Aids Conference Covers Up Hiv Testing Scam

[thamachat]

BANGKOK AIDS CONFERENCE NOT LIVING UP TO ITS BILLING.

By Marcel Girodian

The XV International Aids Conference in Bangkok has the noble theme, "Access For All." According to the conference promoters, "we will ensure that all voices, all experiences and all concerns are represented." Unfortunately the truth falls short of the hype. All voices are not being represented, and access for all is not being granted, with regard to some very fundamental and critical issues.

Let's take the issue of HIV testing. In the US, most of Europe and Australia, a person is not considered HIV infected until a minimum of two criteria have been satisfied--testing positive first to a screening test, which is usually an ELISA test, and then to a confirmatory test, which is almost always the Western Blot. In the US, in fact, if the ELISA is positive, it is usually repeated, then if positive again the Western Blot is run. And if that's positive, the US Centers for Disease Control (CDC) recommends that the entire set of tests be run again, on a new blood sample, to reduce the chances that the tests could be reacting to one of the over 70 common conditions that are documented to cause false positives.

In Thailand, on the other hand, people are routinely pronounced HIV positive based on only two screening tests--two ELISAs or an ELISA and a GPA. The more specific Western Blot is used only if the two screening tests disagree. This has many problems. The ELISA and similar tests were developed to be super sensitive, as a means of screening blood donations. This means they are more likely to be falsely reactive to almost any condition that causes antibody proliferation in the blood. These conditions can be as common as the common cold, flu, herpes, pregnancy or past pregnancy, drug abuse, numerous viral and bacterial infections and many others. Moreover, according to Dr. Praphan Phanuphak, Aids specialist at Chulalongkorn University, in Thailand both tests are usually run on the same single blood sample, which means that if there is some condition causing a false positive, nobody is bothering to wait for the condition to clear and then get a second sample to be sure before declaring the unfortunate person positive.

The US CDC, in its role as Aids advisor to the Thai government (indeed, they have an office in the Thai Ministry of Health Building and offices in large cities throughout Thailand) is not raising its voice in objection to what is a dubious and very cavalier procedure for branding Thai people HIV positive--a procedure that would have a doctor called up for malpractice were it to be done in the US. A procedure that violates CDC's own recommendations for Americans. A simple question is--why? Why is there one HIV positivity standard for westerners, and a different, more lax one, for Thais?

The answer generally given is that the Western Blot test is too expensive for poorer countries. But, according to Dr. Phanuphak, the WB costs only about $30 US in Bangkok. So, while the AIDS establishment wants to ensure "access for all" to highly toxic AIDS drugs which, even in Thailand, cost hundreds to thousands of US dollars a year, per person, they are not willing to provide access for all to a $30 test that could acquit Thai people of being HIV positive in the first place.

How likely a possibility is that? In a study conducted in Russia, 30,000 people tested positive on the ELISA. Of these, only 66 could be confirmed by a positive Western Blot. (Voevodin, A. 1992) In a study published in the New England Journal of Medicine in 1988, 60 to 70% of twice-positive ELISAs were not confirmed by Western Blot (Burke, et al). In a study published in the Journal of the American Medical Association, 30 to 80% of twice-positive ELISAs were not positive on the Western Blot. (Sloand et al, 1991) The medical literature has many studies that have reached similar conclusions.

But what of those cases in Thailand where the Western Blot IS used? It is generally only used as a "tiebreaker" if the two screening tests disagree. But even then, the test is evaluated differently in Thailand than it is in the west. According to Dr. Wiwat Rojanapithayakorn of UN Aids, only two of the 10 bands (which are supposed to represent HIV proteins) on the Western Blot test must be reactive to the person's blood in Thailand in order to declare a person positive. In the US, generally three or more bands are needed. In France and Australia, usually four bands must react before a person is called positive.

Whether called positive based on two screening tests, or on a Western Blot, a HIV positive Thai person could conceivably emigrate to the West and become HIV negative. As a group of scientists from the University of Western Australia, Eleni Papadopulos-Eleopulos, Dr. Valendar Turner, Dr. David Causer and Dr. John M. Papadimitriou, concluded, "Many HIV positive Thais would not be HIV positive in the West."

No AIDS expert has ever provided any logical justification for these differing HIV positivity standards. Since the countries that pronounce people positive without a Western Blot (in Africa, even without any test at all) are generally developing countries, one suspects that "HIV" positivity is politically, not medically defined. As testing positive ruins a person's life, one must ask, who decided that Western lives are more valuable than those of Thais or Africans? Under whose influence have these dubious testing procedures been implemented, and why has nobody in a position of responsibility challenged them?

