🚀 go-pugleaf

On Dec 3, 4:45 pm, Hnic Hastogo <n.has.to...@kinky-kooks.Kom> wrote:
> On Wed, 3 Dec 2008 13:45:58 -0800 (PST), kujebak
>
> <kuje...@eudoramail.com> wrote:
>
> >Bill Z. wrote:
> >> kujebak <kuje...@eudoramail.com> writes:
>
> >> > Bill Z. wrote:
> >> >> kujebak <kuje...@eudoramail.com> writes:
>
> >> >> >  Normal transmission of the HIV virus between individuals is
> >> >> > entirely dependent on a specific type of sexual contact which is
> >> >> > predominant among homosexual men.
>
> >> >> Would you care to revise that statement?  It is the "entirely" part
> >> >> that is wrong.  The probability of infection per sex act is highest
> >> >> for one particular sexual practice, but it is not zero for other
> >> >> ones, including ones common among heterosexuals.
>
> >> >> It's bad form to send out messages that suggest something is
> >> >> completely safe when it isn't.
>
> >> > That was not my point. My point was that normal sex
> >> > among homosexual men is far more risky, with respect
> >> > to HIV transmission, than normal sex (including oral sex)
> >> > among heterosexuals, to the tune of something like 20%
> >> > for the former compared to one tenth of one percent for
> >> > the latter. What is *your* point? That HIV is not just a pro-
> >> > blem of homosexual lifestyle? A disease that spreads
> >> > in the human population predominantly by anal intercourse?
> >> > How could it not be?
>
> >> My point was that what you wrote, regardless of what you probably
> >> meant, was wrong.  If you weren't a jerk (as you turned out to be)
> >> you would have merely posted a correction: your use of the word
> >> "entirely" meant that the risk for any other type of sexual activity
> >> was zero and that simply isn't the case.
>
> >> You claimed to have some health care experience. If so, you should
> >> have realized that posting misleading information that unknowledgable
> >> members of the public might see is not a good idea, particularly
> >> when you state such experience up front.
>
> >> If you weren't so bigoted (you obviously are) you would have realized
> >> what I was saying - it had nothing to do with "lifestyles" real or
> >> imagined.
>
> >There is nothing "misleading" in what I said. I merely cut
> >through decades of willful misinformation piled upon this
> >subject. Your refusal to deal with facts underlying this and
> >other topics - even today, it is not easy to look up actual
> >HIV/AIDS statistics, which are obscured in public health
> >papers and scientific publications under tons of other irrele-
> >vant data, and almost never presented in the mainstream
> >media, but they are there for anyone to see, who actually
> >cares to look - and your quick retreat behind ideological
> >labels clearly indicates where *you* are coming from ;-)
>
> June 27, 2008 / 57(25);681-686
>
> Trends in HIV/AIDS Diagnoses Among Men Who Have Sex with Men --- 33
> States, 2001--2006
>
> In 2008, CDC conducted an analysis of trends in diagnoses of human
> immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)
> among men who have sex with men (MSM) in the 33 states* that have had
> confidential, name-based HIV case reporting since at least 2001. This
> report summarizes the results of that analysis, which indicated that
> the number of HIV/AIDS diagnoses among MSM overall during 2001--2006
> increased 8.6% (estimated annual percentage change [EAPC] = 1.5).
> During 2001--2006, an estimated 214,379 persons had HIV/AIDS diagnosed
> in the 33 states. Of these diagnoses, 46% were in MSM, and 4% were in
> MSM who engaged in illicit injection-drug use (IDU) (i.e., MSM and
> IDU). To reduce the impact of HIV/AIDS in the United States, HIV
> prevention services that aim to reduce the risk for acquiring and
> transmitting infection among MSM and link infected MSM to treatment
> must be expanded.
>
> In this report, HIV/AIDS refers to three categories of diagnoses
> collectively: 1) a diagnosis of HIV infection (not AIDS), 2) a
> diagnosis of HIV infection with subsequent AIDS diagnosis, and 3)
> concurrent diagnoses of HIV infection and AIDS. Reporting cases of HIV
> infection (not AIDS) and AIDS is now legally mandated in all U.S.
