Huckabee supported isolation for HIV+ individuals

Still playing end-of-year catch-up with grants and manuscripts so posting will be sporadic, but I’d be remiss not to mention this story regarding presidential candidate Mike Huckabee’s past views on HIV/AIDS:

In 1992, Huckabee wrote, “If the federal government is truly serious about doing something with the AIDS virus, we need to take steps that would isolate the carriers of this plague.”

“It is difficult to understand the public policy towards AIDS. It is the first time in the history of civilization in which the carriers of a genuine plague have not been isolated from the general population, and in which this deadly disease for which there is no cure is being treated as a civil rights issue instead of the true health crisis it represents.”

***

“Medical protocol typically says that if you have a disease for which there is no cure, and you are uncertain about the transmission of it, then the first thing you do is that you quarantine or isolate carriers,” Huckabee said.

First, Huckabee stands by the comments he made at this time–which were as dumb in 1992 as they would be now. He argues that little was known about the transmission of HIV in 1992, but we certainly knew at that time that it wasn’t some kind of airborne virus that put everyone at risk just by being in the same room with someone who carried it. Additionally, he’s incredibly wrong about the history of medicine and isolation procedures as well: isolation has actually been a relatively rare phenomenon in the history of civilization, and it didn’t always work–the mode of transmission plays a huge role in determining whether isolation is even used, and whether it will be successful. Huckabee ignores this–ignorance on top of ignorance.

And he’s not done yet.

When asked about AIDS research in 1992, Huckabee complained that AIDS research received an unfair share of federal dollars when compared to cancer, diabetes and heart disease.

“In light of the extraordinary funds already being given for AIDS research, it does not seem that additional federal spending can be justified,” Huckabee wrote. “An alternative would be to request that multimillionaire celebrities, such as Elizabeth Taylor (,) Madonna and others who are pushing for more AIDS funding be encouraged to give out of their own personal treasuries increased amounts for AIDS research.”

Now, it could be argued that AIDS *does* receive an “unfair” share of federal money–the other diseases listed certainly cause more deaths in the U.S. But why bring in that model of funding? Because it’s a “Hollywood” disease? Or because it’s a “gay” disease? He mentions:

Also in the wide-ranging AP questionnaire in 1992, Huckabee said, “I feel homosexuality is an aberrant, unnatural, and sinful lifestyle, and we now know it can pose a dangerous public health risk.”

Of course, *any* sexual lifestyle can pose a “dangerous public health risk”. Heterosexuals get sexually-transmitted infections too, including HIV/AIDS.

Huckabee said Saturday that his comments came at a time when “the AIDS crisis was just that _ a crisis. We didn’t know exactly all the details of how extensive it was going to be. There was just a real panic in this country. If I were making those same comments today, I might make them a little differently.” Yes, Mike, I’d advise you to make them more than a “little differently.” In fact, you should go farther and admit you were ignorant of the state of the science back in 1992 as well, and that we knew a lot more details than you suggest. I know politics today is all about standing firm and never admitting any wrongs, but this is ridiculous. I don’t expect him to own up, and I unfortunately expect that many evangelicals would still agree with his stance on homosexuality and HIV, but his statements on isolation are extreme even by 1992 standards–and it isn’t enough to say that he’d say things “a little differently” today and write off all the criticisms to “political correctness.”

Comments

#1 Colugo
December 10, 2007

That’s at least one thing that Huckabee and Fidel Castro have in common.
#2 Barney
December 10, 2007

Governor Huckabee is, of course, an idiot. HIV is barely contagious, and this was more or less known in the early 1990s.

But, it’s simply misleading and unscientific for you to write:

Heterosexuals get sexually-transmitted infections too, including HIV/AIDS.

Yes, heterosexual get std’s, but not often HIV. In the USA, 95% of AIDS cases are young gay men (not Lesbians or older gays) and drug users.

Think about it — the most sexually promiscuous phase a heterosexual’s life is college. You have thousands of white, privileged co-eds humping away — yet virtually no AIDS. Why is it?

Of course, the larger point, that Huckabee was scapegoating and fear-mongering, is true. But, not for the reasons you cite.
#3 Adele
December 10, 2007

Barney sad thing is, you and Huckabee are the same thing. Both of you say HIV is a gay drug disease the rest of us can forget about it.
#4 Barney
December 10, 2007

Adele,

Either you are dense or stupid. I said no such thing.

AIDS is absolutely not a gay disease. Young gay men (not lesbians, nor older gay men) were mostly afflicted, but not because they were gay.
#5 SLC
December 10, 2007

Re Barney

Actually, Mr. Barney is seriously in error as to who gets HIV, at least since the 1980s. It is my understanding that the majority of cases since those times are intervenous drug users. Furthermore, a woman is 20 times more likely to get HIV from an infected man then is a man from an infected woman.
#6 Jeanne
December 10, 2007

Re Barney’s mistaken HIV stats: CDC cumulative estimated statistics, from the beginning of the HIV epidemic through 2005, show that, of about 1.04 million AIDS cases in the U.S., over 17 percent are/were unrelated to sex between men or IDU. Of these, over 75,000 are men, 108,000 are women, and for all but 20,000 the transmission risk was heterosexual sex. As SLC notes, the epi patterns have changed over the years: in 2005, 48% (11,989 of 24,822) of estimated living cases of HIV/AIDS in the 33 states with name reporting were people whose exposure was high risk heterosexual contact or “other”–perinatal, transfusion, hemophilia, unknown. The reasons that AIDS isn’t common among college students include the complex epidemiological relationships among risk, sexual networks, and vulnerability, and the long period of time that can pass between HIV infection and an AIDS diagnosis.
#7 Barney
December 10, 2007

No, Jeanne, you are smoking herb.

The Feds recently issued a report that sexually transmitted diseases are
going through the roof in the USA.

Chlamydia, gonorrhea and syphillis are all way up. Over a million cases each year.

Yet, the article is strangely silent about HIV. It is totally incongrous that all this condomless sex is leading to all these STDs — except for the one that we spend Billions to fight, and wear red ribbons to support.

There is an answer to this, though — deeply buried in the literature in 2 papers:

In Van Voorhis (1991), the authors tested the semen of 25 HIV+ men. Remarkably, they could only find HIV in 1/25 using highly sensitive PCR.

Obviously, if HIV is not generally present in semen, it won’t get transmitted sexually. Condoms are fine, but you need to start de-linking sex from HIV.

More so, in Padian (1997), epidemiologists performed the longest study of heterorsexual transmission of HIV. They followed 175 heterosexual couples, where one of the parties was HIV+ and the other HIV-. After 6 years of sex (1990 – 1996), not one person contracted HIV.

The authors tried to suggest that the low infectivity rate (Zero) was due to condom usage, but they couldn’t quite do that honestly:

“Nevertheless, the absence of seroincident infection over the course of the study cannot be entirely attributed to significant behavior change. No transmission occured among the 25 percent of couples who did not use condoms consistently at their last follow-up nor among the 47 couples who intermittently practiced unsafe sex during the entire duration of follow-up” (Padian, pg 356.)

Bottom line — stds are way up, but not for AIDS, because there is little or no virus in the semen, and therefore, little or no virus to transmit by sex.

Despite all this, it is a good idea to wear condoms, just not due to this AIDS scaremongering.
#8 Molecular Entry Claw
December 10, 2007

[of heterosexual transmission] “75,000 are men, 108,000 are women” [minus a gender unspecified 20,000](Jeanne)

However. . .

“a woman is 20 times more likely to get HIV from an infected man then is a man from an infected woman.” (SLC)

You guys are priceless.
#9 Chris Noble
December 11, 2007

In Van Voorhis (1991), the authors tested the semen of 25 HIV+ men. Remarkably, they could only find HIV in 1/25 using highly sensitive PCR.

Detection of human immunodeficiency virus type 1 in semen from seropositive men using culture and polymerase chain reaction deoxyribonucleic acid amplification techniques.

The paper looks at proviral HIV DNA detection in semen. “Barney” somehow forgets to cite the hundreds of papers that show that HIV RNA is consistently found in semen.
#10 noreeen - Still Standing
December 11, 2007

Dr. Noble just because HIV in found in semen doesn’t prove that HIV causes anything. What about that Padian study of no conversions? Explain that to all of us, especially to those of us where one is HIV-Negative and the other HIV Positive. After ten years, my husband still tests HIV Negative.

I agree with the above comment, most STD’s are up, yet HIV is not. Check out the “true” AIDS cases, not HIV, which are mainly in the original risk group.
#11 McK
December 11, 2007

Study Calls HIV in D.C. A ‘Modern Epidemic’

More Than 80 Percent Of Recent Cases Were Among Black Residents

The first statistics ever amassed on HIV in the District, released today in a sweeping report, reveal “a modern epidemic” remarkable for its size, complexity and reach into all parts of the city.

The numbers most starkly illustrate HIV’s impact on the African American community. More than 80 percent of the 3,269 HIV cases identified between 2001 and 2006 were among black men, women and adolescents. Among women who tested positive, a rising percentage of local cases, nine of 10 were African American.

The 120-page report, which includes the city’s first AIDS update since 2000, shows how a condition once considered a gay disease has moved into the general population. HIV was spread through heterosexual contact in more than 37 percent of the District’s cases detected in that time period, in contrast to the 25 percent of cases attributable to men having sex with men.
#12 Jeanne
December 11, 2007

MEC can’t understand why there are more women than men in the “heterosexual risk only” category, even though women are more likely to be infected through heterosexual contact? That’s pathetic.

Otherwise, the arguments presented here are so compelling, despite the absence of facts, that I now believe that Barney shouldn’t use condoms for receptive anal sex with HIV-infected men. Go for it, Barney! You’ll be fine!
Jeanne
#13 apy
December 11, 2007

noreen,
Maybe we should get to the point where we can agree on the specifics of the science before we start trying to say who causes what with whom? It seems like your initial reaction is to say that “that does not prove anything” rather than “well what does that paper mean?”

But whatever, this is the same stuff that’s been going on for the past 4 months here so no surprises so far.
#14 apy
December 11, 2007

noreen,
Also, indeed that one paper does not prove that HIV causes AIDS. This is part of the reason the “show me the one paper” argument is such a fallacy. It takes a body of evidence to make a statement.
#15 Warren
December 11, 2007

Umm, the stats in African nations might be relevant here too, if we’re going to discuss HIV infection as a crossover into heterosexual populations. Infection rates are about 17 times what we see here in the States, and that is not because Africa is overrun with Teh Gays.

As for Huckabee being wrong: As a former preacher, he’s made a lifetime career of it.
#16 Adele
December 11, 2007

Barney may be I am stupid and dense but you said heterosexuals don’t get AIDS much so its logical AIDS is a gay or drug disease, in your opinion. You said 95% of AIDS in gays and drug users. So you say AIDS is mainly gay and drug diseases.

Exactly what Huckabee says.

But your right you are not like Huckabee another way, Huckabee says HIV causes AIDS and its a public health threat. You say HIV is not real, it doesn’t cause AIDS. So Huckabee is partly right so he’s just a dumb dinosaur not a deniosaur.

Oh and Jeanne answered your question here she is,

The reasons that AIDS isn’t common among college students include the complex epidemiological relationships among risk, sexual networks, and vulnerability, and the long period of time that can pass between HIV infection and an AIDS diagnosis.

College students don’t have AIDS except if they got infected when they were little kids. About zero little kids get infected any more except their mothers listen to Christine Maggiore. College students who get HIV in college don’t get AIDS til alot later.

Oh and Warren? Nice point but Barney and friends says there’s no AIDS in Africa it’s just a lie it’s all malnutrition and the stress of being African they say. There’s this one deniosaur wrote a book, he says positive HIV test comes from a genetic defect in black people!! And Latinos with to much “black blood”!!! Mean and racist some say but it works for Barney and repubicans like Huckabee.
#17 Warren
December 11, 2007

Oh and Warren? Nice point but Barney and friends says there’s no AIDS in Africa it’s just a lie it’s all malnutrition and the stress of being African they say.

