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 Post subject: Re: My partner may have been exposed to HIV.
PostPosted: Tue Feb 01, 2011 8:17 pm 
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mrsbadmouth wrote:
I don't understand. Why would you not take every possible precaution? This just boggles my mind.


I'm not sure I follow. Are you boggled that I don't protect myself from reinfection, or that I don't insist my negative partners use protection? In either case, because we're not talking about plausible risks, even if they are technically possible ones.

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 Post subject: Re: My partner may have been exposed to HIV.
PostPosted: Tue Feb 01, 2011 8:25 pm 
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Squeak wrote:
Given the state's interest in reducing/preventing barebacking, even among + individuals (other, treatable diseases can still be passed - gonorrhea, chlamydia, etc), I'd say that if there were a non-negligible risk of re-infection, it would be documented, if not well documented, by now.

Assuming that extensive documentation in a reasonable timeframe and for a reasonable cost is possible, and that states are capable of exhibiting this kind of foresight.

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That's a valid concern, but only for those who are content to remain without actual insurance.

But a collective failure is everyone's concern.

For example, if people are truly more likely to engage in high risk behavior due to the state accepting some of the costs of that behavior, we'd expect to see transmission rates go up over time. The state is then obligated to bear those costs, which results in budgetary concerns, public resentment (further fueled by a perceived moral failing), and the election of public officials hostile to assistance.

The best approach would be to try to prevent this from happening via collective action, which requires a certain degree of individual commitment to get off the ground.

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 Post subject: Re: My partner may have been exposed to HIV.
PostPosted: Tue Feb 01, 2011 8:43 pm 
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just mumbles wrote:
Assuming that extensive documentation in a reasonable timeframe and for a reasonable cost is possible, and that states are capable of exhibiting this kind of foresight.

The timeframe is for as long as we've been monitoring individuals with hiv. I'd imagine that hiv re/super infection would have some sort of symptom - secondary seroconversion, extended viral load spike beyond a normal blip, medication resistance, etc. The state has been touting the possibility of reinfection as a reason for the + community to not bb for years, without providing any evidence of it's plausibility.

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But a collective failure is everyone's concern. For example, if people are truly more likely to engage in high risk behavior due to the state accepting some of the costs of that behavior, we'd expect to see transmission rates go up over time. The state is then obligated to bear those costs, which results in budgetary concerns, public resentment (further fueled by a perceived moral failing), and the election of public officials hostile to assistance. The best approach would be to try to prevent this from happening via collective action, which requires a certain degree of individual commitment to get off the ground.


That's my point, though - "if people are more likely to get hiv because the state takes care of hiv in individuals without health insurance" is a fairly large "If." I'd need to see some sort of data on the topic. Maybe interviews with people who engage in high risk behavior, asking if one reason they do it is because the state will cover the cost if they aren't able.

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 Post subject: Re: My partner may have been exposed to HIV.
PostPosted: Tue Feb 01, 2011 10:42 pm 
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Squeak wrote:
The timeframe is for as long as we've been monitoring individuals with hiv.

If this were true, we'd already have the answer, barring a grand conspiracy involving all the HIV/AIDS researchers in the world.

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Maybe interviews with people who engage in high risk behavior, asking if one reason they do it is because the state will cover the cost if they aren't able.

Or maybe people on internet forums suggesting that the existence of assistance programs informs their behavior.

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 Post subject: Re: My partner may have been exposed to HIV.
PostPosted: Tue Feb 01, 2011 11:27 pm 
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just mumbles wrote:
If this were true, we'd already have the answer, barring a grand conspiracy involving all the HIV/AIDS researchers in the world.


Don't we already have the answer, though? Reinfection occurs very very rarely in treatment naive and inconsistent populations, while it still technically could happen in individuals who practice adherence, a lack of so much of a single recorded case of it in the X years this has been monitored would suggest that the chance approaches, if not reaches, zero.

Quote:
Or maybe people on internet forums suggesting that the existence of assistance programs informs their behavior.


