Aids In Thailand, How Bad Is It ?

[fisherd3]

Scouser:  How long did you have unprotected sex with your wife, including pre-marital sex, before she was diagnosed?

<{POST_SNAPBACK}>

15 months.

Scouse.

<{POST_SNAPBACK}>

With Scouse, a seemingly very worldly/informed individual, having unprotected sex with his girlfriend/wife as apparently normal behaviour ( as many/most people in a stable relationship end up doing) and in my case , when I asked my tgf why she allowed without any question unprotected sex when suggested after a couple of weeks, she responded 'we boyfriend/ girlfriend' and me doing it (also a relatively highly educated person), not to mention the greater millions who have virtually no education and women no bargaining power in demanding condom use, and the apparent ignoring of condom advice by young people in 'civilised' western societies, indicates that ultimately across the board the believe in and reliance on condom use to curb the HIV /AIDS plague on a worldly basis ( may work in localised situations such as a blitz on tbgs, when maintained) is pretty much almost entirely misplaced and may be providing the various authorities with a false sense of security, weakening the anti HIV propganda ethic.

Until HIV propaganda is seen virtually everywhere in all media all the time , including anti phasing techniques to keep the message fresh, as I believe the original Thai blitz was , unfortunately I think this will prove to be just too expensive for the capitalists to countenance so they will have to deal with decimation of their workforce instead, and pay the cost that way.

[pedro01]

Guys

There's a lot of messages on here which hint at what we hear from many guys who frequent bar girls - that is "It's easier for girls to catch HIV than men" or "It's easier for IV drug users to catch HIV" or "It's the Isaan guys & their 50B prostitutes that get HIV".

Whilst this may be the case, this should not be taken as the green light for irresponsible behaviour. This is not scientific evidence. The fact that Scouse had unprotected sex with his HIV wife is anecdotal evidence. Scouse may have some immunity or just be very lucky. Please do not consider this proof that you do not need protection when having sex - that's a very dangerous thing to do. You could still get it off 1 encounter.

When I met my wife - we used protection until we both got tested (& before you ask - I'm not a bar girl!). I would advise you do the same.

I personally know a guy that caught HIV off a bar girl & gave it to his pergnant wife - so PLEASE people - stop hinting that this is not going to get you because you fit into a perceived low-risk group - it gives people a false sense of security.

Also - don't presume that HIV is now under control & that if you have it, you'll lead a healthy life. If you have a poor liver, the HIV medication could cause lots of problems. Some people do last a long time & others don't - this is not a cold we are talking about.

Better to compare HIV medication with cancer medication (and not diabetes) medication methinks.

Just be careful & don't deny the risks

[Wolfie]

Well said Pedro.

[NarrLing]

I agree Pedro01. Risk of infection doesn’t discriminate. Everyone is at risk if precautions are not taken.

Take into account all the village girls who travel to tourist areas seeking money and possible marriage. Some of them make the move only to support their family. Many of them have had children and unprotected sex prior to their travels. Did their previous partners practice safe sex when they visited other girls?

They initially travel into these areas with little information on safe sex measures or idea of the risks involved. These girls are likely to have unprotected sex for money and not think of the risks. “So what if a crazy Farang offers more money not to wear a condom, I’m on the pill, I won’t get pregnant”.

It is only through education and safe practice that infection levels will improve.

NL

[slimdog]

Certain facts are known about hiv/AIDS many things are still unknown.

One thing which is generally accepted is that three things can make the transfer of the virus easier and also have a detrimental effect on hiv+ sufferers, these are:

Stress

Fatigue

Diet

This is why the disease is more common in less developed countries than others. The problem is made even worse in Africa by two other factors:

Not using condoms; For either financial,religious or personal reasons condom use has never been particularly high within the African continent.

Using Anal sex as a primary form of birth control.

Adding all these factors up,it is no suprise that Africa has the hiv/AIDS problem that it is currently having. Solving it is going to be a monumental task.

[Digger]

Also - don't presume that HIV is now under control & that if you have it, you'll lead a healthy life. If you have a poor liver, the HIV medication could cause lots of problems. Some people do last a long time & others don't - this is not a cold we are talking about.

Better to compare HIV medication with cancer medication (and not diabetes) medication methinks.

Just be careful & don't deny the risks

<{POST_SNAPBACK}>

Pedro, I dont disagree with your sentiment however my post did not portray having HIV as a bed of roses - strict medicine regimes are a fact of life however if you ask experts (as I have), they will confirm that early diagnosis and correct adherance to the medical regimes, people ARE living normal lifes and working. Not the same as cancer in my opinion as the treatment options are very different. How many people do you now working and living normal lives with cancer. Three members of my family have died of cancer and they had a horrible time since diagnosis. The girl who's medicine I pay for works in a mini mart and she leads a completely normal life to all intents and purposes. The people that are dying in the west are typically people who do not follow the medicine regimes and their CD4 levels fall to such dangerously low levels and then get an opportunistic infection from which they cannot recover. With a CD4 count above 350, the chances of catching any such opportunistic infections are way reduced and to all intents and purposes these HIV positive have the same imune strength as a non HIV person.

Has this girl been sick since? Yes she has, she suffered from hypertension and anemia about 4 months into the treatment. Her doctor satisfied that the viral load was undetectable has subsequently reduced the amount of medication she is taking however (and this is where the expertise is required), she did not want to change the medication which would limit her options in the future. She is also mindfull that she has Hep B, which of course affects the liver. Whilst this is not a problem now it might be in the future. Again another reason to work only with specialist doctors that now what they are talking about. Since reducing her dosage, she has had no further sickness of any description. Her liver function tests are all fine as they are checked every 6 months.

