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Epidemiology_rulez_ok

Drink Wawa-beer! The risk of becoming
infected with life threatening bacteria
is only 0.4% each time you drink Wawa-beer!

Don't think about what happens if you
drink Wawa-beer once a week, year after
year! Don't think what happens if many
people drink Wawa-beer! That's fear-
mongering!

Ney

The source of 0.04 percent is here: http://aje.oxfordjournals.org/content/150/3/306.full.pdf?origin=publication_detail

The 4 infections out of 10.000 fellatios looks, of course, very low for an individual.

But you have to think further. To think about actual behaviours, and over a longer time.

One doesn't practice fellatio only once, I suppose. So, if, over the years, you have e.g. 100 fellatios with your HIV-infected partner, your risk is at 4% for becoming infected with HIV.

Not so nice, huh?!

Moreover, there's a public health perspective. If for example you observe just 10.000 uninfected subjects, who repeatedly have receptive oral sex with infected partners (100 times over the years, as mentioned above), then this would result in 400 infected subjects.

While I am quite sure that these sex-is-bad messages are neither helpful for prevention nor beneficial for society as a whole, the 0.04% figure does very little to invalidate the claim that oral sex with infected partners must not be taken lightly.

I hope that I mad a mistake in my calculations, otherwise the SALON piece looks like an unpleasant example of zeitgeistiges Schwadronieren about public health issues, without having enough knowledge about the issue.

Sebastian

A little caveat: Being gay does not make one *inherently* more at risk at contracting HIV. It's the anal sex that's the risk factor - and that's true for male-to-female anal sex as well, of course (not female-to-male, though - strapons are totally safe! ;) ). Likewise, if you're a dude sucking another (HIV positive) dude's cock, you're at no higher risk of getting infected than a gal sucking a (HIV positive) dude's cock.

Andrew

@Damon: You're right in that measuring the risk of HIV transmission involves some unknowns. But there's been plenty of time to study it, and the numbers are pretty well-known. This article cites a number of studies generally showing a 1 in 1250 or higher risk of transmission per sex act. And studying HIV transmission isn't all that difficult -- there were already existing transmission models for tons of other sexually transmitted diseases. A simple Google search will find dozens of peer-reviewed articles on HIV transmission risk. After all, HIV has been one of the most-researched topics in medical history, and how it's transmitted is public health issue #1 in many countries. So there's really not much doubt about it anymore.

@Marmalade: First, why would I listen to a creature that craps in a box? But srlsly, I don't deny that HIV causes AIDS, that's a totally different can of worms. As far as I know, there's no serious reason to doubt that. When scientists do their science stuff in labs, I generally trust them. My beef is with activists and others stirring up a (typical American) moral panic by purposely conflating all sorts of different risk scenarios.

Marmalade Graham

You and Serge Lang.

Damon

I don't disagree with your central message. However, I have several questions about the cited numbers (0.04% and 0.82%), and I can't find the study that is referred to in the linked article. My first concern is that this is a mis-citation. Even relatively intelligent people confuse fraction and percent with alarming frequency (i.e. I am worried 0.04 is really 4%). (As a related aside, there's a very amusing conversation from a couple of years ago between a telephone customer and a customer service representative who confused 0.01 with 0.01%.)

Second, what does this number actually mean? For ethical considerations, it cannot possibly have been determined under laboratory conditions. Moreover, I would imagine that most people would learn about someone's HIV positive status only later. It seems unlikely that most people would knowingly have sex with an HIV-positive person even if the risk of contracting HIV were extremely small (most people exaggerate risk--see "Thinking, Fast and Slow" by Kahneman). Calculating a percent chance of contracting HIV per sexual encounter is further complicated by the fact that diagnosing HIV can be difficult in the early stages of infection. So what is this number? Is it the fraction (or percent) of people who have unprotected sex who contract HIV per sexual encounter? Per year? Lifetime accumulated risk?

These numbers are almost comically vague and are potentially misleading. I don't disagree that purposefully exaggerating the risks involved in having unprotected sex would be a terrible practice. However, citing such numbers without context and without directly linking to the study (or review article) is nearly as abd.

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