How do people REALLY get HIV (2.) A field study.

I came across this study (below) of sexual practice and risk of getting HIV depending on if you are a top, bottom etc. Translating Scientish to English it means:

Doctors in the US studied a large group of men who had sex with men. 60 of those men became HIV+ while the study ran.

* A bottom had 0.82% chance of getting HIV if his top partner was KNOWN HIV POSITIVE and fucked him unprotected. This means a 1 to 122 risk.
* A bottom had 0.27% chance of getting HIV if his top partner had UNKNOWN HIV status and fucked him unprotected. This is a 1 to 370 risk.
* 9 men became HIV POSITIVE after getting buttfucked (unprotected) only once or twice.
* The risk of getting HIV for the top when fucking any man (known HIV POSITIVE or unknown HIV status) was 0.06% per unprotected fuck. This is a 1 to 16 667 risk.
* The risk of getting HIV for the man who gave a blowjob to any man (known HIV+ or unknown HIV status) was 0.04% per unprotected oral sex episode. This is a 1 to 25 000 risk.

My comment: The risk numbers for insertive anal and receptive oral are too small make it outside the margin of error. They might as well have been zero.
My conclusion: Anal sex without a condom is very dangerous for the bottom. A responsible top should use a condom regardless of what he thinks his HIV status is, or abstain from doing anal. Frankly I think a HIV+ man should not buttfuck anyone due to the condom break danger.
---
Am J Epidemiol 1999 Aug 1;150(3):306-11
Per-contact risk of human immunodeficiency virus transmission between ?male sexual partners.
Vittinghoff E, Douglas J, Judson F, McKirnan D, MacQueen K, Buchbinder ?SP
Department of Epidemiology and Biostatistics, University of California ?San Francisco, 94105, USA.
The risk of human immunodeficiency virus (HIV) transmission from ?various types of homosexual contact, including oral sex, is of ?biologic, epidemiologic, and public health importance. The per-contact ?risk of acquiring HIV infection from specific acts was estimated in a ?prospective cohort study of 2,189 high-risk homosexual and bisexual ?men, conducted in San Francisco, California; Denver, Colorado; and ?Chicago, Illinois, in 1992-1994. During 2,633 person-years of ?follow-up, 60 seroconversions were observed. The estimated per-contact ?risk of acquiring HIV from unprotected receptive anal intercourse ?(URA) was 0.82 percent (95% confidence interval: 0.24, 2.76 percent) ?when the partner was known to be HIV+ and 0.27 percent (95% confidence ?interval: 0.06, 0.49 percent) when partners of unknown serostatus were ?included. There was heterogeneity in per-contact risk, with nine ?seroconversions occurring after only one or two episodes of URA. The ?per-contact risk associated with unprotected insertive anal and ?receptive oral sex with HIV-positive or unknown serostatus partners ?was 0.06 and 0.04 percent, respectively. URA accounted for only 15 ?percent of all reported sexual activity by seroconverters. As ?lower-risk practices become more common, they may play a larger role ?in propagating the epidemic and should also be addressed by ?interventions targeting high-risk homosexual and bisexual men.
PMID: 10430236, UI: 99357305

There are some things that should be pointed out. Please excuse my hair splitting.

The study states that 60 seroconversions were observed out of 2600 high risk individuals during the trial. Yet they later attribute this to sex by stating that the HIV was “from” sex. Yet according to the study, there is no way of knowing if the conversions were anything to do with sex or not. Who knows what those 60 individuals got up to over the 2 year period?

The estimated per-contact risk of acquiring HIV from unprotected receptive anal intercourse (URA) with known HIV+ and unknown status are noted. Yet they omit the estimated risk of unprotected sex with known HIV seronegative individuals. Why? How on earth can we clearly tell the supposed difference in risk of infection, if the study ignores one side of the coin? One must not forget, a HIV- result doesn't necessarily mean you're HIV-.

The study admits that the % risks are man made estimates. This means they involve expert opinion, as opposed to pure science. Why bother conducting scientific studies, if the conclusion is an arbitrary estimate? Even if they were not estimates, Silom you're right that working with such low numbers raises questions about statistical validity.

