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Author Topic: one in three progress to AIDS in one year.  (Read 16053 times)

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Offline richie

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Re: one in three progress to AIDS in one year.
« Reply #50 on: June 09, 2011, 10:05:37 PM »
I'm not suggesting a roundup of HIV+ people.  I'm suggesting a plan to test EVERYONE.  Then offer information and treatment.  Where and how we test is up for grabs, but it needs to be thorough (even in old folks homes since they're spreading it too).  That's all. 

If we can vaccinate every child and make it a requirement before they get into school, we can certainly figure out how to test everyone for HIV (a good publicity campaign wouldn't hurt).   

I know it sounds radical.  But I don't think it is.  Just my opinion.

Offline leatherman

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Re: one in three progress to AIDS in one year.
« Reply #51 on: June 09, 2011, 10:10:18 PM »
It should be Federal, as the States will never uniformly comply.  It could be as simple as legislating that anyone with HIV automatically gets Medicaid, and can therefore access appropriate therapy.
work has already been done over the last year to do exactly that.

"State Medicaid 1115 Waiver Option to Expand HIV Care and Treatment Access:

As part of its pledge under the National HIV/AIDS Strategy, the Centers for Medicare and Medicaid Services (CMS) recently released guidance and an application template to make it easier for states to apply for Section 1115 Medicaid waivers to cover pre-disabled people living with HIV. Right now (and until 2014 when health care reform expands Medicaid to most people up to 133% of the federal poverty level), most people living with HIV have to wait until they are disabled by AIDS to be eligible for MEdicaid. An 1115 waiver gives a state flexibility to immediately cover pre-disabled people living with HIV under its Medicaid program, and provides an important tool in addressing the current ADAP crisis."
http://www.taepusa.org/
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline richie

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Re: one in three progress to AIDS in one year.
« Reply #52 on: June 09, 2011, 10:23:39 PM »
Cool!  Didn't know this.  But.....and there are buts....

I see blue states adopting it, red states not adopting it.  Also, I still need to be <133% of the federal poverty level to qualify?  That's how it read to me.  Is that correct?  If so, then that's a bummer. 

Offline phildinftlaudy

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Re: one in three progress to AIDS in one year.
« Reply #53 on: June 09, 2011, 10:43:55 PM »
I'm not suggesting a roundup of HIV+ people.  I'm suggesting a plan to test EVERYONE.  Then offer information and treatment.  Where and how we test is up for grabs, but it needs to be thorough (even in old folks homes since they're spreading it too).  That's all. 

If we can vaccinate every child and make it a requirement before they get into school, we can certainly figure out how to test everyone for HIV (a good publicity campaign wouldn't hurt).   

I know it sounds radical.  But I don't think it is.  Just my opinion.
Couple of problems with this:
1) So, let's say hypothetically that everyone gets tested and they all get tested on January 1st - but then they engage in risky behavior or they had risky behavior a few days before they tested --- the test would not show the infection or they could become infected shortly after having the test.  So, how often does someone get tested?  Annually?  Not gonna be enough.  Quarterly - not gonna be enough.  Maybe it would have to be weekly or even daily.  When the simple answer is to practice safe sex.
2) The reason for mandatory TB testing, in some cases, and mandatory immunizations to go to school  is to prevent the spread of diseases that are transmitted via airborne and non-intimate contact means.  For the most part, HIV is spread via sexual contact - unprotected sexual contact.  With universal precautions in place, transmission in the medical environment is very low (and in the case of a needle stick - today's response would be to start PEP - and I believe that is done whether the person is known to be HIV positive or not.  Spreading of HIV via the blood supply is now rare (possibly even nill) due to screening protocols in place.
3) So, a person tests positive with this test everyone policy - how do we ensure they are compliant with treatment?  Follow them around for life?  If they are not compliant, what is done to them?  Imprisonment?  Man, talk about stigmatization of a disease, if that starts happening.

In a perfect world, person's who are sexually active and have other risk behaviors  or believe they may have otherwise been exposed to the virus would get tested.  I am a definite advocate of testing AND TREATING - but mandatory testing of everyone is letting emotion override intellect and is only a few small steps away from calls to set up quarantine camps for life for those who are positive .

Push the envelope a little bit further and we could evolve into a society that develops a test for criminal behavior and once identified immediately locks people up before they have a chance to commit a crime - unless we figure it out while they are still in the womb - and then we could just preempt the birth....

I don't see how mandatory testing is going to have any effect on diminishing the stigma associated with HIV/AIDS.  It might actually have the reverse effect and increase the stigma.  Instead of using resources to test everyone - let's encourage testing, but put more resources into finding a cure and continuing to get the message out that HIV/AIDS is, for the most part, a preventable disease. --- Just my opinion --- even though it isn't that radical.   :)
September 13, 2008 - diagnosed +
Labs:
Date    CD4    %   VL     Date  CD4  %   VL
10/08  636    35  510   9/09 473  38 2900  12/4/09 Atripla
12/09  540    30    60   
12/10  740    41  <48   
8/11    667    36  <20  
03/12  1,041  42  <20
05/12  1,241  47  <20
08/12   780    37  <20
11/12   549    35  <20
02/12  1,102  42  <20
11/12   549    35  <20

Offline leatherman

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Re: one in three progress to AIDS in one year.
« Reply #54 on: June 09, 2011, 10:51:34 PM »
I see blue states adopting it, red states not adopting it.
Exactly! now the push is on to get states to apply and use the 1115 waiver.

