are adopted, I urge all physicians to stand in opposition and refuse to comply with this CDC proposal. signed www.drdach.com > This new CDC recommendation to routinely test the > entire low-risk population is a BAD IDEA. It is > similar to the program for routine testing of > military recruits in which 0.4 per cent are found to > be HIV positive and otherwise healthy. They know they're going to be tested. They know they won't get in if they test postiive. It's a self selected group of people. It's not the general public. > > This new CDC recommendation to routinely test the > > entire low-risk population is a BAD IDEA. It is [quoted text clipped - 6 lines] > It's a self selected group of people. > It's not the general public. When I went into the service in 1968, we were all pretty much the same age standing in line for medical exams, 18 yo. Not exactly the high risk group age for hiv/aids. If it takes up to 10 years for symptoms to begin... but your point is taken. New CDC HIV testing proposal is BAD medical practice. Damned right ! Let's put a stop to that. And then let's move on to ending TB testing and other sh.t like that. We know it doesn't help anything. We're no better of knowing that stuff. I am a Board Certified MD with 25 years experience diagnosing and treating AIDs patients I am an internet certified idiot. and I am opposed to the new CDC proposal for mandatory HIV testing of low-risk people who come into contact with the medical system at emergency rooms and ambulatory care centers. I'm with you bro. Let's do it ! This is BAD medical practice. Yeah, what the hell does the CDC know anyway? In addition, I urge all physicians to stand up and join with me in opposition to these new HIV testing policies proposed by the CDC. The new CDC recommendation to routinely perform HIV antibody testing on the entire low-risk population is a BAD IDEA. Right. I am posilutely, absitively certain that NONE of those people are HIV positive. And we can give those people a pass for HIV testing when they contribute blood. > New CDC HIV testing proposal is BAD medical practice. > [quoted text clipped - 31 lines] > And we can give those people a pass for HIV testing > when they contribute blood. It is quite possible sir that you are a smart a.s, however I will reserve judgment a little longer.  Signature--Not a righty or a lefty, just a free thinker-- > > New CDC HIV testing proposal is BAD medical practice. > > [quoted text clipped - 37 lines] > -- > --Not a righty or a lefty, just a free thinker-- drdach wrote: Problem is that by routine testing the low risk population (non-iv drug user heterosexuals) we are uncovering HIV positive people who never get sick and don't have a disease, called Elite Controllers. We know from experience that when you notify people in low risk groups that they have HIV, they are fired from their jobs, cant get health insurance, ostracized from the community and some commit suicide. Considering this kind of downside to uncovering this information, it is not valuable. It is harmful . By the way, after 20 years of HIV research, there has never been a documented case (in the medical literature) of HIV or AIDS disease transmitted from Elite Controller to another person (spouse or partner) through heterosexual contact, so the idea that by testing these people we will reduce transmission rate is false. There is no transmission risk from Elite Controllers. In addition, heterosexual transmission between couples is actually quite rare and may never happen after many years of contact in some couples as reported by Dr. MacGregor, Horsburgh and Levy: (see references below) MacGregor RR et al. Failure of culture and polymerase chain reaction to detect human immunodeficiency virus (HIV) in seronegative steady sexual partners of HIV-infected individuals. Clin Infect Dis. 1995 Jul;21(1):122-7. Horsburgh CR et al. Concordance of polymerase chain reaction with HIV antibody detection. J Infect Dis. 1990 Aug;162:542-5. Levy JA. The transmission of AIDS: the case of the infected cell. JAMA. 1988;259(20):3037-8. Regards from www.drdach.com jdach skrev: >>> New CDC HIV testing proposal is BAD medical practice. >>> [quoted text clipped - 43 lines] > user heterosexuals) we are uncovering HIV positive people who never > get sick and don't have a disease, called Elite Controllers. < snip > What about NON-Elite Controllers in the low risk population. Low risk hetrosexuals who happens to get HIV through a one night stand with someone in a high risk group? Do you -want- those to spread the disease? It sounds like it... > What about NON-Elite Controllers in the low risk population. > Low risk hetrosexuals who happens to get HIV through a one night stand > with someone in a high risk group? > Do you -want- those to spread the disease? > It sounds like it... DrDach reply: Heterosexual transmission between couples is actually quite rare and may never happen after many years of contact in some couples as reported by Dr. MacGregor, Horsburgh and Levy: (see references below) In addition, two studies (below) show that long term sexual partners of HIV positive individuals are PCR negative as well as HIV negative, indicating heterosexual transmission of HIV happens rarely. Although dire preditions of a heterosexual epidemic have been made every year since 1987, this has never materialized. AIDS remains mostly confined to the male IV drug users and/or homosexual high risk groups. MacGregor RR et al. Failure of culture and polymerase chain reaction to detect human immunodeficiency virus (HIV) in seronegative steady sexual partners of HIV-infected individuals. Clin Infect Dis. 1995 Jul;21(1):122-7. Horsburgh CR et al. Concordance of polymerase chain reaction with HIV antibody detection. J Infect Dis. 1990 Aug;162:542-5. Levy JA. The transmission of AIDS: the case of the infected cell. JAMA. 1988;259(20):3037-8. Lack of Evidence for Transmission of Human Immunodeficiency Virus through Vaginal Intercourse Journal article by Stuart Brody; Archives of Sexual Behavior, Vol. 24, 1995 These two studies (below) show that long term sexual partners of HIV positive individuals in the study population are HIV negative as well as PCR negative, indicating lack of heterosexual transmission of HIV. : Palumbo P, Skurnick J, J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Dec 1;10(4):436-40. PCR analysis of HIV-seronegative, heterosexual partners of HIV-infected individuals. MacGregor RR, Failure of culture and polymerase chain reaction to detect human immunodeficiency virus (HIV) in seronegative steady sexual partners of HIV-infected individuals. Clin Infect Dis. 1995 Jul;21(1):122-7 Bottom line is this: In no way do I recommend one night stands, as there are many bad STD bugs out there. Please use common sense and avoid STDs with appropriate behavior modification and/or protective measures. However, the risk of HIV sero-conversion has been studied and is quite small (in the order of 1 per thousand sexual contacts) compared to the risk of aquiring a nasty garden variety STD which is much more likely to happen. Regards from www.drdach.com >Heterosexual transmission between couples is actually quite rare and >may never happen after many years of contact in some couples as [quoted text clipped - 3 lines] >individuals are PCR negative as well as HIV negative, indicating >heterosexual transmission of HIV happens rarely. This is just unmitigated horseshit. To the extent "elite controllers" do not readily transmit HIV, that's true and nice--but they reflect only (at most) about 7-10% of HIV+ people. Second, HIV transmission globally is primarily heterosexual sex as its mode of transmission. Anal sex is the easiest way and many hetero couples enjoy this. Certainly, risk factors like STIs and genital lesions increase risk as does a higher viral load. The problem with the testing programs proposed by HIV is that they pretty much DITCH counseling which is vile, evil, stupid and moronic. HIV disease is still stigmatized in the United States. It is still a dangerous disease. Treatment can be complex and certainly have side effects. Transmission to others will be GREATLY reduced with appropriate counseling and follow up care. It is yet another "technololgical fix" happy kind of boneheaded idea one would expect by a corrupt CDC. Like Rumsfeld wants to fight wars with too few troops, poorly outfitted and thinks it can all be done by some computer-game style fix. And we see what that war, brought to us on lies and BOTCHED by that miserable a.shole and Cheney, Powell, Rice, etc., has turned into. It will be