I absolutely agree though with your comments about men catching it. I have been with her perhaps 6 times to see her doctor at Bumrungrad. The doctor she see's runs very late (way over each 10-15 minute appointment time) and that means you are often waiting to see her for well over an hour after your alloted appointment. I see just as many men going in to see this doctor including many farang and unless they are suffering from elephantitis, odds are they are infected with HIV as that is what she specialises in. I have also seen one well known farang I recognised from newspaper pictures going into see this doctor so it can and does affect everybody.

So in essence, its not a walk in the park but its not a death sentence either.

Edited January 14, 2005 by Digger

[Ijustwannateach]

Pedro- cheers. There's a lot of whistling in the dark going on, and we don't need to encourage it. People who have unsafe sexual practices and who are living in denial need to be confronted with accurate information.

"Steven"

[britmaveric]

Pedro- cheers.  There's a lot of whistling in the dark going on, and we don't need to encourage it.  People who have unsafe sexual practices and who are living in denial need to be confronted with accurate information.

"Steven"

<{POST_SNAPBACK}>

Unfortunately those living in denial don't care. (no excuse not to take precautions)

[pyros]

On Koh Samui , my friends GF has HIV . Found out about it about 3/4 months ago . She knew allready because her ex husband died of HIV ( didn't tell him ) . They always performed safe sex ( she wanted ) so no problem for him but still ... If you worry about condoms , please use them always , and try different types . I'm very sure you'll find the type which is the right one for you . I always bring my type from home with me , because i know don't like most Thai condoms . And for your info , AIDS/HIV isn't a disease you heal from , neither can it be controled ( like some people say here on the board ) . They can surpress ( English writing ??? ) it with medicine and maybe able to control it for a certain time but that isn't control like we would like . It isn't certain that it is working tomorrow , you can live for 10/15/20 years but it isn't sure even with the right medication . So ALWAYS USE CONDOMS , remember , it isn't only your life you put at stake , it is also hers and everybody who goes with her after . Also , HIV test's can only put on a positive result after about 3 months after contamination . Before that period ( the 3 months ) you are supercontagious , the viral load in your blood is extremely high and you don't have antibodies yet ( the test determines antibodies ) . If you have unprotected sex in that time the chances of giving in to the partner is close to 100% ( something most people don't know ) . After the 3 months period , your body is having antibodies and the chances of giving it to the partner is maybe 1% .

[mouse]

Recently my sister in law informed us that she was suprised to have gotten pregnant cause she had taken the (normal) birth control pill immdiately after every sexula act. If this is the level of knowledge for a full grown woman of 28 years old, then no wonder many others are so vunerable to STD's.

In our village of about 1,400 people there are presently more than 75 cases of AIDS.

Scouse you are good man!!

[Digger]

) . If you have unprotected sex in that time the chances of giving in to the partner is close to 100% ( something most people don't know ) . After the 3 months period , your body is having antibodies and the chances of giving it to the partner is maybe 1% .

<{POST_SNAPBACK}>

Where are your facts to back this up? This is misleading to say the least. As far as I can ascertain there are no facts on this as nobody in their right mind is going to do the research. Its like playing Russian Roulette with a HIV negative persons well being. Nobody will knowingly expose a HIV negative person to a HIV virus just to tell how infectious the HIV is and then repeat it enough times to draw factual conclusions. It can be deduced however that the 'liklihood' of infection reduces as the amount of virus is lowered in the HIV positive person, however as viral load testing is done on blood, not for example, Sperm, no absolute conclusions can be drawn. By the way the viral load in an infected person does not suddenly crash after 3 months of infection. It gradually reduces and then rises over a number of years not months. After 3 months, viral load is typically around 20-100,000. Once on medication and with viral load undetectable, your statement of 1% liklihood sounds plausible but again its never been proven and somehow I cant see it ever being proven.

[pyros]

) . If you have unprotected sex in that time the chances of giving in to the partner is close to 100% ( something most people don't know ) . After the 3 months period , your body is having antibodies and the chances of giving it to the partner is maybe 1% .

<{POST_SNAPBACK}>

Where are your facts to back this up? This is misleading to say the least. As far as I can ascertain there are no facts on this as nobody in their right mind is going to do the research. Its like playing Russian Roulette with a HIV negative persons well being. Nobody will knowingly expose a HIV negative person to a HIV virus just to tell how infectious the HIV is and then repeat it enough times to draw factual conclusions. It can be deduced however that the 'liklihood' of infection reduces as the amount of virus is lowered in the HIV positive person, however as viral load testing is done on blood, not for example, Sperm, no absolute conclusions can be drawn. By the way the viral load in an infected person does not suddenly crash after 3 months of infection. It gradually reduces and then rises over a number of years not months. After 3 months, viral load is typically around 20-100,000. Once on medication and with viral load undetectable, your statement of 1% liklihood sounds plausible but again its never been proven and somehow I cant see it ever being proven.

<{POST_SNAPBACK}>

I did read this a couple of weeks ago from official health doctors , i'll see if i can find the info on the internet to back me up on this ( and off course i'll send the link in here ... ) . I put a mail to a very good AIDS site with the question and i hope for a answer . I'll send the answer here when i get it ...

Edited January 21, 2005 by pyros

[Digger]

Better to compare HIV medication with cancer medication (and not diabetes) medication methinks.

<{POST_SNAPBACK}>

Doctors are the one's comparing HIV treatment and diabetes treatments, not laymen. Pls see this link:

http://www.thebody.com/Forums/AIDS/Startin...ne/Q142688.html

[pyros]

) . If you have unprotected sex in that time the chances of giving in to the partner is close to 100% ( something most people don't know ) . After the 3 months period , your body is having antibodies and the chances of giving it to the partner is maybe 1% .

