HIV/AIDS Rate in D.C. Hits 3%

Orion · Mar 17, 2009

RightinNYC said:
It's not quite as egalitarian of a disease as you imply. Among heterosexuals who do not engage in homosexual encounters on the side (or have sex with those who do) and who do not share needles, HIV is incredibly rare. It's astoundingly difficult to get HIV from traditional heterosexual sex. The odds that a man having unprotected vaginal sex with an HIV+ female will get infected is 0.05%. That's nearly infinitesimal. For a female involved in unprotected vaginal sex with a man with HIV, the odds only increase to 0.1%. The two main non-childbirth/non-blood transfusion ways that HIV is transmitted are through:

1) Unprotected receptive anal intercourse (0.5%), and
2) IV Drug Needle sharing (0.67%)

For people who are circumcised, the rate is further cut in half. For those that use condoms, it drops another 85%.

Simply put, if you're a circumcised heterosexual who uses condoms and only has intercourse with women who don't have sex with bisexual men or use IV drugs, you really don't need to worry about HIV.

First, your claim that it's astoundingly difficult for heterosexual sex to result in HIV is rather audacious. If two people have unprotected sex and one is infected, the risk is high. After gay men, heterosexual black women have the highest HIV/AIDS rate. (I'm not trying to bring race into this, just offset your argument about "low risk" to heterosexuals.)

Second, it is well known among the health community that gays have a statistically higher infection rate because, unlike their heterosexual counterparts, they get tested more often, and more infected gays are aware of their status than infected heterosexuals. So, statistically, you are correct. This is where statistics do not tell the whole truth.

Everyone should worry about HIV and STDs in general. HIV is not the only uncurable STD either.

And finally... please post sources to the stats you posted so I can verify where you are getting your information. Thanks.

Grateful Heart · Mar 17, 2009

Orius said:
Second, it is well known among the health community that gays have a statistically higher infection rate because, unlike their heterosexual counterparts, they get tested more often, and more infected gays are aware of their status than infected heterosexuals. So, statistically, you are correct. This is where statistics do not tell the whole truth.

Damn. I'm a gay man. And I have to say this is utter nonsense. Gays have a higher infection rate because they get tested more often?

We all know why gay men are at higher risk.

:shock:

jallman · Mar 17, 2009

Grateful Heart said:
Damn. I'm a gay man. And I have to say this is utter nonsense. Gays have a higher infection rate because they get tested more often?

We all know why gay men are at higher risk.

:shock:

The funny thing is that gay men are probably the most inundated with education about HIV than any other group, too.

I think the greatest risk to gay men when it comes to HIV infection is the behaviors of other gay men.

Real Korimyr #9 · Mar 17, 2009

When it hits 10%, can we just quarantine the whole damn city? Probably the best excuse we're ever going to get.

RightinNYC · Mar 17, 2009

Orius said:
First, your claim that it's astoundingly difficult for heterosexual sex to result in HIV is rather audacious. If two people have unprotected sex and one is infected, the risk is high.

No, it's not. Assuming standard vaginal intercourse, the risk for a man is 1 in 2000 and the risk for a woman is 1 in 1000.

HIV - Wikipedia, the free encyclopedia

After gay men, heterosexual black women have the highest HIV/AIDS rate. (I'm not trying to bring race into this, just offset your argument about "low risk" to heterosexuals.)

Because heterosexual black women tend to have sex with black men who tend to have more unsafe sexual encounters on the downlow with other men while not using protection.

Second, it is well known among the health community that gays have a statistically higher infection rate because, unlike their heterosexual counterparts, they get tested more often, and more infected gays are aware of their status than infected heterosexuals. So, statistically, you are correct. This is where statistics do not tell the whole truth.

I don't discount the theory that selection bias could lead to some skewing of the numbers, but I've never seen any evidence for it, nor have I seen anything that purports to claim that it's anywhere near being entirely responsible for the disparity, as you seem to imply.

Everyone should worry about HIV and STDs in general. HIV is not the only uncurable STD either.

I don't disagree at all that people should worry about STD's in general. What I think is counter-productive is when people freak out like crazy about HIV, but are completely oblivious to things like the Hep or the Herp. Hence my earlier statement that HIV is overhyped.

And finally... please post sources to the stats you posted so I can verify where you are getting your information. Thanks.

Per the above link, the infection rate stats come from:

# Smith DK, Grohskopf LA, Black RJ, et al (2005). "Antiretroviral Postexposure Prophylaxis After Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV in the United States". MMWR 54 (RR02): 1–20. Antiretroviral Postexposure Prophylaxis After Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV in the United States </P><P>Recommendations from the U.S. Department of Health and Human Services.

