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Author Topic: Sex, drugs and HIV  (Read 16333 times)

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Offline komnaes

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Sex, drugs and HIV
« on: April 12, 2010, 10:36:37 am »
Just found this on TED.. the caption is the title of a speech.

http://www.ted.com/talks/elizabeth_pisani_sex_drugs_and_hiv_let_s_get_rational_1.html

I watched the whole thing just now.. just want to share and wonder what you think.
Aug 07 Diagnosed
Oct 07 CD4=446(19%) Feb 08 CD4=421(19%)
Jun 08 CD4=325(22%) Jul 08 CD4=301(18%)
Sep 08 CD4=257/VL=75,000 Oct 08 CD4=347(16%)
Dec 08 CD4=270(16%)
Jan 09 CD4=246(13%)/VL=10,000
Feb 09 CD4=233(15%)/VL=13,000
Started meds Sustiva/Epzicom
May 09 CD4=333(24%)/VL=650
Aug 09 CD4=346(24%)/VL=UD
Nov 09 CD4=437(26%)/VL=UD
Feb 10 CD4=471(31%)/VL=UD
June 10 CD4=517 (28%)/VL=UD
Sept 10 CD4=687 (31%)/VL=UD
Jan 11 CD4=557 (30%)/VL=UD
April 11 CD4=569 (32%)/VL=UD
Switched to Epizcom, Reyataz and Norvir
(Interrupted for 2 months with only Epizcom & Reyataz)
July 11 CD=520 (28%)/VL=UD
Oct 11 CD=771 (31%)/VL=UD(<30)
April 12 CD=609 (28%)/VL=UD(<20)
Aug 12 CD=657 (29%)/VL=UD(<20)
Dec 12 CD=532 (31%)/VL=UD(<20)
May 13 CD=567 (31%)/VL=UD(<20)
Jan 14 CD=521 (21%)/VL=UD(<50)

Offline Hellraiser

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Re: Sex, drugs and HIV
« Reply #1 on: April 12, 2010, 11:12:29 am »
Phenomenal presentation by a very good epidemiologist.

Offline pozniceguy

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Re: Sex, drugs and HIV
« Reply #2 on: April 12, 2010, 12:46:56 pm »
great presentation skills, very good message,,,listen carefully and vote.....

Nick
remember the good times...honor the past but don't live there
Le stelle la notte sono grandie luminose, nel cuore profondo del Texas

Offline Boo Radley

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Re: Sex, drugs and HIV
« Reply #3 on: April 12, 2010, 01:13:16 pm »
Personal responsibility!!  Stop making excuses!   Abstinence works!  Just say no!  No more bail-outs!  She looks like a lesbian!

If I'd known Maggie Thatcher BETRAYED ole Ronnie I never would have contributed to the Margaret Thatcher Fund to Bring Back Caning in Public Schools.

Does she have U.S. citizenship?  I'll vote for her for any office even if I have to register in another state.
String up every aristocrat!
Out with the priests and let them live on their fat!





Everything I do, say, think, excrete, secrete, exude, ooze, or write © 2007 Sweet Old Boo, Inc.

Offline GSOgymrat

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Re: Sex, drugs and HIV
« Reply #4 on: April 12, 2010, 04:53:45 pm »
Thanks for posting the video. She makes a lot of good points.

Offline leatherman

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Re: Sex, drugs and HIV
« Reply #5 on: April 12, 2010, 07:12:38 pm »
leatherman enjoyed the vid and speaker very much, and was able to use some of the data and discussion from the vid in a Speakers Bureau meeting at his ASO today. thanks for the heads up on that, K!
leatherman (aka Michael)

We were standing all alone
You were leaning in to speak to me
Acting like a mover shaker
Dancing to Madonna then you kissed me
And I think about it all the time
- Darren Hayes, "Chained to You"

Offline mecch

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Re: Sex, drugs and HIV
« Reply #6 on: April 12, 2010, 09:44:49 pm »
Informative talk, smart and great presenter.

One tidbit bugs me - the graph about rising infections in Gay men where haart is readily available. Scotland was the example.  
The previous graph explained how HAART may not be prevention and one of the reasons is resistance, STI caused spikes, and/or non-adherence.
Then she talks about Scotland and there is a sort of suggestion that these problems with HAART contribute to the spread of aids. Otherwise those people would be dead.  

Yes,she does say that other reasons, in HAART supplied countries - is the lesser fear of HIV, versus the fear we all had of AIDS before HAART.

She is trying to figure out two things -
1) why condom use goes down for gay men where there is easy HAART
and
2) why infection rates go up -  

I would be curious to see more quantatative research on that very issue. I just have a hunch that the infection rates would mostly go back up because of gay men barebacking with untreated HIV+ men, or barebacking with men who don't know their status.  