<{POST_SNAPBACK}>

Where are your facts to back this up? This is misleading to say the least. As far as I can ascertain there are no facts on this as nobody in their right mind is going to do the research. Its like playing Russian Roulette with a HIV negative persons well being. Nobody will knowingly expose a HIV negative person to a HIV virus just to tell how infectious the HIV is and then repeat it enough times to draw factual conclusions. It can be deduced however that the 'liklihood' of infection reduces as the amount of virus is lowered in the HIV positive person, however as viral load testing is done on blood, not for example, Sperm, no absolute conclusions can be drawn. By the way the viral load in an infected person does not suddenly crash after 3 months of infection. It gradually reduces and then rises over a number of years not months. After 3 months, viral load is typically around 20-100,000. Once on medication and with viral load undetectable, your statement of 1% liklihood sounds plausible but again its never been proven and somehow I cant see it ever being proven.

<{POST_SNAPBACK}>

Like i said ... i did send a emal to a AIDS-site to back me up on this and i got a answer . Here it is ...

Dear Serge,

Many thanks for your email.

Everything you have written in your email is correct, according to current understanding of HIV infectiousness. The following page of our website explains this in more detail: http://www.aidsmap.com/en/docs/183CCB5C-3C...DBA5F10932E.asp.

With best wishes,

Chris.

Christopher Gadd

Editor (HIV & AIDS Treatments Directory)

NAM

Lincoln House

1 Brixton Road

LONDON

SW9 6DE

Email: [email protected]

Phone: +44 (0)20 7840 0063

Fax: +44 (0)20 7735 5351

I read on the link they send to me later , but i knew i was right . So , the point is , Always use a comdom , even with a neg. HIV test unless you are very sure of you and your partner .

[Crushdepth]

) . If you have unprotected sex in that time the chances of giving in to the partner is close to 100% ( something most people don't know ) . After the 3 months period , your body is having antibodies and the chances of giving it to the partner is maybe 1% .

<{POST_SNAPBACK}>

Where are your facts to back this up? This is misleading to say the least. As far as I can ascertain there are no facts on this as nobody in their right mind is going to do the research. Its like playing Russian Roulette with a HIV negative persons well being. Nobody will knowingly expose a HIV negative person to a HIV virus just to tell how infectious the HIV is and then repeat it enough times to draw factual conclusions. It can be deduced however that the 'liklihood' of infection reduces as the amount of virus is lowered in the HIV positive person, however as viral load testing is done on blood, not for example, Sperm, no absolute conclusions can be drawn. By the way the viral load in an infected person does not suddenly crash after 3 months of infection. It gradually reduces and then rises over a number of years not months. After 3 months, viral load is typically around 20-100,000. Once on medication and with viral load undetectable, your statement of 1% liklihood sounds plausible but again its never been proven and somehow I cant see it ever being proven.

<{POST_SNAPBACK}>

Last year I went to get tested (just routine precaution but it still freaked me out) and did a lot of reading on the net before hand. There is a huge effort going into epidemiological / population studies and there are reasonably good ballpark estimates of how risky different kinds of behaviour are. If I remember rightly (and I may not), the risk of female to male transmission from 'regular' sex was pretty ###### low (less than 1%), male to female was in the vicinity of 1%, and anal was about 3%. These were all 'population averages' and that as an individual anyone can be a lot more or a lot less susceptible than 'average'.

I also met a HIV researcher last year at a social event. She said the incidence of HIV in Thailand is about 1 person in 60, but its not evenly distributed throughout the population. Guess which end of the stick bar girls are on.

[Digger]

) . If you have unprotected sex in that time the chances of giving in to the partner is close to 100% ( something most people don't know ) . After the 3 months period , your body is having antibodies and the chances of giving it to the partner is maybe 1% .

<{POST_SNAPBACK}>

Where are your facts to back this up? This is misleading to say the least. As far as I can ascertain there are no facts on this as nobody in their right mind is going to do the research. Its like playing Russian Roulette with a HIV negative persons well being. Nobody will knowingly expose a HIV negative person to a HIV virus just to tell how infectious the HIV is and then repeat it enough times to draw factual conclusions. It can be deduced however that the 'liklihood' of infection reduces as the amount of virus is lowered in the HIV positive person, however as viral load testing is done on blood, not for example, Sperm, no absolute conclusions can be drawn. By the way the viral load in an infected person does not suddenly crash after 3 months of infection. It gradually reduces and then rises over a number of years not months. After 3 months, viral load is typically around 20-100,000. Once on medication and with viral load undetectable, your statement of 1% liklihood sounds plausible but again its never been proven and somehow I cant see it ever being proven.

<{POST_SNAPBACK}>

Like i said ... i did send a emal to a AIDS-site to back me up on this and i got a answer . Here it is ...

Dear Serge,

Many thanks for your email.

Everything you have written in your email is correct, according to current understanding of HIV infectiousness. The following page of our website explains this in more detail: http://www.aidsmap.com/en/docs/183CCB5C-3C...DBA5F10932E.asp.

With best wishes,

Chris.

Christopher Gadd

Editor (HIV & AIDS Treatments Directory)

NAM

Lincoln House

1 Brixton Road

LONDON

SW9 6DE

Email: [email protected]

Phone: +44 (0)20 7840 0063

Fax: +44 (0)20 7735 5351

I read on the link they send to me later , but i knew i was right . So , the point is , Always use a comdom , even with a neg. HIV test unless you are very sure of you and your partner .