# ^ Donegan E, Stuart M, Niland JC, et al (1990). "Infection with human immunodeficiency virus type 1 (HIV-1) among recipients of antibody-positive blood donations". Ann. Intern. Med. 113 (10): 733–739. PMID 2240875.

# ^ a b c Coovadia H (2004). "Antiretroviral agents—how best to protect infants from HIV and save their mothers from AIDS". N. Engl. J. Med. 351 (3): 289–292. PMID 15247337.

# ^ Kaplan EH, Heimer R (1995). "HIV incidence among New Haven needle exchange participants: updated estimates from syringe tracking and testing data". J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. 10 (2): 175–176. PMID 7552482.

# ^ Bell DM (1997). "Occupational risk of human immunodeficiency virus infection in healthcare workers: an overview.". Am. J. Med. 102 (5B): 9–15. PMID 9845490.

# ^ a b c d European Study Group on Heterosexual Transmission of HIV (1992). "Comparison of female to male and male to female transmission of HIV in 563 stable couples". BMJ. 304 (6830): 809–813. PMID 1392708.

# ^ a b c d e f Varghese B, Maher JE, Peterman TA, Branson BM,Steketee RW (2002). "Reducing the risk of sexual HIV transmission: quantifying the per-act risk for HIV on the basis of choice of partner, sex act, and condom use". Sex. Transm. Dis. 29 (1): 38–43. PMID 11773877.

# ^ Leynaert B, Downs AM, de Vincenzi I (1998). "Heterosexual transmission of human immunodeficiency virus: variability of infectivity throughout the course of infection. European Study Group on Heterosexual Transmission of HIV". Am. J. Epidemiol. 148 (1): 88–96. PMID 9663408

Orion · Mar 17, 2009

RightinNYC said:
No, it's not. Assuming standard vaginal intercourse, the risk for a man is 1 in 2000 and the risk for a woman is 1 in 1000.

HIV - Wikipedia, the free encyclopedia

Your link is interesting and I accept your information, but the Wikipedia entry makes no mention of homosexuals. Risk assessment does not speak to the number of infectees. Your numbers create the erroneous implication that because homosexual sex is higher risk, that therefore more homosexuals must have AIDS than heterosexuals. This is false. Even if the risk is statistically low, heterosexuals still account for 75% of worldwide transmission of AIDS. Here is a quote from the Government of Canada website:

Heterosexual AIDS(BP-411E)

Government of Canada said:
The World Health Organization estimates that heterosexual transmission has accounted for 75% of the HIV infections in adults world-wide.(2) The remaining 25% are primarily due to the use of contaminated blood and blood products, needle sharing by intravenous drug users, and homosexual/bisexual transmission. Heterosexual intercourse has been the dominant route of transmission in Africa, Asia, South America, Central America and the Caribbean. Indeed, in the United States, AIDS ceased being primarily a disease of gay men in the early 1990s. Data from the United States Centers for Disease Control and Prevention show that the proportion of new cases reported among homosexual/bisexual men decreased from 47.3% in 1993 to 43.3% in 1994. While the rate of AIDS among American gay males decreases, there has been a recorded increase among women and minority groups.

I admit the data is on the older side, but it was the most official data I could find given time constraints.

RightinNYC said:
Because heterosexual black women tend to have sex with black men who tend to have more unsafe sexual encounters on the downlow with other men while not using protection.

This is a supposition, although I am willing to discuss this theory if you wish.

RightinNYC said:
I don't discount the theory that selection bias could lead to some skewing of the numbers, but I've never seen any evidence for it, nor have I seen anything that purports to claim that it's anywhere near being entirely responsible for the disparity, as you seem to imply.

I am also willing to accept that perhaps homosexuals account for the greater demographic in the United States, but I still believe statistics do not paint the whole picture. Statistical reporting obviously accounts for those who we know are infected and have been tested. The numbers are actually greater on all sides.

I also stand by my assertion that homosexuals have higher report rates because they are more invested in seeking testing, especially in areas where anonymous testing is in place. I'm not trying to say that heterosexuals are lazy... I've noticed that heterosexual women are usually more keen to be tested than men, but on the whole homosexuals seem to be more on top of things.

RightinNYC said:
I don't disagree at all that people should worry about STD's in general. What I think is counter-productive is when people freak out like crazy about HIV, but are completely oblivious to things like the Hep or the Herp. Hence my earlier statement that HIV is overhyped.

Out of all possible STDs, HIV is the most serious in nature. Hep A and B are controlled by worldwide vaccination programs, and although Hep C has no vaccine, interferon treatments have come a long way to providing a cure. Other STDs are curable or their symptoms are manageable and non-life threatening. Once HIV becomes AIDS, unless you can afford the expensive medications, there is nothing to save your immune system from devastation and secondary infection. It is definitely spreading at epidemic proportions worldwide. The failure of society to have a dialogue combined with denial of how virulent it is, is what is allowing it to proliferate.