I really don't think there would be many transmissions caused by spikes or resistance or non adherence.  Id like to see the numbers.   She says she is not trying to cast a shadow on the need to treat with HAART, but she kind of casts the shadow, anyway.  

To put it simply.  In barebacking capitals such as London or Berlin or Paris, I do NOT think new infections are much coming from treated HIV+ gay men.  I think the transmission is guys with unknown status, spreading it, for example recent conversions, and guys who are HIV+ and not treated and who bareback who ever is willing, and of course, HIV- guys who just don't care at all and bareback.

Now that I am HIV+ i am meeting more guys in the last category than I knew existed. Guys who are HIV- or think they are, or lie that they are, and have no problem barebacking.
« Last Edit: April 12, 2010, 09:54:32 pm by mecch »
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Hellraiser

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Re: Sex, drugs and HIV
« Reply #7 on: April 12, 2010, 09:54:07 pm »
I watched it this morning, but what she said in relation to infections increasing was roughly this...

Fear of the disease diminishing leads to a rise of riskier practices.  In addition, the people who are on HAART are now living longer and thus instead of dying off have a greater period of time in which they could potentially infect new partners.  She explains that the Viral load may spiral out of control for a number of reasons, be it a blip or a few missed doses of medication. 

Offline Boo Radley

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Re: Sex, drugs and HIV
« Reply #8 on: April 12, 2010, 10:59:30 pm »
Informative talk, smart and great presenter.

...
The previous graph explained how HAART may not be prevention and one of the reasons is resistance, STI caused spikes, and/or non-adherence.
Sorry to be so dense but I'm confused.  HAART isn't preventive.  It's treatment.  

Quote
Then she talks about Scotland and there is a sort of suggestion that these problems with HAART contribute to the spread of aids. Otherwise those people would be dead.  

Yes,she does say that other reasons, in HAART supplied countries - is the lesser fear of HIV, versus the fear we all had of AIDS before HAART.
...

What I understood her to say was as an epidemiologist (and a decent human, a rare combination) her experiences with 3 of the most common groups currently contracting HIV - sex workers, IV drug users, and gay males, the dismaying fact is it seems gay males are one group for whom preventive strategies aren't necessarily working.   HAART per se has nothing to to with it -- might as well be a magic bullet, which seems to be the confusion.  The media and medical care providers, including pharmas and the lot, have all played roles in lessening the fear of contracting HIV (she didn't say this, I do...).  Her remarks that gay men were using condoms and taking care of AIDS patients before society deigned to touch them, greatly reducing transmission rates in the early years of the epidemic (especially in that greatest fucking country in the whole wide world, my beloved USofA, LLC), and the seeming conundrum of new infections at rising or increased rates, hit a chord with me.  Give IV drug users clean needles legally and many will use them.  Frankly I was surprised the campaign with sex workers has such good results since clients have been known to demand condomless sex.   In different situations people have "rational" reasons for acting one way or another.  I can't figure out the rationale of BB sex but then I'm a boring old fart who lost too many friends and acquaintances to forget the holocaust that is AIDS unchecked.  

Of course all that's my paraphrasing, embellishing, or plain imagining since I watched it only once.  And my proclivity for hearing only what I want and discarding the rest is well known among the more sophisticated of my bevies of coteries, admirers, detractors, and general cohort... which includes very few people here I fear.

"All my friends are gay, sweetie!  All my friends are gay!"
« Last Edit: April 12, 2010, 11:01:35 pm by Boo Radley »
String up every aristocrat!
Out with the priests and let them live on their fat!





Everything I do, say, think, excrete, secrete, exude, ooze, or write © 2007 Sweet Old Boo, Inc.

Offline leatherman

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Re: Sex, drugs and HIV
« Reply #9 on: April 12, 2010, 11:20:22 pm »
HAART isn't preventive.  It's treatment.  
HAART has the "preventive" component of lowering the VL to UD thereby allowing people to have unprotected sex without passing on the virus.