<{POST_SNAPBACK}>

I cannot find any reference to the view that after 3 months of infection, the liklihood of transmission is around 1% - did you specifically ask him that in your email. That was the point I was making in case you did not pick that up - I have no issue with the statement that during seroconversion your body has a very high viral load and 'risk' of transmission is logically greater than a undetectable viral load.

[Digger]

) . If you have unprotected sex in that time the chances of giving in to the partner is close to 100% ( something most people don't know ) . After the 3 months period , your body is having antibodies and the chances of giving it to the partner is maybe 1% .

<{POST_SNAPBACK}>

Where are your facts to back this up? This is misleading to say the least. As far as I can ascertain there are no facts on this as nobody in their right mind is going to do the research. Its like playing Russian Roulette with a HIV negative persons well being. Nobody will knowingly expose a HIV negative person to a HIV virus just to tell how infectious the HIV is and then repeat it enough times to draw factual conclusions. It can be deduced however that the 'liklihood' of infection reduces as the amount of virus is lowered in the HIV positive person, however as viral load testing is done on blood, not for example, Sperm, no absolute conclusions can be drawn. By the way the viral load in an infected person does not suddenly crash after 3 months of infection. It gradually reduces and then rises over a number of years not months. After 3 months, viral load is typically around 20-100,000. Once on medication and with viral load undetectable, your statement of 1% liklihood sounds plausible but again its never been proven and somehow I cant see it ever being proven.

<{POST_SNAPBACK}>

Last year I went to get tested (just routine precaution but it still freaked me out) and did a lot of reading on the net before hand. There is a huge effort going into epidemiological / population studies and there are reasonably good ballpark estimates of how risky different kinds of behaviour are. If I remember rightly (and I may not), the risk of female to male transmission from 'regular' sex was pretty ###### low (less than 1%), male to female was in the vicinity of 1%, and anal was about 3%. These were all 'population averages' and that as an individual anyone can be a lot more or a lot less susceptible than 'average'.

I also met a HIV researcher last year at a social event. She said the incidence of HIV in Thailand is about 1 person in 60, but its not evenly distributed throughout the population. Guess which end of the stick bar girls are on.

<{POST_SNAPBACK}>

Average population stats are very dangerous to interpret without understanding the full criteria used in the research.

Typically they will include the whole given population including people that are not sexually active, people in monogomous relationships and so on - these groups have to be included in any average using population studies. So on average, liklihood of transmission is not 1% if your shaggin bar girls every night, given that the population at large in these studies do not have sex with prostitutes - furthermore, these take no account of how frequently condoms were used.

Bottom line is never assume you have a 1% liklihood of contracting HIV in Thailand - odds are you will be proved wrong

[Crushdepth]

Typically they will include the whole given population including people that are not sexually active, people in monogomous relationships and so on - these groups have to be included in any average using population studies. So on average, liklihood of transmission is not 1% if your shaggin bar girls every night, given that the population at large in these studies do not have sex with prostitutes - furthermore, these take no account of how frequently condoms were used.

Bottom line is never assume you have a 1% liklihood of contracting HIV in Thailand - odds are you will be proved wrong

Mostly they were studies of specific sub-groups like sex workers etc, and I think they can take into account condom usage because there are plenty of groups that simply do not use or cannot afford them.

The ballpark transmission figures I mentioned are for unprotected sex with an infected partner who *has* HIV, not for going out and picking somebody up who may or may not have it. By population average I mean the average across a group of people - the actual risk from any given shag depends on a zillion things and presumably varies quite a bit - but the overall average across the group is X.

[Digger]

Typically they will include the whole given population including people that are not sexually active, people in monogomous relationships and so on - these groups have to be included in any average using population studies. So on average, liklihood of transmission is not 1% if your shaggin bar girls every night, given that the population at large in these studies do not have sex with prostitutes - furthermore, these take no account of how frequently condoms were used.

Bottom line is never assume you have a 1% liklihood of contracting HIV in Thailand - odds are you will be proved wrong

Mostly they were studies of specific sub-groups like sex workers etc, and I think they can take into account condom usage because there are plenty of groups that simply do not use or cannot afford them.

The ballpark transmission figures I mentioned are for unprotected sex with an infected partner who *has* HIV, not for going out and picking somebody up who may or may not have it. By population average I mean the average across a group of people - the actual risk from any given shag depends on a zillion things and presumably varies quite a bit - but the overall average across the group is X.

<{POST_SNAPBACK}>

Not sure I follow your logic on this. So presumably the sub group of sex workers had all been diagnosed with HIV. From this sub group, they then test everyone of her clients before (to check there not already HIV positive) and after the event to see if they have caught HIV. Does this really happen? Presume its an NGO/charity doing the research, but not sure if I really believe this could be going on. Bit like watching a bull fight but with humans. You now that odds are the bull will be killed, or if he is unlucky the bull fighter, but to do this with peoples lives who presumably do not know that the sex worker is HIV positive, yet the researchers do, would be considered unethical in almost every country and I would be surprised if NGO's could get funding for this kind of activity. That has always been the issue with testing of various states of viral loads/infection levels as its basically a form of manslaughter.

Do you recall any of the sites you looked at for this?

[meom]

Don't you boys and girls think that once a cure for Aids has been found some other illness will threaten mankind?

I don't wish anybody to get aids or cancer or whatever but maybe these illnesses are just nature's way of saying there are too many people on this planet.

Instead of wasting money on finding all sorts of cures maybe it's better to do nothing thereby allowing the weak to die and the strong to survive.

[pyros]

Don't you boys and girls think that once a cure for Aids has been found some other illness will threaten mankind?

I don't wish anybody to get aids or cancer or whatever but maybe these illnesses are just nature's way of saying there are too many people on this planet.

