I can't argue with that. the part of me that's pursuing a career in the public health sector believes that everyone should have a chance to live their lives without having to worry about some super-bug killing them and their family. however, the logic in my brain states that we are the sum of every decision that we, as individuals, make. life IS a bitch. sometimes the dice come up snake-eyes.

but fucking up is nothing more than human nature. no matter how much more we evolve, there will be certain members of society who never amount to anything, make life-altering decisions, and die early deaths because of them. we'll never totally weed out these 'risk-takers' (although I almost don't call them that--it's too sterile), and I'm sure there will be two people having this same discussion in 100 years and/or 1000 years if we haven't killed ourselves off by then.

it's a tough issue to slice, that's for sure. agree to disagree, I guess.

(just like the virus debate: alive or not alive? they meet most of the classical requirements, but not all).

the problem I have with issues involving human behavior in regards to public health is that life isn't white and black. the world we live in has a lot of gray areas, ones that allow for discussions like this, ones that even predicate both my responses and your responses.

I agree, if that 'super-bug' can get them without any fault of their own. The fact remains that, sans accidental exposure, you have to seek this virus out through risky behavior. If you contract it through risky behavior, so be it. I view it no differently than I do some guy deciding to go base jumping and his parachute not opening.

And one of the primary reasons that I didn't pursue a career in medicine.

Free, unprotected sex once again! :D

dammit, misspelled 'too.'

I like to call these 'special' members of the gene-pool the shallow-enders. they tend to kill themselves off young, albeit not young enough (a lot of them reproduce, sometimes long enough to leave the example for their cursed offspring).

a decent example; my parents. not to put too much of my personal life on the board, but my parents are the best motivation I have for not ending up in the shallow end like they almost did. my dad and mom have been potheads their entire life, sometimes delving into more 'dangerous' drugs. according to popular psychology, I should never amount to anything. I grew up poor, and everything I have I earned with my two hands and two feet, as well as my brain.

it's the classical nature/nurture. vincent bugliosi and charles manson both have genius-level IQ's (within a few points of each other, IIRC). only difference: bugliosi grows up in an affluent neighborhood to parents who care for him, whereas manson never knows his father, is the son of a prostitute, shuttled from 'relative to relative,' and grows up a sociopath.

is it in the genetics? we don't know. there are those in manson's position that grow up to lead perfectly normal lives, even productive lives as contributers to their communities. there are those who grow up in bugliosi's shoes (jeffrey dahmer comes to mind) that end up possibly worse than manson.

the issue is that we have no clue where the line exists, or even if there IS a line to be drawn. gray area.

it's a passion of mine (obviously, as you can see by a few of my posts)

to my misfortune, I guess :p

Not true. HAART can drop your viral load to undetectable levels, but will only extend your life, not allow you to fully recover.

HIV will eventually develop resistances and mutations to the drugs in your system, and the drugs lose their efficacy over time.

This also assumes that you can afford said treatments which will cost upwards of 10K a year, unless you need salvage therapy from a fusion inhibitor, like Fuseon, which costs over 20K by itself.

Average lifespan is increased by about 8-10 years if on the cocktail, but it is by no means a cure all.

1) HIV only has RNA, not DNA
2) The newest drugs are considered either fusion inhibitors (which prevent the drug from fusing with the lymphocyte once it has attached), or attachment inhibitors, which prevent the virus from locking on to specific receptors on your T-Cells.
3) You're right about the viral mutations. HIV is a very quirky virus in that it makes a ton of errors in its replication process. This also causes a big problem with treatment, but you can't really prevent the virus from mutating unless your entire patient base is completely compliant with their regimen, infects no one else, and doesn't exchange viral strains with other infected parties.
4) Genetics play a huge factor in how well you can manage the disease. A portion of the European population has a mutation in the CCR5 Delta 32 receptor that actually makes it substantially more difficult for them to get HIV, and, if they have two such mutations, can be completely immune to infection.
5) AIDS drugs have horrid side effects--liver toxicity, chronic diarrhea, fever, constant nausea, are among a few.

Thanks, Mr. 'Hamas' Jenkins. I'm a little confused on point 1, though. My understanding was that the HIV virus actually converts RNA to DNA which then combines with the host cell DNA. Incorrect?

FAX

:clap:

for a bit of background info for fax (who seems interested), HIV/AIDS is a retrovirus.

No, you're right. The virus itself has only RNA, but after it injects itself into the host cell it essentially hijacks the machinery of the cell and then due to an enzyme known as reverse transcriptase, can create DNA.

The first major AIDS drugs (including AZT), were reverse transcriptase inhibitors. Unfortunately, the virus quickly builds a resistance to them, which is why doctors often prescribe two, along with a protease inhibitor.

Thanks, Mr. H5N1. So, does HIV have DNA, or not? Based on that description, it appears so.

FAX

Hamas, if you've something to say to me, do it on the board, please.

Technically no, but they possess the requisite "chemicals" to allow them to create what's known as complementary viral DNA.

