Friday, December 29, 2006

a couple of questions

If you were a sexual health specialist, would you advise patients to use condoms to protect against AIDS?

If so, would you have sex with someone you knew had AIDS - even if you used a condom.


Chuck said...

As condoms are only 80% effective in preventing the transmission of the HIV virus the answer is no to both questions. Is thier a story than prompted the questions?

Anonymous said...

If AIDs is not diagnosed and one has a promiscuity life, one should use protective material.

If AIDs is diagnosed, one's moral conscience should overrule one's desire to have sex.

SB said...

Chuck: real trials have shown that used CORRECTLY condoms have an almost %100 success rate. Of all the STI's condoms are most effective against HIV.

Note I said CORRECTLY, that 80% figure that gets passed around includes failures such as forgetting to put it on!


Chuck said...

SB, in the real world condoms are used by people who may be drunk or under the influence of drugs. They are often used in the dark.

S C Weller and K Davis-Brady conducted a study of condom effectiveness in reducing heterosexual HIV transmission. The review concludes that consistent and consistent use of condoms results in a 80 percent reduction in HIV transmission. The text of the review is in The Cochrane Library.

This review relates to the real world. The Minster of Health, Pete Hodgson supports this review.

The theoretical 100% success rate is a view pushed by the AIDS Foundation. The AIDS Foundation is in fact a government funded homosexual lobby group. Male homosexuals make up less than 3% of the population yet account for 80% HIV infection acquired in New Zealand.

When the homosexual community can get their rate of HIV and other STDs near the rate of heterosexuals they might be in a position to advice the rest of the population how to avoid HIV.

Anonymous said...

Chuck: You haven't said anything that contradicts what I said.

Numerous studies have shown that when used correctly the 100% figure is obtained in the real world.

Numerous studies have shown that many people do not use condoms correctly. That does not mean that condoms are not 100% effective.

Its stupid to say that the 100% is the work of the AIDS foundation, its available from many studies for example the CDC uses the same figure
To quote their study

"In a two-year study of sero-discordant couples (in which one partner was HIV-positive and one was HIV-negative), no uninfected partner became infected among couples using condoms correctly and consistently at every act of vaginal or anal sex versus 10 percent of those using condoms inconsistently"

The reason for the high rate of HIV in the homosexual community is not that condoms do not work but that they are not using condoms.

I don't regard not putting on a condom as being a failure of the condom but the users of that condom.

That is why sex workers are not regarded as a STI vector any more by health professionals, because of their very high usage and correct usage of condoms.


Chuck said...

SB you say, “Its stupid to say that the 100% is the work of the AIDS foundation.”

I read on your blog, “Fanatics - You go ta love them. They believe 100% that they are right in all “things

I am not stupid and I am informed. The following is about other studies.
A calculation can be as follows. Let us assume the estimate many use is correct that the risk of transmission is roughly one in 200 per episode of unprotected sex with an infected partner. Let us assume 95% protection from the condom for the sake of argument, or a twenty-fold risk reduction. This would give a total risk of one in 4,000 per episode of protected sex. Let us assume a couple has sex just under three times a week, or 150 times a year. The risk of the partner becoming infected in one year despite using a condom then becomes 3.7% or almost 20% in five years. If we only rate the condom protection as 90% instead of 95%, then the five-year infection rate could rise to 40% or 7.4% per year.
How do these theoretical estimates fit with experience? An Italian study of almost 400 women with infected partners found the following:

1.2% always using condoms were infected per year overall.

7.3% not using condoms regularly infected per year overall.

12.3% not using condoms regularly with highly-infectious partners became infected per year.

2.6% not using condoms regularly with partners of low infectiousness became infected per year.
Partners were considered highly infectious if their white cell (CD4) counts were low or if they were becoming unwell. Inconsistent condom use increased risk around six times. Anal sex doubled the risk. AIDS in the partner trebled the risk.
In another study, almost 200 women with HIV-infected haemophiliac partners were studied. Between 1985 and 1992, one in ten became infected. The risk of infection increased with time as the men deteriorated. It is very difficult to obtain meaningful figures for these risks because there are a number of variables: stage of infection, sexual practice, presence of other sex diseases, frequency of intercourse, frequency of condom use. For this reason different studies can give varying results.
A combined European study of 563 heterosexuals with infected partners in stable relationships from nine countries was carried out between 1987 and 1991. People were enrolled in the study month by month so some were part of it for only a short time. Altogether, 12% of the men and 20% of the women became infected. Risk increased to men with stage of illness, and intercourse during menstruation. For women the risk increased with her age, stage of the man's infection and anal intercourse. None of twenty-four couples always using condoms became infected.

If all there was to minimising the risk of HIV infection was to use a condom homosexuals would have lower rate of HIV than heterosexuals. I would think that the rate of condom use amongst homosexuals would be considerable higher than amongst heterosexuals. Not many heterosexuals in a relationship would be using condoms to protect them in the case that their partner was unfaithful.

You are probably correct about prostitutes particularly if they are working in a brothel where they are not using drugs including alcohol. People who believe that the high rate of HIV amongst homosexuals is solely because they do not use condoms frequently enough are deluding themselves.

Anonymous said...

So using the figures from the site you quoted the effective rate is between 90-95% not the 80% that you originally posted.

The WHO is currently quoting the figure of 96% for its protection value.

I always said "almost 100%" not "100%" I would say 96% is almost 100% compared with your figure of 80%.

The study you originally quoted from is a meta study. One of the studies they used in their model also reported a factor of 96%.

So using that sites figures condoms provide a very high but not perfect level of protection against HIV. You don't say how long the Italian study was but 1.2% for always correct always use condoms, is a very low rate and higher than 96% protection.

"None of twenty-four couples always using condoms became infected" so for them condoms were 100% effective!

"You are probably correct about prostitutes particularly if they are working in a brothel where they are not using drugs including alcohol" whats alcohol got to do with condom effectiveness in a brothel?


Chuck said...

SB, the figure that I originally posted was from the Minister of health and he was referring a study of condom effectiveness in reducing heterosexual HIV transmission by S C Weller and K Davis-Brady. If you read the reference I supplied the chances of infection in a five year period based condoms being 95% effective is about 20%. This relates to a heterosexual couple. For homosexual couples the risk would be considerably higher as the virus is transmitted more easily by anal intercourse.

It I have enough to drink that I am a bit over the legal limit and drive home it is unlikely that I will die or kill anyone or even get in an accident. However, if I do this on a regular basis the odds of me getting into a serious accident are considerable. The same applies to sex. If you regularly have sex with someone who is HIV+ or has a high likelihood of being HIV+ the changes of you becoming infect ate also considerable condom or no condom.

You ask, “whats alcohol got to do with condom effectiveness in a brothel?” Obviously if a prostitute and her client is under the influence of alcohol the chance of them using a condom correctly are significantly reduced.

Anonymous said...

Chuck:Obviously if a prostitute and her client is under the influence of alcohol the chance of them using a condom correctly are significantly reduced.

I disagree. Using a condom correctly is really easy. I can't understand why people have problems. If I have had a couple of drinks then I will still have no problem putting it on. If she has had some drinks then she still can put it on.

If we are so drunk so as to unable to put a condom on correctly then we are probably unable to do the business anyway!

I would only agree with your statement if you said "excessive alcohol " and then security would through you out anyway.

Of course if you at home/bar etc then its different!