Instead of wasting money on finding all sorts of cures maybe it's better to do nothing thereby allowing the weak to die and the strong to survive.

<{POST_SNAPBACK}>

No , because that way you can say that a mas murderer also can be free because it's natures way of saying that we are with to much people here .You are right in the way that maybe medicine has taken us way too far ( for ex fertility ) because we are getting weaker and weaker . The risc of serious diseases is getting bigger and bigger as the world is getting smaller and more people are around to carry it , so more infection diseases will break out and 1 day there will be a pandemy which will kill a lot of people in very short time . It can be HIV ,imagine it getting airborne , but can be chicken flu or SARS or other things which don't exist yet . There will always be diseases , it is our role to look that not everybody suffers from it .

BTW , a recent study with people's genes has been vary special ( HIV matters ) . During the plague a couple of century's ago , some people who survived had a form of genetic "malfunction" which made them unaffected by plague . These peoples children further down the line have the same genes and this gen makes them also very resistable to HIV ( possible even that they can't be infected ) . To the recent study about 20% of the european population would be in this category .

Now as a peply to the mail , no i didn't mention numbers in my mail as for the 1% chance and 50% chance numbers ( but i did mention superinfectionenal ) Those

numbers i did read in the report from the doctor when i mentioned it here . If you see the viral load numbers in the reply i've gotten from the site you'll see that these numbers are huge in the first weeks ...1 million/ml and 25.000/ml for the people after months ... these differences are huge . Even if the chances are let's say 10% ( where 1 % in later stadia ) would you take the guess ??? That means that if somebody is really HIV+ you are still going wothout condom because the chances are a lot smaller . Indeed for a female infecting a male the chances are a lot smaller then the other way around but i don't take the chance . Find yourself a good type of condoms and you won't feel a thing of it and even putting it on isn't a drama ( every type of condom is different ) . Just make it a habbit and by that you're chances of getting HIV is close to 0% .

[PvtDick]

Wonderful thought, meom. So maybe next time you're sick you should just stay at home and wait to die instead of seeing the doctor.

[Digger]

Now as a peply to the mail , no i didn't mention numbers in my mail as for the 1% chance and 50% chance numbers ( but i did mention superinfectionenal ) Those

numbers i did read in the report from the doctor when i mentioned it here . If you see the viral load numbers in the reply i've gotten from the site you'll see that these numbers are huge in the first weeks ...1 million/ml and 25.000/ml for the people after months ... these differences are huge . Even if the chances are let's say 10% ( where 1 % in later stadia ) would you take the guess ??? That means that if somebody is really HIV+ you are still going wothout condom because the chances are a lot smaller . Indeed for a female infecting a male the chances are a lot smaller then the other way around but i don't take the chance . Find yourself a good type of condoms and you won't feel a thing of it and even putting it on isn't a drama ( every type of condom is different ) . Just make it a habbit and by that you're chances of getting HIV is close to 0% .

<{POST_SNAPBACK}>

OK so now we have established that you did not ask for confirmation that after 3 months infection, the liklihood of transmission is 1% - which is what you were challenged on and then posted that you knew you were right, quoting a highly respected HIV resource as your proof. Hmmm, somewhat dangerous to get drawn into these situations on 'hearsay'.

Just to re-iterate, there is no scientific proof that I have ever seen that the liklihood of contracting HIV from a HIV positive person is around 1% after 3 months seroconversion. Your sentiment is spot on (i.e use condoms all the time), but dangerous to use figures you have made up to 'support' your arguement because by using the 1% liklihood of infection, your creating the impression that the virus is not likely, on a statistical basis to be transmitted and this has been proved as incorrect. Have a look at this link which although not focused on risk of infection, has as a co-incidence found that overall liklihood of transmission stands at 4% (uncircumcised men) for a relatively high risk group of truck drivers, however useage of condoms is not exactly scientific, but it basically confirms that the risk of transmission is higher than previously thought:

http://www.nam.co.uk/en/news/47AE661F-F92B...5730410F81D.asp

Sounds to me like quite a good comparison with a typical farang in Thailand and probably one of the most compelling I have seen in terms of profiling, albeit the stats are quite old. The key take away quote is as follows:

"Importantly, the authors’ rate of female to male HIV transmission is much higher than previous estimates of below 1 in 1000 from studies of serodiscordant couples in the United States and Europe. “This is the first study to estimate HIV-1 infectivity in a population with multiple, concurrent partnerships of different types,” they state. “HIV-1 infectivity in an African population with multiple partnerships may be substantially greater than previously estimated from studies of monogamous HIV-1-serodiscordant couples.”

Not meaning to be difficult, but this 'hearsay' is very dangerous and I have heard many guys in Bangkok, say "I never use condoms because the risk of transmission from a girl to a guy is so small, its not worth worrying about" - where do they understand this from - god only knows but they are wrong.

[mbkudu]

Don't you boys and girls think that once a cure for Aids has been found some other illness will threaten mankind?

I don't wish anybody to get aids or cancer or whatever but maybe these illnesses are just nature's way of saying there are too many people on this planet.

Instead of wasting money on finding all sorts of cures maybe it's better to do nothing thereby allowing the weak to die and the strong to survive.

So I guess you could say, 'Don't worry about seat belts in cars; if you are killed or paralysed in a car wreck, oh well.' The problem with this reasoning is that many of today's diseases are not natural. I would bet every Baht that I have that 'cancer'

is caused by synthesized food and medicine, pollution, electricity transformers, depleated uranium and other fuels in the ground water and a myriad of other man-made concoctions. There is even strong debate that AIDS/HIV was introduced into humans from faulty polio vaccines derived from contaminated chimp kidneys.

