Seventeen years ago (has it been that long?) I had a friend who was convinced she had AIDS, and was going to die. She’d had unprotected sex with an IV drug user.
We were college students, so I took her to the free clinic. They declined to test her, because she was in a high-risk group. (State law required clinics to provide counseling to people who tested positive.)
I studied up on AIDS, and came across a book called The Myth of Heterosexual AIDS in the school library. That book, along with everything else I read, pretty much convinced me that heterosexual AIDS was threat manufactured by the health industry and the media.
It’s been almost twenty years since then, and the cataclysm projected on newspapers and across TV screens in the late 80’s and early 90’s has failed to materialize.
It’s been a while since I’ve heard anyone talk about heterosexual AIDS, and so I ask: Is heterosexual AIDS still a threat?
In case it’s not clear, my position is it’s virtually impossible to get AIDS from ordinary, vaginal intercourse. When I used to tell people that, they’d look at me like I was a Moonie, or a space alien. Am I still wacko?
So you’re saying that if an attractive woman came up to you and told you that she’d sleep with you, but you should know that she had AIDS, you’d really do it?
So all those people in Africa, all gay? Even the women who got it from their husbands? Or the prostitutes who got it from their clients (or the clients who got it from the prostitutes)?
LinusK didn’t seem to be asking about AIDS worldwide, but about AIDS in the U.S. Your report states that AIDS in the U.S. is prevalent in certain communities, but not in others. 36,084 cases of AIDS looks like long odds in a population of 300 million. I would be concerned if I was a woman who had sex with an I.V. drug user, but my first question to said drug user would be “Do you share needles?”
I think a lot of the confusion on this issue is one of where we (Westerners) live and our culture.
(All of this is from Avert.org, easily discovered in a few clicks so I won’t directly cite each one.)
39.5m people are estimated to be living with HIV, right now.
The lion’s share, 24.7m are in Sub-Saharan Africa.
The remainder (14.8m) break down like this:
North Africa & Middle East: 460,000
South and South-East Asia: 7.8m
East Asia: 700,000
Oceania: 81,000
Latin America: 1.7m
Caribbean: 250,000
Eastern Europe & Central Asia: 1.7m
Western & Central Europe: 740,000
North America: 1.4m
In Sub-Saharan Africa, where the majority (62.5%) of people living with HIV are, HIV is primarily spread through heterosexual intercourse. So when you say that heterosexual HIV is a myth, you have to ignore Sub-Saharan Africa for that to be true. Now, even more importantly is that the largest number of newly infected persons is in Sub-Saharan Africa as well, at the end of 2006 there were 2.8m newly infected persons in Sub-Saharan Africa.
North America has 1.4m cases of HIV, and only 43,000 new infections at the end of 2006.
So out of the 300m people living in the United States, the 30m people living in Canada, and the 105m living in Mexico, only 43,000 were newly infected.
The break down of the newly infected men by sexual orientation in the U.S. (again, from avert.org):
So how likely are you to get HIV through male-female sexual interaction? Well, 60% of new infections (probably) occur from male-male sexual interaction, that leaves intravenous drug users who share needles + heterosexual contact as the other two ways it is primarily transmitted in the United States.
The numbers ultimately boil down to an estimated 5,208 new infections in 2006 (in men) as a result of heterosexual intercourse. An estimated 18,000 new infections from male-male sexual contact and an estimate 5,000 new infections from intravenous drug use.
In the grand scheme of things, you’re correct, your chances of getting HIV in the United States, if you’re a man, through heterosexual intercourse, is very low. Although your chance of getting HIV in general is very low (keep in mind though, that of the 300m Americans, less than 100% are sexually active, so it’s hard to estimate your exact % chance.) For women, heterosexual contact is more dangerous than for men, an estimated 8,200 women were infected by heterosexual contact (the leading cause of new infections in women–not necessarily shocking because it is difficult for homosexual women to transmit it to one another.)
By and large no, in the United States the HIV/AIDS epidemic never really did take off to quite the degree maybe we thought it would. I’d probably say a very large part of that is because the gay community early on realized it was facing an extremely serious problem, and gays in America took steps to reduce their chances of getting the disease, which in turn helped prevent it from spreading so much to the general population. Heterosexuals tend to not be very careful about sex though, and the proportion of new infections caused by heterosexual contact increases every year in the United States. A big part of the reason that HIV is such an epidemic in Africa is many African men just simply will not use condoms, period. And in many African countries women don’t have the sort of civil rights that would enable them to turn their husbands away for sex because he refuses to use a condom, and in the ones where they do, they fear their husbands going to other women.
So while your realistic chances of getting HIV as a heterosexual male in the United States is fairly low; I’m not sold on risking it. Even if you don’t get HIV you could get another STD or even an unwanted baby which is a whole other can of worms (assuming that in addition to not using a condom you’re also not using any other form of birth control.)