I still need to be <133% of the federal poverty level to qualify?
no. "obamacare" is going to require states to provide medicaid to people up to 133% FPL. The 1115 waiver would allow a state the choice to give people making >133%FPL this parital medicaid to cover meds. In effect, an 1115 waiver could wipe out state ADAP and give all pozzies access to HIV meds; however, I'm sure they'll be putting some financial limits onto it.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline richie

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Re: one in three progress to AIDS in one year.
« Reply #55 on: June 09, 2011, 10:52:13 PM »
For what it's worth, I'm also for putting as much money as possible towards a cure.  That's the REAL answer. 

Offline richie

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Re: one in three progress to AIDS in one year.
« Reply #56 on: June 09, 2011, 10:55:40 PM »
Exactly! now the push is on to get states to apply and use the 1115 waiver.
no. "obamacare" is going to require states to provide medicaid to people up to 133% FPL. The 1115 waiver would allow a state the choice to give people making >133%FPL this parital medicaid to cover meds. In effect, an 1115 waiver could wipe out state ADAP and give all pozzies access to HIV meds; however, I'm sure they'll be putting some financial limits onto it.

This is, actually, pretty exciting if it can get going.  Unfortunately, it sounds like it won't help people like me; I'm on the State high-risk insurance pool, which costs me about $12k annually.  But it's all I can get (I'm too far above to FPL to qualify for anything).   If the repubs don't kill healthcare reform, 2014 will be a blockbuster year!

Added:  I just read the statement from the link you posted.  I didn't see anything that referenced anything >133 of the FLP -- only found <133 or 100 or less.  It seems one has to have no income, or still be destitute to qualify for this waiver?   Ugh.
« Last Edit: June 09, 2011, 11:05:13 PM by richie »

Offline Assurbanipal

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Re: one in three progress to AIDS in one year.
« Reply #57 on: June 10, 2011, 12:39:42 AM »
Couple of problems with this:
1) So, let's say hypothetically that everyone gets tested and they all get tested on January 1st - but then they engage in risky behavior or they had risky behavior a few days before they tested --- the test would not show the infection or they could become infected shortly after having the test.  So, how often does someone get tested?  Annually?  Not gonna be enough.  Quarterly - not gonna be enough.  Maybe it would have to be weekly or even daily.  When the simple answer is to practice safe sex.

Well, I'm not in favor of mandatory testing.

But this argument doesn't really hold up.

First, if there are 56,000 new infections per year, then the number of people in the window period would be quite small compared to the 230,000 or so undiagnosed -- well under 10,000 (since most people would show at 6 weeks), and at that level of undiagnosed, the potential level of additional new infections from the undiagnosed would drop dramatically -- especially if this hypothetical universal testing were accompanied by an education campaign and an annual repeat.  If the other 220,000 start to protect their partners better and/or some large fraction get onto treatment, one could see a very significant drop in new infections.

Second, how can one argue that practicing safe sex is the simple answer?  I guess if simple answers aren't required to work?   But if it were simple to get everyone to practice safer sex I wouldn't be here.  And neither would you.
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline anniebc

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Re: one in three progress to AIDS in one year.
« Reply #58 on: June 10, 2011, 12:54:28 AM »

I don't see how mandatory testing is going to have any effect on diminishing the stigma associated with HIV/AIDS.  It might actually have the reverse effect and increase the stigma.  Instead of using resources to test everyone - let's encourage testing, but put more resources into finding a cure and continuing to get the message out that HIV/AIDS is, for the most part, a preventable disease. --- Just my opinion --- even though it isn't that radical.   :)

Mandatory testing won't have any effect on diminishing the Stigma Phil, but if we can get rid of the Stigma, reduce the cost of meds and have enough experts on stand by to counsel everyone who come up with positive diagnosis then maybe, just maybe Mantatory testing would work.

I agree with you Phil  keep the research going and get more Education out here and keep the message alive.

Aroha
Jan :-*
« Last Edit: June 10, 2011, 03:15:23 AM by anniebc »
-----------------------------------------------------------------------
Never knock on deaths door..ring the bell and run..he really hates that.

Offline Matty the Damned

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Re: one in three progress to AIDS in one year.
« Reply #59 on: June 10, 2011, 01:22:55 AM »
I'm not suggesting a roundup of HIV+ people.  I'm suggesting a plan to test EVERYONE.  Then offer information and treatment.  Where and how we test is up for grabs, but it needs to be thorough (even in old folks homes since they're spreading it too).  That's all. 

If we can vaccinate every child and make it a requirement before they get into school, we can certainly figure out how to test everyone for HIV (a good publicity campaign wouldn't hurt).   

I know it sounds radical.  But I don't think it is.  Just my opinion.

Rather than trot out the usual rebuttal(s) to this perennial proposal, I will instead say only "beware the Law of Unintended Consequences."

MtD

Offline spacebarsux

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Re: one in three progress to AIDS in one year.
« Reply #60 on: June 10, 2011, 03:11:58 AM »
I will instead say only "beware the Law of Unintended Consequences."