As crazy as scientists are, I would not be shocked if it turned out to be true. Did people die of cancer before the Industrial Revolution? I think not. If our food and water is not poisoned, and we are not treated like guinea pigs by doctors and scientists, we will get better, until then, good luck to you.

[pautai]

2 dead in the village , and i pay for the medication of an infected child who became infected when her ma had a blood transfusion after delivery . (ma dead )

Viral load is ok child is doing fine at school and looks no different than other kids .

its a well guarded secret , she doesnt know the bad news , she thinks they are vitamin pills but one day in the future she will have to be told the bad news .

I just hope to god that the medicines and vaccines will be more effective soon .

Just how dangerous is a blood transfusion in a Thai hospital ? better to keep your own supply of blood in cold storage if you live in LOS .

[pautai]

Friday, January 21, 2005

Male circumcision reduces the risk of infection with HIV-1 from female sexual partners by more than twofold, according to a study of Kenyan men published in the 15th February edition of The Journal of Infectious Diseases. Although previous studies have found similar trends, this investigation is the first to assess the risk of transmission per sex act in an area where multiple sexual partners and a lack of male circumcision are common, and to take religious and ethnic differences into account.

Although sub-Saharan Africa has a high prevalence of HIV-1 infection, the spread of the virus has not been uniform across the region. While this may be due to differences in behaviour or to biological variation between areas, differences in the number of men who have been circumcised have been identified as a possible cause of the pattern of HIV’s spread.

Many studies have found that circumcision can reduce an individual man’s risk of contracting HIV, but it remains uncertain whether this effect could be caused by circumcised and uncircumcised men having different sexual behaviour. To resolve these issues, investigators from Kenya and the United States carried out a prospective study of HIV infection and sexual behaviour in a cohort of 745 Kenyan men.

“Our results suggest that the probability of female-to-male sexual HIV-1 transmission might be twofold higher for uncircumcised than for circumcised men,” they conclude. “The high probability of per-contact HIV-1 transmission seen in our study may explain the rapid spread of the HIV-1 epidemic in settings where multiple, concurrent partnerships are common.”

The researchers recruited HIV-negative Kenyan men from six truck companies in Mombasa between 1993 and 1997. Six hundred and fifty (87%) of the men were circumcised. Every three months, the men were asked about the number of sex partners, the number of sex acts carried out with three different types of partner (wives, casual partners and prostitutes) and condom use. The men were also tested for HIV-1 at every visit.

The investigators estimated the probability of HIV transmission per sex act for each man using a mathematical model. Based on data published at the same time as their study, the investigators estimated the HIV-1 prevalence as being 10% in wife partners, 25% in casual partners and 65% in prostitutes.

During a median follow-up of 630 days, 43 men became HIV-positive. Eleven of these were uncircumcised and 32 were circumcised. Sexual activity with a wife was reported by 573 men (77%), with a casual partner by 474 men (64%) and with a prostitute by 182 (24%).

Rates of unprotected sex were also high. Five hundred and sixty-nine (99%) of the men who had sex with their wives had unprotected sex, 405 (85%) with casual partners and 129 (71%) with prostitutes.

Overall, there was a 1 in 159 risk of female to male HIV transmission (95% confidence interval: 110, 286) per act of vaginal sex. This risk was 2.49 times greater in uncircumcised men (1 in 196 vs. 1 in 78, p = 0.04). This increased risk was similar when the investigators adjusted the estimated rates of HIV prevalence in the women by up to 10%.

“The foreskin contains high densities of HIV-1 target cells, which suggests that a heightened HIV-1 risk in uncircumcised men is biologically plausible,” explain the authors.

To check for the influence of religious or cultural differences on their results, the researchers repeated their analysis after removing the Muslim men, who are almost all circumcised, finding that this had little effect on their conclusions. Similarly, omission of the data from men of the Luo ethnic group, who have low levels of circumcision, did not affect their conclusions.

Finally, the investigators tested their assumptions that the men did not have sex with their casual partners more than once during follow-up and that condom use reduced the likelihood of HIV transmission by 85%. Re-analysis after removal of either of these assumptions did not cause any change in the observed trends.

Importantly, the authors’ rate of female to male HIV transmission is much higher than previous estimates of below 1 in 1000 from studies of serodiscordant couples in the United States and Europe. “This is the first study to estimate HIV-1 infectivity in a population with multiple, concurrent partnerships of different types,” they state. “HIV-1 infectivity in an African population with multiple partnerships may be substantially greater than previously estimated from studies of monogamous HIV-1-serodiscordant couples.”

“The high probability of per-contact HIV-1 transmission seen in our study may explain the rapid spread of the HIV-1 epidemic in settings where multiple, concurrent partnerships are common. Moreover, our results strengthen the substantial body of evidence suggesting that variation in the prevalence of male circumcision may be a principal contributor to the spread of HIV-1 in Africa.”

Reference

Baeten JM et al. Female-to-male infectivity of HIV-1 among circumcised and uncircumcised Kenyan men. J Infect Dis 191: 546-553, 2005.

[pautai]

Researchers Develop Strategic Plan for AIDS Vaccine Development

By Karla Gale

The Global HIV/AIDS Vaccine Enterprise, an international alliance of independent agencies and organizations conducting or supporting HIV vaccine research, has issued a new roadmap to speed the development of a vaccine by promoting new collaboration, resources, and strategic focus.

"Harnessing new scientific opportunities for HIV vaccine development will require an effort of a magnitude, intensity, and design without precedent in biomedical research," the coordinating committee of the Enterprise writes in its report in the February issue of Public Library of Science (PLoS) Medicine.