The incredible curable AIDS.

from my incomplete understanding of HIV/AIDS, yes and no. (I'm more interested in hemorrhagic fevers like ebola, etc.)

it 'basically' (and it's hard to put into layman's terms, because it's a field filled with jargon and complex biochemical pathways) a RNA retrovirus that writes itself into our genetics, uses the machinery of our cells to reproduce itself, and shuts down our immune system via 'helper-T' cells.

RNA

Why? You'll end it like you do every other disagreement, and I don't want to see it derail/hijack this thread.

Got it. Thanks, Mr. 'Hamas' Jenkins.

FAX

basically it uses our cells' machinery to replicate itself much like our dna does in dna transcription (aids virus is actually 'written' in genetic code via messenger rna)

Considering the post that you responded to, I'm curious as to what offended you. You think junkies deserve, what, compassion?

Fascinating. My confusion was sponsored by the fact that certain drugs used to treat HIV are designed to deliver "bad" DNA building blocks. For some reason, I took this to mean that the virus was using these materials for its own DNA during replication. My bad.

FAX

You posited your take as though anyone who gets the virus currently does so out of stupidity or recklessness and deserves no sympathy.

That's just woefully ignorant. Moreover, although there are definitely people who know that they are playing Russian Roulette, there are often many, many people who are being infected by things that are out of their control.

Take a global view of the problem. It's easy to judge a sex worker in Thailand or a prostitute along a truck route in Africa, but doing so with our knowledge of viral transmission and their knowledge of HIV-AIDS is completely asinine. There are still several places in Africa where it is believed that having sex with a virgin will cure you of AIDS.

Furthermore, there are dozens of women who, as a byproduct of the cultures that they live in, must be subservient to men. Rape, and/or a compulsion to have sex with any man who asks are sad facts of some of these areas.

Additionally, places like the Phillipines have had huge explosions in HIV infection because of the religious influence of the Catholic Church, who expressly forbids condom usage. Of course this doesn't stop sex, but when you are indoctrinated into a faith from birth, it's hard to think logically and rationally about safe sex choices, especially when safe sex with a condom is considered a mortal sin.

But it's also not as cut and dry as you would think in America.

The fastest growing segment of HIV infection is in black women, and this is largely due to the fact that they are being infected by their partners who are having sexual dalliances behind their backs (as part of the down low subculture), picking up bugs, and taking them home.

Now, should you expect a women who has been with a man for a year and is on the pill to use a condom every time they have sex. Technically that's "unsafe" sex, but it sure as hell isn't bug chasing.

Finally, it's not mere happenstance that the poorest areas of this and other countries are also those with the highest rates of HIV infection.

And this doesn't bring into consideration other factors like AIDS fatigue and Condom fatigue.

If you were to extend your claims to their logical conclusion, you would be damning of a large segment of the population.

Yes, there are definitely segments of the population that are reckless and self-destructive when it comes to their health, but saying that people get AIDS/that it's easy to catch only because they are blatantly stupid is one of the most ignorant things I've ever heard.

= You don't DIE from AIDS doesnt cure it. Step in right direction.

As I said, I have nothing but sympathy for those who contract the virus through acts not of their own volition. I thought that was clear.

Perhaps not?

Hamas,

The Catholic Church also forbids sex until marriage. Wouldn't listening to the Catholic Church's position on this lessen the spread of HIV? Why do people listen to the Church when they say "Don't use condoms" but not "Save sex for marriage."

That's the same kind of ridiculous excuse that prompts people to champion abstinence only programs.

If you don't have sex, nothing bad can happen.

Of course, that completely ignores the fact that the sex drive is a completely healthy and natural part of the human animal that is almost impossible to overcome.

People will have sex. It's a fact of life.

The leaders of the Church should be intelligent enough to understand that, but they are too inured to their dogma. If they would at the very least promote an ABC philosphy (which itself is flawed but better than nothing), they could save a lot of lives.

Granted, the above is somewhat of a tangential issue...but if you haven't been taught the importance of safe sex, and given the fact that sex WILL happen often irrespective of religion, it's extremely naive to believe that people who haven't been taught to protect themselves will.

You tell me:

It's easy to say that you have no sympathy for those who catch the short straw in life by participating in "risky" behavior. Until you catch the short straw. The fact is, anything you do... Any VERB in the english language has risks and possible consequences. Sometimes those risks are severe. Riding the subway late at night is a RISKY behavior. The problem is, we should be able to ride the subway whenever we want without having to worry about it. So why not feel bad for those that get mugged on the subway, and try to prevent it, instead of blaming the victim?


You didn't say this, but you do make it sound like you'ld rather they didn't try to cure AIDS, since it's doing such a good job of getting rid of the "less desirables."

Excellent recommendation.

I can't believe it's not AIDS!

That's an accurate statement. One does have to seek the virus out, either willingly or unwillingly. But, do I have sympathy for the sex slave or rape victim who contracts it? Sure, of course. Junkie? No.

The point I was trying to make is that this virus isn't airborne. You can't go to a movie, get coughed on and contract the virus.

Sure, I would feel sympathy for a mugging victim, just as I would a rape victim who contracted the virus via assault.