I look forward to the day when a single scientific document is published, which single handedly proves that an HIV+ status will inevitably cause aids in those whom do not seek treatment. Failing that, I would like to see a study that proves why such a document can never be published. Either way, one deserves proof.

There are some things that should be pointed out. Please excuse my hair splitting.

The study states that 60 seroconversions were observed out of 2600 high risk individuals during the trial. Yet they later attribute this to sex by stating that the HIV was тАЬfromтАЭ sex. Yet according to the study, there is no way of knowing if the conversions were anything to do with sex or not. Who knows what those 60 individuals got up to over the 2 year period?

I wondered about non-sex sources of HIV too. How could they know none of the 60 were infected by dirty needles in IV drug use? (My guess is that the scientists asked the men, even if the summary doesn't say so. But then again the summary can't say everything). But there are problems with relying on interviews for determining what people did, they can misremember or they did something they don't want to admit. Neither getting buttf**ed or using drugs is something everyone wants to own up to.


I look forward to the day when a single scientific document is published, which single handedly proves that an HIV+ status will inevitably cause aids in those whom do not seek treatment. Failing that, I would like to see a study that proves why such a document can never be published. Either way, one deserves proof.

There are people who have lived for 20 years or more with HIV without getting Aids sick, I have read. What if the incubation period is so long that the carrier dies from something else before it gets to Aids? Still, I have also read that the average time from HIV infection to Aids is less than 10 years if untreated.

This bug chaser thing... It takes all sorts to make a world. So shrinks explain it by the chaser wanting to get HIV so the "uncertainty" of the risk is over? I wonder if some are motivated by a kind of attention-getting, that they want the fuss family and doctors will make over them if they get HIV+, that they want to play this victim/patient role.

But what motivates "gift" giver?

Objective.....
I doubt that you will ever find any study that can definitively prove or disprove that HIV inevitably leads to AIDS. However the preponderance of evidence to date is more than compelling. I have yet to see any documentation of a person afflicted with AIDS who was not HIV positive. However there some rare documented cases where individuals infected with virus have not developed AIDS. These people lack the receptor sites on their T cells which the virus requires to attack the cells, thus causing the progression to full blowen AIDS. In the everyone else - the vast majority - an HIV infection inevitably leads to AIDS. It is only a question of how long.

Considering all that has been discovered and written on the subject, I fail to see how any rational person could dismiss the evidence. From what you have written to date in other threads my impression is that you don't entirely believe that HIV is the cause of AIDS. If my understanding is correct then please provide some reputable sources to back up this belief.

I highly recommend this recently-updated Clinical Overview of HIV Disease:

http://hivinsite.ucsf.edu/InSite?page=kb-03-01-01

It is a concise statement of the current science of HIV disease and is useful reading for anyone interested in staying HIV-negative. It may even answer Objective's myriad of doubts regarding the association of HIV and AIDS.

Also, the stated risks associated with sex with a person of unknown HIV status are worthless unless you are tricking in the same pool as the guys in the study. Which none of us is.

But there are problems with relying on interviews for determining what people did, they can misremember or they did something they don't want to admit. Neither getting buttf**ed or using drugs is something everyone wants to own up to.

That could be it silom. One might also consider, in the west at least perhaps a potentially greater indicator of unprotected sex is a person's STD history. The likelihood is that a person will have an STD history, unless HIV is the first STD.

The odds of HIV being the first STD one catches are infinitesimal, because HIV is so hard to transmit relative to other more common STD's.

The bug chaser thing is a reality, I have spoken to such men. It is a form of self martyrdom I've seen more common in feminine individuals and I could quite easily draw parallels between bug chasing and self mutilation (self inflicted injury such as cutting) and purging of recently eaten foods (bulimia), again which only tend to occur in feminine types. The motivation of the gift giver is to provide assistance, and have their behaviour praised as useful; which is something they're hardly used to.