MtD

Agree, mandatory testing (as compared to voluntary testing with consent) is hopping on to a very slippery slope, in my opinion.

Stage 2:- MandatoryTattooing of every poz person with a scorpion sign on their genitals ?
Infected-  2005 or early 2006; Diagnosed- Jan 28th, 2011; Feb '11- CD4 754 @34%, VL- 39K; July '11- CD4 907@26%,  VL-81K; Feb '12- CD4 713 @31%, VL- 41K, Nov '12- CD4- 827@31%

Offline anniebc

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Re: one in three progress to AIDS in one year.
« Reply #61 on: June 10, 2011, 03:17:20 AM »
Agree, mandatory testing (as compared to voluntary testing with consent) is hopping on to a very slippery slope, in my opinion.

Stage 2:- MandatoryTattooing of every poz person with a scorpion sign on their genitals ?

Ouch that hurts just thinking about it... ;)

Aroha
Jan
-----------------------------------------------------------------------
Never knock on deaths door..ring the bell and run..he really hates that.

Offline BT65

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Re: one in three progress to AIDS in one year.
« Reply #62 on: June 10, 2011, 03:58:19 AM »
Once they KNOW their status, they can get treatment (especially if HIV+ = Medicare enrollment),

HIV does not equal Medicare.  In order to get Medicare, for one-a person has to have worked long enough and paid into it enough to get it.  People who haven't worked don't get Medicare.  Two, a person has to meet Social Security's disability definitions.  People don't get disability anymore just because they're HIV+.  And where I work, I see a lot of people (and they're HIV+, I work in an ASO), who get turned down from disability, and in some instances it surprises me.  I believe some of the people I see really deserve disability.  It's getting harder and harder to secure this.
 In the meantime, a lot of people get turned down from Medicaid also (in Indiana, it's not being poor that qualifies when one's an adult, you have to meet Medicaid's requirements for disability which can be more stringent than Social Security's), and have to wait until the state's high risk insurance kicks in.  And they have very strict requirements.  We have to prove residency and income, and for some people who are either undocumented or don't have the proper ID, it can be a clusterfuck.

 So some people end up on patient assistant programs, and they're pesky also.  They're always calling, wanting to know why these people aren't on ADAP, and most times requiring that they apply. The requirements for getting ADAP are the same as getting the state's high risk insurance, which I've mentioned  The drug companies usually don't like to send free meds for more than a year, unless it's unusual circumstances.  It's not as simple as test and treat, with some persons. 
I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

Offline Ann

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Re: one in three progress to AIDS in one year.
« Reply #63 on: June 10, 2011, 06:41:48 AM »
There are other illnesses that require mandatory testing, why not hiv? When I got married in NYC in 1984, I had to be tested for syphilis in order to obtain a marriage licence. I've had several jobs over the years where TB testing was mandatory. Why not hiv? We get too precious over hiv.



~waits for the shit to hit the fan~
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline phildinftlaudy

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Re: one in three progress to AIDS in one year.
« Reply #64 on: June 10, 2011, 08:57:13 AM »
There are other illnesses that require mandatory testing, why not hiv? When I got married in NYC in 1984, I had to be tested for syphilis in order to obtain a marriage licence. I've had several jobs over the years where TB testing was mandatory. Why not hiv? We get too precious over hiv.

~waits for the shit to hit the fan~

I have turned off all fans in my house and have taken out the cleaning supplies  :o

I think there are always going to be instances where mandatory testing is appropriate - example: drug testing for pilots; various testing for those who work in healthcare environment; eye tests for those who are going to drive; syphillis test for those getting a marriage license, etc.

My only issues in regards to HIV testing is that, like it or not, there is a stigma attached to the disease, and mandatory testing is not going to get rid of that stigma.  Also, the lack of treatment access for those who test positive - including access to mental health services.  As we see so often in the Am I Infected area, many people have a great deal of anxiety regarding acquiring HIV.

If large scale testing is going to be done, we have to make sure the system can handle the increased demand for treatment (all aspects of it).

Mandatory testing is an area that has to be treaded into very carefullly because of the potentially dangerous consequences it could have in regards to people not being able to access services and increasing stigma.

I think a well planned and thought out campaign to encourage routine, voluntary testing is needed.  Access to expanded testing and treatment is needed.  And, dedication of resources to get to a cure are in order.

September 13, 2008 - diagnosed +
Labs:
Date    CD4    %   VL     Date  CD4  %   VL
10/08  636    35  510   9/09 473  38 2900  12/4/09 Atripla
12/09  540    30    60   
12/10  740    41  <48   
8/11    667    36  <20  
03/12  1,041  42  <20
05/12  1,241  47  <20
08/12   780    37  <20
11/12   549    35  <20
02/12  1,102  42  <20
11/12   549    35  <20

Offline Miss Philicia

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Re: one in three progress to AIDS in one year.
« Reply #65 on: June 10, 2011, 09:47:12 AM »
how many of you were infected by someone else?