As long as people continue to perpetuate the idea that it's a developing world problem, a minority problem, or a homosexual problem, it will continue to spread. It is partially a lack of seriousness and frankness which makes people feel they can ignore protection in favour of their urges.

Zyphlin · Mar 17, 2009

Yay. So so far this thread has taught me that AIDS is a bipartisan issue as you have liberals going "The mean old conservatives did it!" and conservatives going "The mean old liberals did it!"

Cute.

Hatuey said:
A gun ban and a nigger in the white house makes it the most liberal city in the country. :lol:

Actually the extremely large liberal voting constiuency makes it one of the most liberal cities in the country and the second most liberal "Big" city in the country. Go look at Right's statistics.

Saying that's the reason for the AIDS rate though is kind of idiotic.

talloulou said:
They waited far too long to allow public funding of needle exchange programs. They didn't lift the ban till 2007 despite the abundance of evidence in support of such programs. They've been shown to work. When you are talking about poor drug addicted minorities sex ed in schools is a non-issue.

Do you have anything to back up that needle use was a leading cause of the majority of HIV cases in DC? From what I've heard unprotected homosexual and heteosexual sex are both a larger reason for the raise than needles. Not saying that it didn't have some affect, but some are acting in here as if its the main reason.

I'm with Right on this. We have education, everyone for the most part knows these things now. Its the choice of people for whatever reason to engage in these risky acts. An "open dialog" isn't really going to change things because its not the inability to talk about things that its causing this but the culture that exists that perpetuates such behavior.

Goobieman · Mar 17, 2009

DarkWizard12 said:
Isn't DC like...THE most liberal city in the union(besides San Fran)?
Seems, like your sex ed programs aren't working out as well.

Given that the large majority of HIV infections are directly related to the voluntary engagement of high-risk activities...

Darwin in action.

Erod · Mar 17, 2009

Orius said:
Your link is interesting and I accept your information, but the Wikipedia entry makes no mention of homosexuals. Risk assessment does not speak to the number of infectees. Your numbers create the erroneous implication that because homosexual sex is higher risk, that therefore more homosexuals must have AIDS than heterosexuals. This is false. Even if the risk is statistically low, heterosexuals still account for 75% of worldwide transmission of AIDS. Here is a quote from the Government of Canada website:

So why didn't Arthur Ashe's wife get HIV? Magic Johnson's wife? They must have had sex hundreds of times before they knew they were positive.

I think the VAST percentage of that "75 percent of hetrosexuals" are either bi-sexuals or drug userss.

I've never bought the "if you had sex with her, and she had sex with him, and he had sex with that girl, and she had sex with a guy that had AIDS, then you ALL are at risk for AIDS" argument.

talloulou · Mar 17, 2009

Zyphlin said:
Yay. So so far this thread has taught me that AIDS is a bipartisan issue as you have liberals going "The mean old conservatives did it!" and conservatives going "The mean old liberals did it!"

Cute.

Actually the extremely large liberal voting constiuency makes it one of the most liberal cities in the country and the second most liberal "Big" city in the country. Go look at Right's statistics.

Saying that's the reason for the AIDS rate though is kind of idiotic.

Do you have anything to back up that needle use was a leading cause of the majority of HIV cases in DC? From what I've heard unprotected homosexual and heteosexual sex are both a larger reason for the raise than needles. Not saying that it didn't have some affect, but some are acting in here as if its the main reason.

I'm with Right on this. We have education, everyone for the most part knows these things now. Its the choice of people for whatever reason to engage in these risky acts. An "open dialog" isn't really going to change things because its not the inability to talk about things that its causing this but the culture that exists that perpetuates such behavior.

Here's an old article about the needle exchange programs in 2008, shortly after the ban was lifted.

Congress lifted a decade-long ban in December prohibiting D.C. from using local tax dollars to support needle-exchange programs. Critical funds are now starting to reach these groups, allowing them to increase outreach efforts and add workers like Jackson.

It remains to be seen, though, how much of a dent will be made in slowing the virus, which has touched nearly every cross-section of Washington.

"There is no silver bullet," said Walter Smith, the director of the D.C. Appleseed Center for Law and Justice, an advocacy organization that is monitoring the city's efforts to reduce HIV infection. "There are multiple factors that have produced our high HIV/AIDS rate and it will take multiple factors to bring it down."

The reasons include unstable leadership at the city's HIV/AIDS prevention office, which has had 12 directors in just over 20 years. That has slowed strategies to get a handle on the disease.

Washington also has a high population of black and gay residents — groups where the rate of infection has been high historically.

Still, one statistic has particularly frustrated D.C. officials: More than one in five of Washington's HIV cases were transmitted through intravenous drug use, according to a report released last year by the city's HIV/AIDS Administration.