the same with this less directly but equally boneheaded approach by the CDC. George M. Carter > >Heterosexual transmission between couples is actually quite rare and > >may never happen after many years of contact in some couples as [quoted text clipped - 5 lines] > > This is just unmitigated horseshit. Drs.MacGregor, Horsburgh and Levy disagree with you in peer review medical publications. Please list your peer review medical publications references which support your statement if you have any. > To the extent "elite controllers" do not readily transmit HIV, that's > true and nice--but they reflect only (at most) about 7-10% of HIV+ > people. Please list your peer review medical publications references which support your statement that elite controllers are at most 7-10 per cent of the HIV positive people and not 10 to 20 per cent or 30 to 40 per cent? > Second, HIV transmission globally is primarily heterosexual sex as its > mode of transmission. We are not discussing global. We are talking about here in the USA where primary mode of transmission is not heterosexual since 85% of AIDS cases remain in the high risk groups of homosexuals who engage in anal sex and/or chronic recreational drug abusers. According to the CDC, there is no heterosexual epidemic here is the USA so that heterosexual transmission is not a major causative factor. Please list your peer review medical publications references which support your statement that heterosexual transmission of HIV is the primary mode of transmission and is causing an AIDS epidemic in the heterosexual population in the USA. (You dont have any because there aren't any ) >Anal sex is the easiest way and many hetero couples enjoy this. Please list your peer review medical publications references which support your statement that anal sex is common in the heterosexual population. Same for your statement that anal sex among heterosexual low risk groups (non-drug users) is the major method of conversion of the seronegative spouse. (Again, you dont have any) However, there are many studies which show heterosexual transmission for many couples never happens over many years regardless of the type of sexual practices they use which I have listed above for you) Try to base your discussions on information from the peer reviewed medical literature or from other reliable sources, rather than using fantasy and imagination about what you think people might be doing or not doing in their bedrooms. > Certainly, risk factors like STIs and genital lesions increase risk as > does a higher viral load. [quoted text clipped - 17 lines] > > George M. Carter Routine testing of the low risk population as suggested by the CDC will merely uncover healthy people who are Elite Controllers, HIV positives who remain healthy for many years without the use of anti-HIV drugs. This type of routine HIV testing is harmful because society is harsh on the "known" HIV positive individual, and because the medical system might offer inappropriate anti-HIV toxic drug treatment to these individuals which would seriously threaten their otherwise good health. Here are two references which studied the question of heterosexual transmission: Her is a quote from the second reference:"HIV-negative individuals in stable, monogamous sexual relationships with HIV-infected partners apparently do not have a high incidence of infection despite continued sexual exposure." J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Dec 1;10(4):436-40. PCR analysis of HIV-seronegative, heterosexual partners of HIV-infected individuals.Palumbo P, Skurnick J, Lewis D, Eisenberg M. Department of Pediatrics, University of Medicine and Dentistry, New Jersey Medical School, Newark 07103, USA. A cohort of human immunodeficiency virus (HIV)-discordant couples was established to evaluate risk factors associated with heterosexual viral transmission. Polymerase chain reaction (PCR) was utilized to document the HIV-uninfected status among members of discordant heterosexual couples and to rule out immunosilent infection. HIV DNA PCR specific for a gag gene region was performed on peripheral blood mononuclear cell samples from 203 HIV antibody-negative adults who have long-term heterosexual relationships with HIV-infected partners. The results were negative for 200 but consistently positive in three individuals. More extensive evaluation of these three individuals with an additional primer pair specific for the envelope gene, quantitative DNA PCR, multiple additional time points, and variable nucleotide tandem repeat analyses revealed specimen processing problems in two cases but an apparent true positive PCR assay in the third case. This subject remains antibody and PCR negative for a 32-month follow-up period. These results confirm previous studies that document a negligible incidence of occult HIV infection as delineated by PCR in antibody negative heterosexual partners of HIV-infected individuals. Specimen processing errors occur at a low rate (1% in this study) and require careful evaluation. The possibility of transient, aborted infection versus successful infection with a long immunosilent period was observed in a single individual. Definitive resolution of infection status will require long-term evaluation. PMID: 7583439 [PubMed - indexed for MEDLINE] Clin Infect Dis. 1995 Jul;21(1):122-7 Failure of culture and polymerase chain reaction to detect human immunodeficiency virus (HIV) in seronegative steady sexual partners of HIV-infected individuals.MacGregor RR, Dubin G, Frank I, Hodinka RL, Friedman HM. Department of Medicine, University of Pennsylvania Medical Center, Philadelphia, USA. Because of concern that steady sexual partners of patients infected with human immunodeficiency virus (HIV) may be infected despite negative results in tests for antibody to HIV, we studied 50 sexually active couples with discordant antibody results, assessing the agreement between these serological results and those obtained by p24 antigen testing, the polymerase chain reaction (PCR), and culture. Forty-nine of 50 seropositive sexual partners were also positive for HIV by PCR; the remaining seropositive partner was positive by culture. All seronegative partners also had negative results in the other three tests. Moreover, seronegative partners continued to have negative results in all tests for a mean follow-up period of 17 months despite ongoing sexual relations with their seropositive partners. Seronegative infection was not documented in these partners at risk for sexual transmission of HIV. HIV-negative individuals in stable, monogamous sexual relationships with HIV-infected partners apparently do not have a high incidence of infection despite continued sexual exposure. PMID: 7578720 [PubMed - indexed for MEDLINE] regards from www.drdach.com jdach skrev: >> The problem with the testing programs proposed by HIV is that they >> pretty much DITCH counseling which is vile, evil, stupid and moronic. [quoted text clipped - 35 lines] > Department of Pediatrics, University of Medicine and Dentistry, New > Jersey Medical School, Newark 07103, USA. Is there anything in the analysis as to how often those couples used what kind of protection? Does it say that those couples -ever- had penetrative sex without condoms? > jdach skrev: > [quoted text clipped - 41 lines] > what kind of protection? Does it say that those couples -ever- had > penetrative sex without condoms? drdach replies: In this study, they found a transmission probability of 0.0009 per act from HIV-1-positive men to HIV-1-negative women. Probability of HIV-1 transmission per coital act in monogamous, heterosexual, HIV-1-discordant couples in Rakai, Uganda.Gray RH . Lancet. 