HAART per se has nothing to to with it -- might as well be a magic bullet, which seems to be the confusion.  The media and medical care providers, including pharmas and the lot, have all played roles in lessening the fear of contracting HIV (she didn't say this, I do...).  I can't figure out the rationale of BB sex but then I'm a boring old fart who lost too many friends and acquaintances to forget the holocaust that is AIDS unchecked. 
but you did figure out the rationale. ;) The fear of HIV has been lessened to the point that people aren't scared of it anymore (as they rightfully should be). The "chronic and manageable" one-pill-a-day rock-climbing meme along without seeing AIDS patients dying left and right means it's nothing anyone has to worry about anymore. If you get it, you just take a pill for it now.  ::)

When I talked about this at the meeting today, I talked about all the PSAs I saw in 1992 (along with all those dying friends of mine) being the reason for me getting tested. But now finding an HIV/AIDS PSA, or seeing a character on TV with AIDS/HIV is just about impossible. outta sight, outta mind.
leatherman (aka Michael)

We were standing all alone
You were leaning in to speak to me
Acting like a mover shaker
Dancing to Madonna then you kissed me
And I think about it all the time
- Darren Hayes, "Chained to You"

Offline PeteNYNJ

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Re: Sex, drugs and HIV
« Reply #10 on: April 12, 2010, 11:26:40 pm »
I liked this speech a hell of a lot more than The Guardian article she wrote a few months (?) ago that just said basically said people do stupid thing that is why they get HIV. 

I am glad she went into rationalization, some theoretically causes of rising rates, and addressing the "more infected fish in the pond" and didn't sell it like that was a bad thing.  I think prevention needs to head of the direction that there will be more men living with infection in the gay community and to end stigma and have honest conversations with your partners.  Also, a push toward the difference between prevention and treatment, because treatment is no walk in the park as I am sure we can all attest to.

Offline next2u

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Re: Sex, drugs and HIV
« Reply #11 on: April 13, 2010, 12:29:33 am »
me likey.
midapr07 - seroconversion
sept07 - tested poz
oct07 cd4 1013; vl 13,900; cd4% 41
feb08 cd4  694;  vl 16,160; cd4% 50.1
may08 cd4 546; vl 91,480; cd4% 32
aug08 cd4 576; vl 48,190; cd4% 40.7
dec08 cd4 559; vl 63,020; cd4% 29.4
feb09 cd4 464; vl 11,000; cd4% 26
may09 cd4 544; vl 29,710; cd4% 27.2
oct09 cd4 ...; vl 23,350; cd4% 31.6
mar10 cd4 408; vl 59,050; cd4% 31.4
aug10 cd4 328; vl 80,000; cd4% 19.3 STARTED ATRIPLA
oct10 cd4 423; vl 410 ;); cd4% 30.2
jun11 cd4 439; vl <20 ;); cd4% 33.8 <-Undetectable!
mar12 cd4 695; vl ud; cd4% 38.6
jan13 cd4 738; vl ud; cd4% 36.8
aug13 cd4 930; vl ud; cd4% 44.3
jan14 cd4 813; vl ud; cd4% 42.8
may14 cd4 783; vl *; cd4%43.5
sept14 cd4 990; vl ud; cd4% *
jun15 cd4 1152; vl ud; cd4% *
july15 - STRIBILD
oct15 cd4 583; vl 146; cd4% 42
mar16 cd4 860; vl 20; 44

Offline Boo Radley

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Re: Sex, drugs and HIV
« Reply #12 on: April 13, 2010, 12:40:13 am »
HAART has the "preventive" component of lowering the VL to UD thereby allowing people to have unprotected sex without passing on the virus.

Has that actually been accepted and proven?  I thought the question was still moot.

Quote
but you did figure out the rationale. ;) ...

I was speaking personally.  I believe I understand what's happened and can't believe we would have to return to a time when people were withering and dying every day in front of us to make people understand it ain't over 'til the fat lady zings.
String up every aristocrat!
Out with the priests and let them live on their fat!





Everything I do, say, think, excrete, secrete, exude, ooze, or write © 2007 Sweet Old Boo, Inc.

Offline Hellraiser

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Re: Sex, drugs and HIV
« Reply #13 on: April 13, 2010, 12:46:10 am »
Has that actually been accepted and proven?

2 studies have stated someone with a suppressed viral load has a very low chance of infecting a partner.

Offline leatherman

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Re: Sex, drugs and HIV
« Reply #14 on: April 13, 2010, 12:49:59 am »
Has that actually been accepted and proven?  I thought the question was still moot.
the swiss study of those straight couples conceiving children without passing along the infection is partial proof. so yes, haart bringing the vermemia down to UD is one way to prevent the spread of HIV while still having unprotected sex.
leatherman (aka Michael)

We were standing all alone
You were leaning in to speak to me
Acting like a mover shaker
Dancing to Madonna then you kissed me
And I think about it all the time
- Darren Hayes, "Chained to You"