Not at all. See earlier, about the poster whose brother died of AIDS through no act of his own.

I've always heard that people that continually lose their cats are more prone to contract AIDS, can anyone verify this ?

Wonderful news to hear. Sadly, the worst areas that this disease is being spread, will not get this treatment for years, most likely b/c of the cost- it may seem immoral that it takes that long, but if pharm did not return a profit, a significant portion of medical advancements would not be or progress much slower.

VERY Interesting article about straight men and AIDS from a few years ago...

Reprinted from Details Magazine, March 2004
Whatever Happened to AIDS and Straight Men?
By Kevin Gray

“Health officials have known this for years, but the politically incorrect truth is rarely spoken out loud: The dreaded heterosexual epidemic never happened. The result is a conspiracy of silence. And it’s not in anybody’s interest to clear this up.”

===

In 1987, America was obsessed with sex. On the radio, the average high school rocker heard the command to “push it” and eagerly obliged. On Friday nights he put on acid washed jeans and took his date to see Glenn Close boil rabbit. He received stud lessons from a beer-guzzling, model nailing pooch named Spuds Mackenzie. He channel-surfed in parachute pants and saw Jessica Hahn bring televangelist Jim Baker to his knees. In between, he found TV’s first ever condom ads. Yes, sir, sex was on his mind. And it was about to turn deadly.

That fall, federal health officials sounded a terrifying alarm: AIDS could kill anyone. For six years we had known that the disease was stalking America’s gay men and intravenous-drug users. It deposited purple blotches on their skin, sent their minds into spirals of dementia, reduced their bodies to withered skeletons. Our high-schooler had heard about it but he didn’t give it much thought. Like most of America, he vaguely worried that he might catch it from a toilet seat, a sneeze, or a handshake. But it didn’t truly…concern him.

Until the panic landed with a thump at newsstands. Stacks of U.S. News & World Report heralded “the dawn of fear,” telling him “The disease of them suddenly is the disease of us.” AIDS, it seemed, was spreading through the heterosexual population—through straight sex!—at a fearsome rate that health experts likened to the Black Plague. Surgeon General C. Everett Koop called it “the biggest threat to health this nation has ever faced.”

Suddenly, wherever our kid turned—MTV, Time Magazine—he saw a parade of walking dead, people who looked and talked like him, grimly recounting one-night-stand horror stories. The message: Whether you’re a Berkeley co-ed or a Portland plumber, plain old vanilla intercourse can kill you. And in case he still didn’t get it, from daytime TV came a voice so grave, so full of maternal concern, it stopped him dead in his Reeboks. “Aids has both sexes running scared,” Oprah Winfrey said. “Research studies now project that one in five--listen to me, hard to believe—one in five heterosexuals could be dead from AIDS at the end of the next three years…believe me.”

The idea was staggering: Nearly 44 million people dead in less time than it takes tofinish college. AIDS anxiety suddenly gripped the country. Our young guy recalled last Saturday’s bar pick up, a buddy’s too easy sister, even his new girlfriend. How well did he know her? Some mornings he saw, or thought he saw, a red rash spreading across his flesh (hadn’t it just been a vigorous romp?) and bolted to the nearest clinic for a blood test, joining a brotherhood that doctors called “the worried well.” Sex was no longer just a game; it was Russian roulette.

Since doctors first reported the outbreak of a mysterious new disease in 1981, an estimated 900,000 Americans have been diagnosed with AIDS. Nearly half of them were men who had sex with other men, 27 percent were IV-drug users, and another 7 percent were both. But the politically incorrect truth is rarely spoken out loud: The dreaded heterosexual epidemic never happened.

Straight men and women make up 90 percent of the population, but they account for only 15 percent of non-childhood AIDS cases. Only 6 percent of men with AIDS, the Centers for Disease Control and Prevention says, contracted the virus from straight sex. And even that figure doesn't hold up to a closer look. Several studies now suggest that most men who claim they got the virus this way are lying. They got it from sex with other men or sharing needles with addicts. Those studies also show that many women listed in the straight-sex category are either IV-drug users themselves or have likely contracted AIDS from sex with an IV drug user.

Health officials have known these things for years. A growing pile of federally funded reports on HIV transmission, published over the past decade and available to anyone who has the time to read them, shows that men almost never get HIV from women. In fact, according to a 1998 study in the Journal of the American Medical Association, a disease-free man who has an unprotected one-nighter with a drug-free woman stands a one in 5 million chance of getting HIV. If he wears a condom, it’s one in 50 million. He’s more likely to be struck by lightning (one in 7000,000).

Female to male transmission is very inefficient, says Dr. Nancy Padian a professor in the department of obstetrics, gynecology and reproductive science at the University of California, San Francisco and the author of a 1996 10 year study of HIV infected heterosexual couples, the nation's longest and largest. She points out that “its two to three times easier for men to infect women.” But even so, if there are no other risk factors involved, the rate at which an infected man will transmit the virus to a woman is one in 1,100 sex acts.