As anyone with a modicum of sensitivity should know, testing positive for HIV antibodies produces staggering psychological stress and turmoil in a person, which by itself is proven to suppress the immune system and make a person more likely to get ill. It is well documented that many people commit suicide shortly after being declared HIV positive. Nobody should be branded with the stigma "positive" and have their lives crushed on relaxed criteria that would not be allowed in richer countries.

Another way that the XV International Aids Conference is not providing "Access For All" is that they are not allowing alternative opinions about the nature and causation of AIDS to be heard. People in Thailand are not allowed to know that there are literally hundreds of fully credentialed doctors and scientists, including two Nobel Prize winners, who don't think that HIV is the cause of AIDS, don't think the tests are valid, and point out that the AIDS medicines are toxic and immune-suppressive and capable of causing AIDS all by themselves. You can see a list of these scientists and quotations from them at http://aras.ab.ca/articles/AIDSQuotes.htm

There are many bizarre anomalies about Aids in Thailand that have never been explained. Unlike in the west, where the disease is overwhelmingly restricted to male homosexuals and drug addicts, in Thailand the epidemic is said to be almost entirely heterosexual. Yet approximately 80% of the actual recorded "heterosexual" Aids cases in Thailand have been males. This is despite the fact that females, due to their much more receptive genital anatomy, have been found to be 8 times more likely than males to become infected from a single act of vaginal sex (Padian, et al, 1997). If HIV is the cause of AIDS, why aren't most of Thailand's AIDS cases female? Why are they overwhelmingly male, just as they are in the west?

The idea that the epidemic is caused by heterosexual sex in Thailand, and not by drug use or homosexual anal sex, as it is in the west, is largely based on interviews with people who test positive. But scientists conducting such studies routinely overlook the fact that people lie when self-reporting about stigmatized activities like homosexuality and drug use. We know that Thailand has an unusually large percentage of homosexual males, especially in the north. And, with Thailand's severe drug laws, a person would have to be crazy to admit to a government-connected researcher that he uses illegal drugs. Recreational drugs, whether injected or non-injected, can cause false positive HIV tests, and where are these drugs most available? Why in Northern Thailand, of course, adjacent to Burma and the golden triangle, and, "coincidentally," the epicentre of Thailand's Aids epidemic.

Since prostitution is declared to be a major vector for HIV transmission in Thailand, why are the prostitution centers--Bangkok and Pattaya--not the epicenters of this epidemic? Why is it the north, where there is much less prostitution? And how did a virus that is said to have originated in Africa get to Northern Thailand in such great numbers? Anyone who has spent time in Northern Thailand knows that Africans are about as common there as banana trees are in Sweden. In the west, prostitutes are almost never found to be HIV positive unless they are drug users. Why should this be different in Thailand? Can false positivity, caused mostly by drug abuse, explain the high level of HIV positive tests among brothel workers? It's a perfectly rational explanation that hasn't been pursued.

Thai studies have claimed HIV transmission rates as high as 1 in 18 sexual contacts. But most studies done in the west have concluded that HIV only transmits, at best, 1 in 1000 unprotected contacts, and as little as 1 in 8000 from females to males. Is there something different about Thai genital anatomy that accounts for the staggering difference? Previous suggestions that Thailand had a much more aggressive "subtype E" of HIV were disproven in 1996 by an expert commission at the Robert Koch Institute in Germany, which found no difference in infectivity. Is the discrepancy better explained by the high incidence in Thailand of conditions that cause false positives?

Dr. Christian Fiala, an Austrian physician who worked at Chulalongkorn University in the 1980s, has extensively researched Aids in Thailand. He notes that the definition of AIDS in Thailand differs from that in the West. "First, a fungal infection called Penicillium Marneffei has been added as Aids-qualifying disease. Thereby increasing the overall Aids figure by 8 percent, and even more in the so-called epicenter, the north of Thailand," he writes. PM sufferers would not be defined as having AIDS in the West. And fungal infections are notorious for causing false positive HIV tests. Nobody has researched whether PM does this.