Needle exchanges are being used in 36 states, D.C. and Puerto Rico to slow the spread of the disease through IV use, according to the North American Syringe Exchange Network. Many of the programs are financed with state or local money.

In 1998, however, Rep. Todd Tiahrt, R-Kan., and then-Sen. John Ashcroft, R-Mo., inserted language in the federal spending package that blocked D.C. from funding such programs because of concerns about drug abuse. They were able to do so because Congress approves the city's budget.

FOXNews.com - Washington D.C. Hopes Needle Exchanges Will Curb Soaring AIDS Rate - Health News | Current Health News | Medical News

When 1 out of 5 new transmissions comes from IV drug use it doesn't help to sit on a ban for needle exchange program funds from 1998-2007!

So maybe they didn't know?

Wrong!

From a CDC website:

In 1997, a Report to Congress concluded that needle exchange programs can be an effective component of a comprehensive strategy to prevent HIV and other blood-borne infectious diseases in communities that choose to include them.(1) Federal funding to carry out any program of distributing sterile needles or syringes to IDUs has been prohibited by Congress since 1988. In addition, several states have restricted the funding or operation of syringe exchange programs (SEPs).

http://www.cdc.gov/IDU/facts/AED_IDU_SYR.pdf

Now I never said lack of needle exchange funds was the largest factor but it most surely was a factor for years and years with no real funding between 1998-2007.

RightinNYC · Mar 18, 2009

Orius said:
Your link is interesting and I accept your information, but the Wikipedia entry makes no mention of homosexuals. Risk assessment does not speak to the number of infectees. Your numbers create the erroneous implication that because homosexual sex is higher risk, that therefore more homosexuals must have AIDS than heterosexuals.

I did not, and did not intend to, imply that as it's simply untrue.

This is false. Even if the risk is statistically low, heterosexuals still account for 75% of worldwide transmission of AIDS.

Considering that heterosexuals are approximately 95% of the world's population, that's not really a surprise.

I am also willing to accept that perhaps homosexuals account for the greater demographic in the United States

Of the estimated 317,698 male adults and adolescents living with AIDS, 58% were MSM, 21% were IDUs, 11% had been exposed through heterosexual contact, and 8% were MSM who were also IDUs. Of the estimated 93,566 female adults and adolescents living with AIDS, 64% had been exposed through heterosexual contact, and 34% had been exposed through injection drug use.

Furthermore, your own hypothesis about reporting bias would seem to indicate that these numbers are skewed, though in a different way than you mentioned. Going off of your argument, we can conclude that in a homophobic culture, people who became infected through M2M sex are likely to lie about how they became infected and say that it either happened through heterosexual contact or through IDU. That would seem to skew the number upward, beyond the 64% it's already at.

I also stand by my assertion that homosexuals have higher report rates because they are more invested in seeking testing, especially in areas where anonymous testing is in place. I'm not trying to say that heterosexuals are lazy... I've noticed that heterosexual women are usually more keen to be tested than men, but on the whole homosexuals seem to be more on top of things.

Again, this is completely plausible, but do you have any evidence to support this?

Out of all possible STDs, HIV is the most serious in nature. Hep A and B are controlled by worldwide vaccination programs, and although Hep C has no vaccine, interferon treatments have come a long way to providing a cure. Other STDs are curable or their symptoms are manageable and non-life threatening. Once HIV becomes AIDS, unless you can afford the expensive medications, there is nothing to save your immune system from devastation and secondary infection. It is definitely spreading at epidemic proportions worldwide.

This is all true, but doesn't in any way discount what I said previously.

The failure of society to have a dialogue combined with denial of how virulent it is, is what is allowing it to proliferate.

No, that is not what is allowing it to proliferate. Unsafe sex practices and IDU are what is allowing it to proliferate.

As long as people continue to perpetuate the idea that it's a developing world problem, a minority problem, or a homosexual problem, it will continue to spread.

1) It will continue to spread either way
2) Nobody is saying that it's exclusively the province of those groups, but you can't deny that it's far more prevalent among those groups.

The point is that there is always a trade-off. If you make HIV awareness your #1 overwhelming priority, then you're necessarily doing so at the expense of awareness of other diseases. My point is that HIV is not so serious and prevalent in all communities that it should be addressed uniformly across the board at the expense of other STDs, such as HPV.

It is partially a lack of seriousness and frankness which makes people feel they can ignore protection in favour of their urges.

AIDS education is drummed into the head of every person in this country. In every school in the inner city, there are posters on every wall, discussions in every health class, lectures from every principal. That is not the problem.

HIV/AIDS Rate in D.C. Hits 3%

Orion

Grateful Heart

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jallman

Real Korimyr #9

Not Myself, I'm a Replica of Me

RightinNYC

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Orion

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