Today it’s clear that the AIDS epidemic in the United States peaked in 1993 when 106.000 new cases turned up [A & W note: The 106,00 new cases referred to above were added by reclassifying past and present HIV positives under an expanded definition of AIDS instituted in 1993. This broadened definition included more types of pneumonia, women with cervical cancer, and the non-illness criteria of a lab test of 200 or less T cells that has since been the determining factor for an AIDS diagnosis in at least 50% of all new cases. AIDS cases had actually leveled off by 1992 and increased only due to the expanded definition, a fact omitted from this article]. Then it began a slow decline and has now leveled off to 40,000 new cases a year. Thanks to powerful anti-retroviral drugs that allow HIV-infected people to live longer, AIDS deaths have plummeted 14 percent since 1998, falling in 2002 to a new low of 16,371.
[A & W note: The figure cited above of 40,000 new AIDS cases a year is an error. Rather, official estimates claim there are 40,000 new HIV infections annually in the US. The notion there are 40,000 new HIV positives each year however is derived from an unsubstantiated estimate and calculated by dividing the high end total of estimated HIV positive Americans (around 900,000) by the number of “AIDS years” (around 20). Also, the “powerful new AIDS drugs” thought to be responsible for decreased deaths were introduced in 1996, not 1998 as the articles states, which is a year after AIDS deaths had already peaked. Futher, there is still no published data in the mainstream medical literature showing that these new drugs increase life expectancy, improve clinical health, or prevent the illnesses associated with AIDS. And no AIDS drug since 1986 has ever been tested against a true placebo control.]

Clearly, a single death from this illness is one too many. But AIDS is not killing Americans at the levels of cancer (554,000 deaths in 2001), diabetes (71,000), or Alzheimer’s (54,000). In fact, the CDC has not put the disease on its list of the top 15 killers since 1998.

America may be winning the war on AIDS, but not without collateral damage. After two decades, we are still overwhelmed with misinformation and misconceptions about how the virus spreads. Straight men are still haunted by the notion that old-fashioned sex can be lethal. Among the biggest fear factors, some AIDS educators say, is shoddy federal health data. The CDC statistics are only good as the local health departments that gather them. But many of those departments don’t have time or resources for “surveillance” staff to investigate every person’s claim of how they contracted the virus. If a man wants to lie about having had sex with other men, he can, and that makes it look like more people get AIDS from straight sex than really do. By re-interviewing victims, their doctors, and their families, Chicagohealth officials found in 1997 that in 85% of the cases the city had blamed on heterosexual transmission, other risk factors were present. This phenomenon became a source of black humor at New York City’s overworked health department in the late eighties. “What do you call a man who got HIV from his girlfriend?” the joke went. “A liar.”

The truth is out there, but its not reaching people who have been needlessly scared—the result, some critics charge, of a conspiracy of silence. “It’s not in anybody’s interest to clear this up,” says Joseph Sonnabend, a physician who treated some of New York City’s first AIDS cases. Sonnabend, helped found what later became the American Foundation for AIDS Research (AmFAR), But he quit the group in the mid-eighties when it claimed—falsely, he believed—that a heterosexual epidemic could be coming. “Gay men don’t want it fixed because they’ll be blamed again for the disease,” Sonnabend says. “Charities like AmFAR don’t want it fixed because they’ll lose their funding. And “straight” men with HIV certainly don’t want it fixed because then everybody will know they’ve been having sex with men. Those are the ones who will scream bloody murder if you print all this stuff. You’re outing the poor bastards.”

Any overhaul in America’s AIDS policies has to begin with an overhaul of public perception away from the anyone-can-get-AIDS mentality. That means looking at the cultural forces that originally shaped that perception and continue to do so today. Many scientists now say that the first major public awareness program, 1987’s America Responds to AIDS campaign, was not only largely wasted on mainstream America but deadly to those most at risk, drawing precious funds from the very people AIDS was attacking: gays, bisexuals, drug addicts, and the poor.

Certainly the horizons of the AIDS epidemic were less clear in 1987. “With diseases like this you’re working with a moving target,” says Walter Dowdle, who helped start the CDC’s anti-AIDS office. “We knew the groups hardest hit were gay men and drug addicts. But we didn’t have a lot of information about heterosexual spread.”

Nevertheless, by 1987 the CDC knew that vaginal intercourse was an extremely inefficient way of transmitting the virus. The agency had already produced research that showed the widespread fears of contagion were exaggerated. Less than two months before it launched its AIDS campaign, the CDC’s epidemiology chief, Harold Jaffe, publicly criticized the everyone-gets-AIDS message, noting the risk to straight America was “very small.”

“People would talk about the hypothetical housewife in Des Moines,” says Jaffe, now the director of the CDC’s AIDS-prevention program. “Was she at risk? The answer was ‘not really,’ unless her husband happened to be a drug user or a bisexual.”

In trying to address groups at risk—gay men and drug addicts—the CDC’s Dowdle had already run into political and cultural roadblocks. Broadcasters refused to carry announcements advocating condom use. Ronald Regan remained infamously silent of AIDS almost until the end of his presidency, and moral objections led his White House to quash the publication of a 1986 brochure prepared by the CDC that touted condoms. “We were getting virtually nowhere with the Regan administration,” Dowdle says. “They paid no attention to it at all.”