Fiala also points out that, in Thailand, a so called "symptomatic HIV-infection" is also counted as an AIDS case. "Any HIV-positive patient, suffering from one of…11 mostly unspecific symptoms will get this diagnosis," he says. These people are added to the AIDS case numbers in Thailand, although they would not be considered AIDS cases in the rest of the world. "'Symptomatic HIV infections' represent more than 40% of the national figure and are highest in the north of Thailand, the so called epicenter of Aids,” says Fiala.

So not only would many HIV positive Thais not be HIV positive in the west, almost half of all Thais reported as "AIDS cases" would not be considered to have AIDS in the west.

Dr. Fiala also points out that HIV's rapid increase in Thailand in the 1990s happened at the same time that Thai sexually transmitted disease (STD) rates were declining sharply. Since HIV is 100 to 2000 times harder to transmit than other STDs, if other STDs decline, HIV should decline much more. Instead it skyrocketed as other STDs were crashing. This is impossible behavior for an allegedly sexually transmitted HIV.

Dr. Fiala also finds other baffling contradictions: "The highest prevalence of STDs is in Bangkok. But HIV and AIDS are both highest in the North. But STD prevalence is second lowest in the North. And even if one looks in more detail at the North one sees that there is absolutely no correlation between STDs and AIDS. With Phayao Province having the lowest STD prevalence and the highest number of AIDS cases in the North or on the other hand Lamphun Province with the highest STD prevalence and AIDS cases below average."

Because many Thai bar girls come from Issan, one would expect Issan to have a high rate of AIDS. Instead, Issan has one of the lowest AIDS rates of any region in Thailand. In short, the Thai AIDS data do not support the idea that AIDS is heterosexually transmitted. Fiala concludes, "Whatever might be the cause of HIV-positive tests in Thailand, it can not be heterosexually transmitted like the other STDs."

People in the US, Europe, Africa and India now have access to alternative opinions about Aids that are held by a growing number of medical specialists. Thai people, living in a culture that does not easily permit dissent, do not. They have little chance of finding out that all of the supposed "facts" about Hiv and Aids have been challenged by fully credentialed doctors and scientists. Considering that throughout medical history, the establishment view about all sorts of maladies has ultimately been proven false, by now we should have a more enlightened attitude. The right to hear alternative and dissenting opinions about medical matters should be a basic human right, especially to those people branded "HIV positive" under these very dubious circumstances.

But the XV International Aids Conference, sponsored and financed as it is by the drug companies, will recognize no such human rights except the right they claim everyone has to swallow (at public subsidy) toxic chemotherapy drugs which, though endlessly hyped as "life-saving," have never been demonstrated in any study to actually prolong life. Yes, these drugs often reduce a laboratory measure questionably called "viral load" and they seem to raise the white blood cell count, but there is little evidence that anyone who takes them actually lives longer. Indeed, two recent studies from Uganda (Morgan D et al, 2002 and Collaborative Group on AIDS Incubation and HIV Survival, 2000) found that unmedicated HIV + Ugandans lived as long after diagnosis as did HIV + westerners who were taking the Aids drugs. And these Ugandans had the disadvantage of being malnourished, while the westerners had plenty of food. (Malnutrition is the world's leading cause of immune deficiency.)

Though they haven't been proven to extend life, the AIDS drugs that XV International wants everyone to have access to have been proven to have many grotesque side effects such as heart failure, liver failure, kidney failure, pancreatitis, destruction of blood cells and bone marrow, nerve damage, psychiatric problems, anemia, diarrhea, blindness, cancer, redistribution of bodily fat from the face to the back (the so-called "Buffalo Hump"), and muscle wasting--side effects which are conveniently attributed to "HIV," although there are no known mechanisms by which "HIV" can be causing them.

XV International Aids Conference should either address these issues in a very public way, thereby ensuring "Access for All" to critical information that might allow Thai people to see Hiv positivity and Aids in a new light, or change their slogan to "Access For All To Our Unvalidated HIV Tests and Extremely Profitable Drugs," which perhaps sums up their philosophy more accurately.

[Pepe']

thamachat,

I didn't read the entire post as some of this is old news. However the non availibility of western blot test is definitely obscene.

I will finish reading this later. Thanks for the post.

Where is it from?

[thamachat]

Pepe, the Western Blot IS available here, it is just not used routinely. People who get two positive ELISAs are branded "positive" and the Western Blot is not done.

Someone who knew about this could insist that the WB be done, but how many Thais know about the different kinds of Hiv tests? They just know they are having an "Aids test."