Which would be sensible if AIDS were a syndrome that’s been a documented historical fact of our 160,000 or so years of evolution (as H. sapiens), but of course it isn’t.

Not that I expect facts to have much weight with denialists; if Barney et. al. fall into that camp, no amount of reality will have the necessary effect.
#18 pat
December 11, 2007

what % of gays are stricken by HIV?

personally I want to know what % of gay Aids patients have a drug history. Aids has nothing to do with being gay; I think we all agree.
#19 Adele
December 11, 2007

Pat I wish that was right but it’s not, you and me can agree but Huckabee and alot of people call AIDS a gay disease. Some people say gay people do drugs and drugs cause AIDS. So being gay is indirect cause of AIDS not idrect, in their opinion that is wrong.
#20 Greta Christina
December 11, 2007

Apparently Huckabee also thinks that the laws of aeronautics show that bumblebees can’t fly.

I’m just sayin’, is all.
#21 Chris Noble
December 11, 2007

Dr. Noble just because HIV in found in semen doesn’t prove that HIV causes anything.

What it does tell me is that when “Barney” cites one study (that just happens to be mentioned in Duesberg’s book) out of thousands that show HIV to be found in semen that “Barney” is being dishonest. “Barney” also fails to mention that HIV could be cultured from four of the patients. He can’t even accurately present the information from the paper he cites let alone the totality of the literature.

The question then is why is “Barney” so determined to deceive you.
#22 Molecular Entry Claw
December 11, 2007

Dr. N

Ok back to kindergarten. Pieces of RNA are not transmissible replication competent virions.

The question is why do you insist something is there which cannot be found – which cannot even be cultured in many cases?

Why do you pretend there is a “totality of the literature”?
#23 MEC
December 11, 2007

PS. Dr. N,

What does “the totality of the literature” say will happen if one sex is 20 times as prone to get infected with something as the other? You see the aptly named Jeanne has a little trouble with her(?) epidemic calculus you might be able to help her with.
#24 Chris Noble
December 11, 2007

Why do you pretend there is a “totality of the literature”?

Uhhh. Because there is more than just one paper that looks at HIV in semen.
#25 Barney
December 11, 2007

Chris Noble,

You really don’t get it.

Look at the Voorhis paper I cited, and then you cited.

They had 25 “HIV+” men. They looked at the semen of these 25 “HIV+” men.

Were they able to find HIV in the semen of each of these 25 “HIV+”?

NO.

Using PCR, they could only detect HIV in ONE OF THE 25 HIV+ MEN!

1 of 25 semen samples. By coculture on mitogen-activated peripheral blood leukocyte target cells, 19 of 24 PBMC and 4 of 24 semen samples were positive for infectious HIV-1. Of the four culture-positive semen samples, three were negative for the proviral form of the virus in the polymerase chain reaction assay

They could only culture HIV in 4 of the 25 “HIV+” men.

Only a real stupid zealot could misinterpret these results — even in HIV+ men, there ain’t any HIV in 82% of them.

Hence, that is why sexual transmission of HIV is so low and trivial.
#26 Chris Noble
December 12, 2007

“Barney” the deception is that you give one paper (that coincidentally appears in Duesberg’s book) and fail to mention the hundreds of other papers that have looked at HIV in semen. You fail to mention the difference between proviral DNA and viral RNA.

All you have to do is go to pubmed and type in “HIV semen”.

If you bothered to do so you would find articles like this.

Amplified transmission of HIV-1: comparison of HIV-1 concentrations in semen and blood during acute and chronic infection.
#27 Barney
December 12, 2007

So, you’re ignoring the DATA in the Van Voorhis paper?
#28 Chris Noble
December 12, 2007

So, you’re ignoring the DATA in the Van Voorhis paper?

Don’t be stupid. Nobody is ignoring the data. The paper has been cited 93 times in the literature.

You on the other hand are ignoring the DATA in the hundreds of other papers.

You seem completely oblivious to the distinction between proviral DNA in sperm and free viral RNA in seminal fluid. Is this intentional.

Viral load in semen and blood are variable. Both are higher in acute infection with obvious implications for transmission risks and epidemiology.
#29 Molecular Entry Claw
December 12, 2007

Viral load in semen and blood are variable. Both are higher in acute infection with obvious implications for transmission risks and epidemiology.

Only to you Dr. N, only to you and your fellow blondes.
But, ok, once more: A PCR viral load test is not proof of the presence of a single, transmissible replication competent virion. Period.

What’s even worse, you also forgot to give us the male to female ratio in a heterosexual epidemic where females, acordingto SLC, are at twenty times higher risk of infection than males. Jeanne’s hairdresser is waiting with bated breath for your answer.
#30 DrFrank
December 12, 2007

So, what exactly is being claimed by the crank faction here? That HIV doesn’t cause AIDS, or just that there’s a huge scientific conspiracy to do unnecessary research on something that’s actually trivial? Or both?
#31 carter
December 12, 2007

BOTH
Except Dr Frank, It’s not a conspriacy. It’s Business as usual. Assumptions based on massive assumpions, grandious statements and flawed logic. Just look at the contradictory evidence.
#32 Ian Gould
December 12, 2007

“Bottom line — stds are way up, but not for AIDS, because there is little or no virus in the semen, and therefore, little or no virus to transmit by sex.”

I’m sure the millions of Africans and Asians who’ve contracted AIDS through heterosexual sex will be glad to hear it.
#33 Ian Gould
December 12, 2007

“Except Dr Frank, It’s not a conspriacy. It’s Business as usual. Assumptions based on massive assumpions, grandious statements and flawed logic. Just look at the contradictory evidence.”

Amazing isn’t it, that somehow despite this massive incompetence life expectancies keep going up.
#34 Barney
December 12, 2007

Chris Noble,

It’s hard to communicate with you. Let’s take it from the top.

1. Huckabee was wrong about the infectious nature of HIV in 1992. By then, the scientific evidence demonstrated overwhelmingly that HIV was not spread by casual contact. You can smooch, hug, fondle, befriend, hire and fire, any AIDS patient as much as you like without any fear of getting cooties. Most sane people understand this. There is no reason to stigmatize an AIDS patient.

2. Also, the scientific evidence demonstrated that HIV is transmitted by mother to child. But, again, this provides no scientific basis for transmission with casual contact, since we are only born one time.

3. That basically leaves sex as the primary mechanism by which the virus is trasmitted.

4. But that poses a problem — sex, like eating and breathing, is a ubiquitious activity.

5. In Padian (1997), the DATA showed “no seroconversions” by healthy uninfected adults, after 6 years of sex, including anal sex, with HIV+ adults.

6. In Van Voorhis (1991), the DATA showed that PCR (dna) could only detect HIV in 1 of 25 HIV+ men.

So, please explain why nobody thru sex contracted HIV in Padian, and why only 1 out 25 HIV+ men had detectable HIV in their semen in Van Voorhis? How hard is it to connect these two critical dots for you?

Once you do that, you will stop trying to explain and rationalize away data that conflicts with your pre-written script.

Yes, it is good to wear condoms for a host of good reasons, but this has nothing to do with the scientific evidence that suggests HIV is not spread through casual contact, is spread thru birth, but probably not spread thru sex.

Go read about the great Dr. Joseph Goldberger and the phone “infectious” Pellagra epidemic — you will learn something.
#35 Adele
December 12, 2007

Barney try some thing drastic. Read the Van Voorhis paper. Your point 6 shows you didn’t.
6. In Van Voorhis (1991), the DATA showed that PCR (dna) could only detect HIV in 1 of 25 HIV+ men.

Van Voorhis Fertility and Sterility 1991 detected HIV INFECTED CELLS in 23 of 25 infected men, in a isolated subset of blood cells. They found HIV INFECTED CELLS in semen from just one men.

So 22 or 23 men w/o HIV INFECTED CELLS in semen did have HIV INFECTED CELLS in a subset of their blood cells. Thats why remember health ed Professor how blood-blood is more efficient then semen for infection.

OK great so HIV infected cells. You don’t have to have infected cells in semen or in a subset of your blood cells to be infectios. You can have virions. Authors did the co-culture. Now we know co-culture like here is not so hot on getting right numbers ok so its an under estimate!! But they get positive on 19 of 24 in blood and 4 of 24 in semen.

OK so do like the Duesberdactyl and pretend its the only paper on HIV in blood and semen ever. What’s the conclusion, you say contact w/blood is worse then contact w/semen some times. And Most people w HIV positive tests have culturable HIV in their bllod and HIV positive cells in their blood. And DNA negative in some cells doesn’t mean you haveno HIV in your whole body. And culture is not the best way of measuring virus. And wouldn’t that be nice to have a way for measuring virions not just DNA oh wait there is it’s RT-PCR!!

And more now we have data infectious semen is highest in acute phase. So a-symptomatic phase men have lower semen virus

Oh by the way ever see those EMs of cell-free virus in semen? I can get the paper but may be you don’t want to see it.
#36 SLC
December 12, 2007

Just to be more accurate, my statement about a female being 20 time more likely to become HIV positive from an infected male then vice versa was for unprotected sex where the man was not wearing a condom.
#37 apy
December 12, 2007

Barney,
Aren’t those Padian numbers for ‘safe sex’? Which would mean wearing a condom. I recall her statement specifically saying that not practicing ‘safe sex’ one was 20x more likely to become infected. Is this correct Barney or am I confused?
#38 jen_m
December 12, 2007

Could you guys please go back to one of the other threads you’ve dominated if you’re going to fight about whether HIV exists, so the rest of us can complain about Huckabee in relative peace? This thread is about homophobia, bigotry, and inappropriate application of public health measures to forward a political agenda.

(And, no, apy, the paper that “Barney” is citing isn’t of safe sex. I will paste the abstract in the Mbeki thread, just as an incentive.)
#39 Adele
December 12, 2007

No jen_m apy is right the paper Barney cites is a study where they teach safe sex.

Over time, the authors observed increased condom use (p 0.001) and no new infections. Infectivity for HIV through heterosexual transmission is low, and STDs may be the most important cofactor for transmission. Significant behavior change over time in serodiscordant couples was observed.

In it 19% of females got infected by there male partners 2% of males from females but from the study no new infections with increased condom use.

The STD link is consistant with the blood vs semen thing Van Voorhis says about.
#40 Chris Noble
December 12, 2007

So, please explain why nobody thru sex contracted HIV in Padian, and why only 1 out 25 HIV+ men had detectable HIV in their semen in Van Voorhis? How hard is it to connect these two critical dots for you?

There is a high chance that you are Hank Barnes/David D.Steele in which case you already know that this study has been discussed ad infinitum.

Discussion of the Padian paper

The basic pattern is to stick to one paper and repeat the same fallacious claims over and over again whilst ignoring hundreds of other papers that refute your claims. Apparently now you’ve found another paper to add to your small bag of tricks.

The paper I cited above was meant to provide you with a few clues. If you are Hank Barnes/David D. Steele then you are completely immune to clues.

I’ll spell it out for you. HIV viral load in both blood and semen is variable and this has a very strong effect on transmission risk. During the acute infection stage viral load is high and the transmission risk is orders of magnitude higher. If you followed the literature rather than reading Denialist books and webpages you would have noticed several papers by Chris Pilcher on the importance of increased transmission risk during acute infection. The discordant couples in the prospective part of Padians study were well past the acute infection period. It is also a truism that monogamous couples do not create an epidemic.

I apologise to the rest of the people reading this thread as “Barney” competes and outclasses Huckabee in the stupidity stakes.
#41 ElkMountainMan
December 13, 2007

Speaking of Huckabee….

The man is quite clueless in quite a few ways, but he could serve the useful function of getting a Democrat into the White House. I admit Huckabee does at least have a sense of humor. Anyone who watches his “Chuck Norris” commercial and DOESN’T feel some tiny glimmer of warmth is beyond help in the laughs department.
#42 jj mollo
December 13, 2007

So really. What is the right way to fight a new disease that is going to kill millions? I guess you can’t know that at first. And maybe you don’t know that vaccine development will be a failure, but a strong initial response seems called for. Huckabee might have been a little slow on the uptake, but that doesn’t invalidate the question.