Congress, though, had become increasingly alarmed by the CDC’s reports loudly disseminated by gay activists and charity groups like AmFAR that AIDS was killing off straight Americans. In 1987, Congress ordered the CDC to send out a nationwide mailing to educate Americans about the dangers of AIDS.

Dowdle, who was put in charge of this mission, knew that mainstream America cared little for the plight of drug addicts, prostitutes, and homosexuals. William F. Buckley Jr. had suggested that anyone with HIV be tattooed to protect the healthy. Liberace died of the disease without ever admitting he had it. When Americans were asked by Gallup pollsters if AIDS was God’s punishment for immoral behavior, 43 percent of the respondents said yes.

There was only one way to make all Americans concerned about AIDS: Put out the word that the disease was an equal-opportunity killer, one that could get your best friend or your mom. Otherwise, straight America would never support the kind of funding desperately needed for research and care. “Only by democratizing the epidemic,” says Dr. Ronald Bayer, a professor of public health at a Columbia university, “by saying we’re all equally at risk, would anyone pay attention.”

To do this, the CDC needed professional help. After putting a $27 million campaign out to bid, it hired one of the nations largest ad agencies, Ogilvy & Mather, and specifically the services of a bright 32-year-old ad man named Steve Rabin, who headed the agencies health unit in Washington, D.C. Rabin, an openly gay man who had seen friends die of AIDS, held 20 focus groups around the country that August and found that nearly all Americans—straight and gay—thought of AIDS as someone else’s problem. He knew, and his CDC bosses agreed, that they had to underscore the universality of AIDS to make it a public-health priority.

That fall, Rabin shot a series of 38 TV spots, many of which featured men and women with AIDS. They were not identified as gay or as IV-drug users, and the ads addressed their high-risk activities only in veiled ways. During the filming, one young man, the son of a Baptist minister, looked into the camera and said, “If I can get AIDS, anyone can.” The line was an unscripted surprise, and it became the unofficial slogan for the campaign—the TV spots, along with eight radio announcements and six print ads, all of which made a personal, heartfelt appeal to Americans to talk to their family about AIDS. What the CDC knew, but kept from the public, was that the young man was gay. Instead he was presented as an equal-opportunity victim—a preacher’s son!—of the burgeoning pandemic.

In July 1988, the CDC mailed its “Understanding AIDS” brochure to 126 million American Households. Coming from C. Everett Koop’s desk, it finally used the frank language activists had sought, talking about anal sex and discussing the use of condoms and lubricants (even warning against items like Crisco because they break down the latex in condoms).

But despite the plain talk, the brochure still blurred the line between mainstream Americans and those who were at high risk. A middle aged blonde stared out from one page, telling those Des Moines housewives and Dallas freshmen that AIDS is not a “they” disease, it’s an “us” disease.” What the brochure didn’t mention was that she was an IV-drug user.

The media heard the alarm and dispatched its legions of camera crews and producers. The three major networks ran graphic coverage of the brochures on their nightly newscasts. “We jokingly called it the anal-sex triple crown,” Rabin says, noting it was the first time that these words had been uttered on national TV. The campaign, along with the media coverage, transformed AIDS from “the gay cancer” into a mainstream obsession.

The vision of a heterosexual plague fit nicely with the goals of two other camps, which agreed on almost nothing else: The gay left, which saw it as the only way to make straight America pay attention, and the Christian right, which found in it a powerful weapon to beat back the sexual revolution. If sex-crazed Americans couldn’t be shamed into chastity and monogamy, by God, they could be scared into it. This was a message that a nation hung over from the binges of the sixties and seventies was ready to hear.

“I used to say we were like the body of a bird being beaten to death by the left and right wing,” says James Currin, who was head of the CDC’s AIDS program at the time and is now dean of Emory University’s Rollins School of Public Health. “The gay community had its civil-rights agenda and people on the right had a political, traditional-values agenda.” As a result, in the public mind AIDS was now swiftly spreading through the entire population.

A decade and a half has passed, but that belief hasn’t gone away. Indeed, it has been pushed by health experts urging condom use to protect against all STDs, by feminists seeking to make men more responsible for their sexual behavior, by TV news shows looking for scare ratings, and by a national hunger for innocent victims. How could anyone imagine that God was punishing Ryan White, the 13 year old who contracted HIV from a tainted blood-clotting agent in 1984 and died in 1990? White’s specter continues to haunt the AIDS landscape. Though HIV was virtually wiped out from the nation’s blood supply by 1985, the Ryan White National Youth Conference attracts more than 600 people each year to such uncontroversial workshops as HIV prevention through the arts.

Heterosexual AIDS even acquired a celebrity spokesman in 1991 when Magic Johnson announced that he had contracted HIV through promiscuous sex with women. Activists trotted him out to warn America of the AIDS boogyman lurking at the foot of the bed, a role he still serves today (Johnson did not respond to several interview requests). Meanwhile, red ribbons flutter down red carpets. The paparazzi regularly shoot Liz Taylor and Liz Hurley, Macy Gray and Tim Robbins heading into the latest AmFAR fund-raiser in Cannes to net another million at events sponsored by Volkswagen and De Beers.