What you say about people living 20 years with hiv is really true. The official position is some kind of unproven, hypothetical genetic immunity (to AIDS, not to HIV supposedly). How someone can be vulnerable to a highly adaptive pathogen (and it's spectrum of strains), but not to that pathogen's activity, does not make logical sense to me. But the burden of proof is not on me to make sense of it, it's on the HIV community.


I doubt that you will ever find any study that can definitively prove or disprove that HIV inevitably leads to AIDS. However the preponderance of evidence to date is more than compelling.

Compelling evidence? I would love to see some. Find some and share it please. The very reason I question the whole affair is because no research body appears interested in proving or disproving this eitherway. A belief in the absence of logical proof is defined as a faith. Indeed there is endless research and investment into HIV as you say. So with this huge pool of research, the burden is on you to provide proof to me. Not the other way around.

It never took proof to convince you of HIV as a sole cause, so why do you need proof to the contrary?

I am not suggesting I have evidence which which to disprove any existing authoritative document on HIV, because there is no such authoritative document exists to be disproven! I am suggesting that there is currently no scientific documents which either singly or collectively demonstrate that HIV inevitably causes AIDS. On that basis, I question how the popular belief is justified. The opposing position, appears to be one which questions why I fail to have faith. I find it astonishing.

I just read http://hivinsite.ucsf.edu/InSite?page=kb-03-01-01 as posted by a member of the forum. Nowhere on that page does it say that HIV inevitably causes aids. Indeed it says that there were many theories in the 80's, most of which were discounted. Furthermore, sources 12-14 do nothing other than note higher HIV prevelence in high risk AIDS groups. No proof about a cause at all.

Gallo [13] states: “The number of HTLV-III isolates reported here underestimates the true prevalence of the virus since many specimens were received in unsatisfactory condition. Other data show that serum samples from a high proportion of AIDS patients contain antibodies to HTLV-III.”

How can he possibly derive satisfactory conclusions from a sample that he himself determined to be in unsatisfactory condition? Is that science? Is that evidence? It also only says that a 'high' proportion of AIDS sufferers had HTLV-III antibodies (HTLV-III later renamed to HIV). That means that there were plenty of AIDS patients whom had no HIV antibodies in Gallo's testing, hence how can one possibly conclude it as a rule, when there are exceptions as noted in the very same paper?

Levy [14] “Infectious retroviruses have been detected in 22 of 45 randomly selected patients with acquired immune deficiency syndrome (AIDS) and in other individuals from San Francisco. The AIDS-associated retroviruses (ARV) studied in detail”

AIDS associated does not mean AIDS causing. Furthermore, why on earth were there HIV- AIDS patients? Is this any basis for reliable conclusions to be made?

[Newbie]

I know that anecdotal evidence is pretty worthless, but its interesting to note how many members of this forum are HIV+ or have boyfriends who are HIV+ - certainly far greater numbers per capita than the general population. Given the sexual activity that is practiced here, it would be hard to ignore a causal link between such sex and HIV.

its interesting to note how many members of this forum are HIV+ or have boyfriends who are HIV+

Who is HIV+? Is there a list of members? It's only interesting to note if there is any truth to the list you have

I just read http://hivinsite.ucsf.edu/InSite?page=kb-03-01-01 as posted by a member of the forum. Nowhere on that page does it say that HIV inevitably causes aids.... Furthermore, sources 12-14 do nothing other than note higher HIV prevelence in high risk AIDS groups. No proof about a cause at all.

Objective, the references (12-14) you quote are from 1984, a period when the science of HIV was just beginning, our understanding was limited, the technology for analyzing the virus in blood was in its infancy, and there was some understandable uncertainty. Those sources are important, however, because they were among first researchers to identify a link between HIV and AIDS. To quote selected phrases from those early papers and use them for an argument today, 22 years later, that the medical community is uncertain of the cause of AIDS, is simply laughable.

There are 308 sources for that well-referenced paper. It is "telling" that to support your position you must attack the three from 1983/84.