There was a lot of outrage in SF when they closed down the bathhouses, but I don’t think too many people would disapprove of that action in hindsight. Was there anything else we could have done? We could have spent more money on research, for sure, but if RR had done everything right, what course of action should he have taken? I mean, we put TB victims in jail for not taking their medicine. The mode of transmission may be different, but how does that matter in the long run? Is it the fact that the jinni is already out of the bottle? Whereas TB is almost under control?
#43 Dave Briggs
December 14, 2007

It seems apparent that he was making those comments out of fear.
Dave Briggs :~)
#44 Unsympathetic reader
December 16, 2007

Chris Noble: “Barney” the deception is that you give one paper (that coincidentally appears in Duesberg’s book) and fail to mention the hundreds of other papers that have looked at HIV in semen. You fail to mention the difference between proviral DNA and viral RNA.

Man, that crap is old. And still it persists. Phil (ID Wedgie) Johnson didn’t appreciate the difference either when he first popped up on sci.med.aids well over a decade ago.
#45 Unsympathetic reader
December 16, 2007

jj_mollo: “Was there anything else we could have done?”

Yes, earlier & better screening of blood-derived products could have been done. It also might have helped to reduce the stigma of the disease and see that people at risk sought screening.
#46 Darin Brown
December 16, 2007

Adele said,

“And wouldn’t that be nice to have a way for measuring virions not just DNA oh wait there is it’s RT-PCR!!”

virion A complete viral particle [my emphasis], consisting of RNA or DNA surrounded by a protein shell and constituting the infective form of a virus.

– American Heritage Medical Dictionary, 2004 edition

But now for something more interesting.

OK, I thought this Padian shit had been put to rest. Apparently not. I guess I have to s-p-e-l-l i-t o-u-t for you dimwits.

“A common practice is to quote out of context a sentence from the Abstract of the 1997 paper: ‘Infectivity for HIV through heterosexual transmission is low’. Anyone who takes the trouble to read and understand the paper should appreciate that it reports on a study of behavioral interventions such as those mentioned above: Specifically, discordant couples were strongly counseled to use condoms and practice safe sex (1,12). That we witnessed no HIV transmissions after the intervention documents the success of the interventions in preventing the sexual transmission of HIV. The sentence in the Abstract reflects this success — nothing more, nothing less.”

OK, then, let’s do a simple numerical argument to see if Padian’s justification holds water.

Let’s make it real simple — let’s only look at unprotected (or inconsistent condom use) male-to-female transmission. I’m going to do some basic estimations here, which are likely not exact, but rough and ready enough for government purposes, as they say. (I had a CS prof who asked on our final exam for us to “estimate the number of blades of grass on a football field”.)

The prospective portion of the study examined about 3,000 couple-months of data. Let’s say that’s about 30,000 acts of heterosexual intercourse. I don’t find the male -> female to female -> male breakdown for the prospective portion, so I’ll use the fact about 80% of the cross-sectional couples were male -> female, so we get about 24,000 acts of male -> female heterosexual intercourse. Padian says that even after their mind-controlling “counselling”, still 25% at the end weren’t using condoms consistently, and since one can assume it was even worse before this “counselling”, let’s say that about 1/3 of all those male -> female heterosexual acts were unprotected. That gives us about

8,000 acts of unprotected male -> female heterosexual intercourse

in the prospective study.

Again, the number might not be exactly on the mark, but the result below will be so far out of touch with reality by orders of magnitude, you’ll see it doesn’t matter much.

In the cross-sectional portion of the study, Padian estimates male -> female “infectivity” at about 1/1000. We can think of the 8,000 acts above as Bernoulli trials with probability of “success” p = 1/1000.

Now, a rough and ready estimate of the probability of observing NO SUCCESSES over N trials with probability of success p is given by

(1/e) ^ (Np)

i.e. the number 1/e raised to the power (Np). If you don’t understand why this is true, then you must have fallen asleep during Stats 101 when they were covering independence of events and Calculus II when they were covering the exponential function.

So, here the probability is

(1/e) ^ (8) = 1/(e^8) = about 1 in 3,000.

In other words,

If Padian’s cross-sectional conclusions are true, then the probability that she would observe the actual prospective results that she DID OBSERVE would only be about 1 in 3,000.

NOW, do you see why Padian’s paper is such a friggin’ BOMBSHELL???

darin
#47 Chris Noble
December 16, 2007

The prospective portion of the study examined about 3,000 couple-months of data. Let’s say that’s about 30,000 acts of heterosexual intercourse. I don’t find the male -> female to female -> male breakdown for the prospective portion, so I’ll use the fact about 80% of the cross-sectional couples were male -> female, so we get about 24,000 acts of male -> female heterosexual intercourse. Padian says that even after their mind-controlling “counselling”, still 25% at the end weren’t using condoms consistently, and since one can assume it was even worse before this “counselling”, let’s say that about 1/3 of all those male -> female heterosexual acts were unprotected. That gives us about 8,000 acts of unprotected male -> female heterosexual intercourse

Fail.
74% were using condoms consistently. 14.5% abstained totally. This leaves about 11.5% who were not using condoms consistently. This doesn’t mean as you appear to conclude that they were not using condoms at all. Where are you getting your estimates of the number of sex acts from?
#48 Mr Natural
December 16, 2007

Huckabee??!!

He has something to do with this discussion no doubt. After all, if HIV is like “being hit by a Mack truck” and is going to wipe out Uganda, then it would follow that people should be isolated from such a deadly threat. Oh – those things have no basis! So lets bash Huckabee because he was misled by the type of illogic always on display here?

But no doubt we’ll soon be informed that it’s all the denialists fault that he made those statements, not the advocates of the unstoppable-killing-machine theory of HIV.

And Adele, always entertaining and a barrel of laughs – (needed at the moment as my Jets go down in flames) – tells us “And wouldn’t that be nice to have a way for measuring virions not just DNA oh wait there is it’s RT-PCR!!”

What is one to make of such a statement? Perhaps our s/hero is not aware of the distinction between lab and natural RTs? Or that 10^6 virions/ml would enable one to at least find the 70S RNA (equivalent to complete dimeric genome) ex vivo. Oh right, even current technology will somehow just fall short of this detection. Silly me, RT-PCR does it because it’s the only way it can be done.

Ah yes, Nancy Padian is in the news again. Darin, no doubt has misinterpreted her study because she and Adele says her studies were actually meant to prove that condoms work. And, of course, only a conspiracy nut like myself would say the Padian et al studies 1988-97 actually did have controls that weren’t published. For obvious reasons.
#49 Mr Natural
December 16, 2007

Oh wait, the Jets just scored a touchdown.

Later for you guys …
#50 Will
December 16, 2007

Fail.
74% were using condoms consistently. 14.5% abstained totally. This leaves about 11.5% who were not using condoms consistently. This doesn’t mean as you appear to conclude that they were not using condoms at all. Where are you getting your estimates of the number of sex acts from?

Chris, you are making quite an assumption here. You are assuming that “constent” condom use means condom use EVERY SINGLE TIME with no exposure to bodily fluids from “infected” individuals. If any assumption could be made, it would be that even those in the “consistent” condom use category were exposed to infected bodily fluids. Take of your “orthodox” blinders and see the light. It’s staring you right in the face.
#51 Mr Natural
December 17, 2007

“Accurate semen analysis by polymerase chain reaction may require enrichment of the infected cell population and/or a reverse transcriptase step to enable detection of the infectious ribonucleic acid form of the virus.”

Chris: “The paper looks at proviral HIV DNA detection in semen. ‘Barney’ somehow forgets to cite the hundreds of papers that show that HIV RNA is consistently found in semen.”

The paper also assumes p24 = “infectious HIV-1(:)by coculture on mitogen-activated peripheral blood leukocyte target cells, 19 of 24 PBMC and 4 of 24 semen samples were positive for infectious HIV-1″, based on the last abstract sentence quoted above.

So Chris, how is HIV-1 distinguished from HTLV-I (with its gag-pol hybridizations to HTLV-III and very own p24)?
#52 Mr Natural
December 17, 2007

Adele: “There’s this one deniosaur wrote a book, he says positive HIV test comes from a genetic defect in black people!!”

Adele, it was the NIH’s O’Brien et al who published more than one paper on the superior Caucasian gene that bestows magical resistance to the killer virus.
#53 Mr Natural
December 17, 2007

Warren: “Which would be sensible if AIDS were a syndrome that’s been a documented historical fact of our 160,000 or so years of evolution (as H. sapiens), but of course it isn’t.

“Not that I expect facts to have much weight with denialists; if Barney et. al. fall into that camp, no amount of reality will have the necessary effect.”

Of course??!! Speaking of bold and audacious faith posing as fact, this one takes the cake. Warren informs us that he knows for sure that in all of human history there have never been populations with the broad spectrum of conditions that qualify as AIDS, eg low t4 cells. This kind of irrationality is absolutely breath taking.
#54 Mr Natural
December 17, 2007

Amazing isn’t it, that somehow despite this massive incompetence life expectancies keep going up. Posted by: Ian Gould | December 12, 2007 9:05 AM

Yes Ian, amazing modern plumbing and industrial infrastructure, which are seriously deficient in places like Africa. But these factors are just more denialist claptrap. Of course.
#55 Mr Natural
December 17, 2007

Chris: “Huckabee was wrong about the infectious nature of HIV in 1992. By then, the scientific evidence demonstrated overwhelmingly that HIV was not spread by casual contact. You can smooch, hug, fondle, befriend, hire and fire, any AIDS patient as much as you like without any fear of getting cooties. Most sane people understand this.”

Wait a minute guy, you’re rewriting history. Even as late as 1992, it was STILL FIRMLY ESTABLISHED in the lay mind that an unstoppable AIDS virus was going around in the gay community. Why would ordinary people believe that “science” was not telling them to be very afraid with the fantastic projections of future deaths during that period? It was billed as an unprecedented risk. So why should officials concerned with the public safety believe it to be less than past contagions? Remember, the promised vaccine was by 1988. So Huckabee’s ignorant because researchers had demonstrated their failure to comprehend the problem by 1992?

And what about Gallo’s “saliva” results?
#56 Mr Natural
December 17, 2007

Forgive me Barney, I misquoted you as Chris.

But the questions ARE directed to all the Huckabee bashers assembled here.
#57 Mr Natural
December 17, 2007

“Could you guys please go back to one of the other threads you’ve dominated if you’re going to fight about whether HIV exists, so the rest of us can complain about Huckabee in relative peace? This thread is about homophobia, bigotry, and inappropriate application of public health measures to forward a political agenda.”
Posted by: jen_m | December 12, 2007 1:41 PM

Yes, jen, I’m happy to stick with the subject of this thread. But the “relative peace” you’re not going to get; after all, we’re talking about a major presidential candidate. Since I’ve decided to defend Huckabee on this issue (praise Tara for bringing this up), why not stay on point by answering the above questions.

Convince me that “homo-” trumps “germ” phobia in the history of the AIDS epidemic. It looks to me that the medical “political agenda” of our government officials both right and left is to “stigmatize” the general population to the extent they can get away with it.
#58 Michael Ralston
December 18, 2007

I admit to being a bit fuzzy on the history here, but wasn’t it the case that by the time it was being called AIDS and not GRID, that we knew how it spread?
#59 Mr. Natural
December 18, 2007

Good question Michael.

As late as one month before the famous press conference (April 23, 1984), it was still being stated by JAMA/CDC (several published articles): “the etiology of this disorder remains unknown”.

I will dig out the references if anyone needs them.
#60 Darin Brown
December 18, 2007

[from another thread]

Chris said:

“Darin Brown desperately arguing that there is no such thing as specific antibodies and ‘Truthseeker’ desperately arguing that not only do HIV neutralizing antibodies exist but that they ‘defeat’ HIV have convinced me I am an idiot for wasting my time here.”