But more than any other force, television news, that bastion of American skepticism and objectivity, has fanned the heterosexual panic from the start. One 1992 study found that the AIDS victims shown on the nightly news were almost never gay men or IV-drug users, despite the overwhelmingly greater incidence of the disease in those groups. The disparity, says Michael Fumento, a conservative science writer and former AIDS analyst for the U.S. Commission on Civil Rights, is the fault of journalistic “crusaders,” reporters who peddle sentiment rather than skepticism, cherry picking victims who look like the viewers. Media outlets boost ratings by keeping us glued to the tube out of terror, and along the way they reinforce the idea that we are all equally at risk.

“It’s the same thing with the SARS hysteria,” says Fumento, a debunking specialist who wrote the controversial 1990 book The Myth of Heterosexual AIDS. “Scientists said over a million people could die. CNN claimed it could overwhelm the US hospital system. Not a single American died. The media likes a good story and it doesn’t understand its own limitations. It doesn’t look under the rug.”

For all its lethal impact, HIV is a weak virus. Left at room temperature for a week, it has only a 10% chance of survival. Simple cleansers, such as dish soap, can kill it. Unlike herpes and gonorrhea, which can be contracted through genital contact, HIV is transmitted when blood or semen makes its way into tears in the mucus membranes or the skin. STDs that cause open sores help HIV enter the body: such concurrent infections are now understood to be crucial in spreading AIDS.

AIDS works like this: HIV, the human immunodeficiency virus, attaches itself to lymphocytes, including T4 cells, which are responsible for calling other immune cells into action during an infection. The virus then starts incubating inside the host cell, avoiding detection by patrolling antibodies. During this time, which can last a decade, the virus is dormant but can be transferred to other people through these infected T4 cells.

The question of what triggers an HIV infection to become AIDS is controversial. What is known is that at some point, the virus replicates by taking over the T4 cells, doubling its numbers every 12 hours. Eventually, such work in the service of its enemy exhausts the T4 cell and it dies like an overworked motor. With its T cells devastated, the immune system breaks down, leaving the body vulnerable to the opportunistic cancers and infections that typify AIDS. One such cancer, Kaposi’s sarcoma, ravages such internal organs as the lymph nodes, brain, lungs, and digestive tract.

But if HIV can’t reach the lymphocytes, there’s no infection. This is why it’s so hard to contract the virus through old-fashioned vaginal sex. The vagina is a rugged structure, built to withstand everything from a thrusting penis to the passage a baby's head during childbirth. Its walls are muscular, covered by a thick layer of epithelial cells that resist tearing and that secrete a lubricating mucus that contains enzymes for fighting off bacteria. Its blood vessels run well below the surface, barring HIV from direct contact with the blood and thus from the lymphocytes

“The vagina is an organ that is essentially designed to prevent abrasion,” says Robert Root-Bernstein, a professor of physiology at Michigan State University and recipient of a MacArthur Genius Fellowship. “The blood vessels are buried quite deep, so there are no lymph nodes present. It's very difficult to get anything vaginally into the blood.”

The rectum, on the other hand, offers almost no protection. It is lined with extremely thin tissue, no thinner than a lambskin condom, and can easily tear. It is part of the lower intestine, which has evolved to perform one major task—uptake nutrients and water from your bowels into your circulatory system—and so it is intertwined with capillaries. To keep out the bacteria that thrive in the colon, half your immune system surrounds your gut in the form of lymph nodes whose sole job it is to monitor the water and nutrients re-entering the body.

The rectum has no mucus-secreting cells to help ease the passage of a penis. The subsequent tearing in the cell walls (which lubricants do little to prevent) offers HIV-carrying ejaculate easy access to lymphocytes that cluster just beneath the surface. From there HIV enters the bloodstream. Dildos, sometimes used before such penetration, do further damage and increase the likelihood of transmission, as do hemorrhoids. A constant hazard of anal sex, hemorrhoids can rupture and bleed, providing the virus with another gateway the bloodstream. Semen also has enzymes that help it bore through these cell walls, even in the absence of tearing. (Anal intercourse is far less risky for the active partner)

Interestingly, for healthy men and women, oral sex carries practically no risk of infection. Enzymes in saliva attack and deactivate many types of bacteria and viruses. Even those infectious agents that pass this first line of defense are typically destroyed by stomach acids. When semen is swallowed, those gastric juices reduce it to little more than its chemical components, and it largely gets digested as simple protein.

In all three types of sexual activities—vaginal, anal, oral—things get more complicated when other sexually transmitted diseases are present. Those that cause open sores such as syphilis, chlamydia, gonorrhea, and herpes, increase the chances of both contracting and spreading HIV. If there’s a syphilitic sore on the penis, and army of blood vessels grow around it to bring lymphocytes to the area and eliminate the infection. Not only does HIV get an open door to stroll right in, it also gets an inviting welcome from the lymphocytes, which it clings to like a grateful party crasher.