I wrote this. It was supposed to appear in one of the major Thailand English language newspapers today but, as I am not in Thailand, I don't know whether it actually ran.

[udon]

thamachat,

thanks for that info.

For a dummy like me going to the Red Cross aids test center, once a year, what should I insist on in the test?

[thamachat]

udon, you should insist that, if the screening test is positive, that they do a Western Blot. But first I would read the information in the link I provided. You may decide it's better not to get tested at all. Or, at least, to do it in a different country where Western Blot evaluation standards are more rigorous.

[stroll]

I am one of the people who went for an aids tests in the 80s, believing the media and government hype, and was told by staff at the (government) std-clinic to forget about it with my lifestyle. I have followed discussions about HIV since and concluded that the evidence is far from conclusive, as mentioned in the article with reference to HIV in Thailand, there are so many irregularities that one wonders about the reliability of the information.

Re. Northern Thailand, anybody who is familiar with the way hospitals are run by the medical profession, will not take the data seriously. I am not doubting the existance of HIV/aids, but one needs to first of all question the origin of the statistics and the political and other motives of those who are financing and using them to assess how wide spread it in fact is or not.

[Limbo]

I am not doubting the existance of HIV/aids, but one needs to first of all question the origin of the statistics and the political and other motives of those who are financing and using them to assess how wide spread it in fact is or not.

Thanks for the article Mr. Thamachat.

I think Mr. Stroll hits the nail on its head.

The AIDS/HIV industry has many branches. Prostitution is one of them, but the medical one is gaining power since so much money is involved.

What the, mostly quite young, doctors and epidemiologists of the American Center for Disease Controle are doing here is certainly not too transparent. Ok, for themselves it is part of their career and they are well-paid. Next stop Africa and then back to the States with their digital memories.

The 'ethical question' has been raised in the American Senate already a couple of years ago. Thai groups used words as 'guinea-pigs'.

When I remember well, an enormeous amount of money got the CDC access to the AIDS/HIV scene in Thailand to do research and possibly experiments.

So if Thailand benefits it is indirect at its best. The newspapers at that time, I guess seven or eight years ago, suggested that the earlier mentioned enormeous amount of money would be used to give AIDS-medicine to Thailand. That effectively stopped the discussion.

What I understand now, is that these medicines never were given. The new American regime found a cheaper solution: Abstinence.

I am not sure if Mr. Bush, even if it was not election time, could have got the word 'masturbation' over his lips. I think it is a better alternative than abstinence, because it is at least a form of sex (auto-sex) and recent research shows that it even might prevent prostate-cancer.

[Limbo]

I am not sure if Mr. Bush, even if it was not election time, could have got the word 'masturbation' over his lips. I think it is a better alternative than abstinence, because it is at least a form of sex (auto-sex) and recent research shows that it even might prevent prostate-cancer.

I forgot two things.

The research was done to dismantle the myth that masturbation causes a bad back, it was supposed to weaken the spinal cord. This medical insight was strongest promoted by the Vatican, which as we all know, strongly promoted population-extension.

I once mentioned the word 'masturbation' in the presence of some American aquaintances ('tough' guys, with tattoos) and they were rather shocked. They looked like young boys catched in the act of steeling cookies.

[Debaryman101]

Does anyone know the percentage of the thai population that has AIDS? Last time i was in thailand My Wife's friend joke with me that I should kill mosquito's that bite me as soon as they land on me Do They carry AIDS? Does anyone Know? I"m not sure about this.

Chok dee

[udon]

My Wife's friend joke with me that I should kill mosquito's that bite me as soon as they land on me Do They carry AIDS? Does anyone Know?

A good and scarey point.

I too have worried about this.

Imagine the panic if a respected scientist said "yes they do"!

[stroll]

I think not. But mossies carry Malaria and Dengue fever.

[LivinLOS]

The official line is not Mosquitos do not carry HIV between carriers... Personally I have grave doubts about this and wonder about the prevelence of the pandemic in mosquito rich counties (sub saharan africa SEA asia etc).. I am curious if controlling panic and fear factor has lead to this assesment (then again I am a belive nothing of what you hear and half of what you see kinda guy)...

From some reading on the subject the argument goes that the mosquito has a sufficiently fine removal system that the virus does not have a chace to get back into the bitten persons bloodstream..

Does anyone have any information on the now FDA approved DIY saliva swab tests ?? They are retailing at $20 and can be purchased (IIRC) in some US states.. I know this is not 100% effective and also the 3 month lag time is also a factor but when pharmacies (and short time hotels) can stock these for immediate check ups it would be a god send IMHO..