Well, you ARE an idiot, Chris, but not for that reason!!

Only an true idiot like you would confuse the issue of SPECIFICITY with NEUTRALIZATION.

SPECIFICITY = do the antibodies ever bind into antibody/antigen complexes in the ABSENCE of the whole antigen under consideration??

NEUTRALIZATION = do the antibodies effectively neutralize the whole antigen under consideration??

Again, these are COMPLETELY different issues and only a true dimwit like you would confuse the two issues.

Chris said,

“74% were using condoms consistently. 14.5% abstained totally. This leaves about 11.5% who were not using condoms consistently. This doesn’t mean as you appear to conclude that they were not using condoms at all. Where are you getting your estimates of the number of sex acts from?”

Where would YOU get the number from, Chris? Any number YOU come up with is going to be a similar kind of gorilla math like I did above, because PADIAN DOESN’T GIVE SUFFICIENT INFORMATION TO RELIABLY ESTIMATE SUCH A NUMBER. Thank you for proving my point, that the data in the prospective section is so damnable, they had to say virtually nil about it.

“No transmission occurred among the 25 percent of couples who did not use condoms consistently at their last follow-up nor among the 47 couples who intermittently practiced unsafe sex during the entire duration of the follow-up.”

The 11.5% who weren’t using condoms consistently is at the END. A QUARTER of the couples practiced unsafe sex at some point. While you are correct, this doesn’t mean they were never using condoms, neither is the other way around true, that those who said they practiced “consistent condom use” ALWAYS used condoms. If you think everyone who preaches or reports to use condoms “consistently” ALWAYS uses them, I guess you haven’t gotten laid very often, Chris.

I’ll repeat my point above — the numbers are SO off by orders of magnitude that it doesn’t matter. Let’s say just 10% of the sex acts were unprotected. This corresponds to the case when the badly-behaved “inconsistent condom use” crowd was still about 60% (SIXTY PERCENT) of the time using condoms and only 40% of the time not. (40% of 25% is 10%.) That still means the probability of observing zero seroconversions would be about

(1/e) ^ (2400/1000) = 1/(e ^ 2.4) = about 9%.

Say only 5% were unprotected (only 1200 acts of unprotected ****ing in 3000 couple-months!!). This corresponds to the case when the badly-behaved “inconsistent condom use” crowd was still about 80% (EIGHTY PERCENT) of the time using condoms and only 20% of the time not. (20% of 25% is 5%.) Then we get

(1/e) ^ (1200/1000) = 1/(e ^ 1.2) = about 33%.

Say only 1% (only 240 acts of unprotected ****ing in 3000 couple-months!!) were unprotected. This corresponds to the ABSURD case when the badly-behaved “inconsistent condom use” crowd was still about 96% (NINETY-SIX PERCENT) of the time using condoms and only 4% of the time not. (4% of 25% is 1%.) Still we get only

(1/e) ^ (240/1000) = 1/(e ^ .24) = about 78%.

In order to approach even a 95% probability of observing zero seroconversions requires about a miniscule .2% rate of unprotection, corresponding to an absurd value of only about 50 acts of unprotected ****ing in 3000 couple-months!!

In other words, they only forget to bring the Trojans along once every 5 years or so.

Like I said, if you believe that number as even remotely plausible, you must still be some kind of 50-year-old virgin or something.

And I’m really disappointed Chris. You didn’t trot out your usual “but Darin, infectivity is highest during times when viral load is highest!!!” bullshit you normally resort to when pinned to the ground. If you HAD, this would have been my taut reply:

Okay, let’s assume you are correct Chris, about viral load increasing transmission rate. Here’s what some papers have to say:

“In multivariate analyses of log-transformed HIV-1 RNA levels, each log increment in the viral load was associated with a rate ratio of 2.45 for seroconversion” Viral load and heterosexual transmission of human immunodeficiency virus type 1. Rakai Project Study Group, N Engl J Med. 2000 Mar 30;342(13):921-9.

“The overall transmission rate per 1000 coital acts was 1.36. Transmission rates increased significantly from 0.09/1000 acts at >3,500 copies/ml (RR = 1), to 1.53/1000 acts at 3,500-9,999 copies (RR = 17.0), 1.94/1000 acts at 10,000-49,999 copies (RR = 21.6) and 2.98/1,000 acts at 50,000 copies/ml or above (RR = 33.1).”, Serum Viral Load and the Rate of HIV-1 Transmission per Act of Heterosexual Intercourse in HIV Discordant Couples, Rakai, Uganda, Wawer MJ, Gray RH, Sewankambo NK, Serwadda D, Quinn TC, Lutalo T, Wabwire-Mangen F, Li C. Int Conf AIDS. 2000 Jul 9-14; 13: abstract no. TuOrC422.

Moreover, it is clear, say from Figure 3 of Variation in HIV-1 set-point viral load: Epidemiological analysis and an evolutionary hypothesis, Proc Natl Acad Sci U S A. 2007 October 30; 104(44): 17441-17446, about as “up-to-date” a publication as you will find, that the factor of increased transmission rate is no more than about 30 over the varying viral loads.

So let’s give you the benefit of the doubt, Chris and assume transmission really is 30 times more likely during these increased viral load times. How often does this time period occur?

“Although Dr Pinkerton noted that patients with primary HIV infection have exceptionally high viral loads, the period for which they are highly infectious is relatively short, typically no more than 49 days.”, Michael Carter, Monday, August 20, 2007 aidsmap news.

Assuming a median time to “progression to AIDS” (whatever THAT means) of about 10 years, let’s even assume that this “acute infectious period” constitutes 2% of all possible HIV-transmissable sexual acts and then consider a hypothetical 1,000,000 sexual acts:

20,000: acute infectious period; rate ~30 times “normal” rate
980,000: “normal” rate

Taking the hallowed Rakai Project Study at face value, they still noted the OVERALL transmission rate to be about 1.36 in 1,000:

“The overall transmission rate per 1000 coital acts was 1.36.”, Serum Viral Load and the Rate of HIV-1 Transmission per Act of Heterosexual Intercourse in HIV Discordant Couples, Rakai, Uganda, Wawer MJ, Gray RH, Sewankambo NK, Serwadda D, Quinn TC, Lutalo T, Wabwire-Mangen F, Li C. Int Conf AIDS. 2000 Jul 9-14; 13: abstract no. TuOrC422.

Now, if the OVERALL transmission rate is about 1.36 in 1,000, then one would expect about 1,360 transmissions to occur over our hypothetical 1,000,000 sexual acts. How many of these would occur during the “acute infectious period”?? Since 30 times 1/1000 equals about 1/33, it follows we should expect about 600 transmissions during this “high viral load” time of infectiousness. But we still should expect about 1,300 transmissions TOTAL. So, there’s still another 700 transmission that must occur during the 990,000 acts of “normal” ordinary viral load time.

Note that in this estimation, 600/1,300 = about 46% of all “transmissions” are occurring in the “high viral load time”, yet according to the Pinkerton study,

“Approximately 2760 (8.6%) of the estimated 32,000 sexually-acquired HIV infections in the USA each year are due to acute-phase transmission of the virus.”, How many sexually-acquired HIV infections in the USA are due to acute-phase HIV transmission?, AIDS. 21(12):1625-1629, July 31, 2007, Pinkerton, SD.

Come again???

In other words, my estimate is really really (REALLY!) giving you the benefit of the doubt. Far less than 46% of all “transmissions” occur during high viral load, so in fact my estimate OVER-estimates the number occurring during “high viral load” time.

The upshot is that the “normal” transmission rate must still be about equal to our ordinary, unchanging, unchangeable rate of about 1 in 1000. Even using my gorilla math above, with 46% of transmission occurring during “high viral load” times, still the “normal” rate is only about .7 per 1000 acts. And in fact it must be much MORE, according to Pinkerton!! And the probability that Padian would observe zero seroconversions is still virtually nil. And you still don’t have any good answers to Padian.

But since you DIDN’T resort to your desperation argument about viral loads and infectivity, I’ll assume you already registered my argument independently and arrived at the conclusion that advancing such an argument was futile from the beginning.

Damn, this is just too much FUN.

darin
#61 dk
December 18, 2007

Oh here he comes, I seems that darin is no longer affiliated with any university, ie john moore’s battle against denilaism is working…….. is this correct Mr brown?since you have so much free time now, maybe you can hang out with cooler and margulis the fraud and talk about bush planting explosives in the towers………….or you can talk about Shyh ching lo, another fraud, and his Weaponized mycoplamsas! Or the biggest frauds of them all,Duesberg, mullis, gilbert etc…..who just got insanely jealous of the successed of superior scientists like gallo and baltimore……….

the deniers are dwindling, thats what happens when you trumpet psuedoscience in the face of overwhelming evidence, what makes you tick brown, im trying to understand where you people are coming from, the case for hiv causing aids was settled in the early 80′s in the peer reviewed literature, we dont need frauds like brown spreading debunked lunacy.
#62 Dale
December 18, 2007

And you still don’t have any good answers to Padian.

Well, no, darin… YOU don’t have any good answers to Padian. Or to the literature that her paper is a part of. But if you’re looking for some, I’d suggest you start with the retrospective portion of her study. And then you may move on to some of the sexual contact tracing reports and the phylogenetic analysis of viral RNA sequences.
#63 jen_m
December 18, 2007

Again, why are you moving this discussion of transmission modeling into this thread?

Mr. Natural, I’ll tackle your questions, because I remember 1988-1991 pretty clearly. Those were my undergrad years. (The first set, anyway.)

“Even as late as 1992, it was STILL FIRMLY ESTABLISHED in the lay mind that an unstoppable AIDS virus was going around in the gay community. Why would ordinary people believe that “science” was not telling them to be very afraid with the fantastic projections of future deaths during that period? It was billed as an unprecedented risk. So why should officials concerned with the public safety believe it to be less than past contagions? Remember, the promised vaccine was by 1988. So Huckabee’s ignorant because researchers had demonstrated their failure to comprehend the problem by 1992?”

I don’t know about in the gay community, but when I was in college in the late 80s and early 90s, we had these little educational groups that came around and showed us how to use condoms (remember the Mentor condom system, anyone? It actually glued on to the penis. I can’t imagine why it’s not with us anymore.) But at the groups I attended, I didn’t hear questions about household contact, or about airborne disease. Those were pretty ordinary, horny college students, but they weren’t completely unaware of the world around them. It wasn’t billed as unprecedented risk. It certainly didn’t stop my friends and me from screwing around like we’d invented it. And there were rumors – unfounded, probably – that someone on campus did have the virus, so it wasn’t as if we didn’t think we’d encounter it.

The Ryan White CARE Act was enacted by Congress in 1990, two years before Huckabee ran for office – by that point, most of the real stupidity had been eradicated from the mainstream by the publicity of the Ryan White case. For pity’s sake, the Act’s authors included Utah Republican Orrin Hatch, a pretty right-wing, homophobic kind of guy. If Orrin could get a grip on his phobias, whether of germs or gays, long enough for compassion to rule, then it’s reasonable to expect Huckabee to have done the same then and now.

Whether it’s bigotry against gay people or a deeply ignorant fear of all germs, he doesn’t belong in the Oval Office if he can’t reason past his fear.

I really don’t know what Gallo’s saliva has to do with anything. The little educational groups (of lay college students themselves) were pretty emphatic that you were taking risks with unprotected oral sex, but that deep kissing was fine as long as you didn’t brush your teeth right beforehand. (Really, we used the term “deep kissing”. I remember this like it was yesterday, even though it was nearly 20 years ago. It was all so very awkward.) Trust me, there was no dearth of necking at school, either.