My guess would be everyone.
"Iíve slept with enough men to know that Iím not gay"

Offline GSOgymrat

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Re: one in three progress to AIDS in one year.
« Reply #66 on: June 10, 2011, 10:24:54 AM »
There are other illnesses that require mandatory testing, why not hiv? When I got married in NYC in 1984, I had to be tested for syphilis in order to obtain a marriage licence. I've had several jobs over the years where TB testing was mandatory. Why not hiv?

Because HIV is not transmitted through casual contact I don't think widespread mandatory testing is warranted. Certain employers need to do mandatory testing for TB due to the nature of the work and the nature of that illness. HIV is not the same. That said, due to the progressive nature of the disease it is important for people to find out if they are HIV+ as soon as possible. Therefore I do think that there should be "opt out" testing for anyone who goes to the ER, urgent care, health department or doctor's office (if labs are drawn). Counseling is available through all those locations and confidentiality laws are already in place. Everyone on this forum agrees that people need access to healthcare and treatment but we shouldn't let access to treatment decide who gets tested. It is not fair to the uninsured to only test people who have insurance and not provide routine testing for those who don't. It also doesn't work to say we are not going to test anyone unless everyone has access to treatment.

We get too precious over hiv.

I agree. Obviously some people feel because of stigma that HIV needs to be in it's own special category, with it's own special policies and it's own special laws. Making HIV exceptional, particularly legally, increases stigma. HIV needs to be treated as the virus it is.

Offline drewm

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Re: one in three progress to AIDS in one year.
« Reply #67 on: June 10, 2011, 10:32:00 AM »
There are other illnesses that require mandatory testing, why not hiv? When I got married in NYC in 1984, I had to be tested for syphilis in order to obtain a marriage licence. I've had several jobs over the years where TB testing was mandatory. Why not hiv? We get too precious over hiv.



~waits for the shit to hit the fan~

I don't know that I necessarily have a problem with mandatory testing. The alternative, as has been suggested, is the spreading of the virus and the huge costs associated with hospital treatment when the disease fully manifests.
Diagnosed in  May of 2010 with teh AIDS.

PCP Pneumonia . CD4 8 . VL 500,000

ATRIPLA - VALTREX -  FLUOXETINE - FENOFIBRATE


Numbers consistent since 12/2010 - VL has remained undetectable and CD4 is anywhere from 275-325

Offline Assurbanipal

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Re: one in three progress to AIDS in one year.
« Reply #68 on: June 10, 2011, 11:30:22 AM »
Everyone on this forum agrees that people need access to healthcare and treatment but we shouldn't let access to treatment decide who gets tested. It is not fair to the uninsured to only test people who have insurance and not provide routine testing for those who don't. It also doesn't work to say we are not going to test anyone unless everyone has access to treatment.


Beautifully expressed.
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline richie

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Re: one in three progress to AIDS in one year.
« Reply #69 on: June 10, 2011, 12:47:44 PM »
I like Ann's word "Precious."  Quite accurate.

What I'm suggesting IS mandatory testing.  But going with that has to be requisite changes in law, i.e., make Medicare available to anyone testing positive (whether they're eligible under today's rules or not) so they can get treatment IF THEY WANT.  Even if they don't want it, they'll be aware they're HIV+, and less likely to unknowingly infect others.  THAT would slow down HIV transmission to a crawl, at least in the US.  Maybe it will stop it and end the epidemic that's killed all my friends.

As for the stigma, I seriously doubt it will ever go away.  So fuck it.  Test test test and stigma be damned.  There will be stigma without testing, there will be stigma with it.  So just get it overwith already and get rid of HIV the best way possible.  It's just a virus.  Nothing more.  Just like Ann said.  

By the way Ann, I'm definitely a fan of yours.   Love your posts.  

Offline newt

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Re: one in three progress to AIDS in one year.
« Reply #70 on: June 10, 2011, 01:39:00 PM »
I prefer people to test who want and see value in testing rather than getting forced. Access to decent care seems key here otherwise there's bugger all point in knowing.

Medical treatment is generally premised on informed consent so don't see why it is different for HIV which is not contagious. This for me is an over-riding principle.  If you are going down the forced care route then why not ban burgers, barbeques and alcohol, make people exercise, stop intensive farming, ban international air travel and many, many other things that cause ill health and spread disease more serious that HIV?

Condoms are difficult, people don't like them. I think overall we have done rather well with them.

- matt
"The object is to be a well patient, not a good patient"

Offline Hellraiser

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Re: one in three progress to AIDS in one year.
« Reply #71 on: June 10, 2011, 01:51:49 PM »
I never consented to being tested but it saved my life.  I'm quite glad it happened.  No one else has been in my situation on these forums I guess?

Offline drewm

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Re: one in three progress to AIDS in one year.
« Reply #72 on: June 10, 2011, 02:02:28 PM »
I never consented to being tested but it saved my life.  I'm quite glad it happened.  No one else has been in my situation on these forums I guess?

Hellraiser, I did consent (in the Emergency Department) at the hospital and YES, it saved my life. I am not making excuses when I say that I did not get tested for years because I was afraid of the potential results. I know now that this defies logic but at the time it seemed logical that mentally, I feared that I would 'lose it' with a POZ diagnoses. That fear was based on a ton of erroneous information about testing, the stigma and the survivability of this disease. I am still seeing my same fears from those recently diagnosed.