[Debaryman101]

Does anyone know the % of aids cases in thailand compared to the population?

or was it in the first post and i didn't bother to read the whole thing

chok dee

[LivinLOS]

I have heard all kinds of 'estimates' that seem very off the wall..

I recently read that here on Phuket ladies in the 16 - 30 age group (must be a very high risk demographic considering the 'working' population on this toruist island) getting pre natal HIV testing / screening were 2.5 % positive.

This was considered bad news as it had jumped from 1.5% in the last test phase.

Personally I thought 2.5% was pretty low considering new york has a higher % for the entire population.

[Digger]

Interesting comments raised in the article however I would have thought the HIV test was just the first element. Assuming someone tests positive, they then go onto having CD4 and viral load tests. Its these tests that confirm in the doctors eyes what they have seen in the test results. For example, if an elisa shows HIV and Western Blot is negative, somewhere like Bumrungrad then asks patient for another blood sample and runs Viral load and CD4 tests. These tests would then show CD4 either at normal or lower than normal levels and viral load levels way up or undetectable. Exactly this procedure was followed for a girl who's treatment I pay for. I guess the problem comes when when the option is given of the viral load and CD4 tests which together cost about 7,000 baht from memory. Very easy for many to say whats the point of paying (or cannot pay) for further tests to confirm the already bad news.

FYI, I would guess that a normal CD4 level and no viral load would be considered negative wheras a low CD4 count and a high viral load is considered positive. The scenario I am aware showed a CD4 count of 350ish against normal of 650+ and a viral load of some 200,000 versus a normal reading of 0. The specialist doctor that was doing the treatment/tests etc had no doubt that this girl was sero-converting after being struck down by flu type symptons (which is why she at Bumrungrad in the first place and a savvy general practice doctor wanted a second opinion from Infectious disease specialist).

[thamachat]

Do some reading at the link I suggested. None of these tests have ever been validated by the presence of Hiv, which the manufacturers admit in their package inserts. So all claims of "99.9% accuracy" are totally unfounded. They are just detecting elevated levels of antibodies caused by all kinds of maladies.

[thamachat]

I inadvertently omitted an important fact in my piece (I've since revised the original post), which is the following:

Fiala also points out that, in Thailand, a so called "symptomatic HIV-infection" is also counted as an AIDS case. "Any HIV-positive patient, suffering from one of…11 mostly unspecific symptoms will get this diagnosis," he says. These people are added to the AIDS case numbers in Thailand, although they would not be considered AIDS cases in the rest of the world. "'Symptomatic HIV infections' represent more than 40% of the national figure and are highest in the north of Thailand, the so called epicenter of Aids,” says Fiala.

So not only would many HIV positive Thais not be HIV positive in the west, almost half of all Thais reported as "AIDS cases" would not be considered to have AIDS in the west.

[the scouser]

Last November I set off for Thailand with a song in my heart, looking forward to marrying the apple of my eye. We duly married, I stuck some money in a Thai bank, obtained my non-immigrant "o" in Penang and ultimately got my 1-year stamp. Life was rosy and got even better when my wife was found to be pregnant.

The day after her pregnancy was diagnosed she returned to the hospital for routine tests. She was unable to piss in the bottle and me being my impatient self I decided to bugger off to my favourite haunt for a Chang or four. Whilst gently sipping my beer, radiating a golden aura at the thought of being a father for the first time, my wife telephoned in floods of tears demanding that I return to the hospital.

As I approached the building she came sprinting down the street and flung herself into my arms, sobbing into my ear that she had been found to be hiv positive. It was akin to being belted across the head by a concrete slab. I was stunned. I nearly crumbled at the knees. Selfishly my first thought was that I may have the disease too and that I would also have to undergo a test. My second was that if I too was positive, was it me that gave it to her?

My wife and I went to another hospital the same day and both underwent tests. Prior to the blood samples being taken we were weighed and had our blood pressure taken. The nurse commented that mine was high. On an impluse I wanted to strangle the life out of the bitch. There was I having been told that my wife was hiv positive and I could possibly be too. No ###### wonder my blood pressure was high.