I also don’t understand what 1984 has to do with this, at all. If Huckabee had said that stuff in 1984, I would be a lot more sympathetic, but I would also be surprised, because at that point it was still being called “gay cancer” in the lay press, or at least the kind of press I was exposed to as a middle-schooler, and it was not getting a lot of media attention as a problem for anyone but gay men in major metropolitan areas.
#64 ElkMountainMan
December 18, 2007

I’d suggest you start with the retrospective portion of her study.

…An excellent suggestion, Dale. In his rush to use his calculator for a “FUN” round of amateur mathematics, Darin missed several key points.

First, in Padian’s study, a fifth of the female partners of HIV+ positive males contracted the virus from their partners; the 1997 report follows only those who had not been infected by the start of the prospective study.

Second, the positive partner in each of the 175 couples covered by the 1997 report (out of 442 initially) was beyond the acute phase of infection by the time of enrollment in the prospective study. The optimal window for transmission had passed.

Third, at least some of the remaining negative partners at the start the prospective study had presumably been exposed repeatedly to HIV but had not been infected productively. Numerous reports suggest that some people are at high risk for infection and seem to have been exposed many times without becoming infected. It is likely that at least some of the remaining negative partners are relatively resistant to infection. Darin fails to model this possibility in his simplistic equations.

Fourth, Darin’s assertion that “consistent” condom use means less than what it implies is empty talk without any support. If participants were lying or the “consistent” group was really quite “inconsistent,” the burden of proof is on Darin.

Darin’s comments would be an embarassment to any professional mathematician who had even a journalist’s knowledge of HIV, but I commend him for his effort. Even with his naive, invalid assumptions and grade school calculations, he has at least raised the level of debate from Truthseeker’s “I know you are but what am I?” tenor.
#65 Molecular Entry Claw
December 19, 2007

Third, at least some of the remaining negative partners at the start the prospective study had presumably been exposed repeatedly to HIV but had not been infected productively. Numerous reports suggest that some people are at high risk for infection and seem to have been exposed many times without becoming infected. It is likely that at least some of the remaining negative partners are relatively resistant to infection. Darin fails to model this possibility in his simplistic equations.

And just how Sir Elkie, would you popose to model this mysterious resistance to infection? By race? Age? Social status?.

But, Sir Elkie, YOU are an embarassment to the Shill Chapter of the Latter Day HIV Church for not keeping up with current events: It’s the fibres stupid!
No not viral load but fibres in semen is the most imortant variable to factor in when talking about HIV transmission:

“Semen boosts HIV transmission:

Fibres may be more important than viral load in determining transmission rates.

A component found in semen can enhance HIV transmission by as much as 100,000-fold, researchers have found”

http://www.nature.com/news/2007/071212/full/news.2007.373.html

Eternal shame on you, Sir Elkie, for not modelling those scientifically sexy fibres into your simplistic and amateurish attempt at rebutting Darin’s maths.

Fourth, Darin’s assertion that “consistent” condom use means less than what it implies is empty talk without any support. If participants were lying or the “consistent” group was really quite “inconsistent,” the burden of proof is on Darin.

Nonono, Sir Elkie, the authors of the study, those who actually use the word “consistent”, must tell us what they mean. If not, those of us who are not virgins have to apply our own experience regarding the occassional
“slip” and escape of bodily fluids during years of “consistent” condom use. Or perhaps we could just look for clues in the classic HIV/AIDS literature – like this study, one among several which appear to show that
“consistent” condom use increases the risk of HIV transmission:

Nelson, K.E., Celentano, D.D., Suprasert, S., Wright, N., Eiumtrakul, S. et al. 1993 Risk Factors for HIV Infection Among Young Adult Men in Northern Thailand. Journal of the American Medical Association. 270, 955-960.:

“increased condom use was associated with an increased risk for HIV-1″, “indeed, those who reported ever having used a condom with a CSW had a higher HIV prevalence”.

Fourth, Darin’s assertion that “consistent” condom use means less than what it implies is empty talk without any support. If participants were lying or the “consistent” group was really quite “inconsistent,” the burden of proof is on Darin.

Darin’s comments would be an embarassment to any professional mathematician who had even a journalist’s knowledge of HIV, but I commend him for his effort. Even with his naive, invalid assumptions and grade school calculations, he has at least raised the level of debate from Truthseeker’s “I know you are but what am I?” tenor.
#66 MEC
December 19, 2007

Seems I mangaed to cut and paste Sir Elkie twice – or is it those Xmas imps again? Kindly disregard the last two paragraphs in the post above.
#67 Rachel
December 19, 2007

In addition to what jen_m said (and on the original topic), a 1986 Surgeon General’s Report on Acquired Immune Deficiency Syndrome stated that “AIDS is not spread by common everyday contact” and “Quarantine has no role in the management of AIDS because AIDS is not spread by casual contact.”

http://profiles.nlm.nih.gov/NN/B/B/V/N/_/nnbbvn.pdf
#68 Chris Noble
December 19, 2007

Damn, this is just too much FUN.

Go ahead rant. It will make you feel better.

“The” Padian study helpfully refers you to a previous study for more details about the prospective part of the study.

Prevention of heterosexual transmission of human immunodeficiency virus through couple counseling.

Table 2 shows details about the number of couples who reported practising abstinence and safe sex (using condoms all of the time) at each follow up.

At the first follow up 24 out of the remaining 144 (17%) reported abstinence. Of the 120 who were not abstinent 105 (88%) reported using condoms all of the time. This only leaves 15 couples who reported some unsafe sex for this six month period.

At the next follow up only 6 couples reported some unsafe sex in the previous six month period

At the third follow up no couples reported any unsafe sex in the previous six months.

Contrast this with Mr Hanky’s free interpretation of the study.

NOT ONE SINGLE PERSON (175 discordant couples), after unlimited, abundant, (dare I even say wild and kinky?) sexual acts over 10 years contracts HIV. Not one.

The only thing that you and Mr Hanky have demonstrated in your “critiques” of the Padian paper is your ability and desire to delude yourself.

In the previous study on “the” Padian paper you were given a paper that found a transmission risk of 8.9/10000 for couples discordant for HSV2.

Your single objection to this paper was that the couples were encouraged to modify their behaviour to prevent the transmission.

For some reason you could not bring yourself to apply the same reasoning to “the” Padian paper.
#69 ElkMountainMan
December 20, 2007

Ah, ma MEC a moi,

You complain that Dr. Padian and colleagues need to give their definitions. They did. The study’s authors define “inconsistent condom use” as less than 100%. Strike one.

Or perhaps we could just look for clues in the classic HIV/AIDS literature, you continue. Unfortunately, cutting and pasting from virusmyth doesn’t count as reading the literature. Copying two phrases from a denialist website, phrases taken out of context from a six-page paper, is no substitute for critical thinking. This all-too-typical denialist approach to literature review is just a game of broken telephone…with the class prankster at the start of the line and VERY high stakes for the downstream players. Strike two.

Only by completely ignoring Kenrad Nelson and co-authors (“Risk Factors for HIV Infection Amoung Young Adult Men in Northern Thailand,” JAMA 270 (8), 1993) could you draw the bizarre conclusion that their data show that
“consistent” condom use increases the risk of HIV transmission. Strike three. You’re out, MEC, but I’m not done yet.

Since you haven’t read the paper, here is a summary. The authors study 2,417 young military conscripts in Thailand, almost a thousand of whom have visited a sex worker at least once. Information on the habits and health of the conscripts is recorded and analyzed.

The data indicate that condom use decreases risk of HIV infection. Conscripts who visit sex workers and never or only sometimes provide their own condoms (relying on the brothel to provide them or not using them at all) have a higher odds ratio than those who claim to take their own condoms to every visit.

At the same time, those who report EVER using a condom with a sex worker DO have a slightly higher odds ratio than those who say they NEVER used a condom with a sex worker. A contradiction? Not really, or only to those who read virusmyth’s distortions and nothing else.

Virusmyth’s cherry-picked quote, “Indeed, those who reported ever having used a condom with a CSW had a higher HIV prevalence” is followed by the explanation:

The increased risk of HIV infectious associated with ever having used a condom was confounded by the frequency of sex with a CSW in the recent past when the risk of HIV infection was highest.

In other words, conscripts who had more visits with sex workers and more recent visits with sex workers (i.e. were at higher risk) were more likely to have used a condom at least once than the colleague-cajoled conscripts, fresh-faced momma’s boys who had gone along to the brothel once or twice for a clumsy coupling.

In the “Comment” section, Nelson et al explore the condom issue again:

We attempted to ascertain information on how frequently condoms broke or slipped off during sexual intercourse. Such problems were reported by some men, mostly from the group who also reported frequent brothel attendance in the past year. Indeed, the reported use of condoms was confounded by the frequency of sex with a CSW, especially in Chiang Mai [high-prevalence area, EMM], in the past year. (my emphasis)

In other words, the more frequently, recently, and in high-prevalence areas a man visited a sex worker, the more likely he was to have used a condom at least once, to have had a condom failure, and to have become infected.

There are many interesting facts in this paper. I wish I could post the whole thing: the first diagnosed AIDS case in Thailand indicates the virus arrived via Europe; the virus spread almost entirely by heterosexual sex, at least in this cohort (having sex with a female was the highest-risk behavior in this study, followed by high number of lifetime partners and visits to CSW); this steadily climbing seroprevalence was documented, putting the lie to Duesberg’s cherry-picked flat-line “we get it from our mothers” claim.

But I can only invite you to read it. MEC, I think you might actually find the paper interesting and instructive, even on a personal level. From what I hear, HIV may have been introduced into Thailand by a European, but the rampant European participation in sex tourism there is now ensuring some viral genetic flow in the other direction. Or, as the distinguished social commentator J. Timberlake observed, “What goes around comes around…”
#70 Molecular Entry Claw
December 20, 2007

Dearest Sir Elkie (or is this simply Adele in a spell checked version?),

You complain that Dr. Padian and colleagues need to give their definitions. They did. The study’s authors define “inconsistent condom use” as less than 100%. Strike one.

First miss: inability to read the simplest prose. I asked for the definition of “consistent” not “inconsistent”. Simply saying that inconsistent condom use is less than 100% really doesn’t tell us much, so again does consistent mean 100% use per default or what?
You have already demonstrated the point of this question, since you can always be relied on to go for the gambit hook, line and sinker(are you sure you’re not Adele?) What So what I was expecting from Padian was something like this from Nelson:

We attempted to ascertain information on how frequently condoms broke or slipped off during sexual intercourse
etc. etc.

Did Padian made such an attempt, or did she just assume like you that consistent 100%?

Second and third miss: Bluster. Zero argument. (Just as well you weren’t done yet eh?)

Virusmyth’s cherry-picked quote, “Indeed, those who reported ever having used a condom with a CSW had a higher HIV prevalence” is followed by the explanation:

Sir Elkie, the cherry-picked quote was this: “increased condom use was associated with an increased risk for HIV-1″

The increased risk of HIV infectious associated with ever having used a condom was confounded by the frequency of sex with a CSW in the recent past when the risk of HIV infection was highest.

In other words, conscripts who had more visits with sex workers and more recent visits with sex workers

Ah, Sir Elkie, I see. To explain the numbers we have to model in the day to day increase of HIV prevalence in Thailand. Nice one.

But then why didn’t you think to model the fluctuations in viral load, thrush, the size of the male member, etc. at the time of intercourse in Padian’s subjects – not to mention those all-important fibres in semen? Why didn’t you model infidelity? Or were all couples guaranteed consistently monogamous over a period of 10 years?

We attempted to ascertain information on how frequently condoms broke or slipped off during sexual intercourse. Such problems were reported by some men, mostly from the group who also reported frequent brothel attendance in the past year

I am enlightened. Not only had HIV prevalence risen significantly in the past year, but the quality of the condoms had also fallen accounting for more mishaps. Now I know you are Adele.

There are many interesting facts in this paper. I wish I could post the whole thing: the first diagnosed AIDS case in Thailand indicates the virus arrived via Europe; (having sex with a female was the highest-risk behavior in this study, followed by high number of lifetime partners and visits to CSW); this steadily climbing seroprevalence was documented, putting the lie to Duesberg’s cherry-picked flat-line “we get it from our mothers” claim.