2001 Apr 14;357(9263):1149-53. www.drdach.com jdach skrev: >> jdach skrev: >> [quoted text clipped - 51 lines] > > www.drdach.com And I repeat: Was that WITH or WITHOUT condoms? It oughtn't be a very hard question to answer, eh doc? > jdach skrev: > >> jdach skrev: [quoted text clipped - 55 lines] > And I repeat: Was that WITH or WITHOUT condoms? > It oughtn't be a very hard question to answer, eh doc? drdach replies: These are transmission rates with unprotected intercourse (see table summary of multiple studies below). As you can see heterosexual transmission rates are very low. Approvimately one per thousand unprotected sexual contacts. This could explain why the predicted heterosexual AIDS epidemic never happended in the USA over the past 20 years. Observed rate of transmission by unprotected intercourse Year of study <1/1000 M ---> F, <0.5/1000 F ---> M 1986 0.8--1/1000 M ---> F 1987 0.5--2.3/1000 1988 0.8--1/1000 1989 0.6--2.6/1000 M ---> F 1994 0.5--1.2/1000 M ---> F 1996 1/1000 1997 0.9/1000 M ---> F, 0.11/1000 F ---> M 1997 0.6--0.9/1000 M ---> F 1998 0.6--0.8/1000 M ---> F 1998 7% per year = 1/1000 at 70 acts/year 1999 Haiti 10/100 person-years M ---> F, 5/100 person-years F ---> M = 1/1000 /for M ---> F, 5/10,000 for F ---> M at 100 acts/year 2002 Africa 8.2/1000 within ~2.5 months after seroconversion; 1.5/1000 within 6--15 months after seroconversion; 2.8/1000 in the 6--25 months before the death of the infected partner 2005 Africa regards from www.drdach.com "jdach" <drdach@drdach.com> wrote in message ... > Try to base your discussions on information from the > peer reviewed medical literature or > from other reliable sources, rather than using fantasy and imagination > about what you think people might be doing or not doing in their > bedrooms. Well Carter, there is no use trying to solicit funds from him, LOL > "jdach" <drdach@drdach.com> wrote in message > > Try to base your discussions on information from the > > peer reviewed medical literature or > > from other reliable sources, rather than using fantasy and imagination > > about what you think people might be doing or not doing in their > > bedrooms. > Well Carter, there is no use trying to solicit funds from him, LOL reply from drdach: Death be not Proud, by John Gunther. regards from www.drdach.com snip >Drs.MacGregor, Horsburgh and Levy disagree with you in peer review >medical publications. Please list your peer review medical >publications references which support your statement if you have any. If I feel like it, I'll dig up the research. I don't get paid to but since you're a big doctor with a nice income undoubtedly, why don't you look it up yourself? Meantime, show me evidence that "elite controllers" represent more than a fraction of HIV positive individuals. Guess what. You can't. George M. Carter > snip > >Drs.MacGregor, Horsburgh and Levy disagree with you in peer review [quoted text clipped - 12 lines] > > George M. Carter reply from drdach: CDC numbers posted show a million HIV positives and only 42,000 AIDS cases in 2004. A simple subtraction operation shows that there are 960,000 HIV positives who are not sick with AIDS. How many of these people are Elite Controllers? Could there be 200,000 to 400,000 or perhaps more ? I predict there are many more than estimated. Where is your evidence that most of these 960,000 HIV positive people are not Elite Controllers? You don't have any. There is none. You have given us only estimates and guesses based on the imagination. Perhaps you could share your evidence with our readers who would like to see it. regards from www.drdach.com >> snip >> >Drs.MacGregor, Horsburgh and Levy disagree with you in peer review [quoted text clipped - 18 lines] >cases in 2004. A simple subtraction operation shows that there are >960,000 HIV positives who are not sick with AIDS. Wow. You have to be kidding? Could you possibly be that confused and stupid? > >> snip > >> >Drs.MacGregor, Horsburgh and Levy disagree with you in peer review [quoted text clipped - 18 lines] > >cases in 2004. A simple subtraction operation shows that there are > >960,000 HIV positives who are not sick with AIDS. > Wow. You have to be kidding? Could you possibly be that confused and stupid? reply from drdach: What's your problem? Perhaps the subtraction operation of CDC numbers threatens your belief system in some way. Perhaps you could share this with our readers who would like to understand you. regards from www.drdach.com snip >What's your problem? Perhaps the subtraction operation of CDC numbers >threatens your belief system in some way. Perhaps you could share this >with our readers who would like to understand you. All I need to share you've done for me. You've proven you haven't the intellectual rigor to be a "doctor" of any kind. You are not any kind of an authority. You're just another f.cking net nut. George M. Carter > snip > >What's your problem? Perhaps the subtraction operation of CDC numbers [quoted text clipped - 10 lines] > > George M. Carter reply from drdach: I must apologize for threatening your belief system so that you must now resort to childish insults. If you must do so, at least give us some good ones that are not so boring. regards from www.drdach.com >reply from drdach: > >I must apologize for threatening your belief system so that you must >now resort to childish insults. If you must do so, at least give us >some good ones that are not so boring. LOL. I did provide information. You ignored it. Feh. >I must apologize for threatening your belief system so that you must >now resort to childish insults. If you must do so, at least give us >some good ones that are not so boring. > "If I wanted your opinion, I'd have called during visiting hours." ;-P Signature"If Christians want us to believe in a Redeemer, let them act redeemed." --Voltaire > snip > >What's your problem? Perhaps the subtraction operation of CDC numbers [quoted text clipped - 10 lines] > > George M. Carter reply from drdach: It seems Mr. Carter that you have a lot of baggage to carry around: (see below) http://www.pahealthsystems.com/archive253-2005-6-444458.html from : redrum1@alltel.net 2005-06-12, 11:46 am Carter actually isn't allowed to "think"... pharma wouldn't stand for it. Not for one second, as evidenced by Pharma Ilk Carter, Stein, Canzi, Mailman and others operating from their public relations internet damage control boiler rooms. However, Carter's lies are intended to distance himself and his previous ACT UP co-conspirators from their sordid pasts, when they were paid to solicit victims for the pharma poison squads. The only exception to the ACT UP = PHARMA DEATH rule was, of course, ACT UP San Francisco (see the pharma gang's attacks on AUSF's Pasquarelli, especially after his death to get the true flavor of the compassion professed by Carter et al). Carter says "no, I didn't take pharma money", but the facts remain otherwise. Unfortunately for Carter, he can't go back and destroy every copy of POZ Magazine in which his columns and SPV-30 ads appeared. Would anyone care to guess which industry funded POZ? Carter also refuses to disclose his seemingly endless other financial conflicts of interests involving his Pharma money and his internet "nutriceutical" schemes (NAC, SPV-30, etc., etc.). Then there were all those drug company-paid trips here and there; and various other pharma-funded-and-sponsored opportunites for self-promotion and profit. Some call those "International AIDS Conferences", but by now we know better, don't we? Carter and his "friends" were there. Always. And they NEVER paid their own way. NEVER! The drug companies paid them and the drug companies even orchestrated their "protests", (e.g. the parade of actor-protesters demanding their latest cures in front of the news media - ALL of it was phony). The term "Quizzling" comes to mind. And then there was Carter's crowned jewel - Arkopharma France's SPV-30 and his true one chance to be a hero! Carter admits taking their money, but now brushes it off as if a pittance. He'll only admit that much because he was caught in the act ... again. But Carter lies when he claims that he didn't write the ads for SPV-30. He did. Carter admits "helping" with the distribution of this immune system killer, a confession that Carter refuses to reconcile with all the goodies he received along the way. Carter also downplays the deadly nature of the SPV-30 boxwood extract's high volume of steroidal drug compounds (nearly 70) which were even classified at the time as good candidates for cancer therapy. Similar to tamoxifen, they were highly immunosuppressive, if only by inference understood by even the most casual observer. Yet there Carter was - making money by killing those whose HIV-positive tests left them desperate, lonely and vulnerable to psychopathic predators of Carter's sad ilk - a seemingly endless stream of opportunists who, like roaches, scamper off when light is shed on their handiwork ... and conflicts of interest. That's why Carter's desperation is so obvious - as evidenced by his recent "child molester" ploy and the various other smear campaigns he regularly orchestrates against his tormentors (anyone with common sense and/or science). That's what Carter and his co-workers here are paid to do. That's the job for the Pharma PR boiler rooms who plague Usenet for the purpose of obscuring the truth that is so embarassing and risky to their employers. (Hence the demise of sci.med.aids - the group which was "moderated" by the Pharma PR boiler rooms ... into oblivion). redrumtza >reply from drdach: > >It seems Mr. Carter that you have a lot of baggage to carry around: >(see below) So you pull up a post that is an act of libel from Fred Shaw as evidence that I have some baggage? Interesting! Gosh, should I apologize for disturbing your delicate equanimity that you would stoop to re-posting libel? >http://www.pahealthsystems.com/archive253-2005-6-444458.html > [quoted text clipped - 4 lines] >Canzi, Mailman and others operating from their public relations >internet damage control boiler rooms. As I'll reiterate here, I don't take pharma money. I think big pharma is just about the worst thing that ever happened to healthcare, science and medicine. Carry on, "dr." dach! Frodlet had lots of nasty things to say about everyone who disagreed with him. I'm quite familiar with his sh.t. George M. Carter > CDC numbers posted show a million HIV positives and only 42,000 AIDS > cases in 2004. A simple subtraction operation shows that there are > 960,000 HIV positives who are not sick with AIDS. Duhhh. One figure is the HIV prevalence and the other is the AIDS incidence. The actual figure you wanted was the number of people living with AIDS which is estimated to be about 415,000 in 2004 in the US. A large proportion of people infected with HIV do not show clinical symptoms for a number of years. This does not make them elite controllers or long term non-progressors. Chris Noble For someone who is supposedly an accredited physician with 25 years experience of AIDS our friend Dr Dach seems to have next to no grasp of epidemiology. Dr Dach, please can you give citations of peer-reviewed publications providing evidence that those who would test positive through a screening programme are "elite controllers" > > CDC numbers posted show a million HIV positives and only 42,000 AIDS > > cases in 2004. A simple subtraction operation shows that there are [quoted text clipped - 12 lines] > > Chris Noble > For someone who is supposedly an accredited physician with 25 years > experience of AIDS our friend Dr Dach seems to have next to no grasp of [quoted text clipped - 3 lines] > providing evidence that those who would test positive through a > screening programme are "elite controllers" reply from drdach: My point is that many of the 1 million HIV positives in the USA who are healthy and dont have AIDS (and have never taken anti-HIV drugs) are probably Elite Controllers. By doing routine HIV screening as suggested by the recent CDC recommendation, we will uncover these people to the medical system and in some unfortunate cases they will be offered and given anti-HIV drugs, an obvious mistake, since the adverse risk of such drugs is greater to them than the risk of being an elite controller (there is no risk to elite controllers and no risk of transmission of HIV from elite controllers to others ) regards from www.drdach.com >> For someone who is supposedly an accredited physician with 25 years >> experience of AIDS our friend Dr Dach seems to have next to no grasp of [quoted text clipped - 9 lines] >healthy and dont have AIDS (and have never taken anti-HIV drugs) are >probably Elite Controllers. Your "point" is delusional horseshit based on nothing but denialist fantasies. Unless you actually have some data that support this crock? What? Silence? nothing? So I thought! > > CDC numbers posted show a million HIV positives and only 42,000 AIDS > > cases in 2004. A simple subtraction operation shows that there are [quoted text clipped - 12 lines] > > Chris Noble reply from drdach. Accepting your stated number, the number for people living with AIDS is 415,000 as you say, then we would merely subtract this number from the 1 million HIV posiitve in the USA which gives us 585,000 HIV positive people in the USA who are healthy and don't have AIDS. This is a large number of people, many of whom could be Elite Controllers who are HIV positive and remain healthy for many years never taking any anti - HIV drugs. Dont you agree? regards from www.drdach.com "jdach" <drdach@drdach.com> wrote in message > Accepting your stated number, the number for people living with AIDS is > 415,000 as you say, then we would merely subtract this number from the > 1 million HIV posiitve ... HIV (Human immunodeficiency virus) attacks the body's immune system. When it does, HIV weakens the body's ability to fight off infection. If left untreated, HIV will eventually weaken the immune system so much that the person will become sick from certain types of infections. When the person gets these infections, he is said to have AIDS (acquired) immunodeficiency syndrome. For some, it takes a long time to develop these infections and therefore AIDS. For others it takes less time. Not everyone with HIV has AIDS and AIDS is not the same as HIV. > "jdach" <drdach@drdach.com> wrote in message > > [quoted text clipped - 3 lines] > > HIV (Human immunodeficiency virus) attacks the body's immune system. drdach reply: What part of the immune system? be specific. > When it does, HIV weakens the body's ability to fight off infection. If left untreated, HIV will eventually weaken the immune system so much that the person will become sick from certain types of infections. drdach reply: Kaposi's Sarcoma is a hallmark of AIDS. Where does Kaposi's Sarcoma fit in here. This is a cancer , not an infection. > When the person gets these infections, he is said to have AIDS (acquired) immunodeficiency > syndrome. For some, it takes a long time to develop these infections and therefore AIDS. For > others it takes less time. Not everyone with HIV has AIDS and AIDS is not the same as HIV. drdach reply: Elite Controllers are HIV positive and never get AIDS, and never take anti-HIV drugs. How many Elite Controllers are there in the 1 million HIV positives in the population? 18,000 deaths from AIDS are reported annually by the CDC. Why aren't the other 982,000 HIV positives also dead or dying from AIDS? Perhaps many of them are Elite Controllers who will remain healthy and will never get AIDS. regards from www.drdach.com "jdach" <drdach@drdach.com> wrote in message > > "jdach" <drdach@drdach.com> wrote in message > > > [quoted text clipped - 5 lines] > > drdach reply: What part of the immune system? be specific. Most of your immune system is made up of cells in your blood. Lymphocytes, which are white blood cells, are the backbone of the immune system. A healthy drop of blood contains a mix of red blood cells which carry oxygen to other body cells, plasma a pale yellow fluid, platelets which help in clotting blood, and different kinds of lymphocytes. Healthy blood contains enough lymphocytes to help your body recognize and fight pathogens, organisms such as viruses that can cause disease. Among the human cells that the AIDS virus attacks is a lymphocyte type called helper T-cells. These cells help direct many of the activities of the immune system. Over many years, HIV causes a dramatic drop in the number of helper T-cells in the blood. When enough of the helper T-cells are destroyed, the immune system becomes weak, and people develop AIDS. Because their immune systems are weak, they may get many diseases such as pneumonia and cancer. > > When it does, HIV weakens the body's ability to fight off infection. If left untreated, HIV will eventually weaken the immune system so much that the person will become sick from certain types of infections. > drdach reply: Kaposi's Sarcoma is a hallmark of AIDS. Where does > Kaposi's Sarcoma fit in here. This is a cancer , not an infection. The herpes virus HHV8 is the cause of KS and it is not a cancer. New research suggests that infection with bacteria from the Chlamydia family may play a role in the development of a type of lymphoma that affects the tissue around the eye, raising hopes that antibiotics may one day prove to be an alternative to chemotherapy or radiation. The study, presented at the European Cancer Conference, is the latest to link infection with cancer, following the establishment of the human papilloma virus as the major cause of cervical cancer and the bacteria Helicobacter pylori as a cause of stomach cancer. Chlamydia psittaci, can be contracted from infected birds such as parrots. Scientists also suspect it can come from household cats because they also carry it. Chlamydia psittaci is known to cause a lung infection called psittacosis. In the study, Dr. Changhoon You from the Asan Medical Center in Seoul, South Korea, compared chlamydia infection in 33 people with ocular