"The first trial of an HIV vaccine was done almost 18 years ago. We have come to realize that developing an HIV vaccine is much more complex than we all thought," Dr. Jose Esparza, of the Bill and Melinda Gates Foundation, told Reuters Health.

To make an HIV vaccine a reality in the foreseeable future, "we need a new game plan that brings more corroboration, a better exchange of information and a more systematic approach to explore different vaccines," he said.

The committee hopes to "develop a common set of criteria to make decisions about which ones should be tested and which ones should move to larger scale trials," he added. "The field today is inundated with 'me-too' products, similar candidate vaccines, and not enough innovation."

The scientists were able to agree on the scientific questions that must be answered to develop an HIV vaccine that induces both cellular and humoral immunity, Dr. Esparza said. But without the Enterprise, "the current system does not have the required infrastructure or resources to answer those questions."

Specific goals will be to develop new standard assays; a system of "core" reference laboratories that will service satellite labs; a global quality assurance function to encompass all participating laboratories; and a source of common reagents, including antisera/antibodies and viral isolates.

The Enterprise Coordinating Committee estimates that, to meet these goals, current expenditures on HIV vaccine research and development will need to be doubled to $1.2 billion annually.

This proposal is "an excellent start to a continuing dialogue of utmost importance," Dr. David D. Ho, the director of the Aaron Diamond AIDS Research Center in New York, comments in a related editorial.

01/19/05

PLoS Medicine 2005;2:e25-e36.

[pautai]

Higher Rates of Heterosexual Transmission of HIV Outside Developed Countries is Better Understood

By Harvey S. Bartnof, MD

In countries outside of North America, Europe and Australia, the majority of sexual transmission of HIV takes place by the heterosexual route. While the incidence rate of HIV heterosexual transmission has been increasing in developed countries, the difference between the rate in those and developing countries has not been entirely known. Now, the difference may be understood better, based upon research presented at the 7th Conference on Retroviruses and Opportunistic Infections (7th CROI).

The first report was authored by M.A. Cohn, MD and colleagues from the Howard Hughes Medical Institution-NIH (National Institutes of Health) Research Scholars Program. Dr. Cohn found that the rate of vaginal inflammation was 84% among a sample of HIV positive Thai women, compared to only 14% among a sample of HIV positive US women. The inflammation was T cells in the "epithelium," the top or innermost layer of cells in the vagina. T cells are targets for and manufacturers of HIV. Biopsy samples of the vagina were used for testing. (The total number of women tested was not stated in the abstract.) Among the HIV positive women from Thailand, the higher rate of vaginal inflammation was associated with a 50-fold increased level of HIV RNA viral load in the epithelium. Without a microscope, the vaginal tissue on "gross" examination did not appear abnormal. There was no association between the inflammation and the presence of other STDs (* sexually transmitted diseases). The presence of STDs was determined by testing cervical (lowest part of the uterus)-vaginal "lavage" fluid, whereby sterile normal saline is placed into the vagina and then removed. Researchers tested the lavage fluid for gonorrhea, chlamydia, Candida (yeast), trichomoniasis ("trick"), and bacterial vaginosis.

The authors concluded, "The higher rates and increased risk of heterosexual transmission in Thailand may be due, in part, to chronic inflammation at the site of heterosexual viral transmission leading to the accumulation of activated T cells." They continue, "Such T cells might act as targets for initial viral infection and subsequently as reservoirs that support efficient transmission." They add, "Studies aimed at finding the etiological agent(s) (infectious cause) that cause the inflammation may lead to therapies that decrease the risk of transmission."

The authors did not provide evidence of chronic inflammation prior to HIV infection, only a one-time "picture" after HIV infection. It is possible that the inflammation was not present prior to HIV infection. If that were the case, then the authors' conclusion regarding "initial viral infection" would not be true. However, the differences might help to explain heterosexual transmission by vaginal intercourse after the women were infected, to their male sex partners.

The authors did not indicate how the lavage fluid was tested for STDs. In 1999, there is an assumption that "nucleic acid testing" (NAT for STD genes) was the method used for testing gonorrhea and chlamydia, and not "culturing" (whereby organisms are grown in the laboratory). Since the primary location for these two STDs is at the cervix, it is possible that the lavage fluid did not detect those infections at that location. The standard method for testing for those two infections would be to obtain mucous or discharge at the cervix. However, NAT is so sensitive that even testing urine is able to detect infection.

If the findings are real and not an artifact of the testing mechanism, the question is why the difference in the rate of vaginal inflammation between the Thai and US women? The HIV subtype or "clade" in Thailand primarily is "E," whereas the most common subtype in North America and Europe is "B." Does subtype E cause more inflammation than subtype B? That might be a reason or co-factor, but the researchers did not prove that. Or, is there another infection (possibly a STD) that might be causing the increase in vaginal inflammation amongst the Thai women?

Other potential confounding factors are the stage of HIV disease and anti-HIV therapies. The authors indicate that blood samples were obtained. However, they did not report the median vial load and CD4 counts for the women. Were the two groups of women matched for HIV RNA viral load in blood and for CD4 counts? If the Thai women were more advanced in their HIV disease with higher blood viral loads and lower CD4 counts, it is possible that those differences might account, in part, for the higher vaginal viral load and higher rate of vaginal inflammation amongst the Thai women. Also, whether any of the women were taking anti-HIV therapies was not mentioned. Nonetheless, the findings are provocative and appear to provide some insights into the differences of heterosexual HIV transmission in different populations.

In the second report, researchers looked for other factors that might explain differences in HIV infection within heterosexual populations on the African continent. Reported rates of infection among selected populations of certain countries are much lower than that of other countries. This has occurred even with a similar duration of the HIV epidemic in those countries. Therefore, the authors examined potential co-factors in the low prevalence areas of Cotonou, Benin and Yaounde, Cameroon with high prevalence areas of Kisumu, Kenya and Ndola, Zambia. The study was "cross-sectional," with a random, one-time evaluation of approximately 1,000 men and 1,000 women. The age range was 15-49 years.