Clearly you have your own agenda, and to each his own. But for anyone else reading this who may truly be interested in the science of this issue (relationship of HIV and AIDS), check this out:

http://www.niaid.nih.gov/factsheets/evidhiv.htm

Here are the main points from that discussion. Each point is discussed in detail in the paper, with studies and references cited, but to save space I've omitted the detailed discussion and provided only the topical bullets. At the end of the paper, there is even an "Answering the Skeptics" section, that appears to have been written just for Objective!

EVIDENCE THAT HIV CAUSES AIDS

HIV fulfills Koch's postulates as the cause of AIDS.

AIDS and HIV infection are invariably linked in time, place and population group.

Many studies agree that only a single factor, HIV, predicts whether a person will develop AIDS.

In cohort studies, severe immunosuppression and AIDS-defining illnesses occur almost exclusively in individuals who are HIV-infected.

Before the appearance of HIV, AIDS-related diseases such as PCP, KS and MAC were rare in developed countries; today, they are common in HIV-infected individuals.

In developing countries, patterns of both rare and endemic diseases have changed dramatically as HIV has spread, with a far greater toll now being exacted among the young and middle-aged, including well-educated members of the middle class.

In studies conducted in both developing and developed countries, death rates are markedly higher among HIV-seropositive individuals than among HIV-seronegative individuals.

HIV can be detected in virtually everyone with AIDS.

Numerous studies of HIV-infected people have shown that high levels of infectious HIV, viral antigens, and HIV nucleic acids (DNA and RNA) in the body predict immune system deterioration and an increased risk for developing AIDS. Conversely, patients with low levels of virus have a much lower risk of developing AIDS.

The availability of potent combinations of drugs that specifically block HIV replication has dramatically improved the prognosis for HIV-infected individuals. Such an effect would not be seen if HIV did not have a central role in causing AIDS.

Among HIV-infected patients who receive anti-HIV therapy, those whose viral loads are driven to low levels are much less likely to develop AIDS or die than patients who do not respond to therapy. Such an effect would not be seen if HIV did not have a central role in causing AIDS.

Nearly everyone with AIDS has antibodies to HIV.

Numerous serosurveys show that AIDS is common in populations where many individuals have HIV antibodies. Conversely, in populations with low seroprevalence of HIV antibodies, AIDS is extremely rare.

The specific immunologic profile that typifies AIDS - a persistently low CD4+ T-cell count - is extraordinarily rare in the absence of HIV infection or other known cause of immunosuppression.

Newborn infants have no behavioral risk factors for AIDS, yet many children born to HIV-infected mothers have developed AIDS and died.

The HIV-infected twin develops AIDS while the uninfected twin does not.

Studies of transfusion-acquired AIDS cases have repeatedly led to the discovery of HIV in the patient as well as in the blood donor.

HIV is similar in genetic structure and morphology to other lentiviruses that often cause immunodeficiency in their animal hosts in addition to slow, progressive wasting disorders, neurodegeneration and death.

HIV causes the death and dysfunction of CD4+ T lymphocytes in vitro and in vivo.

[Smiles]

Thanks SF Farang, for the research.
But especially for this:


" ... To quote selected phrases from those early papers and use them for an argument today, 22 years later, that the medical community is uncertain of the cause of AIDS, is simply laughable ... "

Cheers ...

Objective, the references (12-14) you quote are from 1984, a period when the science of HIV was just beginning, our understanding was limited, the technology for analyzing the virus in blood was in its infancy, and there was some understandable uncertainty. To quote selected phrases from those early papers and use them for an argument today, 22 years later, that the medical community is uncertain of the cause of AIDS, is simply laughable.

You need to know a few things. All research to date is built upon the assumptions made in the 1980's. HIV was indicated as a cause of HIV in the 1980's and never questioned, that has carried through to today. Believe is that science had already proven HIV, yet when one looks back at the proof in the 80's, there is none.

In 20 years, there has been no document that proves HIV inevitably causes aids. This statement is irrefutable. All that exists is a “link”, that has been suggested. Suggested. Never proven.

The URL you have provided is courtesy of the US government. Documents published by the US government are about as trustworthy as the Iraqi mobile germ warfare labs. Governments are full of politicians, and politicians are professional liars.