O please go on, post the whole thing and teach me a little bit about Thailand Sir Elkie. I especially like the part about how having sex with a female was the highest-risk behaviour, and how male on male sex and IV drugs don’t even figure on your list. Perhaps you have some words of wisdom about the Thai E-strain of HIV and pussies with teeth?

There was a an explosive climb in testing in Thailand around 1990, and therefore not surprisingly a corresponding explosive climb in people testing positive around the time when these studies were made.
#71 ElkMountainMan
December 22, 2007

MEC,

The estimated prevalence of HIV does not automatically increase as a result of increased testing and higher numbers of known positives. Larger sample size merely provides a better basis for more accurate estimates of prevalence. An “explosive climb in people testing positive” due to “an explosive climb in testing” could produce a lower, an unchanged, or an elevated estimate of national or regional prevalence. In Thailand, as in most countries, the data have consistently supported a steady increase in prevalence.

As for your other objections, each derives from your failure to read the Nelson paper and your insistence on misreading my comments on it. As such, there is little reason for me to address them.

Do, please, accept my congratulations, though. You, MEC, have earned the coveted Impervious to Evidence Badge, Order of Duesberg.
#72 Molecular Entry Claw
December 22, 2007

Sir Elkie, i can’t tell you how disappointed I am to see you don’t want to teach me a little about Thailand and its peculiar HIV/AIDS “epidemic”. I was expecting so much after these deep factual and moral profundities from you:

From what I hear, HIV may have been introduced into Thailand by a European, but the rampant European participation in sex tourism there is now ensuring some viral genetic flow in the other direction. Or, as the distinguished social commentator J. Timberlake observed, “What goes around comes around…”

Allow me to teach you something then. Sex tourism, including Vietnam era R&R has been big and on the rise in Thailand from before HIV hit America and the rest of the world. Yet the “explosion” was for some reason delayed until a decisive change in Thai attitude and politics around 1989, which included widespread HIV testing, especially among the “risk groups”.- And yes, coming from the North of Thailand (you ARE aware that Chiang Mai lies to the North aren’t you?) is one of the biggest risks in itself. Thus the biggest risk area geographically was the one furthest away from the sex tourist centres to the South.

You were so kind as to inform us that the Thai epidemic, like the African, is heterosexual. Here is a little something about that from Dr. Christian Fiala, who has actually spent considerable time in Thailand. Also notice what he says about the North relative to Bangkok:

“It is widely believed that HIV spreads mainly by heterosexual means. It is also widely believed that the high prevalence of STDs facilitates the transmission of HIV. It is therefore interesting to analyse some data from a country with a well documented high prevalence of STDs like Thailand:

- Prevalence of HIV among STD patients

The prevalence of STDs has been very high since decades. Nevertheless the HIV-epidemic is said to have started only around 1990, many years after its introduction into Thailand and 10 years later than in the US. It is difficult to understand why HIV should have started to spread heterosexually only when STD rates where on a sharp decline.

- Geographical distribution of STDs and HIV/AIDS

The highest prevalence of STDs is generally found in great cities. This is also true in Thailand, with Bangkok on the lead compared to other regions in the country. Nevertheless there is no correlation to the HIV-prevalence and the number of AIDS-cases. Both of them are highest in the North also known as part of the Golden Triangle and one of the biggest opium producers in the world. But STD prevalence is second lowest in this region. And even if one looks into more detail at the provinces of the North Region one is confronted by the fact that there is absolutely no correlation between STDs and AIDS. With Payo Province having the highest STD-prevalence and the lowest number of cumulative AIDS-cases in the North or on the other hand Lamphun Province with the highest number of cumulative AIDS cases and a STD-prevalence below average.

Again whatever might be the cause of HIV-positive tests in Thailand it can not be heterosexually transmitted like the other STDs.

Chitwarakorn A. et al, Sexually Transmitted Diseases in Asia and the Pacific, 1998,

Ministry of Public Health, AIDS Division, HIV/AIDS Situation in Thailand October 31, 1998 Office of Communicable Disease Control Region 10, Chiang Mai, Thailand”.

Please don’t hesitate to ask if there’s something that’s still not clear to you about the Thai “HIV epidemic” and how they do things in Thailand, Sir Elkie.
#73 video share
December 22, 2007

“Except Dr Frank, It’s not a conspriacy. It’s Business as usual. Assumptions based on massive assumpions, grandious statements and flawed logic. Just look at the contradictory evidence.”
that somehow despite this massive incompetence life expectancies keep going up.
#74 vidrom.com
December 22, 2007

Seems I mangaed to cut and paste Sir Elkie twice – or is it those Xmas imps again? Kindly disregard the last two paragraphs in the post above.
#75 cooler
December 22, 2007

Google “elkmountainman” man if you want a real laugh………..there is a man who uses this name whos on every single dating site imaginable……………….youre arguing with a madman

Almost as pathetic as the blogowner Tara. Ive repeatedly shown her peer reviewed studies that mycoplamsa incognitus/penetrans induces death and disease in every animal inoculated, it was not a contaminent for Lo saw it in the tissues by EM,didnt find it one healthy control, antibody testing is unreliable, for the animals that died had a weak antibody response when near death. Researchers at the university of Alabama confirmed it was a pathenogenic strain when they inoculated mice with it and found it to be very invasive vs. the ordinary strain of MF.

Dr. Nicolson is finding it by PCR in appx 50% of CFS/fibromyaligia pateints etc, she, being the hack that she is has not shown the slightest interest, helping murder and torture the lives of young people because shes a fauci/ CDC sycophant.

But good old Tara will talk about “chocolate and the gut” and other bullcrap, but not the only microbe that induces death and disease in every animal inoculated, kochs postulates turned upside down. thanks Tara for helping destroy the lives of hundereds of thousands of people with this microbe that can masquerade as many different illnesses, by not raising more awareness about this infection at the campus you work at, or at least writing a blog about it you are what you call others, a true “denilaist” who’s killing and torturing young people with your scientific negligence.

Project day lily google it. Part of the bioweapons program.
#76 cooler
December 22, 2007

great looks like whoever was on those dating sites using the name “elkmountainman” dissapeared of google, I swear I saw it a few weeks ago. Wonder if Tara will respond to my accusation of her being a scientifically negligent sanctimonious moron…………
#77 ElkMountainMan
December 23, 2007

MEC,

You may be surprised to learn that the presence of termites is a prerequisite for termite infestation.

Let us suppose that in 1985, Dr. Peter Duesberg introduced some termites onto an island previously devoid of any such pests. The termites spread and began destroying property, prompting the government to monitor their spread and the risk factors for infestation. It is found that wetter, lower-lying areas are at higher risk for infestation. In fact, a house built high and dry seems to be at lower risk of infestation than a house built in a wetter, more humid area, even though a greater percentage of the latter houses are built with some physical termite barriers.

Unencumbered by knowledge, you, MEC, misinterpret this study and tell us that the termite barriers actually raise the risk of termite infestation, while Dr. Christian Fiala protests that, in 1990, weather conditions on the island were not as favorable for the spread of termites as they had been in 1980. How, then, could termites have prevailed in 1990 when they were so demonstrably absent in 1980? Furthermore, you suggest, the termites do not exist; what we observe as “termites” has always been present on the island. The apparent increase in prevalence is due only to increased “termite” testing.

Our world is replete with examples of logical fallacy, MEC; there is little need for you to furnish more. Why not edify us instead with tales of Thai kings, recipes for your favourite Thai dishes, or lectures about Thai geography? Stick with what you know, in other words.
#78 Tara C. Smith
December 23, 2007

cooler, project day lily isn’t exactly peer-reviewed research.
#79 cooler
December 23, 2007

ummmmm no, im talking about shyh ching lo’s md phd reasearch, peer reviewed, the military’s most decorated infectious disease pathologist who inoculated chicken embryos, chimpanzees, primates, and mice with mycoplasma incognitus/penetrans in peer reviewed papers and patents, and they all sickened and died…. Ive posted them several times….garth nicolson later published in peer review journals finding it by PCR in many cfs/fibro/als cases…………..nice try to change the subject, heres a good primer for you, Lo’s chapter on mycoplasmas in an academic book clearly showing pathengenicity in humans and animals………..
http://books.google.com/books?id=G3rURFq6u84C&pg=PA525&lpg=PA525&dq=mycoplasmas+shyh+ching+lo&source=web&ots=6qLbUOPYbf&sig=U3CTEnCCOvGv2cxbWW4pqo6qQBU

Its pretty solid stuff, when are you going to do a blog on the only microbe that kills every animal inoculated………..? or are you going to continue your close mindedness and cost people their lives?
#80 cooler
December 23, 2007

“The meeting was led by Dr. Joel B. Baseman, a mycoplasma expert at the University of Texas Health Sciences Center at San Antonio. He said the participants were ”very impressed with the quality of science that Dr. Lo’s group displayed.”

”The pathology data was solid and convinced us that the agent is in the tissues,” Dr. Baseman said. The ability of M. incognitus to cause a fatal wasting disease in monkeys and mice persuaded most participants that the microbe ”has the potential to cause disease in humans,” Dr. Baseman said New york times 1990

Basemans summary of Lo’s research………is he a woo to Dr smith?

Dr. Nicolsons research on mycoplamsas and chronic illnesses

Biomedical Therapy 1998; 16: 266-271.

Diagnosis and Treatment of Chronic Mycoplasmal Infections in Fibromyalgia and Chronic Fatigue
Syndromes: Relationship to Gulf War Illness

Garth L. Nicolson, Marwan Nasralla, Joerg Haier and Nancy L. Nicolson

The Institute for Molecular Medicine, 16371 Gothard St. H
Huntington Beach, CA 92679

Summary

Mycoplasmal infections are associated with several acute and chronic illnesses, including Pneumonia, Asthma, Rheumatoid Arthritis, Immunosuppression Diseases such as AIDS, Genitourinary Infections and Gulf War Illness (GWI). Using forensic Polymerase Chain Reaction blood samples from 132 Chronic Fatigue Syndrome (CFS) (Myalgic Encephalomyelitis ) and/or Fibromyalgia Syndrome (FMS) patients were investigated for the presence of mycoplasmal infections in blood leukocytes. CFS and FMS patients had completely overlapping signs and symptoms and were grouped for purposes of analysis. There was a significant difference between symptomatic CFS/FMS patients with positive mycoplasmal infections (~63%) and healthy positive controls (~9%) (P<0.001). We also examined the incidence of Mycoplasma fermentans infections in these CFS/FMS patients (~50%) and controls (0%)(P<0.001). The prevalence of mycoplasmal infections in female and male symptomatic patients was similar. Similar to GWI patients with mycoplasmal infections (~50%) and with similar signs and symptoms, mycoplasma-positive CFS/FMS patients respond to 6-week cycles of particular antibiotics: doxycycline, minocycline, ciprofloxacin, azithromycin and clarithromycin. Multiple cycles of these antibiotics plus nutritional support appear to be necessary for recovery.

Im waiting for you to be a responsible scientist and raise more awareness about this infection……………
#81 cooler
December 23, 2007

great right when I provide even more peer reviewed research showing Lo’s animal inoculations/ nicolsons finding it in appx 50% of CFS patients the filter screws me over
#82 Molecular Entry Claw
December 23, 2007

Sir Elkie,

Your resort to cloaking your pathetic white flag waving in poor analogies about termites, suggesting among other things that “termite” testing, extensive enough to show that the bugs didn’t exist then, was carried out in Thailand in 1980 – years before the tests were even invented – tells me that it would be wise for you to return to your dating websites where you are no doubt more expert.

Christian Fiala’s argument is very, very easy to grasp, if one doesn’t confuse oneself more than one already is, by trying to conceal one’s lack of argument in analogy:

Decreasing incidence of all other STDs, explosive increase in mainly heterosexually transmitted HIV.