Some of the results were as follows. The rates of HIV infection in the four locations were 3% in Cotonou, 4% in Yaounde, 20% in Kisumu, and 23% in Ndola. The rates among women in those four locations were 3%, 8%, 30%, and 32%, respectively. Interestingly, reported rates of high risk (unprotected, no condom) sexual behavior was not significantly different when comparing the four locations. However, other factors were different.

Firstly, the rates of syphilis or herpes simplex type 2 ("genital herpes") or both were much higher in Kisumu and Ndola, when compared to Cotonou and Yaounde. Those two STDs manifest as ulcerations that have been previously associated with an increased risk of transmitting or receiving HIV infection. (An ulcer is a condition whereby the outer layer of skin is not intact and a shallow "crater" or indentation is present, until the STD sore or lesion has healed. At the ulcer location, the skin is not intact and the normal barrier to infection is disrupted.) The specific rates of these STDs were not stated in the abstract.

The other co-factor was that there was a higher rate of circumcision (no foreskin on the penis) among the men in Cotonou and Yaounde than among those in Kisumu and Ndola. There are many studies in the medical literature that repeatedly document a higher rate of circumcision among heterosexual men from developing countries with a lower rate of HIV infection. The reason is thought to be that the inner lining of the foreskin has only one layer of cells that might be more susceptible to interruption with sexual intercourse, thereby losing a protective barrier. The other reason might be that HIV-infected mucous (from the vagina) would remain under the foreskin after heterosexual vaginal intercourse for a period of time, unless the man immediately washed under the foreskin. The longer that HIV-infected fluid might remain there, the greater the risk of becoming infected, particularly if there were a STD ulceration there. The specific rates of circumcision were not stated in the abstract. The information about these findings was presented by Dr. A. Buve, from the Institute of Tropical Medicine in Antwerp, Belgium.

In two other oral presentations, the risk of heterosexual HIV transmission among 915 discordant couples (one HIV positive, the other HIV negative) in Uganda or Zambia was significantly associated with a higher HIV RNA viral load in blood. For more information about those two reports, see Day 1 of the 7th CROI above.

* STDs mean sexually transmitted diseases

2/21/00

References

Buve A. HIV/AIDS in Africa: why so severe, why so heterogeneous? Abstract and oral presentation S28 at the 7th Conference on Retroviruses and Opportunistic Infections; January 30-February 2, 2000; San Francisco, California.

Cohn MA and others. Chronic inflammation with increased HIV RNA expression in the vaginal mucosa: association with heterosexual transmission of HIV. Abstract and poster presentation 117 at the 7th Conference on Retroviruses and Opportunistic Infections; January 30-February 2, 2000; San Francisco, California.

Fideli U and others. Virologic determinants of heterosexual transmission in Africa. Abstract and oral presentation 194 at the 7th Conference on Retroviruses and Opportunistic Infections; January 30-February 2, 2000; San Francisco, California.

Quinn TC and others. Viral load and risk of heterosexual transmission of HIV-1 among heterosexual partners. Abstract and oral presentation 193 at the 7th Conference on Retroviruses and Opportunistic Infections; January 30-February 2, 2000; San Francisco, California.

[pyros]

OK so now we have established that you did not ask for confirmation that after 3 months infection, the liklihood of transmission is 1% - which is what you were challenged on and then posted that you knew you were right, quoting a highly respected HIV resource as your proof. Hmmm, somewhat dangerous to get drawn into these situations on 'hearsay'.

Just to re-iterate, there is no scientific proof that I have ever seen that the liklihood of contracting HIV from a HIV positive person is around 1% after 3 months seroconversion. Your sentiment is spot on (i.e use condoms all the time), but dangerous to use figures you have made up to 'support' your arguement because by using the 1% liklihood of infection, your creating the impression that the virus is not likely, on a statistical basis to be transmitted and this has been proved as incorrect. Have a look at this link which although not focused on risk of infection, has as a co-incidence found that overall liklihood of transmission stands at 4% (uncircumcised men) for a relatively high risk group of truck drivers, however useage of condoms is not exactly scientific, but it basically confirms that the risk of transmission is higher than previously thought:

Not meaning to be difficult, but this 'hearsay' is very dangerous and I have heard many guys in Bangkok, say "I never use condoms because the risk of transmission from a girl to a guy is so small, its not worth worrying about" - where do they understand this from - god only knows but they are wrong.

<{POST_SNAPBACK}>

I agree to your point of view . My point of view however was of the kind that some people stay with a girl for the complete holiday ( or something like that ) and they just rely on a quick HIV test ( which the doctors easily falsify if you ask for it ) to leave the condoms off . My point was , ALWAYS use it , even if the test shows you that she/he is negative . Because of the multiple partners there is no way to be certain for the coming months ( HIV testing , like i said ,even then Thai doctors strech the truth a littlebit ) . I had several Thai bargirls already who say to me , not to use condoms , but i always use and used it . People have to realise that AIDS/HIV is not controlable ( a post earlier ) , not even with the current medicines ( maybe it can , maybe it can't , maybe today yes , maybe tomorrow not ) and that if you or your partner have multiple contacts you must use condoms , because it is not safe .

[kwiz117]

Sometimes back ..... was the guy to talk about AIDS.

Friend of mine said that he died from it recently. If it is true, my sympathy to his family..

/edit

/name not allowed on thaivisa.

Edited January 26, 2005 by Darknight