> states, the District of Columbia, and five U.S. territories. The CDC
> case definition for HIV infection (not AIDS) requires a positive test
> result from an assay approved by the Food and Drug Administration that
> demonstrates evidence of HIV infection; the case definition for AIDS
> requires meeting the HIV infection (not AIDS) case definition, plus
> diagnosis of at least one AIDS-defining illness or a CD4+ T-lymphocyte
> count of <200 cells/µL.  Using the HIV/AIDS Reporting System (HARS),
> case report data were collected by local and state health department
> staff members and then transmitted to CDC devoid of patient names. The
> findings in this report are based on HIV/AIDS diagnoses made during
> 2001--2006 and reported to CDC as of June 30, 2007 (1).
>
> Numbers of diagnoses were adjusted for reporting delays and for
> redistribution of cases with missing risk factor information, using a
> standard method that has been described previously (2). This method
> does not include statistical adjustments for diagnosed but unreported
> cases or for cases yet to be diagnosed. To facilitate comparisons
> between the estimated number of diagnoses occurring in 2001 and the
> number occurring in 2006, 95% confidence intervals (CIs) were
> calculated. To examine trends, EAPCs with corresponding CIs were
> calculated. EAPC measures the differences between adjacent years under
> examination and then averages these inter-year differences. In this
> report, transmission categories¤ are discrete (e.g., "MSM" is distinct
> from "MSM and IDU" and "IDU" is distinct from "MSM and IDU").
> Accordingly, MSM who were also injection-drug users (MSM and IDU) were
> excluded from analysis of MSM.
>
> Of 214,379 HIV/AIDS diagnoses in 33 states during 2001--2006, a total
> of 97,577 (46%) were among MSM. Decreases in diagnoses were observed
> in all transmission categories except MSM (excluding MSM and IDU)
> (Figure 1). Among males, MSM accounted for 97,577 (63%) of cases. Men
> aged 25--44 years accounted for 64% of cases among MSM (Table). Among
> MSM, the number of diagnoses increased from 16,081 (CI =
> 15,784--16,377) in 2001 to 17,465 (CI = 16,938--17,992) in 2006; (EAPC
> = 1.5) (Figure 1).
>
> From 2001 to 2006, a 12.4% (EAPC = 1.9) increase in the number of
> HIV/AIDS diagnoses among all black MSM was observed; however, an
> increase of 93.1% (EAPC = 14.9) was observed among black MSM aged
> 13--24 years (Figure 2). During 2001--2006, approximately twice as
> many (7,658) diagnoses occurred in black MSM aged 13--24 years as in
> their white counterparts (3,221). The largest proportionate increase
> (255.6% [EAPC = 30.8]) was among Asian/Pacific Islander MSM aged
> 13--24 years. Among MSM aged 13--24 years, statistically significant
> increases in diagnoses as measured by EAPC were observed in all
> racial/ethnic populations except American Indian/Alaska Natives. Among
> MSM of all ages, statistically significant increases as measured by
> EAPC were observed in blacks, Hispanics, and Asian/Pacific Islanders.¦
>
> Reported by: A Mitsch, MPH, X Hu, MS, K McDavid Harrison, PhD, T
> Durant, PhD, Div of HIV/AIDS Prevention, National Center for HIV/AIDS,
> Viral Hepatitis, STD, and TB Prevention, CDC.
> Editorial Note:
>
> During 2001--2006, male-to-male sex remained the largest HIV
> transmission category in the United States and the only one associated
> with an increasing number of HIV/AIDS diagnoses. In this analysis,
> statistically significant decreases in HIV/AIDS diagnoses were
> observed for all other transmission categories (i.e., among persons
> likely to have been infected through high-risk heterosexual contact,
> IDU, MSM and IDU, and other routes). Among MSM aged 13--24 years,
> statistically significant increases in diagnoses were observed in
> nearly all racial/ethnic populations. These findings underscore the
> need for continued effective testing and risk reduction interventions
> for MSM, particularly those aged <25 years.