Offline leatherman

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Re: Sex, drugs and HIV
« Reply #15 on: April 13, 2010, 01:08:02 am »
I believe I understand what's happened and can't believe we would have to return to a time when people were withering and dying every day in front of us to make people understand it ain't over 'til the fat lady zings.
it's all about the advertising, and the advertising says the HIV is no worse that diabetes, folks, so pop your pill and go rock climbing etc. Really look at these ads for the various haart meds sometimes. Why nearly everyone is pretty, sexy, and healthy looking. Why would anyone be scared of getting a disease like that?? ::) and since the infection rate is gays in the US in on the rise again, the advertising must be working. ;)

of course, I don't know the solution since the answer really is murky. I mean, for instance, look at the things I say to the newbies here. On one hand I say, there are better meds than in 92, and you will probably live a longer healthy life, so don't think you're going to die just cause you found out your poz. Yet on the other hand I say, if you let that hiv go untreated you'll get those nasty ol' OIs and die cause it's still the same ol' terminal disease that it's always been. It's not a killer; but it is a killer.  ::) it does tend to make my advice sound a little psychotic LOL

But they haven't gotten everyone to stop smoking yet either (although it's been 1 yr and 78 days since my last cig ;D ), so we'll probably never see the infection rate of HIV drop below a certain percentage either. :-[ It's just not scarey enough anymore.
leatherman (aka Michael)

We were standing all alone
You were leaning in to speak to me
Acting like a mover shaker
Dancing to Madonna then you kissed me
And I think about it all the time
- Darren Hayes, "Chained to You"

Offline Hellraiser

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Re: Sex, drugs and HIV
« Reply #16 on: April 13, 2010, 01:24:50 am »
I'm actually kinda curious why they don't have some sort of mandatory testing for HIV.  Even if it was only once every 4 years (say with your driver's license) it would be a way to make sure everyone is being checked for the communicable potentially lethal virus.  Step 1 is making sure everyone who has it knows that they have it, Step 2 would be educating them on how not to spread it or perhaps lowering their viral load to the point where they hopefully could not spread it.  I know those two things seem monumental but, the alternative is what exactly, pray it doesn't keep spreading?

I've always thought a particularly nasty twist of fate would be if some virus that was lethal mutated into something airborne.  Imagine if the whole world had HIV, I'd bet there'd be an effective cure in under 10 years.

Offline Matty the Damned

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Re: Sex, drugs and HIV
« Reply #17 on: April 13, 2010, 01:36:39 am »
I'm actually kinda curious why they don't have some sort of mandatory testing for HIV.  Even if it was only once every 4 years (say with your driver's license) it would be a way to make sure everyone is being checked for the communicable potentially lethal virus.  Step 1 is making sure everyone who has it knows that they have it, Step 2 would be educating them on how not to spread it or perhaps lowering their viral load to the point where they hopefully could not spread it.  I know those two things seem monumental but, the alternative is what exactly, pray it doesn't keep spreading?

I've always thought a particularly nasty twist of fate would be if some virus that was lethal mutated into something airborne.  Imagine if the whole world had HIV, I'd bet there'd be an effective cure in under 10 years.

Mandatory HIV testing? Sort of runs contrary to the concept of informed consent. Also, what of the window period?

A negative HIV antibody test does not mean a person does not have HIV.

MtD

Offline leatherman

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Re: Sex, drugs and HIV
« Reply #18 on: April 13, 2010, 02:00:37 am »
Mandatory HIV testing? Sort of runs contrary to the concept of informed consent.
not that I really want to turn this thread into a whole testing issues discussion; but when I go for a physical, they take blood and check my cholesterol, which could possibly kill me in 20 yrs if it's bad, but they won't check it for a terminal illness that could kill me in 10 yrs, unless I specifically ask??

After speaking/prevention events my clinic puts on, in the Q and A afterwards, there's almost always a question from someone thinking HIV tests are already done as a standard. They're always surprised to find out that unless they specifically ask to be checked out for the terminal disease, they won't test for it, but they'll test for all that other less important stuff.

You'd think by now people in America would understand that there's no such thing as preventive medicine going on here. LOL

I understand your points about informed consent and window periods; but most doctors don't even make the offer of having the test. The burden falls on the (un-informed) patient to ask for the test and some of time they just assume such an important test is already being done, especially if blood is drawn.

making the HIV test more complicated to get, and not part of standardized testing, makes HIV seem "special", and stigma only follows from being that kind of special. ;)
leatherman (aka Michael)

We were standing all alone
You were leaning in to speak to me
Acting like a mover shaker
Dancing to Madonna then you kissed me
And I think about it all the time
- Darren Hayes, "Chained to You"

Offline tednlou2

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Re: Sex, drugs and HIV
« Reply #19 on: April 13, 2010, 02:12:17 am »
Thanks for the link.  I enjoy this woman.  So they are the ones who took TED.com, so I couldn't have it..lol.  And, TED Airlines, too.