Sure. Point me to where that happened. On the off hand chance you're referring to the exchange I had with Adah, lemme save you a step. One concern she mentioned was people without access to health care. I was just pointing out that in San Diego, there is no one who does not have access to HIV treatment. Note that my behavior is impacted by the near impossibility of my transmitting, not by the above fact.

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 Post subject: Re: My partner may have been exposed to HIV.
PostPosted: Tue Feb 01, 2011 11:50 pm 
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Squeak wrote:

Sure. Point me to where that happened. On the off hand chance you're referring to the exchange I had with Adah, lemme save you a step. One concern she mentioned was people without access to health care. I was just pointing out that in San Diego, there is no one who does not have access to HIV treatment. Note that my behavior is impacted by the near impossibility of my transmitting, not by the above fact.


Whoops. That might have been my fault. I pulled it from wiki:

Quote:
Some workers in the US HIV community report that a number of younger men seek infection as a way to receive benefits, a "free ride," because they would qualify to receive Section 8, Social Security and other benefits from getting infected with HIV.[3]


Which pulled it from this article:

^ a b Shirley Hawkins. ""‘Bug Chasers’ popularity increases among gay males"". Retrieved 2009-08-16.[dead link]

Which looks like a bad link at this time. It's totally my fault and although I don't sway one way or another on the topic, I feel terrible that I posted it without doing more in-depth research on it. Sorry guys. I'll see if I can find anything legit on that claim...


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 Post subject: Re: My partner may have been exposed to HIV.
PostPosted: Wed Feb 02, 2011 12:32 am 
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Squeak wrote:
Don't we already have the answer, though? Reinfection occurs very very rarely in treatment naive and inconsistent populations, while it still technically could happen in individuals who practice adherence, a lack of so much of a single recorded case of it in the X years this has been monitored would suggest that the chance approaches, if not reaches, zero.

No, we don't have the answer. There have only been a handful of cases of reinfection ever reported in the literature, due to the difficulty involved in establishing that reinfection has occurred. As it turns out, we do have known cases of reinfection occurring in individuals adhering to a treatment regime.

And the research is almost impossible to do, so I think it's unwise to infer from the fact that the research doesn't exist that it's a risk that can be dismissed.

Quote:
One concern she mentioned was people without access to health care. I was just pointing out that in San Diego, there is no one who does not have access to HIV treatment.

Which suggests that if it weren't for assistance programs, this would be a concern.

Which is not to say that your behavior changes. Only that it is informed by your evaluation of the possible consequences.

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Last edited by mumbles on Wed Feb 02, 2011 12:36 am, edited 1 time in total.

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 Post subject: Re: My partner may have been exposed to HIV.
PostPosted: Wed Feb 02, 2011 12:35 am 
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Why take any risk at all? Condoms are so cheap and convenient. Is skin-to-skin contact really that important?


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 Post subject: Re: My partner may have been exposed to HIV.
PostPosted: Wed Feb 02, 2011 12:43 am 
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I don't care how minute the chances are, if anyone hears that the person they're about to sleep with is HIV positive and they don't think they need protection, there is something wrong with their way of thinking. It doesn't matter if it's not an automatic death sentence anymore. There are plenty of curable STD's out there, but even if there is a cure, why would you want to risk getting that disease in the first place? And how can you be comfortable that there's even a remote chance that you might give it to someone else?

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 Post subject: Re: My partner may have been exposed to HIV.
PostPosted: Wed Feb 02, 2011 12:56 am 
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mrsbadmouth wrote:
I don't care how minute the chances are, if anyone hears that the person they're about to sleep with is HIV positive and they don't think they need protection, there is something wrong with their way of thinking. It doesn't matter if it's not an automatic death sentence anymore. There are plenty of curable STD's out there, but even if there is a cure, why would you want to risk getting that disease in the first place? And how can you be comfortable that there's even a remote chance that you might give it to someone else?


I don't know, you guys. I can think of some scenarios where I wouldn't think someone was "wrong" in their way of thinking for doing this. What if you fall in love with someone after dating them for a couple weeks, then find out they have HIV. You use protection for several years, but then you decide not to here and there. Are you "wrong"?