adnexal lymphoma, or OAL, and 21 people with a comparable but non-cancerous condition called non-neoplastic ocular adnexal disease. He found the Chlamydia psittaci strain was present in 78 percent of the cancer patients, but only in 23 percent of those in the comparison group. In a previous study conducted in Italy, the bacteria were found in 80 percent of people with the lymphoma and in none of those in a comparison group of healthy people. "In the future, eradication of the (germ) could be a common treatment method for low-grade lymphoma, replacing current cytotoxic chemotherapy or radiation," You said. The Chlamydia family of bacteria has been linked to cancer before. Scientists already have shown that another strain, Chlamydia trachomatis, is linked to the development of cervical cancer. Another, Chlamydia pneumoniae, has been linked to lung cancer. Ocular adnexal lymphoma belongs to a group of lymphomas where cellular changes result from immune system responses gone awry. Scientists say it makes sense that infections such as chlamydia could contribute to the development of the disease. "It makes biological sense, but whether it will translate into anything practical, and for how many patients, this is the question," said Dr. Joachim Yahalom, a lymphoma specialist at Memorial SloanKettering Cancer Center in New York who was not connected with the research. In many of these types of lymphoma, an infection can start the process, but at some point the cancer becomes independent of the infection. So unless the infection is treated early, antibiotics may not be enough, Yahalom said. Alan Cantwell M.D. alancantwell@sbcglobal.net http://www.ariesrisingpress.com > > When the person gets these infections, he is said to have AIDS (acquired) immunodeficiency > > syndrome. For some, it takes a long time to develop these infections and therefore AIDS. For [quoted text clipped - 4 lines] > Elite Controllers are HIV positive and never get AIDS, and never take > anti-HIV drugs. Anti HIV drugs? Care to name a few of the wonder drugs? > How many Elite Controllers are there in the 1 million HIV positives in > the population? 18,000 deaths from AIDS are reported annually by the > CDC. Once again you allow your terms hiv/aids to become interchangable as if they are a single dis-ease. OIs also seem to be absent in all of your postings. >Why aren't the other 982,000 HIV positives also dead or dying from > AIDS? Absent any reference to the duration of their hiv, how can I answer such an open ended question. > Perhaps many of them are Elite Controllers who will remain > healthy and will never get AIDS. Perhaps not > > > CDC numbers posted show a million HIV positives and only 42,000 AIDS > > > cases in 2004. A simple subtraction operation shows that there are [quoted text clipped - 22 lines] > positive and remain healthy for many years never taking any anti - HIV > drugs. Dont you agree? >From the 80s it has been apparent that the median time from infection with HIV to progression to AIDS is of the order of several years. Where cohorts of HIV positive people have been followed for long time periods the vast majority suffer progressive CD4+ cell depletion and eventually progress to full blown AIDS. At a given time it is by nature of the the long progresion time 100% certain that a large proportion of people infected with HIV do not have clinical symptoms.This does not make them elite controllers or long-term non-progressors. All available data suggests that long-term non-progressors represent a very small fraction of those infected with HIV. Chris Noble jdach skrev: >> snip >>> Drs.MacGregor, Horsburgh and Levy disagree with you in peer review [quoted text clipped - 25 lines] > > regards from www.drdach.com What about the NON-Elite controllers who just got infected two weeks ago? No need to discover them, eh? I mean, they don't show any symptoms of developing AIDS (yet), so they've got to be Elite Controllers, right? > > CDC numbers posted show a million HIV positives and only 42,000 AIDS > > cases in 2004. A simple subtraction operation shows that there are [quoted text clipped - 7 lines] > > > > regards from www.drdach.com > What about the NON-Elite controllers who just got infected two weeks > ago? No need to discover them, eh? I mean, they don't show any symptoms > of developing AIDS (yet), so they've got to be Elite Controllers, right? reply from drdach: By the above statement, it seems you are saying that NON-Elite controllers can somehow be magically converted into Elite Controllers. Is it required to assume that all Elite Controllers were "converted" from a prior conditrion in which they were not previously Elite Controllers? Or perhaps no conversion process is needed to explain the presence of Elite Controllers. Do you have any medical references for this idea of a conversion process for Elite Controllers or are you creating it from your imagination? regards from wwww.drach.com > Heterosexual transmission between couples is actually > quite rare and may never happen after many years of contact in some > couples as reported by Dr. > MacGregor, Horsburgh and Levy: (see references below) A few questions, doctor... 1. What was the reported HIV transmission/infection rate between serodiscordant heterosexual couples in the Horsburgh study? 2. Have you actually read these papers? 3. Why does a search for your reference on the Horsburgh article only show up on AIDS-rethinkers web sites? (Is the reason that the correct title actually refers to human immunodeficiency virus, but this was shortened to HIV by the rethinkers, and cut/pasted by you, indicating you have not independently sourced and quoted this citation, merely parroted what the rethinkers say?) 4. Do you realise that studying discordant couples (who have NOT transmitted HIV between them over many years of contact and are therefore by definition already selected out as inefficient transmitters of virus) is not a good way to pick up new seroconversions? (This is known as selection bias - see you can still maybe learn something by visiting these boards) > > Heterosexual transmission between couples is actually > > quite rare and may never happen after many years of contact in some [quoted text clipped - 21 lines] > seroconversions? (This is known as selection bias - see you can still > maybe learn something by visiting these boards) reply from drdach: Are you making the statement that heterosexual transmission (seroconversion) between discordant couple is quite common? If so, how many sexual contacts on average are required for seroconversion? Are you making the statement that seroconversion of in discordant couples always happens ? And if so, how many years or sexual contacts on average aree required for sero-conversion? Please clarify these questions for the readers of this newsgroup. We would like to know. regards from www.drdach.com Just answer the questions I have asked, doctor. Our readers would appreciate clarification of these issues. Or perhaps you are admitting you have not read the Horsburgh paper and cannot quote verbatim what it says about serodiscordant heterosexual transmission? > > > Heterosexual transmission between couples is actually > > > quite rare and may never happen after many years of contact in some [quoted text clipped - 36 lines] > > regards from www.drdach.com > Just answer the questions I have asked, doctor. Our readers would > appreciate clarification of these issues. Or perhaps you are admitting [quoted text clipped - 41 lines] > > > > regards from www.drdach.com drdach replies: I would ask you to please answer the question posed to you. This does not require you to read any material and does not require you to memorize and quote any material as you have asked of me. If you wish to discontinue this discussion please say so. The question posed to you: Are you making the statement that heterosexual transmission (seroconversion) between discordant couple is quite common? If so, how many sexual contacts on average are required for seroconversion? Are you making the statement that seroconversion of in discordant couples always happens ? And if so, how many years or sexual contacts on average aree required for sero-conversion? Please clarify these questions for the readers of this newsgroup. We would like to know. regards from www.drdach > drdach: > > I would ask you to please answer the question posed to you. This does > not require you to read any material and does not require you to > memorize and quote any material as you have asked of me. If you wish > to discontinue this discussion