We had to wait forty minutes for the results. I didn't know it was possible to smoke so many Krong Thip within such a time. We were summoned to see the doctor, my wife first. After about five minutes she emerged with her head down, which said it all. The result had been confirmed. I was ushered in and for what seemed like an eternity, but was no more than five seconds, the doctor shuffled her papers before quietly saying that I was negative. God, I was torn in two. Relief at my own condition but distraught at my wife's.

Over the ensuing few days we came to terms with the diagnosis that my wife was hiv positive but it wrecked our future life together in Thailand and to compound our grief my wife miscarried four days after having been found positive.

We set about going to the UK which is where we are now. I felt that the treatment would be better and free. We were notified today that we have an appointment at the hospital here next week.

The point of this post is to say that having read the original one we now have a glimmer of hope.

Scouse.

[the scouser]

a HIV positive Thai person could conceivably emigrate to the West and become HIV negative.

That's exactly what we're hoping.

Scouse.

[andyinkat]

My heart goes out to the both of you. I really hope things turn out okay.

[ProThaiExpat]

While I don't think the original post is balanced in its reporting, it does make an excellent point.

I do know from actual experience with athletes who are HIV infected with bad symptoms and T-cell counts of below 50, that their lives were markedly changed and were brought back from near cetain death by "coctails" when they became available.

Prior to their discovery, death from Aids was certain. Now people are living twenty years or longer after sysmptoms appear. Thus I strongly disagree with that portion of the artilce that states that there is no proof that modern Aids drugs prolong life. I have seen it happen and I don't believe in "spontaneous remission" of Aids, as in cancer or other diseases were remission is proved to occur.

If the "point" of the article is to question Aids information disseminated by governmental agencies, I couldn't agree more.

One only needs to go back to the early eighties and review the health warnigs being issued to see how falcious the information was. Undobtedly justified as for the "public good". Scare tactics do work.

A personal friend of mine who was one of the earliest HIV doctors in the early eighties, told me confidentially, that the chances of getting aids in any given exposure, if bodily fluids are not exchanged, is less than one tenth of one percent.

Thus the rate of transmission from female to male or passive male to active male is a least as low as reported in the aritice posted at the beinging of this thread.

Such information, however, is against the "interest" of the CDC in attempting to stop the "pandemic", so it would not be promulgated except in obscure scientific articles.

The flip side of the Thai experience, is the government is not as restricted by "rights" as in the west so it can produce and distribute low-cost anti-viral drugs to the general population to the benefit of all.

One can only hope that the level of medical practice in Thailand is high enough so that physicians in state supported hospitals properly test patients diagnosed as HIV positive before prescribing anti-viral combination drugs.

This does not address, however, the psychological damage done to innocent people who are told they are HIV positive when they are not. Perhaps a Ministry of Health regulation requiring certain follow up tests after the initial HIV positive test.

Those more knowledeable might choose to comment on a possible scenario that government officials, on a public health basis, are willing to let the HIV positive patient "progress" to full blown aids with symptoms prior to treating the condition, as there is a fierce debate as to when treatment should start,

[NoAjarn]

If i remember rightly, about 10 years ago Thailand was using a test that if you had malaria your test would say you are HIV positive, not a very happy thought that one.

As for mossies, the largest areas of HIV are malarial areas, if mossies could pass on the virus and it was made public, what do you think would happen? I for one would be using 10 cans of insect spray per week, and i imagine everybody else in the world who could afford 10 cans of spray per week would be, I got to admit though I do spray my tiny little garden with mossie killer==hate the bloody things.

[naja]

Thamachat-a very good post that should be repeated regularly on this forum.

to quote more results on studies on HIV in Thailand-In 1993 one study on Thai military conscripts in Northern Thailand "...condom use was reported in 61.5% of men with last sex with a CSW but was not shown to be protective of prevalent HIV infection" and the authors concluded that"....The epidemic of HIV infection has spread widely among young men in Northern Thailand,despite reported frequent and recent use of condoms".

It is possible that many of the conscripts lied when they stated they had been using condoms because in a 1996 study by the same investigator on another batch of conscripts concluded ,as a result of Thailand's public health programs there had been substantial changes in the sexual behavior among young men resulting in increased condom use and a decrease in the rate of HIV infection.

So, in one study condoms were of little use ,but in another they were of value.

As one critic said of the second study: post hoc ergo propter hoc.,and that comment would also apply to the first study.

And as the editor of the Oxford Companion to Medicine [late 1980's] stated ."....most medical research was second rate'.

The British Medical Journal [bMJ] has a special response site devoted to HIV/AIDS.