Mandatory routine testing with the promise of effective treatment seems like a more prudent route to really get a grip on this virus.
« Last Edit: June 10, 2011, 06:28:55 PM by drewm »
Diagnosed in  May of 2010 with teh AIDS.

PCP Pneumonia . CD4 8 . VL 500,000

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Offline richie

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Re: one in three progress to AIDS in one year.
« Reply #73 on: June 10, 2011, 02:04:46 PM »
I prefer people to test who want and see value in testing rather than getting forced. Access to decent care seems key here otherwise there's bugger all point in knowing.

Medical treatment is generally premised on informed consent so don't see why it is different for HIV which is not contagious. This for me is an over-riding principle.  If you are going down the forced care route then why not ban burgers, barbeques and alcohol, make people exercise, stop intensive farming, ban international air travel and many, many other things that cause ill health and spread disease more serious that HIV?

Condoms are difficult, people don't like them. I think overall we have done rather well with them.

- matt


This whole discussion re mandatory testing is all just mental masturbation anyway.  It will NEVER happen.  But it IS fun to discuss.  In the US, it would take a President willing to push this and hence destroy his political career.  That just won't happen.  There isn't that much political capital in the entire WORLD to have this happen.   But it's fun to postulate over drinks.

I suppose it COULD happen in a dictatorship or similar since control is so absolute.  But even then, the cost would probably stop it (let's see -- China with 1.3B people, $10 per test, $10.3B just to do this?!)  It won't happen.

But again, fun to argue about.  


Offline Hellraiser

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Re: one in three progress to AIDS in one year.
« Reply #74 on: June 10, 2011, 02:53:03 PM »
10.3Billion would just be the ante.  To actually treat all the resulting positive results would be the issue.  Honestly though 10billion dollars isn't a lot in terms of US economy seeing as we just finance everything anyway.

Offline mecch

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Re: one in three progress to AIDS in one year.
« Reply #75 on: June 10, 2011, 02:53:33 PM »
You can't "round up people with HIV to test them" since there is no way to identify who doesnt know.
The logic in this thread is going down the toilet as well as respect for individual liberty.
HIV is not transmitted through air, coughing, touching, toilet seats or doorknobs.  In how many recent threads have we had to discuss treatment as prevention and still people aren't thinking it through, just gut reaction comments and "great ideas".
William F Buckley had the great round up idea in the 80's.  Tatoo HIV+ on HIV+ people.  Well, that solves the problem of people who know.  
Bring on all your illegal and offensive ideas about how to deprive the liberty of the ones who don't.  I will be happy to send them to the National Review in memory of William F.
ďFrom each, according to his ability; to each, according to his needĒ 1875 K Marx

Offline bocker3

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Re: one in three progress to AIDS in one year.
« Reply #76 on: June 10, 2011, 04:14:32 PM »
There is a difference to Mandatory testing and Routine testing.  People often have a battery of blood tests performed during physicals and other medical exams.  Having HIV testing be one of those tests makes it ROUTINE -- it's not mandatory because you don't have to go have you blood work done.  No one is going to track you down and impose some "penalty" on you.
Personally, I think HIV testing should become ROUTINE -- but not mandatory.

Hey Ann -- I know it's a bit of a stretch, but the examples of other mandatory tests that you give aren't truly mandatory -- they all are part of something you are choosing to do, e.g. get married, hold a particular job.  So those tests are tied to something else -- I think this discussion on mandatory HIV testing is simply that -- get an HIV test or else.  So we would be holding HIV to a different standard here.  Hence, why I think routine vs. mandatory is the best choice.

Mike
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Offline Miss Philicia

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Re: one in three progress to AIDS in one year.
« Reply #77 on: June 10, 2011, 06:30:55 PM »
Hmm. Yeah regional differences.

No, not really -- my roommate in Richmond, VA attempted to get me to go get tested when the test was first available in 1987. This wasn't something just being done in NYC or San Francisco contrary to what someone else just stated.  He went and got the test, I didn't -- my excuse is that I was just a big ole sissy, nothing else.
"Iíve slept with enough men to know that Iím not gay"

Offline anniebc

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Re: one in three progress to AIDS in one year.
« Reply #78 on: June 10, 2011, 06:50:04 PM »

.  Even if they don't want it, they'll be aware they're HIV+, and less likely to unknowingly infect others.  THAT would slow down HIV transmission to a crawl, at least in the US.  Maybe it will stop it and end the epidemic that's killed all my friends.


Richie in a perfect world this would be wonderful...but sadly this is not a perfect world.

Aroha
Jan
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Offline richie

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Re: one in three progress to AIDS in one year.
« Reply #79 on: June 10, 2011, 06:55:16 PM »
Anniebc --

You're preaching to the choir.  I'm just suggesting radical change, not perfection.  I agree that doesn't exist as far as I can see!

Offline Dachshund

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Re: one in three progress to AIDS in one year.
« Reply #80 on: June 10, 2011, 08:40:11 PM »
I think I was tested 1-2 times a year, every year from 1986 or so.  

And yet you still managed to get infected.