A healthy man or woman with no STDs and few activated T cells is highly unlikely to contract HIV even if exposed to it through oral or vaginal intercourse (of course anal sex can be just as deadly for a woman as it is for a gay man). Without activated T cells to invade, the virus will normally die.

“You need these other diseases in order to transmit HIV vaginally,” says Donald Capra, an immunologist at Oklahoma Medical Research Foundation, who was among the first to publicly question the exaggerated heterosexual HIV figures. “To the extent that American men have STDs, they also have access to health care. So it’s extraordinarily rare for them to have untreated venereal disease. A woman with herpes gets Valtrex. A guy with gonorrhea gets penicillin. While there is certainly the young lady who meets a guy, has sex and gets AIDS, and makes the front pages of the newspaper, that’s an exceedingly rare event.”

Because HIV is so hard to transmit, it hasn’t spread with the Black Plague ferocity predicted by Oprah and others in the eighties. The news, however, isn’t good for everyone. Among those who were always the highest risk for infectio—gay men, bisexuals, IV-drug users, and their sex partners—AIDS is making a stealthy comeback. A large part of the blame falls on the misguided notion that AIDS is now a “manageable” disease, thanks to powerful drug cocktails that stave off its progression and steroids that make victims appear healthy. But an equal part can be pinned directly on all the fear-mongering about heterosexual AIDS. By emphasizing the universality of AIDS—a message fueled by government warnings, celebrity crusaders, and a crisis-craving media—and paying for awareness programs at wealthy college campuses, the country has diverted precious funds from those who need them the most. The Bush administration, experts charge, will only hurt matters if it succeeds in increasing the $100 million already spent on abstinence-only sex education. This program, favored in Bush’s home state of Texas, bans discussion of the dangers of specific sex acts and the effectiveness of condoms.

In parts of the third world, AIDS has, in fact, exploded among heterosexuals. But it has taken hold only in some regions, and among people whose immune systems are already crippled. For instance, the African epidemic is largely confined to the sub-Sahara, where malnutrition, poor health care, and such diseases as malaria and tuberculosis are rampant. In addition, because of their country’s history of apartheid, many South Africans live and labor in squalid camps hundreds of miles from their homes. There, men with untreated STDs will often have sex with HIV infected prostitutes, contract the virus themselves, and bring it home to their wives, who, when they get pregnant, pass it along to their children. (Rural China, where similar conditions exist, is also suffering.) Oprah and Bono have lured TV crews to blighted African villages where the heterosexual epidemic is real. Viewers at home are left with the impression that AIDS—always the equal opportunity killer—could yet make its way into their own bed if they’re not careful.

HIV has indeed crept into American bedrooms, but only those within pockets of poverty, malnutrition, and poor health care. It has become “ghettoized,” and is spreading fastest among black and Hispanic men (some of them hiding their bisexuality) and black women. The CDC duly reports these facts, but in media coverage the behaviors that put people at risk are glossed over.

Many of the new cases involving black women are simply blamed on heterosexual contact. But it turns out that a number of these infected women have resorted to prostitution to make ends meet. That means they are having unprotected sex, often anal sex, with needle-sharing drug users, and are likely using drugs themselves. But when the New York Times tells us in a front-page story on July 3, 2001, that HIV is taking a toll on rural black women via heterosexual sex, we have to wait until the 36th paragraph to learn that they are turning tricks.

“These are not women who stand on a street corner. They go out when they need drugs,” says Root-Bernstein, who wrote the 1999 book Rethinking AIDS: The Tragic Cost of Premature Consensus. “They’ll go to a crack house and basically bend over and let anybody do whatever they want to for 2 hours. And the men who are having sex with them will have anal sex because they can do it there and they can’t get it elsewhere, so why not? And when you’re high you don’t care, either. So now we have behaviors that maybe they don’t want to admit to.”

Not only are such behaviors hidden from mainstream America, but the disease itself is beginning to disappear into these crack houses and poverty shacks, just as a 1993 National Research Council report predicted. At this time, the NRC said that the United States would remain largely untouched by AIDS, while those most affected would continue to be “socially invisible” and “beyond…the attention of the majority population.” That warning “provoked howls of protest,” says Ronald Bayer, the Columbia professor who sat on the NRC panel that wrote the report. “People said we’d have blood on our hands.” Critics charged that the NRC’s message would cause the government to “neglect the places where AIDS might occur,” Bayer says. In fact, the opposite has happened: The places that have been neglected are precisely those that have been most devastated.

The CDC, acknowledging that prevention efforts have stalled, announced last year that it would focus more money and energy on people already carrying HIV in effect, shifting to them the burden of stopping the virus’s spread. By diverting $42 million in funding, the move threatens to dismantle, or at least cut the budgets of 211 community-based groups, most of which serve at-risk minority communities. Among programs that would be affected are workshops that target urban teens, those that teach safe sex in San Francisco’s Mission district, and a counseling program for poor black women in Baltimore where syphilis rates are skyrocketing. Critics say the move is a dangerous shift away from proven prevention methods; one black AIDS activist said the policy was “Insane and, I feel, genocidal.”