please say so. (You are a pretentious git, aren't you? remember my unanswered questions?r I posted my questions first) > The question posed to you: > > Are you making the statement that heterosexual transmission > (seroconversion) between discordant couple is quite common? If so, how > many sexual contacts on average are required for seroconversion? No it is not common. In fact it is relatively difficult. However the reproductive number for HIV (R0) is greater than one. > Are you making the statement that seroconversion of in discordant > couples always happens ? And if so, how many years or sexual contacts > on average aree required for sero-conversion? No, many couples will remain serodiscordant over many years - this is because infectivity in the index case may be very low and if the couples use barrier methods then infection is very unlikely to happen. > Please clarify these questions for the readers of this newsgroup. We > would like to know. > > regards from www.drdach Now I have answered your additional questions to me, I would like you to answer my earlier questions. Our readers wish to know. If you do not wish to continue to discuss this topic in a rational and reasoned manner, you can always indicate you wish to stop posting. My questions were: 1. What was the reported HIV transmission/infection rate between serodiscordant heterosexual couples in the Horsburgh study? 2. Have you actually read these papers? 3. Why does a search for your reference on the Horsburgh article only show up on AIDS-rethinkers web sites? (Is the reason that the correct title actually refers to human immunodeficiency virus, but this was shortened to HIV by the rethinkers, and cut/pasted by you, indicating you have not independently sourced and quoted this citation, merely parroted what the rethinkers say?) 4. Do you realise that studying discordant couples (who have NOT transmitted HIV between them over many years of contact and are therefore by definition already selected out as inefficient transmitters of virus) is not a good way to pick up new seroconversions? (This is known as selection bias - see you can still maybe learn something by visiting these boards). I also have some supplementary questions which will establish your opinions on HIV transmission. These do not require you to memorise or quote material, opinions will suffice for now. 5. Do you believe HIV can be transmitted heterosexually? 6. Why do you think people who test HIV positive but do not have AIDS are automatically categorised as "elite controllers"? Have you never heard of incubation periods? Thank you for finally addressing these points. > > Heterosexual transmission between couples is actually > > quite rare and may never happen after many years of contact in some [quoted text clipped - 5 lines] > 1. What was the reported HIV transmission/infection rate between > serodiscordant heterosexual couples in the Horsburgh study? About one in a thousand sexual contacts as I have said in previous posts.(see quote from his paper below) Longini IM Jr., Clark WS, Haber M and Horsburgh CR. The stages of HIV-1 infection, ... heterosexual HIV-1 transmission. J Infect Dis 1990, 161:833-877 "The probability of transmission of HIV-1 from male to female during an episode of intercourse has been examined in seven studies. Analysis of data from North American and European studies of heterosexual couples provide estimates of per-sex-act HIV-1 transmission of approximately 1 in 1000 (0.001, ranging from 0.0008 to 0.002)." http://www.retroconference.org/2001/posters/222.pdf > 2. Have you actually read these papers? reply from drdach: yes...see the quote above. > 3. Why does a search for your reference on the Horsburgh article only > show up on AIDS-rethinkers web sites? (Is the reason that the correct > title actually refers to human immunodeficiency virus, but this was > shortened to HIV by the rethinkers, and cut/pasted by you, indicating > you have not independently sourced and quoted this citation, merely > parroted what the rethinkers say?) drdach replies: Here is the reference web site for you from an AIDS conference: http://www.retroconference.org/2001/posters/222.pdf > 4. Do you realise that studying discordant couples (who have NOT > transmitted HIV between them over many years of contact and are > therefore by definition already selected out as inefficient > transmitters of virus) is not a good way to pick up new > seroconversions? (This is known as selection bias - see you can still > maybe learn something by visiting these boards) drdach replies: seven studies showing the same number is about as good as it gets in terms of scientific credibility. regards from www.drdach.com > > > Heterosexual transmission between couples is actually > > > quite rare and may never happen after many years of contact in some [quoted text clipped - 21 lines] > > http://www.retroconference.org/2001/posters/222.pdf No - I asked about the transmission rate in the Horsburgh paper (Concordance of polymerase chain reaction with human immunodeficiency virus antibody detection. J Infect Dis. 1990 Aug;162(2):542-5) which is the one you previously cited in evidence as showing minimal heterosexual transmission David:> > 2. Have you actually read these papers? > reply from drdach: yes...see the quote above. Reply from David: Well, have you read the ones I actually asked about, specifically the Horsburgh paper above on PCR concordance? If you have you can easily quote the HIV seroconversion rate, surely? > > 3. Why does a search for your reference on the Horsburgh article only > > show up on AIDS-rethinkers web sites? (Is the reason that the correct [quoted text clipped - 8 lines] > > http://www.retroconference.org/2001/posters/222.pdf David replies: That doesn't answer my question. > > 4. Do you realise that studying discordant couples (who have NOT > > transmitted HIV between them over many years of contact and are [quoted text clipped - 7 lines] > seven studies showing the same number is about as good as it gets in > terms of scientific credibility. David: That doesn't answer my question. I asked if you accepted that studies on serodiscordant couples are affected by selection bias. For what it is worth, I agree HIV is not easily transmitted through heterosexual intercourse. However it IS transmitted, and transmission rates are demonstrably higher when HIV load is high (as is the case in the first few months after HIV acquisition) and if there are cofactors such as concommitant genital ulceration/STIs. >j > http://www.retroconference.org/2001/posters/222.pdf "HIV-1 can be transmitted through contaminated blood and blood products, from mother to child, or through sexual contact. The predominant mode of transmission of human immunodeficiency virus worldwide is heterosexual intercourse." You use the numbers as if they prove that heterosexuals have nothing to worry about. How silly. How deeply stupid and uncomprehending of the paper you cite. You want to use this paper to neatly wrap up your delusions. Sadly, it doesn't work that way. But, and I agree with David, there are definitely ways to reduce HIV transmissibility that we have LONG known about. Condoms. Diagnosis and treatment of concomitant STIs. What is also ridiculous about your assertions is that you don't look at the risk of other infections. Syphilis. Gonorrhea. Chlamydia. George M. Carter > >j > > http://www.retroconference.org/2001/posters/222.pdf [quoted text clipped - 20 lines] > > George M. Carter drdach replies: We know from HIV testing of military recruits that the incidence of an HIV positive test in the general population is about 4 per thousand. This is public domain data. Assuming random heterosexual contacts in this population, it is easy to calculate the number of sexual contacts needed for HIV transmission and sero-conversion for the average person. On the average, 250 different sexual contacts within the general population will be required to find the one HIV positive person who could then transmit the HIV virus. Assuming a monogamous relationship with this HIV positive person, 1000 sexual contact with that one person would then be needed for HIV transmission. However, instead of a monogamous relationship, there is the continued pattern of unprotected sexual contacts throughout the general population, then 250 x 1000 would be the calculated number of sexual contacts. This requires 250,000 different sexual contacts. This explains why heterosexual transmission of HIV in the general population is quite rare. It is far more likely that our hypothetical sexually adventurous