Offline mecch

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Re: one in three progress to AIDS in one year.
« Reply #81 on: June 11, 2011, 07:34:57 AM »
And yet you still managed to get infected.
Which is an interesting comment because it relates to this discussion how??
ďFrom each, according to his ability; to each, according to his needĒ 1875 K Marx

Offline Dachshund

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Re: one in three progress to AIDS in one year.
« Reply #82 on: June 11, 2011, 07:53:58 AM »
Which is an interesting comment because it relates to this discussion how??

Gee, I wonder? Why bother to test if you don't practice safe sex.

Offline Ann

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Re: one in three progress to AIDS in one year.
« Reply #83 on: June 11, 2011, 09:27:43 AM »
Hmm... well, I never actually said I was for mandatory testing - I'm not. I just threw some questions out there. Naughty of me, I know. ;)

I AM for routine, opt-out testing. It's bound to slow the rate of onward transmissions. For example, in countries where routine, opt-out testing is in place for pregnant women, the rate of mother-to-child infections is practically non-existent. Opt-out testing is working - and working well - in pregnancy, so why shouldn't it work equally as well in the general population?

I really don't get the "we can't test because of access to treatment issues" argument. Not knowing their status is not going to make anyone any less hiv positive, but it's been shown again and again that people who know their hiv status are much less likely to pass their virus on, treatment or no treatment.
Condoms are a girl's best friend

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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline CaptCarl

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Re: one in three progress to AIDS in one year.
« Reply #84 on: June 11, 2011, 10:12:23 AM »
This whole discussion re mandatory testing is all just mental masturbation anyway.  It will NEVER happen.  But it IS fun to discuss.  In the US, it would take a President willing to push this and hence destroy his political career.  That just won't happen.  There isn't that much political capital in the entire WORLD to have this happen.   But it's fun to postulate over drinks.
But again, fun to argue about.  

Stupid question: Why waste the time and energy aruing and postulating overthings that will never happen? Wouldn't  the energy you put into this form of mental masturbation be better used by trying to come up with realistic and workable solutions? Otherwise, what's the point in wasting time over all of this?

CaptCarl
 
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Offline leatherman

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Re: one in three progress to AIDS in one year.
« Reply #85 on: June 11, 2011, 10:18:16 AM »
Quote
I AM for routine, opt-out testing.
sadly, here in America with the extra stigma that we've added to HIV by acting like it's something special/scary, testing is not routine and is opt-in -- and that's IF the doctor thinks to ask you to opt-in.

I know over a dozen people who went months to years before a doctor finally explained that no HIV test had been given and suggested it to the patient - and for all those people HIV was the underlying problem. I have to wonder how their lives might have been better if treated sooner because the HIV test was routine and opt-out from the very beginning.
leatherman (aka mIkIE)


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Offline Miss Philicia

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Re: one in three progress to AIDS in one year.
« Reply #86 on: June 11, 2011, 11:16:51 AM »
Stupid question: Why waste the time and energy aruing and postulating overthings that will never happen? Wouldn't  the energy you put into this form of mental masturbation be better used by trying to come up with realistic and workable solutions? Otherwise, what's the point in wasting time over all of this?

CaptCarl
 


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"Iíve slept with enough men to know that Iím not gay"

Offline Matty the Damned

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Re: one in three progress to AIDS in one year.
« Reply #87 on: June 11, 2011, 11:32:49 AM »
sadly, here in America with the extra stigma that we've added to HIV by acting like it's something special/scary, testing is not routine and is opt-in -- and that's IF the doctor thinks to ask you to opt-in.

I know over a dozen people who went months to years before a doctor finally explained that no HIV test had been given and suggested it to the patient - and for all those people HIV was the underlying problem. I have to wonder how their lives might have been better if treated sooner because the HIV test was routine and opt-out from the very beginning.

What you wonder is irrelevant. I'm surprised that you would stand up in this place preaching about testing given what happened to your previous partners.

You should dwell on that. We all know what you are.  >:(

More generally, people have a choice about what medical tests they are subjected to. To the confuzzled newly diagnose person I say, don't let left wing do gooders talk you out of your freedom.

I see no reason to abandon that freedom. It may not suit some tightasses around here, but then freedom never does.

MtD
(Who says FREEDOM FREEDOM FREEDOM!)

Offline leatherman

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Re: one in three progress to AIDS in one year.
« Reply #88 on: June 11, 2011, 12:14:37 PM »
What you wonder is irrelevant. .... We all know what you are.  >:(
My thoughts, opinions, and questions are just as relevant as yours. You are no more than just another person on the planet, and I am entitled to my opinions just as you are. I don't tell you that your comments are irrelevant and only ask that in return. Numerous times we have shown that we do not like one another and yet you persist in attacking me or my posts while I leave you in peace. Your typical veiled slander of me is rude and unwarranted.

I'm surprised that you would stand up in this place preaching about testing given what happened to your previous partners.
but that is exactly why I think testing should be recommended more and easier to opt into. My story with Jim is a prime example of why testing is so important. As I have explained innumberable times (and received grief for it from a group of people here) because Jim went untested for so long he's now dead. You can't have a better example of why testing should be done than that - unless it's the person who finally got tested today after presenting to the hospital and is going to live because the doctors will treat them properly.