Let me repeat that for you:

Decreasing incidence of all other STDs, explosive increase in mainly heterosexually transmitted HIV – Does not compute

Maybe that is why your analogy gets all twisted around and turned upside down in your slippery hands:

while Dr. Christian Fiala protests that, in 1990, weather conditions on the island were not as favorable for the spread of termites as they had been in 1980

To the contrary Sir Elkie, the “weather” was obviously very favourable for “termites” (HIV) around 1990, only thing is “termites” apparently thrive best in conditions not relished by all other STDs. How can that be, Sir Elkie? Did you not just proclaim from your scientific lectern on high that HIV in Thailand was transmitted mainly in the same way as all other STDs?

Well, if by “weather” you mean “political climate”, the conundrum should become transparent even to you. Around 1989, the Thai government started encouraging the testing, finding and reporting of positives among high-risk groups (people who were already stigmatized and so didn’t cause the nation too much loss of “face”.) There was furthermore a convergence of interest between the global AIDS machine and Thai and international moral sentiment, which allowed them to arbitrarily attribute the “epidemic” to female prostitute to male customer transmission, with understanding that the Thai prostitutes in North furthest away from the sex tourist centres to the South had acquired
the “termites” from those sex tourists a thousand miles away.

I’m sure this all makes perfect sense to you, Sir Elkie, nevertheless may I kindly advice you to get Chris Noble, your undisputed fact twister champion and, quite frankly, in a different league from you and Adele, to take over for you, because your already soggy bottom just keeps sliding down that muddy bank.
#83 cooler
December 23, 2007

…………. We also examined the incidence of Mycoplasma fermentans infections in these CFS/FMS patients (~50%) and controls (0%)(P<0.001). The prevalence of mycoplasmal infections in female and male symptomatic patients was similar. Similar to GWI patients with mycoplasmal infections (~50%) and with similar signs and symptoms, mycoplasma-positive CFS/FMS patients respond to 6-week cycles of particular antibiotics: doxycycline, minocycline, ciprofloxacin, azithromycin and clarithromycin. Multiple cycles of these antibiotics plus nutritional support appear to be necessary for recovery

continuation of Nicolsons peer reviewed work posted above
#84 cooler
December 23, 2007

Mec,
you should read the first page of the book link I posted, Shyh ching Lo’s demolishes the hiv hypothesis in the first page, he and the entire armed forces of pathology, some of the most gifted scientists in the world, publicly supported duesberg in the early 90′s.
#85 MEC
December 23, 2007

Cooler,

Done. Everybody who is not a shill recognizes that Duesberg was one of the first to indentify the central pradoxesin the HIV/AIDS hypothesis even if they don’t agree with all his conclusions.
#86 Sascha
December 23, 2007

“There is then one Lord and Duesberg, and not two or three; one who is, and there is no other besides him, the only true Duesberg. For ‘the Lord Duesberg,’ says Inventing the AIDS Virus, ‘is one Lord. And there is also one Son, God the Duesberg. . . . And there is also one Duesberg”
#87 kozmetik
December 23, 2007

Seems I mangaed to cut and paste Sir Elkie twice – or is it those Xmas imps again? Kindly disregard the last two paragraphs in the post above.
#88 ElkMountainMan
December 24, 2007

MEC,

I agree with you that Chris Noble is quite the rational thinker and an excellent communicator.

As for the rest of your statements and implications, they are again based in misunderstandings. The Nelson et al paper is available. Why will you not read it?
#89 directory
January 9, 2008

indeed that one paper does not prove that HIV causes AIDS. This is part of the reason the “show me the one paper” argument is such a fallacy. It takes a body of evidence to make a statement.
#90 Darin Brown
January 11, 2008

Some IDIOT said:

“Second, the positive partner in each of the 175 couples covered by the 1997 report (out of 442 initially) was beyond the acute phase of infection by the time of enrollment in the prospective study. The optimal window for transmission had passed.”

I REPEAT!!!!

And I’m really disappointed Chris. You didn’t trot out your usual “but Darin, infectivity is highest during times when viral load is highest!!!” bullshit you normally resort to when pinned to the ground. If you HAD, this would have been my taut reply:

Okay, let’s assume you are correct Chris, about viral load increasing transmission rate. Here’s what some papers have to say:

“In multivariate analyses of log-transformed HIV-1 RNA levels, each log increment in the viral load was associated with a rate ratio of 2.45 for seroconversion” Viral load and heterosexual transmission of human immunodeficiency virus type 1. Rakai Project Study Group, N Engl J Med. 2000 Mar 30;342(13):921-9.

“The overall transmission rate per 1000 coital acts was 1.36. Transmission rates increased significantly from 0.09/1000 acts at >3,500 copies/ml (RR = 1), to 1.53/1000 acts at 3,500-9,999 copies (RR = 17.0), 1.94/1000 acts at 10,000-49,999 copies (RR = 21.6) and 2.98/1,000 acts at 50,000 copies/ml or above (RR = 33.1).”, Serum Viral Load and the Rate of HIV-1 Transmission per Act of Heterosexual Intercourse in HIV Discordant Couples, Rakai, Uganda, Wawer MJ, Gray RH, Sewankambo NK, Serwadda D, Quinn TC, Lutalo T, Wabwire-Mangen F, Li C. Int Conf AIDS. 2000 Jul 9-14; 13: abstract no. TuOrC422.

Moreover, it is clear, say from Figure 3 of Variation in HIV-1 set-point viral load: Epidemiological analysis and an evolutionary hypothesis, Proc Natl Acad Sci U S A. 2007 October 30; 104(44): 17441-17446, about as “up-to-date” a publication as you will find, that the factor of increased transmission rate is no more than about 30 over the varying viral loads.

So let’s give you the benefit of the doubt, Chris and assume transmission really is 30 times more likely during these increased viral load times. How often does this time period occur?

“Although Dr Pinkerton noted that patients with primary HIV infection have exceptionally high viral loads, the period for which they are highly infectious is relatively short, typically no more than 49 days.”, Michael Carter, Monday, August 20, 2007 aidsmap news.

Assuming a median time to “progression to AIDS” (whatever THAT means) of about 10 years, let’s even assume that this “acute infectious period” constitutes 2% of all possible HIV-transmissable sexual acts and then consider a hypothetical 1,000,000 sexual acts:

20,000: acute infectious period; rate ~30 times “normal” rate
980,000: “normal” rate

Taking the hallowed Rakai Project Study at face value, they still noted the OVERALL transmission rate to be about 1.36 in 1,000:

“The overall transmission rate per 1000 coital acts was 1.36.”, Serum Viral Load and the Rate of HIV-1 Transmission per Act of Heterosexual Intercourse in HIV Discordant Couples, Rakai, Uganda, Wawer MJ, Gray RH, Sewankambo NK, Serwadda D, Quinn TC, Lutalo T, Wabwire-Mangen F, Li C. Int Conf AIDS. 2000 Jul 9-14; 13: abstract no. TuOrC422.

Now, if the OVERALL transmission rate is about 1.36 in 1,000, then one would expect about 1,360 transmissions to occur over our hypothetical 1,000,000 sexual acts. How many of these would occur during the “acute infectious period”?? Since 30 times 1/1000 equals about 1/33, it follows we should expect about 600 transmissions during this “high viral load” time of infectiousness. But we still should expect about 1,300 transmissions TOTAL. So, there’s still another 700 transmission that must occur during the 990,000 acts of “normal” ordinary viral load time.

Note that in this estimation, 600/1,300 = about 46% of all “transmissions” are occurring in the “high viral load time”, yet according to the Pinkerton study,

“Approximately 2760 (8.6%) of the estimated 32,000 sexually-acquired HIV infections in the USA each year are due to acute-phase transmission of the virus.”, How many sexually-acquired HIV infections in the USA are due to acute-phase HIV transmission?, AIDS. 21(12):1625-1629, July 31, 2007, Pinkerton, SD.

Come again???

In other words, my estimate is really really (REALLY!) giving you the benefit of the doubt. Far less than 46% of all “transmissions” occur during high viral load, so in fact my estimate OVER-estimates the number occurring during “high viral load” time.
#91 Darin Brown
January 11, 2008

“Oh here he comes, I seems that darin is no longer affiliated with any university, ie john moore’s battle against denilaism is working…….. is this correct Mr brown?since you have so much free time now, maybe you can hang out with cooler and margulis the fraud and talk about bush planting explosives in the towers………….or you can talk about Shyh ching lo, another fraud, and his Weaponized mycoplamsas! Or the biggest frauds of them all,Duesberg, mullis, gilbert etc…..who just got insanely jealous of the successed of superior scientists like gallo and baltimore……….

the deniers are dwindling, thats what happens when you trumpet psuedoscience in the face of overwhelming evidence, what makes you tick brown, im trying to understand where you people are coming from, the case for hiv causing aids was settled in the early 80′s in the peer reviewed literature, we dont need frauds like brown spreading debunked lunacy.”

Your pathetic rambling speaks for itself, schmuck.

You got a REAL ****ING NAME to attach to this rhetorical crap-ass GARBAGE???

I got a REAL NAME. I’m out here, with my ASS ON THE LINE. I don’t hide behind pseudonyms or aliases. Say what you want about Chris Noble’s intellectual prowess (or lack thereof), at least he has the COJONES and integrity to put his name out there in the open.

That’s what I thought. You ****ing COWARD. PUNK.

darin
#92 Adele
January 11, 2008

Darin the guy who wrote that stuff about you. It was a guy named Steve B he also goes by cooler, Billy bip bip. He is a even worse writer then me. He doesn’t know what he thinks some times he disagress with Duesberg usually not. HE always says stuff about mycoplasma or mycoplamsa like he says. He always says shyh ching lo not Shyh-Ching Lo Etc.

Awhile ago Steve pretended to be some one else a Orthodox dude or something. That is what you saw. Or it was some guy pretending to be Steve possible I guess but who has so much time. He said alot of mean things about “denailists” , about you to. Who knows why, the guy is mental. May be he thought if he’s mean and he pretends he is Ortodox he can make “Orthodox” people look bad. Don’t worry about him just real orthodox people like me.
#93 jen_m
January 11, 2008

That was signed “dk”, Adele, and since it talked about Dr. Lo’s work as “fraud”, and about Drs. Duesberg, Mullis, and Gilbert as “the biggest frauds of all”, I really doubt it was cooler. Cooler can get himself into plenty of trouble on his own without your volunteering him for more.

I can’t speak for “dk” or anyone else, but I don’t use my full name here because I don’t want to be taken as representing my employers or funders, and because there are a few genuine crazy people who read/post here who may or may not be harmless. (On the other hand, a true obsessive could probably reason out who I am. I also try not to be too obnoxious and hope that keeps my risk down. Not that anyone around here is ever obnoxious.)
#94 carter
January 11, 2008

directory said, “It takes a body of evidence to make a statement.”

Oh, that’s just balarchy! You tards cant even produce a handful proof out of thousands of peices of crap. Pathetic.
#95 cooler
January 11, 2008

umm no I would never say those horrible things to a great man like Darin Brown, someone here is sockpupetting me, someone posted under the name “coulor” and I think it was Adele, and she calls me mental. Jen m, i dont get into any trouble, im a scrict follower of robert Koch, microbes that induce disease in experimental animals or more of a threat than those that dont, you should learn a lot from my posts, sonny.
#96 cooler
January 11, 2008

Someone sockpuppeted me on another blog as well, that dk maniac, also someone sockpuppeted truthseeker here etc, some of you coco birds need help.
#97 Sascha
January 11, 2008

“some of you coco birds need help.”

said the kettle.
#98 Adele
January 11, 2008

Jen M sorry I am obnoxious you might be right but who ever wrote as “dk” was using coolers exact writing style, I’ve been reading cooler’s crap for a year and I recognize it. So it was cooler trying to make scientists look bad or it was a person who knows cooler as good as me and can imitate him. WAsn’t me cooler I can’t do you so good!! I say it was cooler drunk or high.
#99 Chris Noble
January 21, 2008

Darin Brown wrote:Come again???