>
> The data in this report indicate when persons were diagnosed with HIV
> infection, rather than when they became infected. This is an important
> distinction because a person might have been infected with HIV for
> years before receiving a diagnosis of HIV infection. Determining when
> persons who have been diagnosed were actually infected is difficult.
> Although HIV diagnosis data can provide some indication of underlying
> trends in HIV infection, this approach has limitations. A greater
> number of tests for HIV infection among MSM might partially explain
> the observed increase in HIV/AIDS diagnoses. However, available data
> suggest that these increases cannot be explained by increases in
> testing alone; the increase could be attributed to more targeted
> testing, increasing incidence, or some combination of these.**
>
> To improve the nation's ability to track new HIV infections, CDC has
> established a new system for measuring incident HIV infections at the
> population level. A novel laboratory method will be combined with
> standard case surveillance procedures and statistical estimations to
> provide a better means of estimating national HIV incidence from the
> number of persons who are newly diagnosed with HIV (3). This system
> will be able to distinguish between recent and long-standing HIV-1
> infection on a population level. Estimates from the new system are
> expected to be available in 2008. The new system will provide a better
> tool for measuring progress in the prevention of HIV infection than
> data based on HIV/AIDS diagnoses alone, such as those described in
> this report. Nevertheless, diagnosis data will continue to play an
> important role in monitoring the HIV epidemic, particularly among
> adolescents and young adults who, because of their age, are unlikely
> to have been infected many years before diagnosis. Additionally,
> HIV/AIDS diagnosis data will continue to provide useful information
> for evaluating efforts to increase HIV testing and will allow programs
> that do not conduct HIV incidence surveillance to monitor the HIV
> epidemic in their local area.
>
> The findings in this report are subject to at least four limitations.
> First, the 33-state case surveillance data are not representative of
> all HIV-positive persons in the United States. However, the
> racial/ethnic disparities described in this report are similar to
> those observed in AIDS cases from all 50 states (4). Second, since
> 1993, the proportion of HIV/AIDS cases reported to CDC without an
> identified risk factor for HIV infection has been increasing. In 2006,
> no risk factor was reported for 25% of HIV (not AIDS) adult and
> adolescent cases reported to CDC (4). This results in an increasing
> proportion of cases that are assigned to transmission categories
> (including male-to-male sexual contact) not based on interview with
> patients, but rather via statistical adjustment. Risk factor
> information often is missing because patients decline to disclose
> behaviors that might place them at risk for HIV transmission or are
> unaware of their sex partners' high-risk behavior. Third, methods for
> reporting delay adjustments have greatest uncertainty for the most
> recent years' estimates of HIV/AIDS diagnoses; therefore, recent
> trends should be interpreted with caution. Finally, a backlog of cases
> diagnosed earlier than recorded in the data might have exaggerated the
> number of diagnoses in the first 2--3 years after name-based HIV (not
> AIDS) case reporting was implemented (5). For example, retrospective
> ascertainment of name-based HIV case reports might have resulted in a
> substantial number of cases that were recorded as diagnosed during
> 2001--2002 but were actually diagnosed earlier. New York's
> implementation of name-based HIV reporting in June 2000 might have
> magnified the effect of this backlog on the 33-state trend analysis
> because New York data represented 21% of all HIV/AIDS diagnoses during
> 2001--2006. After exclusion of New York from this analysis, however,
> an even larger statistically significant increase in HIV/AIDS
> diagnoses among MSM was observed during 2001--2006 (EAPC = 3.1 [CI =
> 2.4--3.9]).
>
> To reduce transmission of HIV among MSM of all races/ethnicities,
> prevention strategies should be strengthened, improved, and
> implemented more broadly. Testing is important in preventing HIV
> transmission because it provides knowledge of one's infection status;
> after persons become aware that they are HIV positive, most reduce
> their high-risk sexual behavior (6). In addition, an estimated 25% of
> HIV-infected persons have not received a diagnosis of HIV infection
> (7). These persons represent a challenge in terms of HIV prevention
> and case ascertainment. Moreover, testing is the first step to linking
> persons infected with HIV to medical care. CDC recommends at least
> annual testing for sexually active MSM and an "opt-out" approach for
> screening of all patients aged 13--64 years in clinical settings (8).