“The CDC’s message is to get tested and know your status,” says Dr. Judy Auerbach, AmFAR’s vice president for public policy. “But that message is not focused explicitly on the traditional at-risk groups. It’s much more generic, and so you could argue that it’s not reaching the people it needs to.”

To this day, anyone who talks honestly about the true risks of HIV among heterosexuals is asking for the same attacks the NRC report ignited. The most vocal opponents are often those with political agendas or those with the most to lose. “The right wingers like the heterosexual message because it is pro-family and warns against extramarital affairs,” says Michelle Cochrane, a visiting scholar at the University of California, Berkeley, and author of When AIDS Began, a recent book that examines some early scientific and cultural misunderstandings of the disease. “Gay men like it because it keeps people aware and keeps funds coming in. And the feminists like it because it gets condoms on the guys and forces them to take greater sexual responsibility.”

It is true that AID does not discriminate: anyone can get it. But not everyone is at equal risk. AIDS is an opportunistic disease in every sense. Not only does it attack the human body at its weakest points; it infects the social body in the same way. AIDS hits hardest where social institutions, such as health-care facilities and drug treatment programs, are most scarce—among the poor and disenfranchised. As the disease continues to kill Americans, it will not cut across class, racial, or ethnic lines. Instead it will target those who, as the NRC report noted, “have little economic, political and social power.” This will be the ultimate cost of an AIDS policy that emphasizes moral instruction and abstinence over accurate education about the real risks.

“If you want to stop heterosexual transmission, you focus on poor ghetto communities because that ‘s where it is, among the drug users,” Bayer says. “Your not going to stop AIDS by spending money where it is non-existent.”

Increasing numbers of researchers say thousands of lives could be saved every year by spending more on AIDS prevention among at-risk groups: reminding gay men to avoid unprotected anal sex, persuading drug addicts to use clean needles, and teaching prostitutes to insist on condoms. In 1996, James G. Kahn, an epidemiologist at the University of California, San Francisco, brought out a statistical model showing that by spending just $1 million among these high-risk groups over five years, the United States would avert 150 new infections. Targeting low-risk groups would prevent three.

“The public dollar is limited,” Bayer says. “Obviously, if you spend more in ghetto communities, you have less to spend in Scarsdale, New York. And it may be that someone in Scarsdale doesn’t get the message. But there’s a better likelihood that you will have a greater impact if you focus on where the epidemic is. It seems to me that the ethics of public health require you to take care and to protect the greatest number of people. Not scare the hell out of everyone.”

Sorry to hear that. I have a good friend in CA who is going on 14 years living with HIV. Hopefully this treatment will be affordable enough where regular people can get it.

I liken HIV to a mugger. People SHOULD be able to have sex with each other the same way a woman SHOULD be able to ride the subway at night. Regardless of whether you're gay or straight, or whatever.

I don't agree with people doing drugs, but the fact is... That's not my call to make. Sure, it's against the law, but so is filesharing, speeding, tax evasion, getting in a fight, driving with expired tags or no insurance. These are all things I might be guilty of if looked at closely enough... What if AIDS were spread by these things, would I deserve it?

Sounds like you probably do.

Since it isn't, I fail to see the relevance.

"if you get aids you deserve to die"

~Signed the GOP~

"aids is more important than cancer"

~Signed Liberals~

Print em!

http://blog.wired.com/wiredscience/2...mental-ai.html
Experimental AIDS Vaccine May Increase Risk of HIV
By Brandon Keim October 25, 2007 | 11:18:31 AMCategories: AIDS/HIV, Medicine & Medical Procedures

The frustrating saga of AIDS vaccines -- 22 years of research, and not a single one yet works -- has taken a sad turn: an experimental vaccine developed by Merck may leave people more vulnerable to HIV infection.

The Washington Post reports that 19 South Africans who received the vaccine during a clinical trial have contracted the virus, compared to 11 people who received a placebo. Investigators are contacting participants to let them know whether or not they received the vaccine.

The trials, which began in December 2004, were not limited to South Africa, but included 15 U.S. cities, along with sites in Peru, Brazil, Australia, Haiti, the Dominican Republic and Jamaica. Those participants have not yet been told whether they received the vaccine; researchers will meet in November to decide whether the South African results are an aberration or indicative of a fundamental flaw in the vaccine.

It's possible that the infections were purely coincidental. It's also possible that the vaccine "could have caused immunological changes that made it easier for the virus to take hold during a later exposure."

This is a major setback for not only for Merck's vaccine, which was developed in conjunction with the NIH, but for the entire AIDS vaccine field. The Post notes that "researchers worldwide considered it the most promising candidate yet in a multibillion-dollar quest for an AIDS vaccine dating to the 1980s."

Why have AIDS vaccines proved so difficult to develop? An article published several years ago in PLoS Medicine discusses the many reasons -- the virus's hardiness, its uncanny ability to adapt to not only drugs but immune responses, and our own incomplete understanding of it. But some people are able to resist infection despite repeated exposures; and some are able to control the virus spontaneously. A vaccine is possible. And someday we'll find it.

Exactly.