I saw a study a few months ago that there is a high percentage of couples in magnetic relationships where the neg partner doesn't get infected.  I was trying to find it--maybe some of you saw it, too.  It got me to thinking about what she said about HIV actually being hard to transmit through sex.  If a couple makes it through the seroconversion stage where the viral load goes really high, then the chances of the negative partner getting infected goes way down--especially after HAART is started.  

I do think many of us took more chances, because we weren't seeing people dying of AIDS like so many others did.  If we saw friend after friend die, I know I probably wouldn't have had sex at all or made very sure I didn't get infected.  I think many of us who got the virus from someone we were in a relationship with would probably have used condoms even in the relationship--if we were seeing our friends die.  It was sad to see when other groups infection rates were dropping, the gay infection rates didn't.  

By the way, I would never believed that second pic of Joseph was the same guy in the first pic.  I really thought she was going to say Joseph died after showing that first pic.  Wow.    

Offline tednlou2

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Re: Sex, drugs and HIV
« Reply #20 on: April 13, 2010, 02:22:51 am »
I'm actually kinda curious why they don't have some sort of mandatory testing for HIV.  Even if it was only once every 4 years (say with your driver's license) it would be a way to make sure everyone is being checked for the communicable potentially lethal virus.  Step 1 is making sure everyone who has it knows that they have it, Step 2 would be educating them on how not to spread it or perhaps lowering their viral load to the point where they hopefully could not spread it.  I know those two things seem monumental but, the alternative is what exactly, pray it doesn't keep spreading?

I've always thought a particularly nasty twist of fate would be if some virus that was lethal mutated into something airborne.  Imagine if the whole world had HIV, I'd bet there'd be an effective cure in under 10 years.

I think I read somewhere that some hospitals and clinics are now asking whether the patient would like an HIV test while they are there.  It said they asked everyone--not just people they thought were gay or drug users.  It isn't mandatory, but a good start.  I don't think this is the norm at most hospitals yet.  Since many young people don't go the the hospital, their primary care doc should ask as standard procedure.  I saw a report on the news where older people in retirement homes were being asked to have a test due to the rise of HIV among our grandparents.  

Offline PeteNYNJ

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Re: Sex, drugs and HIV
« Reply #21 on: April 13, 2010, 03:32:11 am »
Quote
I do think many of us took more chances, because we weren't seeing people dying of AIDS like so many others did.  If we saw friend after friend die, I know I probably wouldn't have had sex at all or made very sure I didn't get infected

Am I the only person who sees the fact that I didn't see my friends dying of AIDS as a good thing?

 I would love to debate that fact that MORE people in the late 90's living with HIV/AIDS and living healthier could be the reason why more people today are infected.  I don't see this as a bad thing (meaning I don't fault them), I just see this as a failure in the prevention model set up in the late 80s/early 90s.  How do we address these new people who are living?  Great posters with men climbing mountains?  When lifesaving HIV drugs were first discovered no one wanted to publicize "wow, this sucks".  It was triumph, and the result was an attitude of triumph.  Now we know that although the virus can be put into check, there are many side effects.

How do we balance this?  There is so much demonetization, especially among HIV neg gay men, but they never want to take responsibility for their own health. It is up to us, the pozzies to not only disclose our status but to educate.  It gets very tiresome.

« Last Edit: April 13, 2010, 03:33:54 am by PeteNYNJ »

Offline tednlou2

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Re: Sex, drugs and HIV
« Reply #22 on: April 13, 2010, 04:05:30 am »
Am I the only person who sees the fact that I didn't see my friends dying of AIDS as a good thing?

 I would love to debate that fact that MORE people in the late 90's living with HIV/AIDS and living healthier could be the reason why more people today are infected.  I don't see this as a bad thing (meaning I don't fault them), I just see this as a failure in the prevention model set up in the late 80s/early 90s.  How do we address these new people who are living?  Great posters with men climbing mountains?  When lifesaving HIV drugs were first discovered no one wanted to publicize "wow, this sucks".  It was triumph, and the result was an attitude of triumph.  Now we know that although the virus can be put into check, there are many side effects.

How do we balance this?  There is so much demonetization, especially among HIV neg gay men, but they never want to take responsibility for their own health. It is up to us, the pozzies to not only disclose our status but to educate.  It gets very tiresome.



I'm definitely not saying I wish my friends were dying of AIDS before I got infected, so I would have known better and remained neg.  I'm so happy I've only really known personally just 2 people who died of AIDS--2 too many.  I hope I didn't give that impression.  It is because I had only seen one person, a family friend, when I was 16 die of AIDS that I didn't think HIV was as wide-spread as it is.  However, I did worry about HIV and took precautions--obviously not enough.  I think I did believe if HIV was so prevelant, I would have known many more people with the virus.  I probably did know many others, but due to the awesome meds they were able to keep it a secret.  The other person I knew who died was after I was already infected.  He just refused to take the meds.