I’m not challenging this, but it just sounds very odd. There is a clinic that tests for HIV, but denies all patients who are high risk? Who are they testing then? Nuns? I work in blood transfusion, so we deny donations from “high risk” donors, but what you’re saying sounds ass-backwards. High risk groups are the ones who need the testing the most.
Is it because they didn’t want to spend money on the state-madatory councilling? That sounds stupid too. It’s not councilling as in “don’t worry your life isn’t over, we can make it through this”, the councilling is education about living as a person infected with HIV. Encouraging safe sexual practices, and instructions on obtaining clean IV’s for drug addicts.
Can someone, not necessarily the OP, explain this?
Michael Fumento’s The Myth of Heterosexual AIDS has a lot in common with the people in 2001 who began describing the the Millennium computer bug as a “hoax”–they missed an important piece of the event. Fumento was writing in 1989 about how the predictions of 1982 had not come to pass. To make his point, he had to ignore that fact that most of the “alarmist” news (along with many of the specific actions undertaken by the medical community) were responsible for averting what could have become a disaster. When AIDS was a “homosexual” disease, it was harder to get research money and there was less effort to contain it. Once it was broadcast as a doomsday scenario, research was ramped up, blood supplies were more rigorously tested, more information was distributed regarding ways to reduce risk, junkies were given the opportunity to use clean needles, etc. When all of those efforts resulted in lower transmission rates, Fumento walked onto the scene, seven years late, and declared that we did not need to have invested all that energy–ignoring on the fact that the energy so expended–including much admittedly wasted energy–had been successful in averting the disaster.
Was there excessive hype?
Sure.
Was research (ultimately) funded at levels out of proportion to the (eventual) danger?
Probably.
But just as the computer Millennium bug disaster was averted with hyperbolic warnings that finally prompted businesses to invest in fixing it (including an extraordinary amount of waste by people who really did not understand what was needed), so the heterosexual AIDS epidemic was averted in the U.S. because the alarmist cries–even the silly ones–finally got through to enough people that policies and personal actions were changed, resulting in a lower risk. Note that in Africa, where such “alarmist” cries were unheared or dismissed, there is no question, at all, that AIDS is a heterosexual disease.
Actually, one of Fumento’s major points is that female-to-male transmission thru vaginal intercourse is rare in the US. Much heterosexual transmission in the US is females contracting the disease thru intercourse with bisexual men or IVDAs, or mothers passing the disease to their children, or IVDAs giving the disease to each other.
A common misconception in the US is that “heterosexual AIDS” refers primarily to contracting the disease thru heterosexual intercourse with a partner who is not in any other risk group. This is mostly not a major factor here.
Fumento makes the point that AIDS is a disease of everyone in somewhat the same manner that breast cancer is a disease that everyone is at risk for. Technically, this is true - some hundreds of men get breast cancer every year in the US - but “heterosexual breast cancer” as a health risk is not that much different from female breast cancer as a health risk.
But this -
strikes me as a bit of an overstatement. The primary barrier to the explosion that was predicted for AIDS among heterosexuals in America who are not otherwise at risk is the difficulty of actually contracting the disease thru vaginal intercourse. Closing bath houses and so forth probably reduced the reservoir of infection so that cases of AIDS crossing over into heterosexual populations were reduced, but that probably had its major impact on gays, not heterosexuals. And the gay community fought furiously to prevent the authorities from closing down the bath houses.
The other phenomenom is statistical, where reduction in rates for one population means that another populations rates will change in comparison. If you have a thousand new infections per year in group A and three in group B, and then next year you have two thousand infections per year in A and ten in B, it is true that “rates are increasing among B faster than for A”. It is more than a little misleading to say “scientists predict that, if current trends continue, all of group B is going to DIE!!!” even if you are doing it to increase funding for A and B.
One thing that always puzzled me was why AIDS seemed to be mostly a problem for homosexual men in the US, but seemed to be transmitted heterosexually in Africa.
I asked that question in a thread that the hamsters seem to have eaten years ago. One answer I remember is that untreated venereal disease is fairly common in Africa, and that the resulting open sores make the transmission of HIV during heterosexual intercourse more likely.
It started in America among gays, and this drastically slowed the spread to the straight population for the obvious reason that straights and gays seldom have sex. That didn’t stop it being transmitted via bisexuals, blood and so forth, but it slowed the movement of the virus from one population to the other. AIDs in Africa didn’t start out among gays, so it spread normally among straights.
The strains of AIDS most common in Africa are somewhat more infectious, and are easier to pass via vaginal/oral intercourse as opposed to anal sex.
The Catholic Church has been more successful in preventing condom use in Africa.