Besides, the site states that Koch's postulates have been fulfilled:

1. Epidemiological association: the suspected cause must be strongly associated with the disease.
2. Isolation: the suspected pathogen can be isolated - and propagated - outside the host.
3. Transmission pathogenesis: transfer of the suspected pathogen to an uninfected host, man or animal, produces the disease in that host.

1. Yet there is no strong association. Indeed there are instances in research where there is AIDS in the absence of HIV antibodies. Hence postulate 1 is unfulfilled.

2. If HIV could be isolated, then the basis for a HIV test would simply be an attempt to isolate the virus, but that's not what is done. Ever! If HIV had ever really been isolated, there would be endless photographs of it produced by a reputable scientific body. There are no such photographs of HIV because it has never been isolated in total purity, the particles never look the same, so there is no way to know what is being viewed. In books, and magazines, and even research papers, all you'll ever see are artists renditions. Hence postulate 2 is unfulfilled.

3. Transmitting HIV to a host does not always cause symptoms of AIDS. Hence postulate 3 is unfulfilled. If you want to trust your government, that's a political decision, not s scientific one.

Your site totally IGNORES postulate 4, and pretends it doesn't exist by omitting it entirely. WHY would anyone do this? Postulate 4 “The pathogen must be recoverable from the experimentally infected host.” They fail to include this postulate because the health dept. know that HIV isn't always founds in AIDS patients, and that there is research to back this up. Indeed it was mentioned above. Hence postulate 4, which the site prefers not to mention, is ALSO not fulfilled. Disgrace.

I could go on, but the misinformation on that site is exhaustive.

[Bob]

I'd argue the world is not flat but I'm sure somebody, objectively, would take issue with that too! :geek:

[Smiles]

A person learns many lessons over a long life . . . one of the most important is to always view askance (if not immediately distrust) anyone who starts of a discourse, argument, or opinion, with the phrase, " ... You need to know a few things ... "

Cheer ...

[marc11864-old]

that the ora-quick test, which has been commonly used to confirm HIV antibodies especially in places like SF City Clinic has thrown a number of false-negatives and they're now scrambling to retest a number of previously negative result testees (please don't laugh, i only made it to 2nd grade :P )

Objective, have you been reading virusmyth.net? It is... ahem... not very objective.

Silom, yes and no, but I do not speak for the multitude of PHD academics on that site, I speak for myself. I maintain that the only way to be objective on this matter, and on any matter, is to rely on science and on proof. If that makes me unobjective to you, so be it.

Marc11864, I remember reading about the problem with Ora-quick tests, but - not to be picky - the news reported here was that false positives, not false negatives, were the problem. People went in for an Ora-quick test, got the result in 20 minutes that they were HIV positive, then a normal (old-fashioned) blood draw was performed and sent off for confirmatory testing, which took 1 or 2 weeks. Several of these confirmatory tests came back negative, so that's how they found out about the false positive problem. I guess it's no fun walking around for 2 weeks thinking you are positive, when you aren't. From the news:

"In late 2005, counselors at several HIV testing programs (mainly in New York City and San Francisco) reported apparent clusters of positive OraQuick HIV test results on oral fluid that were ultimately found to be negative on confirmatory testing. At some locations, the reported rate of false-positive test results was as high as 9 per 1000...."

The URL you have provided is courtesy of the US government. Documents published by the US government are about as trustworthy as the Iraqi mobile germ warfare labs.

Well I guess I shouldn't be too surprised to see Iraq finally introduced into this discourse. :scratch: Your scientific method - discrediting all medical research that disagrees with your position just because it's posted on a US government website - is certainly enlightened. :pukeleft: But it is consistent with a Grand Government Conspiracy theory. Can't wait for your next chapter - perhaps "How AIDS was developed by the CIA"?
:help:

Can't wait for your next chapter - perhaps "How AIDS was developed by the CIA"?

Actually HIV was “discovered” by a US government department, after credit was effectively stolen from a European research institute. Feel free to verify that for yourself, and try to avoid sourcing your scientific data from politicians. To my knowledge, the CIA has nothing to do with any diseases, so I am uncertain why you raise it.