As an example about the thinking of young people, I had my best friend over for Easter.  We went out to the grocery store and he arranged a hook-up with some guy.  He begged me to stop by this guys apt on the way home.  I did.  I told him to do his business and I'll wait in the living room.  The guy was wanting me to join in.  He was talking about some skinny guy he met that he "was sure had AIDS."  I declined the offer to join in as I'm in a relationship, but also because I'm poz and didn't want to get into all that.  I did tell him he shouldn't judge who is poz by looking at them.  If I had joined in, he would have been having sex with someone poz thinking I must be negative because I wasn't skin and bones.  He was just 21, so that explains how young people think.  I thought I could tell who was poz when I was that age.         


Offline PeteNYNJ

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Re: Sex, drugs and HIV
« Reply #23 on: April 13, 2010, 04:14:04 am »
Tednlou2

I did not mean specifically you, I just see this argument a lot.  If we (the second generation of HIV) would have seen our friends die of AIDS, we wouldn't have gotten it.  I for one am glad I didn't see my friends die of AIDS.  I don't believe this is a newbie vs LTS conversation either, it is a prevention campaign issue.  How do you present the reality of HIV infection to those who have only been raised in a time of treatment and not prevention?

How do we eliminate stigma?  How does that happen when honesty about being positive means to some social shunning?  Why do those who know the risks still get infected? (I believe a mental health component should be a huge part of prevention - care about yourself enough to not get infected).

Complicated issues that need more than just black and white thinking.

Offline Matty the Damned

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Re: Sex, drugs and HIV
« Reply #24 on: April 13, 2010, 04:54:56 am »
Tednlou2

I did not mean specifically you, I just see this argument a lot.  If we (the second generation of HIV) would have seen our friends die of AIDS, we wouldn't have gotten it.  I for one am glad I didn't see my friends die of AIDS.  I don't believe this is a newbie vs LTS conversation either, it is a prevention campaign issue.  How do you present the reality of HIV infection to those who have only been raised in a time of treatment and not prevention?

How do we eliminate stigma?  How does that happen when honesty about being positive means to some social shunning?  Why do those who know the risks still get infected? (I believe a mental health component should be a huge part of prevention - care about yourself enough to not get infected).

Complicated issues that need more than just black and white thinking.

All of my life has been dominated by AIDS. When I came out in 1988 AIDS was everywhere. Queens were dropping dead between beers at the Oxford.

I do not like to think about how many I've buried to AIDS.

Didn't give me pause for thought when I was infected in 2000 or 2001.

MtD

Offline PeteNYNJ

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Re: Sex, drugs and HIV
« Reply #25 on: April 13, 2010, 05:00:11 am »
Matty 

IMHO  people could drop dead next to you at a bar but the dick wants what it wants and we know how many stupid decisions are made due to what the dick wants (gay and straight).

Ugh, who knows

Offline Matty the Damned

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Re: Sex, drugs and HIV
« Reply #26 on: April 13, 2010, 05:03:27 am »
Matty 

IMHO  people could drop dead next to you at a bar but the dick wants what it wants and we know how many stupid decisions are made due to what the dick wants (gay and straight).

Ugh, who knows

Indeed Petey. The standing prick has no whatsiname and all that.

MtD

Offline RapidRod

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Re: Sex, drugs and HIV
« Reply #27 on: April 13, 2010, 06:47:12 am »
the swiss study of those straight couples conceiving children without passing along the infection is partial proof. so yes, haart bringing the vermemia down to UD is one way to prevent the spread of HIV while still having unprotected sex.

The Swiss study was bunked when it came out. Just because someone has an undetectable serum viral load doesn't mean they have an undetectable semen viral load.

Offline GSOgymrat

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Re: Sex, drugs and HIV
« Reply #28 on: April 13, 2010, 06:58:16 am »
I'm surprised drug companies are not pushing harder for more testing or even paying for testing at ERs and physicians offices. Every time someone tests HIV+ they have a life long customer, which is exactly what they want.

Offline Jeff G

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Re: Sex, drugs and HIV
« Reply #29 on: April 13, 2010, 07:26:41 am »
I'm surprised drug companies are not pushing harder for more testing or even paying for testing at ERs and physicians offices. Every time someone tests HIV+ they have a life long customer, which is exactly what they want.


I have been thinking along the same line of reasoning for some time . It seems getting a test for HIV antibodies is more than some people can bring themselves to schedule and follow through on .