>
> Ulcerative and nonulcerative sexually transmitted diseases (STDs) such
> as syphilis and gonorrhea facilitate HIV transmission from infected
> MSM and acquisition of HIV by noninfected MSM; therefore, screening
> for STDs in private and public clinical settings is an important
> component of HIV prevention in MSM (9). STD and HIV prevention efforts
> should be as fully integrated as possible. Furthermore, associations
> have been observed between abuse of illicit and legal drugs such as
> methamphetamine and alcohol, respectively, and high-risk behavior
> among MSM. Screening for substance abuse in private and public
> clinical settings is an important tool for reducing HIV
> transmission.   Strengthened collaborations between STD, HIV, viral
> hepatitis, and substance abuse programs should result in more
> effective HIV prevention efforts.
>
> CDC assists in the creation, development, and dissemination of
> behavioral interventions for the MSM population. Recently, in
> collaboration with the state health department and local organizations
> in North Carolina, CDC implemented a successful intervention for young
> black MSM (10). This intervention has resulted in decreases in
> high-risk sexual behavior and the number of sex partners with whom
> such behavior occurred. CDC recommends that state and local health
> departments allocate HIV prevention resources to ensure that program
> operations reflect the current state of the HIV/AIDS epidemic in the
> geographic areas for which each health department is responsible. In
> support of CDC's strategic goal of reducing the number of new HIV
> infections in the United States,¤¤ the proportion of MSM who adopt
> behaviors that reduce risk for HIV transmission must increase.
> References
>
>    1. CDC. HIV/AIDS Reporting System (HARS) user manual. Atlanta, GA:
> US Department of Health and Human Services, CDC; 2000.
>    2. Green TA. Using surveillance data to monitor trends in the AIDS
> epidemic. Stat Med 1998;17:143--54.
>    3. Lee LM, McKenna MT. Monitoring the incidence of HIV infection in
> the United States. Public Health Rep 2007;122(Suppl 1):72--9.
>    4. CDC. HIV/AIDS surveillance report, 2006. Vol. 18. Atlanta, GA:
> US Department of Health and Human Services, CDC; 2008:12. Available athttp://www.cdc.gov/hiv/topics/surveillance/resources/reports.
>    5. Torian L, Bennani1 Y, Wethers J, Schwendemann J, Nash D. Use of
> the serologic testing algorithm for recent HIV seroconversion to
> assess specificity of routine surveillance to detection of incident vs
> prevalent HIV: evaluation of the first 2 years of named HIV reporting,
> New York City, June 1, 2000 to June 30, 2002. 11th Conference on
> Retroviruses and Opportunistic Infections, 2004. Session 135 poster
> abstract. Available athttp://www.retroconference.org/2004/cd/abstract/964.htm.
>    6. Marks G, Crepaz N, Senterfitt JW, Janssen RS. Meta-analysis of
> high-risk sexual behavior in persons aware and unaware they are
> infected with HIV in the United States: implications for HIV
> prevention programs. J Aquir Immune Defic Syndr 2005;39:446--53.
>    7. Glynn M, Rhodes P. Estimated HIV prevalence in the United States
> at the end of 2003 [Abstract T1-B1101]. Programs and abstracts of the
> 2005 National HIV Prevention Conference; June 12--15, 2005; Atlanta,
> GA. Available athttp://www.aegis.com/conferences/nhivpc/2005/t1-b1101.html.
>    8. CDC. Revised recommendations for HIV testing of adults,
> adolescents, and pregnant women in health-care settings. MMWR
> 2006;55(No. RR-14).
>    9. Fleming DT, Wasserheit JN. From epidemiological synergy to
> public health policy and practice: the contribution of other sexually
> transmitted diseases to sexual transmission of HIV infection. Sex
> Transm Infect 1999;75:3--17.
>   10. Jones KT, Gray P, Whiteside YO, et al. Evaluation of an HIV
> prevention intervention adapted for black men who have sex with men.
> Am J Public Health 2008;98:1043--50.

Who cares about HIV incidence among IV drug users, or different
racial groups? Is there anywhere in this report a mention of the
probability of HIV transmission from an HIV positive male to another
man through unprotected homosex?