The Pinkerton estimate of 8.6% is lower than all other estimates.

Even if you choose this estimate over others in the literature then a disproportionate number of infections occur in the acute infection stage. Of the people infected with HIV in the US only about 0.5% are in the acute infection stage. The transmission rate in the acute infection stage is about 25 times higher than that for the chronic infection stage.

You also completely failed to address the points I made regarding the “Padian study”.

Table 2 shows details about the number of couples who reported practising abstinence and safe sex (using condoms all of the time) at each follow up.

At the first follow up 24 out of the remaining 144 (17%) reported abstinence. Of the 120 who were not abstinent 105 (88%) reported using condoms all of the time. This only leaves 15 couples who reported some unsafe sex for this six month period.

At the next follow up only 6 couples reported some unsafe sex in the previous six month period

At the third follow up no couples reported any unsafe sex in the previous six months.
#100 Fleming
January 22, 2008

Why were there no seroconversions in Padian’s prospective study, Chris?
#101 Chris Noble
January 23, 2008

Why were there no seroconversions in Padian’s prospective study, Chris?

Why would you expect to have seen any seroconversions?

Prevention of heterosexual transmission of human immunodeficiency virus through couple counseling.

All of the couples were aware that one of them was HIV+. They were all counselled to change their behaviour to reduce the risk of transmitting HIV to their partners.

As can be seen in the numbers in this paper there was very little unsafe sex between these couples after they had received counselling.

In the first six month period of follow only 15 couples reported any unsafe sex whatsoever. This reduced to 6 and 0 in the following two follow ups.

None of the infected partners were in the acute stage of infection and transmission risk is known to be low in the chronic stage.
#102 MEC
January 23, 2008

transmission risk is known to be low in the chronic stage.

Dr. Noble, I really like the way you use that word “known”: “It is known”. “We now know that…” It make it all sound so right and scientific.

We now know that certain fibres in semen can increase HIV transmission up to 100,000 times. That seems to be far more important than how chronic the infection is. What do you think, Dr. Noble?

http://www.nature.com/news/2007/071213/full/news.2007.373.html;jsessionid=800A2B815B18CA6DB721344E3832489E
#103 ElkMountainMan
January 24, 2008

Many thanks to MEC for bringing this paper to our attention again. MEC has taken an important step in admitting that HIV can be transmitted sexually and can be more infectious in some settings than in others.

I encourage him or her to take another big step and read the article on peptide fibril-enhanced transmission in the 14 December Cell.

(Viral existence denialists may wish to avoid Figure 2 in the Cell paper, as it shows virions attaching to cells.)

The paper does not suggest that fibrils “can increase HIV transmission up to 100,000 times.” The authors don’t report on HIV-1 transmission from human to human, and they find a roughly four-fold enhancement in amount of HIV-1 cDNA over controls when a rat model is exposed to fibrils.

At limiting dilution of virus, the authors report, fibrils can increase the infectious titer of virus as determined in culture by much as 400,000 times. Enhanced infectious titer does not always translate into an effect of similar magnitude on infectability in culture, nor into a similar effect on host-to-host transmission.

Using a variety of primary cells and lines, the authors find that amyloid fibrils (“SEVI”) enhance infectibility in culture. In Figure 4, PBMCs, monocyte-derived macrophages, and dendritic cells or T-cells in co-culture with a cell line show a dose-dependent effect of the fibrils. At the highest doses, the effect (depending on virus) ranges from 4 to 66 times the control levels. In rats, the effect is about 4x.

The more complex the system and the less purified the components, the lower the effect seems to be. I point this out only to remind MEC that a “100,000″ fold effect on transmission is not in evidence. SEVI may be important in transmission, but viral load is also important along with many other factors.

MEC could even begin with the “preview” of the data by Nadia Roan and Warner Greene, who make some good points:

First, Dr. Noble is right. “It is known”–and it is “right and scientific” based on more than one preliminary study–that high viral loads, for example during acute infection, are associated with a much higher chance of transmission. As a result, transmission risk is on average much lower during chronic infection. Dr. Noble does not state or imply that stage of infection is the only determinant of transmission risk.
(Roan and Greene write of frequency increases when viral loads are especially high in the male donor or genital ulcers are present in the female recipient (Gray et al., 2001).)

Second, these findings are exciting and could result in new, more effective prophylaxis. However, they remain a bit preliminary. We can’t yet say, “it is known” that the amyloid fibrils (“SEVI”) have the same effect on the recipient’s immediate target cells (in vitro or in vivo) as they seem to have on a limited number of cell types in the laboratory. (whether SEVI indeed enhances HIV infection of primary cells isolated from the vagina, cervix, and endometrium remains to be determined. )

Third, These findings raise the possibility that the low ratio of infectious to noninfectious virions found in most viral samples could relate more to the ineffective delivery of virions to target cells (Thomas et al., 2007) rather than the presence of large numbers of defective particles. The delivery question as it relates to the virion ratio has been discussed for many years, although the HIV/AIDS deniers seem not to have noticed that one of their major planks is being eaten through.
#104 Chris Noble
January 24, 2008

transmission risk is known to be low in the chronic stage.

Dr. Noble, I really like the way you use that word “known”: “It is known”. “We now know that…” It make it all sound so right and scientific.

What is your point? That transmission risk is high during the chronic infection stage? Or are you just ranting for the sake of ranting?
#105 Sascha
January 24, 2008

Here’s something for coolaid:

http://news.bbc.co.uk/2/hi/science/nature/7203186.stm

mycoplasma genitalium; I love it!
#106 MEC
January 24, 2008

I beg your pardon Sir Elkie, the line from Nature.com was this:

A component found in semen can enhance HIV transmission by as much as 100,000-fold,

I guess I wasn’t being sensitive to the difference between “enhance” and “increase”. Perhaps you could elaborate on the technical definition of “enhance” when used in medical parlance and how it relates to transmission rate. For instance would it be possible to have enhanced and decreased transmission at the same time?

These findings raise the possibility that the low ratio of infectious to noninfectious virions found in most viral samples could relate more to the ineffective delivery of virions to target cells (Thomas et al., 2007) rather than the presence of large numbers of defective particles. The delivery question as it relates to the virion ratio has been discussed for many years, although the HIV/AIDS deniers seem not to have noticed that one of their major planks is being eaten through.

Ok Sir Elkie, I’m not going to pull the “give me a viual of even one infectious virion in a fresh blood sample from a patient with, say, a viral load of 2 million” line on you. But in return you must give me a little guidance here:

How can poor delivery make a virion less infectious? Is the property of infectiousness not inherent in the object?Is the Seed itself deemed less fertile if it happens to fall on rocky soil?

Once that is clear, we might be in a better position to understand how “fibrils can increase the infectious titer of virus as determined in culture by as much as 400,000 times.”
#107 Chris Noble
January 24, 2008

I beg your pardon Sir Elkie, the line from Nature.com was this:

If you want to know what the research actually found then read the paper and not the news article. The paper is in Cell not Nature.

It is very telling that you are so very keen to ridicule a paper that you haven’t read let alone understood.
#108 Fleming
January 25, 2008

Regarding Padian, Chris asks:

Why would you expect to have seen any seroconversions?

(1)Because about 25% of the couples did not consistently use condoms. “Nevertheless, the absence of seroincident infection over the course of the study cannot be entirely attributed to significant behavior change. No transmission occured among the 25 percent of couples who did not use condoms consistently at their last follow-up nor among the 47 couples who intermittently practiced unsafe sex during the entire duration of follow-up” (Padian, pg 356.)

(2) Because the years of the study were 1990-1996, before HAART, so you can’t attribute this data to the wonders of drugs.

(3) Because at least 39% of the couples engaged in anal sex at the beginning of the study, so you can’t limit this to purely vaginal sex

(4) Because Padian made no a priori prediction that she would find no seroconversions. Your post hoc rationalization to explain away this data is laughable and exposes you as an AIDS activist without a shread of scietific integrity.
#109 MEC
January 25, 2008

Dr. Noble, I’m not ridiculing the paper. I’m ridiculing you.

And I was asking genuine questions about how infectiousness is defined.

Compared to your latest couple of Comments, I’d say I would have won on substance even if I had let Harvey Bialy’s parakeet peck randomly at the keyboard.
#110 Chris Noble
January 25, 2008

Nice cut and paste from Barnesworld Fleming.

If you read the original paper you would have noticed the bit immediately after your quote: “This evidence also argues for low infectivity in the absence of either needle sharing and/or cofactors such as concurrent STDs”.

You can also read other papers by Padian that present evidence that the tranmsission risk is variable.

Wiley JA, Herschhkorn SJ, Padian NS. Heterogeneity in the probability of HIV transmission per sexual contact: the case of male-to-female transmission in penile-vaginal intercourse. Stat Med 1989;8:93-102.

You can also read papers that go into greater detail of the counselling that was given to the discordant couples.

Padian NS, O’Brien TR, Chang Y, Glass S, Francis DP. Prevention of heterosexual transmission of human immunodeficiency virus through couple counseling. J Acquir Immune Defic Syndr. 1993 Sep;6(9):1043-8

The counselling sessions were very successful in reducing unsafe sex practices.

Padian made no a priori predictions that she would find any seroconversions. In fact, the paper above demonstrates that she did her best to prevent any transmissions.

Instead of Denial the message that you should be getting is that HIV already has a low infectivity and only simple measures are necessary to completely halt the epidemic.
#111 ElkMountainMan
January 25, 2008

How can poor delivery make a virion less infectious?

MEC could ask, “How can poor delivery make a bullet less fatal?” Bullets of a given type and manufacture have similar potential to kill…under the right (or wrong) circumstances. A bullet tossed at its target by hand cannot kill like a bullet fired from a gun. A bullet fired into water slows quickly to non-lethal velocity. A bullet fired in air experiences air resistance and gravity and may not reach its target. A bullet fired in outer space could kill its intended target a million km after firing. But not if it hits the target in the foot: its interaction with the target is also important.

The infectious titer of a virus sample is determined in standardized assays. Altered conditions or “targets” may change the determined titer. The Cell paper MEC read about in a journalist’s account, like many other papers before it, suggests that the ratio of uninfected to potent virions has been greatly overestimated by some scientists in the past because of the inherent limits of their assays. It also shows that there is no substitute for the simple measures Chris Noble just advocated. Low viral load may reduce the chance of transmission, but it does not reduce it to zero. The 14 December Cell paper suggests that just a few virions can start an infection.

Safe sex is always important.
#112 MEC
January 25, 2008

Sir Elkie,

“Viral load” does not pick and choose between defective and “potent” virions. There is a question as to how many of the RNA fragment detected are part of a whole virion able to infect and replicate, regardless of how well the bullet is aimed.

It is not very reassuring to read that up until recently this was erroneous guesswork. What changed that state of affairs? what standardized assay is now able to give us the correct ratio not only of infectious to non-infectious virions, but also in terms of effective delivery of the infectious ones? I believe your own argument was that, even with the supposedly improved technology, in vitro measurements cannot be applied in vivo.
#113 ElkMountainMan
January 27, 2008

MEC, you wonder what percentage of HIV genomes detected by viral load assays belongs to replication-competent virions. The answer depends on the players and the setting. The “correct ratio” of infectious to non-infectious virions is not a universal constant. It depends on virus strain, mutations, and traits of the cell(s) producing the virus; on physical and chemical characteristics of the extracellular milieu; on type and density of target cells available.

Viral load assays measure how much viral RNA is present in the blood at a given time. Clinically, this is a useful measurement. And a simple one. Viral load assays do not measure the ratio of infectious to non-infectious virions.

The Cell paper on fibril-mediated enhancement of infectious titer reminds us that a single viral particle can, under certain circumstances, suffice to begin a productive infection. Unless the ratio of infectious to non-infectious virions is always zero (and we know it is not), the denialist argument that viral load overestimates the ratio is not only wrong (since the assay does not even pretend to estimate the ratio); it is pointless.