My best friend has been having terrible skin issues with fatigue and infections for years now and has refused to go in for a hiv test . I finally convinced him its time to test so we are doing it today at 11:00 . I just hope he shows up for the appointment .

He has been to more than a few doctors about his health problems and not once has any one suggested a hiv test and that just blows my mind .
« Last Edit: April 13, 2010, 07:40:18 am by jg1962 »
HIV 101 - Basics
HIV 101
You can read more about Transmission and Risks here:
HIV Transmission and Risks
You can read more about Testing here:
HIV Testing
You can read more about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read more about HIV prevention here:
HIV prevention
You can read more about PEP and PrEP here
PEP and PrEP

Offline leatherman

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Re: Sex, drugs and HIV
« Reply #30 on: April 13, 2010, 10:18:24 am »
The Swiss study was bunked when it came out.
wow, i had never heard that. do you have more information?

I think that would be especially good to know, since even members here have actually gone on to have unprotected sex (w/o sperm washing), conceived children and not spread the infection to their partner (though the risk is not 0%). If that sort of scenario is not true, then we should not be encouraging straight pozzies to try to have children lest they infect their partners.

http://forums.poz.com/index.php?topic=17088.0
http://forums.poz.com/index.php?topic=29744.0
http://forums.poz.com/index.php?topic=30170.0
http://forums.poz.com/index.php?topic=26774.0
http://forums.poz.com/index.php?topic=5569.0
http://forums.poz.com/index.php?topic=3947.0
http://forums.poz.com/index.php?topic=5598.0
leatherman (aka Michael)

We were standing all alone
You were leaning in to speak to me
Acting like a mover shaker
Dancing to Madonna then you kissed me
And I think about it all the time
- Darren Hayes, "Chained to You"

Offline Matty the Damned

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Re: Sex, drugs and HIV
« Reply #31 on: April 13, 2010, 10:35:45 am »
wow, i had never heard that. do you have more information?

I think that would be especially good to know, since even members here have actually gone on to have unprotected sex (w/o sperm washing), conceived children and not spread the infection to their partner (though the risk is not 0%). If that sort of scenario is not true, then we should not be encouraging straight pozzies to try to have children lest they infect their partners.

http://forums.poz.com/index.php?topic=17088.0
http://forums.poz.com/index.php?topic=29744.0
http://forums.poz.com/index.php?topic=30170.0
http://forums.poz.com/index.php?topic=26774.0
http://forums.poz.com/index.php?topic=5569.0
http://forums.poz.com/index.php?topic=3947.0
http://forums.poz.com/index.php?topic=5598.0

Perhaps Roddles meant that the Swiss study was somewhat narrow in its scope and is sometimes misinterpreted.

MtD

Offline Hellraiser

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Re: Sex, drugs and HIV
« Reply #32 on: April 13, 2010, 10:41:26 am »
Perhaps Roddles meant that the Swiss study was somewhat narrow in its scope and is sometimes misinterpreted.

MtD

There is however a second study that says essentially the same thing, I believe it was Danish in origin.

Although from the reading I've been doing I'm seeing a lot of scientific shoulder shrugging. One study says they can't figure it out at all.  Another says VL in blood is usually higher than VL in semen however there are a few exceptions.  Although even those exceptions given extended periods of time on HAART fall into line with a UD semen VL.  I tend to think if they had +/- couples not using protection for years at a time with a suppressed VL and no cases of infection however that the real world application adds up moreso than the scientific theorycrafting.

Offline leatherman

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Re: Sex, drugs and HIV
« Reply #33 on: April 13, 2010, 10:49:17 am »
I tend to think if they had +/- couples not using protection for years at a time with a suppressed VL and no cases of infection however that the real world application adds up moreso than the scientific theorycrafting.
and that's the same logic that explains why we don't see a huge upswing in superinfections, and re-infections in +/+ couples on meds with UD VL (gay or straight). ;) so there is some sort of empirical evidence that HAART does prevent the spread of HIV, and hence is one prevention method as I told BR originally

edited to add:
I never said that HAART was a perfect prevention method ;) :D
« Last Edit: April 13, 2010, 11:13:34 am by leatherman »
leatherman (aka Michael)

We were standing all alone
You were leaning in to speak to me
Acting like a mover shaker
Dancing to Madonna then you kissed me
And I think about it all the time
- Darren Hayes, "Chained to You"

Offline RapidRod

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« Last Edit: April 13, 2010, 08:14:37 pm by RapidRod »

Offline leatherman

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Re: Sex, drugs and HIV
« Reply #35 on: April 13, 2010, 08:38:34 pm »
http://www.natap.org/2009/CROI/croi_157.htm

http://www.aegis.org/news/catie/2010/CATE-N20100301.html
thanks. ;)
I guess. That's some scary stuff.