That sentence is a little misleading; I for a moment thought that it was implying your risk is 1 in 5 million if the partner is positive. Wikipedia says that it is indeed slightly easier to contract HIV via receptive anal intercourse (estimated chance of 50 in 10,000 exposures to an infected source) as compared to insertive anal intercourse (estimated chance of 6.5 in 10,000 exposures to an infected source) insertive vaginal intercourse (estimated chance of 5 in 10,000 exposures to an infected source) or receptive vaginal intercourse (estimated chance of 10 in 10,000 exposures to an infected source). Maybe a clinician or virologist can say whether those numbers are accurate; I’m not totally sure.
Factors that increase the HIV positive rate in Africa include–
[ul]
[li]Prevalence of untreated STDs, which increases the rate of HIV transmission[/li][li]“Dry sex” – that is, the use of abrasive drying agents in vaginal intercourse is culturally preferred in some regions; this leads to genital abrasions which increase HIV transmission rate[/li][li]Poor educational standards, especially with resepect to sexual education[/li][/ul]
There is also good reason to believe that the actual incidence of AIDS has been greatly exaggerated. According to “Workshop on AIDS in Central Africa” (Bangui, Central African Republic, 22-25 Oct 1985, by the World Health Organization), a score of 12 or more using the following criteria was deemed sufficient to diagnose AIDS:
**Important signs ** (meriting a score of 4)[ul]
[li]Weight loss exceeding 10% of body weight[/li][li]Protracted asthenia[/li][/ul]
**Very frequent signs ** (meriting a score of 3)
[ul]
[li]Continuous or repeated attacks of fever for more than a month[/li][li]Diarrhea lasting for more than a month[/li][/ul] Other signs With a score of 4:
[ul]
[li]Oropharyngeal candidiasis[/li][li]Chronic or relapsing cutaneous herpes[/li][li]Generalized pruritic dermatosis[/li][li]Herpes zoster (relapsing)[/li][/ul] With a score of 2:
[ul]
[li]Cough[/li][li]Pneumopathy[/li][li]Generalized adenopathy[/li][li]Neurological signs[/li][/ul]
*With a score of 12:*Generalized Kaposi’s sacroma
This allows for quick diagnosis, but the drawback is that it does not require direct testing.
Even direct testing can be inaccurate as well. In South African’s pregnancy clinci surveys, for example, a single ELISA (Enzyme-linked Immunosorbent Assay) antibody test is deemed to be sufficient for diagnosis. However, even Abbott Laboratories – the manufacturer of the test kits used – has warned that conditions such as pregnancy can produce false positives. In addition,the antibody tests used were not specific to AIDS. Parasites that cause malaria, for example, can trigger the same results. According to one paper, when the malaria antibodies are removed, 80% of the suspected HIV infections vanish (reported in “AIDS in Africa: In Search of the Truth,” Rolling Stone, November 22, 2001).
So in addition to the problems reported earlier in this thread, I think there’s good reason to be skeptical about the astronomical number of AIDS infections in Africa that are often claimed.
One thing that changed a lot, I think, is the rate of condom use. I don’t know where to find a stat for this, but what older (50 and 60s) people tell me is that pre-HIV and post-Pill, there was sort of a Golden Age of bareback boning. The worst STD you could get would clear up with a course of antibiotics that were fairly cheap and things weren’t antibiotic resistant then, or maybe there just wasn’t so much awareness of antibiotic resistance. Gazillions of women got on the Pill when it became legal, and enjoyed sex without condoms and with little fear, and of course there was little to no reason for gay men to use condoms before HIV. So from '65 to the mid '80s (Koop didn’t advocate sexual education to combat HIV infection until his report in '86), there was little idea that people could use condoms as a life-saving measure - they were for preventing pregnancy and maybe a round of penicillin if you were really unlucky.
While condoms aren’t infallible, the increase in their use and even availability surely has some impact on reducing the AIDS crisis, yes? (Or preventing, if you insist, 'though I still think that over half a million people dead over 20 years from AIDS in the US counts as a “crisis”, even if it could have been worse.)
BTW, there’s a great timeline of HIV issues here Note the jump in “known deaths in the US” from AIDS between 1988 and 1989 - 4,855 in '88 to 14,544 in '89. Change in record keeping, or does the virus have some sort of 9 year life cycle?
Colorectal cancer claims a lot more deaths – over 57,000 per year, which means that its mortality rate is more than twice that of AIDS. It’s also a lot harder to prevent than HIV infection. Still, we don’t hear any clamor about a “colorectal cancer crisis.” Lung and breast cancer have even higher death tolls. Those are just specific varieties of cancer, mind you; the total death toll from cancer blows that of AIDS away.
Mind you, I’m not deny the tragedy of these AIDS-related deaths, nor am I suggesting that we should eliminate funding for AIDS research. I merely suggest that it gets a disproportionate amount of attention in the media and among various interest groups.