For the life of me, I just don't understand why you and some others think that my dead partner is not a great example of why testing is neccesary. Telling this story to the public has encouraged people to finally get tested, and several people have found that they were positive and got treatment in time that they aren't dead like my partner. For me, that's proof that although you and others have an issue with me for telling my story of me, Randy and Jim, our story has saved lives by getting people tested and treated in time.

As I have clearly stated before, not only does the fault lie with us for not getting Jim tested; but it also lies with every medical professional that dealt with us for not suggesting routine opt-in testing. When Jim got sick and they began to run tests, they discovered an odd white blood cell count that led to the cancer discovery; but still no one tested him for HIV.

It wasn't until he was in the hospital for a week, that I asked and found that no HIV had been run yet. ::) I mean, reallly. Someone presents with an unexplained illness with an HIV positive partner and no medical professional even suggests an HIV test?!?!? Many people believe that HIV is a test run in the battery of blood tests that may be given and that just isn't the case at all, as it isn't even suggested in cases that would warrant it.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline Matty the Damned

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Re: one in three progress to AIDS in one year.
« Reply #89 on: June 11, 2011, 12:27:34 PM »
words

Mikey,

It's not that you have dead boyfriends what makes decent folk detest you, it's how you wave their bones around as if the rest of us owe you some sort of respect because they died.

We don't. You've not cornered the market on human suffering.

JIm and Randy are dead. You need to let those fuckers rest in peace.

Frankly the way you bang on about your dead husbands is disturbing -- bordering on the creepy. It's like you're a shiver looking for a spine to run up.

Ick. You really are horrible. :(

And that's a shame. Your politics are, for the most part, good. Very good. In a different world I could work with you.

But not in this world.

MtD

Offline bocker3

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Re: one in three progress to AIDS in one year.
« Reply #90 on: June 11, 2011, 01:46:43 PM »
Many people believe that HIV is a test run in the battery of blood tests that may be given and that just isn't the case at all, as it isn't even suggested in cases that would warrant it.

I find this little nugget hard to believe.  I have never met a person who assumed an HIV test is part of any battery of routine lab tests.  In fact, most people don't even give any thought at all to what their doctor's are ordering for routine testing -- I can't tell you how many times that I would be about to draw someone's blood and they would ask me, "So, what tests are being done today?"  Back in the time that I did this -- I was not allowed to tell them -- I just referred them back to their doctor.  No one -- I mean NO ONE -- ever said, then let's not do this now, I want to know what is being drawn.  I would bet (pure conjecture here) that very few of them ever did call the doc and ask.

Mike
Atripla - Started 12/05
Reyataz/Norvir - Added 6/06
Labs - Pre-Meds
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Offline Jeff G

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Re: one in three progress to AIDS in one year.
« Reply #91 on: June 11, 2011, 01:52:57 PM »
I find this little nugget hard to believe.  I have never met a person who assumed an HIV test is part of any battery of routine lab tests.  
Mike

I was thinking the same . I would think a HIV test would not be a routine test actually .  
« Last Edit: June 11, 2011, 02:16:09 PM by jg1962 »

Offline Ann

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Re: one in three progress to AIDS in one year.
« Reply #92 on: June 11, 2011, 02:00:05 PM »
We do see people in Am I Infected who seem to think that hiv would be flagged in ordinary blood testing - but they don't seem to think that hiv is specifically being tested for, only that the doctor would recognise a case of hiv infection going by their CBC and/or Chem Screen. I think that relates to how many people see doctors as all-seeing, all-knowing, more than anything else.
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Miss Philicia

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Re: one in three progress to AIDS in one year.
« Reply #93 on: June 11, 2011, 02:25:47 PM »
We do see people in Am I Infected who seem to think that hiv would be flagged in ordinary blood testing - but they don't seem to think that hiv is specifically being tested for, only that the doctor would recognise a case of hiv infection going by their CBC and/or Chem Screen. I think that relates to how many people see doctors as all-seeing, all-knowing, more than anything else.

The Am I Infected forum, I would think, isn't the greatest barometer of the human condition seeing as how it's heavily weighted by people with un-treated obsessive compulsive disorders.
"Iíve slept with enough men to know that Iím not gay"

Offline leatherman

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Re: one in three progress to AIDS in one year.
« Reply #94 on: June 11, 2011, 03:35:42 PM »
it's how you wave their bones around...
Frankly the way you bang on about your dead husbands is disturbing
oddly enough, I was only talking about the need for more routine opt-in testing in this thread and it was YOU that brought up my deceased partners. It was your critique of me that compelled me to explain that having learned a very valuable lesson about the need for testing (ie my last late partner's death) I actually do have a premise on which to promote more testing to be easier to obtain. You are the one who quit discussing the issue about testing and made your post a personal attack at me. As always, I never initiate any correspondence between you and I; it was YOU who took this to the personal issue of me and my life and my late partners.

and quite frankly as one who has not had the distinct experience of losing not one but two long-term partners, I really don't care whether you approve of how much I speak of them or not. Losing them had more of a profound change (mentally, emotionally, and physically) on my life that coming to terms with being gay or my own HIV/AIDS diagnosis. Everyone here is entitled to their own experiences, which define them, the way they view life and what they bring to these discussions.