individual would have multiple recurring garden variety nasty STD's with their consequences for many years before HIV seroconversion. This also explains why no heterosexual epidemic has materialized after 20 years of dire predictions. The numbers change of course for high risk populations where many of the sexual partners are HIV positive. For example if our hypothetical adventurous person has sex with 300 people per year (one a day) and all these people are HIV positive, then one could calculate sero-conversion within three years. Of course, other factors such as co-existing STD's may accelerate this time table. So this then brings us to a discussion of the question of the origin of the HIV in the 0.4 per cent (4 per thousand) of the general population which is HIV positive, if heterosexual transmission would require 250,000 different sexual contacts. How did these 0.4 percent or 1 million people in the general population get to be HIV positive? The obvious possible answer is via maternal - fetal transmission. They received the HIV from their mothers. For readers who would like more discussion of this issue, please reply to my contact page on my web site www.drdach.com Here is direct quote from Horsburg's article from an AIDS conference which provides a reference for the 1 per thousand number. This is the article you are asking about and here is the quote which you can read for yourself. Longini IM Jr., Clark WS, Haber M and Horsburgh CR. The stages of HIV-1 infection, ... heterosexual HIV-1 transmission. J Infect Dis 1990,161:833-877 "The probability of transmission of HIV-1 from male to female during an episode of intercourse has been examined in seven studies. Analysis of data from North American and European studies of heterosexual couples provide estimates of per-sex-act HIV-1 transmission of approximately 1 in 1000 (0.001, ranging from 0.0008 to 0.002)." http://www.retroconference.org/2001/posters/222.pdf regards from www.drdach.com OK--first off, you've posted this email multiple times again. Are you selling Coke or working for the Bush team or something? Saying the same crap over and over don't make it true or not crap. Let's take a look. First--none of the statements you make below are cited--you provide in fact only one citation. dach replies: >We know from HIV testing of military recruits that the incidence of an >HIV positive test in the general population is about 4 per thousand. >This is public domain data. Cite it. Or are you incompetent as a researcher? >Assuming random heterosexual contacts in this population, it is easy to >calculate the number of sexual contacts needed for HIV transmission and >sero-conversion for the average person. It is "easy" you claim to make this calculation? I think it is probably easier to look at it from the standpoint of incidence and prevalence data. These clearly indicate that HIV is readily transmissible through heterosexual sex. Of course, your use of the term "average" person is utterly meaningless. What is that? >On the average, 250 different sexual contacts within the general >population will be required to find the one HIV positive person who >could then transmit the HIV virus. Unsupported claim. >Assuming a monogamous relationship >with this HIV positive person, 1000 sexual contact with that one person >would then be needed for HIV transmission. Another unsupported claim. And one that where any grain of truth may exist is based on your poor grasp of the English language. >However, instead of a >monogamous relationship, there is the continued pattern of unprotected >sexual contacts throughout the general population, then 250 x 1000 >would be the calculated number of sexual contacts. This requires >250,000 different sexual contacts. Deranged extrapolation and unsupported claim. Come on, big guy. This is the best you can do with all your remarkable expertise and fancy letters after your name? Feh. >This explains why heterosexual >transmission of HIV in the general population is quite rare. But it isn't rare. Where you begin to make your problem is presuming that per-coital act is somehow an indicator of actual incidence, let alone prevalence, of HIV infection among heterosexual individuals. >It is far >more likely that our hypothetical sexually adventurous individual would >have multiple recurring garden variety nasty STD's with their >consequences for many years before HIV seroconversion. This also >explains why no heterosexual epidemic has materialized after 20 years >of dire predictions. What are you dithering about? You make this claim and obviously don't know the facts. A heterosexual pandemic is going on right now. The one cite you have provided is 16 years old: Longini IM Jr., Clark WS, Haber M and Horsburgh CR. The stages of HIV-1 infection, ... heterosexual HIV-1 transmission. J Infect Dis 1990,161:833-877. I don't believe it supports the extrapolations you have made from the data presented. Indeed, those extrapolations are merely the regurgitations of denialist cant. George M. Carter *** [We.C.454] INFECTIOUSNESS AND STAGE OF HIV-INFECTION De Vincenzi, Isabelle. European Centre for the Epidemiological Monitoring of AIDS, St Maurice, France Early studies of female sex partners of HIV-1 infected men with hemophilia indicated that advanced stages of HIV-1 infection were associated with increased infectiousness; partners of men who had clinical signs of HIV-1 disease were more likely to be HIV-1 seropositive than were partners of asymptomatic men [Jason-86, Bardin-86, Goedert-87]. Longini et al. [Longini-89] estimated the per-contact transmission probability with a spouse who had AIDS to be eight times greater than for sexual contact with an HIV-1 infected spouse who had pre-AIDS symptoms. Studies of male-to-male transmission via receptive anal intercourse also observed increased infectiousness if the index cases had HIV-1 related disease [Coates-88, DeGruttola-89, Seage-89]. More recent studies of the heterosexual partners of HIV-1 infected IDU, bisexual men, and blood transfusion recipients have shown an association between the prevalence and incidence of HIV-1 infection and the presence in the index cases of clinical signs and symptoms of HIV-1 infection, low CD4+ cell counts, and p24 antigenemia [Nicolosi-JAIDS-94, European-92, Seidlin-93, O'Brien 94]. It has been argued that in cross-sectional analyses, clinical stage may be a marker of the duration of relationship (and thus the duration of exposure to HIV-1] rather than a marker of infectiousness. However, prospective studies which were designed to account for the duration of exposure showed the same association [Musicco-94, de Vincenzi-94]. Increased infectiousness associated with advanced HIV-1 disease may be related to higher HIV-1 viremia found during late stages of disease [Saag-91]. Increased infectiousness in advanced HIV-1 disease has been shown to be more pronounced among index case women than men [European-92]; possibly due to the fact that cervico-vaginal secretions contain a higher quantity of lymphocytes (target cells for HIV-1) than semen [Levy-93]. Recent analyses suggest that HIV-1 infectiousness may also be increased substantially in the brief primary infection phase following acute infection [Mastro-94, Jacquez-94], consistent with the markedly higher plasma viremia observed during this phase [Daar-91, Clark-91]. Jacquez et al. [Jacquez-94], in analyses of data from cohorts of homosexual men in the United States during the 1980s, suggest that the fast early rise in HIV-1 incidence was due to markedly increased infectiousness during primary HIV-1 infection and the exposure of many recently infected men to multiple sex partners. They estimated that the per-anal-intercourse transmission probability during primary HIV-1 infection was 500 times the per-contact risk during the long asymptomatic phase (compared to a 10-fold increase of risk in the period leading to AIDS was) [Jacquez-94] The modelling of data from the European partner study also evidenced a significant increase of infectiousness during primary HIV infection, although this increase was much lower than in the above study (x6 compared to x500). An epidemiologic study conducted in the early phase of the explosive heterosexual HIV-1 epidemic in Thailand estimated a high female CSW-to-male transmission probability per sexual contact, thought to be due in part, to increased infectiousness during primary infection [Mastro-94, Satten-94]. I De Vincenzi, 14 rue du Val D'osne, 94110 St Maurice, France *** Baeten et al. Female-to-Male Infectivity of HIV-1 among Circumcised and