However, the risk of HIV transmission is not eliminated nor is it negligible. Indeed, sexual transmission of HIV has occurred in multiple cases when viral load in the blood was less than 50 copies/ml. - from the aegis.org link

and ouch. I guess the mods better quit telling people that oral sex is not a risk and that sperm-washing is the only way for straight couples to truly be "safe" in trying to conceive a child. Plus we need to all re-examine that whole issue about sero-sorted poz-on-poz re-infection and super-infection.
leatherman (aka Michael)

We were standing all alone
You were leaning in to speak to me
Acting like a mover shaker
Dancing to Madonna then you kissed me
And I think about it all the time
- Darren Hayes, "Chained to You"

Offline Matty the Damned

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Re: Sex, drugs and HIV
« Reply #36 on: April 13, 2010, 08:42:04 pm »
I guess the mods better quit telling people that oral sex is not a risk

This is not true and you know it.

MtD

Offline leatherman

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Re: Sex, drugs and HIV
« Reply #37 on: April 13, 2010, 08:55:39 pm »
This is not true and you know it.

MtD
read those links. there's hiv in semen even when someone is UD (by blood test), therefore, oral sex is transmission risk.

personally, I have never known or heard of anyone truly getting infected through oral sex, or by having sex with an person with UD viral load, but that's obviously not what the science says is possible.
leatherman (aka Michael)

We were standing all alone
You were leaning in to speak to me
Acting like a mover shaker
Dancing to Madonna then you kissed me
And I think about it all the time
- Darren Hayes, "Chained to You"

Offline Hellraiser

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Re: Sex, drugs and HIV
« Reply #38 on: April 13, 2010, 09:04:13 pm »
There might be HIV in semen but it has no way to in via the mouth is what he means.  Also superinfection isn't really an issue theoretically because the HAART most of us are on should act as PrEP against any new strain.  I'm convinced superinfection is mostly a mythical beast anyway.

Offline Matty the Damned

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Re: Sex, drugs and HIV
« Reply #39 on: April 13, 2010, 09:11:46 pm »
read those links. there's hiv in semen even when someone is UD (by blood test), therefore, oral sex is transmission risk.

personally, I have never known or heard of anyone truly getting infected through oral sex, or by having sex with an person with UD viral load, but that's obviously not what the science says is possible.

You know what I'm saying. Your claim that the moderators assert HIV is not transmitted via oral sex is a lie.

MtD

Offline mecch

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Re: Sex, drugs and HIV
« Reply #40 on: April 13, 2010, 09:37:09 pm »
Could we bring this back to the epidemiologist's statements.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline decayingsinner

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Re: Sex, drugs and HIV
« Reply #41 on: April 13, 2010, 09:42:39 pm »
A little late on the reply. I just watched the video and only though this is one tiny segment of the HIV epidemic, I thought this was very informative and hopefully would entice, hopefully, a small segment at a minimum of listeners  to think with their hear rather than their dick or whatever drug they are craving for. OVerall, it was moving and makes me wish past judgments were acting upon differently.  I do know that I can only live with the choices I have made and for all future choices.

Offline Boo Radley

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Re: Sex, drugs and HIV
« Reply #42 on: April 13, 2010, 09:43:17 pm »
Could we bring this back to the epidemiologist's statements.

What?  Break with long-standing tradition??   Iconoclast!!
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Offline RapidRod

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Re: Sex, drugs and HIV
« Reply #43 on: April 14, 2010, 06:24:45 am »
thanks. ;)
I guess. That's some scary stuff.

However, the risk of HIV transmission is not eliminated nor is it negligible. Indeed, sexual transmission of HIV has occurred in multiple cases when viral load in the blood was less than 50 copies/ml. - from the aegis.org link

and ouch. I guess the mods better quit telling people that oral sex is not a risk and that sperm-washing is the only way for straight couples to truly be "safe" in trying to conceive a child. Plus we need to all re-examine that whole issue about sero-sorted poz-on-poz re-infection and super-infection.
http://www.aegis.com/news/pr/1998/pr980105.html

Offline Lis

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Re: Sex, drugs and HIV
« Reply #44 on: April 15, 2010, 02:48:36 am »
Yes.  can you say backwards,,, thats the USA
poz 1986....

Offline Cliff

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Re: Sex, drugs and HIV
« Reply #45 on: April 15, 2010, 04:53:04 am »
Great presentation skills.  But I was left wanting a bit more substance.  Maybe I skipped over it, but specifics on how to deal with increasing infections in the gay community seemed lacking.

 


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