Losing Randy and Jim and retaining them as part of who I am is who leatherman/mikie is. Everything I think and do is filtered through those losses. As I've said before, I wake up every day in SC now for no other reason than the fact that they are both dead and I can no long live with them as I did for 25 yrs in Ohio. You may not like that I speak of my deceased partners; but I don't particularly like the fact that they're dead either.

I personally don't like your attitude toward cats, nor the "humor" you display in these forums; but I don't go around attacking you saying that your attitudes are irrelevant - I just accept you for the person you are. I would suggest that if you don't like the things I discuss that you simply ignore me. Or if you choose to comment on me and my life as you did, expect me to continue talking Randy and Jim ad nauseaum. ;)
leatherman (aka mIkIE)


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Offline Ann

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Re: one in three progress to AIDS in one year.
« Reply #95 on: June 11, 2011, 03:57:10 PM »
The Am I Infected forum, I would think, isn't the greatest barometer of the human condition seeing as how it's heavily weighted by people with un-treated obsessive compulsive disorders.

Eh, even people who didn't display the typical OCD red-flags have thought that a CBC could flag an hiv infection.

Most people know that CBCs include white blood cell counts, and many people are vaguely aware that hiv has something to do with a type of white blood cell, so it's not that far a reach. It's actually kinda logical, even though it's erroneous.

Remember, I'm not saying they think they're being tested for hiv, but that they think there will be tell-tale signs in normal blood work when hiv is present. It is a fairly common assumption, and not just with the OCD crowd.

Trust me sweetie, I've probably read every single thread ever written in that forum - going back to the very first FuseTalk days nine years ago.
Condoms are a girl's best friend

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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Miss Philicia

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Re: one in three progress to AIDS in one year.
« Reply #96 on: June 11, 2011, 05:24:32 PM »

Trust me sweetie, I've probably read every single thread ever written in that forum - going back to the very first FuseTalk days nine years ago.

... which is why I pity you
"Iíve slept with enough men to know that Iím not gay"

Offline leatherman

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Re: one in three progress to AIDS in one year.
« Reply #97 on: June 11, 2011, 05:32:19 PM »
Remember, I'm not saying they think they're being tested for hiv, but that they think there will be tell-tale signs in normal blood work when hiv is present. It is a fairly common assumption, and not just with the OCD crowd.
exactly. many people of the vast un-HIV-educated believe that somehow an HIV test or diagnosis should come out of regular "blood work" - especially when they present with symptoms of an unknown cause. They believe they are being checked for many things. what things (STDs? cancers? flu?) they don't particularly know; but as HIV is found in blood the logic would seem that "blood work" would turn up HIV also.

I find this little nugget hard to believe.  I have never met a person who assumed an HIV test is part of any battery of routine lab tests.  In fact, most people don't even give any thought at all to what their doctor's are ordering for routine testing -- I can't tell you how many times that I would be about to draw someone's blood and they would ask me, "So, what tests are being done today?"  Back in the time that I did this -- I was not allowed to tell them -- I just referred them back to their doctor.  No one -- I mean NO ONE -- ever said, then let's not do this now, I want to know what is being drawn.  I would bet (pure conjecture here) that very few of them ever did call the doc and ask.
if the people didn't know what the blood draw tests were, didn't call the doctor to ask for specifics, don't give any thoughts to the tests, and you weren't allowed to tell them, how can you just assume that they didn't think HIV was part of the battery of tests? It's just as logical to think that they did assume HIV was included in the mysterious set of tests. Their questioning obviously shows that the doctor did not explain well or the patient was too upset to understand properly. If the doctor has asked for an HIV test also, and gotten the extra consent, you would think the patient could remember at least that part of what they were being tested for. These scenarios actually show how uninformed people are when they give consent to the initial battery of tests.

Of course no one backed out. When you've asked the doctor to determine what illness you have and he orders a battery of tests you probably wouldn't back out of any of them because you wouldn't know which one would show up with the answer of you symptoms. That's why a battery of tests is ordered. How many un-HIV-educated people would know that the HIV test would require extra consent? Many probably do assume that the testing that has been ordered looks for all sorts of STDs, HIV, cancers, etc. since they've given consent to a "battery of tests" for multiple things that might be causing the symptoms for which they presented.
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline Miss Philicia

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Re: one in three progress to AIDS in one year.
« Reply #98 on: June 11, 2011, 06:26:10 PM »
I've never encountered a single person that believed what the two of you are claiming. Obviously I travel in different circles... or something. For this I am thankful.
"Iíve slept with enough men to know that Iím not gay"

Offline mecch

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Re: one in three progress to AIDS in one year.
« Reply #99 on: June 11, 2011, 07:21:32 PM »
Mikey,

It's not that you have dead boyfriends what makes decent folk detest you, it's how you wave their bones around as if the rest of us owe you some sort of respect because they died.

We don't. You've not cornered the market on human suffering.

JIm and Randy are dead. You need to let those fuckers rest in peace.

Frankly the way you bang on about your dead husbands is disturbing -- bordering on the creepy. It's like you're a shiver looking for a spine to run up.

Ick. You really are horrible. :(

And that's a shame. Your politics are, for the most part, good. Very good. In a different world I could work with you.

But not in this world.

MtD

Just thought I should save this gem.

ďFrom each, according to his ability; to each, according to his needĒ 1875 K Marx

 


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