Uncircumcised Kenyan Men. JID 2005:191 (15 February) Background. A lack of male circumcision has been associated with increased risk of human immunodeficiency virus type 1 (HIV-1) acquisition in a number of studies, but questions remain as to whether confounding by behavioral practices explains these results. The objective of the present study was to model per-sex act probabilities of female-to-male HIV-1 transmission (i.e., infectivity) for circumcised and uncircumcised men, by use of detailed accounts of sexual behavior in a population with multiple partnerships. Methods. Data were collected as part of a prospective cohort study of HIV-1 acquisition among 745 Kenyan truck drivers. Sexual behavior with wives, casual partners, and prostitutes was recorded at quarterly follow-up visits. Published HIV-1 seroprevalence estimates among Kenyan women were used to model HIV-1 per-sex act transmission probabilities. Results. The overall probability of HIV-1 acquisition per sex act was 0.0063 (95% confidence interval, 0.0035- 0.0091). Female-to-male infectivity was significantly higher for uncircumcised men than for circumcised men (0.0128 vs. 0.0051; ). The effect of circumcision was robust in subgroup analyses and across a wide range Pp.04 of HIV-1 prevalence estimates for sex partners. Conclusions. After accounting for sexual behavior, we found that uncircumcised men were at a 12-fold increased risk of acquiring HIV-1 per sex act, compared with circumcised men. Moreover, female-to-male infectivity of HIV-1 in the context of multiple partnerships may be considerably higher than that estimated from studies of HIV-1-serodiscordant couples. These results may explain the rapid spread of the HIV-1 epidemic in settings, found throughout much of Africa, in which multiple partnerships and a lack of male circumcision are common. > OK--first off, you've posted this email multiple times again. Are you > selling Coke or working for the Bush team or something? Saying the > same crap over and over don't make it true or not crap. That's what killfiles are for. Hint. [snip remainder of remainder of intelligent quesions to which the 'doctor' will reply with the same cut and paste horseshit] >> OK--first off, you've posted this email multiple times again. Are you >> selling Coke or working for the Bush team or something? Saying the [quoted text clipped - 4 lines] >[snip remainder of remainder of intelligent quesions to which the 'doctor' >will reply with the same cut and paste horseshit] LOL....I keep hoping that if I give the trolls enough data, like a princess-kissed-frog, they might turn into something a wee bit brighter, if not a prince. Preferably before they wind up buying denialist lies and delusions like "ARV are toxic poison" and wind up dead like David Pasquarelli. George M. Carter >We know from HIV testing of military recruits that the incidence of an >HIV positive test in the general population is about 4 per thousand. > Incorrect. What we know from that is merely that the subset of the general population which seeks to join the military has an infection ratio of four per thousand. 'Tis curious that you're on the record as opposing the direct sampling of the general population, from which we could obtain an accurate picture... Curious indeed. >On the average, 250 different sexual contacts within the general >population will be required to find the one HIV positive person who [quoted text clipped - 5 lines] >would be the calculated number of sexual contacts. This requires >250,000 different sexual contacts. Ah, the maximal improbability defense. "We won't get a hit until all the chances are taken." The various state lotteries have odds of millions to one. Yet every week, we see folks who haven't bet millions of times getting the jackpot... You know, you're not very good at this. >The numbers change of course for high risk populations where many of >the sexual partners are HIV positive. For example if our hypothetical >adventurous person has sex with 300 people per year (one a day) Ahem, the average year sports more than 300 days. >So this then brings us to a discussion of the question of the origin of >the HIV in the 0.4 per cent (4 per thousand) of the general population [quoted text clipped - 4 lines] >received the HIV from their mothers. > <LOL!!!> And where did mommy get it? Her mommy? You complete unfamiliarity with the fact that children who acquire AIDS via their mother don't tend to live to child-bearing age is quite amusing. >For readers who would like more discussion of this issue, please reply >to my contact page on my web site www.drdach.com > Now why would we want to do that? It's so much more fun to f.ck you in public. Signature"If Christians want us to believe in a Redeemer, let them act redeemed." --Voltaire > > >j > > > http://www.retroconference.org/2001/posters/222.pdf [quoted text clipped - 46 lines] > explains why no heterosexual epidemic has materialized after 20 years > of dire predictions. This piece of Duesbergian stupidity is dead. Or perhaps it is an undead zombie roaming the earth looking for innumerate brains to infect. http://scienceblogs.com/goodmath/2006/09/pathetic_statistics_from_hivai.php Chris Noble snip >This piece of Duesbergian stupidity is dead. Or perhaps it is an undead >zombie roaming the earth looking for innumerate brains to infect. > >http://scienceblogs.com/goodmath/2006/09/pathetic_statistics_from_hivai.php Thanks, Chris. And David T --thank you too for all your cogent replies! One nice thing about the delirious dithering of denialist dingbats (aside from inspirational alliteration), is that I am always learning something from those that take the time to respond. Friction makes the pearl! In oysterhood, George M. Carter > > > > Heterosexual transmission between couples is actually > > > > quite rare and may never happen after many years of contact in some [quoted text clipped - 71 lines] > the first few months after HIV acquisition) and if there are cofactors > such as concommitant genital ulceration/STIs. drdach replies: However, I don't think selection bias is an issue for this question, since transmission rates have been studied multiple times and found to be about 1 per thousand sexual contacts. However, if you have any further information you would like to share about selection bias, please do so. Thank you for finally admitting that HIV is not easily transmitted within heterosexual couples. We can go further with the discussion: We know from HIV testing of military recruits that the incidence of an HIV positive test in the general population is approx. 4 per thousand. This is public domain data. Assuming random heterosexual contacts in this population, it is easy to calculate the number of sexual contacts needed for HIV transmission and sero-conversion for the average person. On the average, 250 different sexual contacts within the general population will be required to find the one HIV positive person who could then transmit the HIV virus. Assuming a monogamous relationship with this HIV positive person, 1000 sexual contact with that one person would then be needed for HIV transmission. However, if there is a continuation of unprotected sexual contacts throughout the general population, then 250 x 1000 would be the calculated number of sexual contacts. This requires 250,000 different sexual contacts. This explains why heterosexual transmission of HIV in the general population is quite rare. It is far more likely that our hypothetical sexually adventurous individual would have multiple recurring garden variety nasty STD's with their consequences for many years before HIV seroconversion. Thhis also explains why no heterosexual epidemic has materials after 20 years of dire predictions. The numbers change of course for high risk populations where many of the sexual partners are HIV positive. For example if our hypothetical adventurous person has sex with 300 people per year (one a day) and all these people are HIV positive, then one could calculate sero-conversion within three years. Of course, other factors such as co-existing STD's may accelerate this time table. So this then brings us to a discussion the question of how is it that 0.4 per cent (4 per thousand) of the general population is HIV positive if heterosexual transmission is so difficult - it would require 250,000 different sexual contacts? How did these 0.4 percent or 1 million people in the general population get to be HIV positive? The obvious possible answer is via maternal - fetal transmissi |
Enable EMail Alerts
Start New Thread
Reply to this Message