Are we saying it's wrong for people to engage in risky behavior? Something is wrong with their thinking? Because I can think of so many situations where people engage in risky behavior but others don't think there is something "wrong" with them.


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 Post subject: Re: My partner may have been exposed to HIV.
PostPosted: Wed Feb 02, 2011 1:22 am 
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graffitipassion wrote:

Are we saying it's wrong for people to engage in risky behavior? Something is wrong with their thinking? Because I can think of so many situations where people engage in risky behavior but others don't think there is something "wrong" with them.



Actually, yes. People who do heroin and cocaine have something wrong with them, the disease of addiciton. Self preservation is kind of ingrained into most living things. That doesn't mean that they're bad people, they just have a problem.

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 Post subject: Re: My partner may have been exposed to HIV.
PostPosted: Wed Feb 02, 2011 1:48 am 
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just mumbles wrote:
No, we don't have the answer. There have only been a handful of cases of reinfection ever reported in the literature, due to the difficulty involved in establishing that reinfection has occurred. As it turns out, we do have known cases of reinfection occurring in individuals adhering to a treatment regime.

And the research is almost impossible to do, so I think it's unwise to infer from the fact that the research doesn't exist that it's a risk that can be dismissed.


Could you provide some links establishing the difficulty, as well as the cases of reinfection with strict adherence? I'm intrigued.

Quote:
Which suggests that if it weren't for assistance programs, this would be a concern. Which is not to say that your behavior changes. Only that it is informed by your evaluation of the possible consequences.


It could be a concern. So could people being turned down for actual health insurance due to a pre-existing condition. Neither of these are something I think about when someone opts not to use condoms with me, though, because the first thing that would need to exist would be a plausible chance for me to pass it on.

Adah - I always have condoms available, I just no longer insist on them. I could start an informal poll of neg tops that come through my bedroom, but I can already tell you what their response will overwhelmingly be. The chances for transmission approach zero, and if they did get it, it's a manageable disease.
http://www.thebody.com/content/treat/art49400.html
Brief of the article, if you don't want to read it: A Swiss study declared that undetectable viral load + no coinfections = zero chance to pass on the hiv. Australian group countered with a mathematical model assuming that hiv is still hypothetically transmissible.

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 Post subject: Re: My partner may have been exposed to HIV.
PostPosted: Wed Feb 02, 2011 1:59 am 
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mrsbadmouth wrote:
graffitipassion wrote:

Are we saying it's wrong for people to engage in risky behavior? Something is wrong with their thinking? Because I can think of so many situations where people engage in risky behavior but others don't think there is something "wrong" with them.



Actually, yes. People who do heroin and cocaine have something wrong with them, the disease of addiciton. Self preservation is kind of ingrained into most living things. That doesn't mean that they're bad people, they just have a problem.


What about people who go skydiving? Or white water rafting?

Many people also have "risky" behavior ingrained in their personalities. It's actually quite normal. Here's an article...just the first one that popped up when I did a quick search...but the point is, it's not that abnormal or wrong to engage in risky behavior:

http://www.psychologytoday.com/articles ... risk-taker

Quote:
Humans are a risk-taking species. Our ancestor Homo sapiens originated in East Africa, and within the relatively short span of 100,000 years or less spread over the entire globe. It turns out that explorativeness may be the key to the survival of the species.

The hunting of large and dangerous game by men required a type of thrill- and adventure-seeking that also contributes to the success of the human race. Over the millennia, men also found in combat and war an outlet for their need for adventure.

Mating, too, was a dangerous game that required risk-taking. The innate incest taboo drove men to seek mates outside their small groups, sometimes from unfriendly groups.


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 Post subject: Re: My partner may have been exposed to HIV.
PostPosted: Wed Feb 02, 2011 2:25 am 
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mrsbadmouth wrote:
graffiti wrote:

Are we saying it's wrong for people to engage in risky behavior? Something is wrong with their thinking? Because I can think of so many situations where people engage in risky behavior but others don't think there is something "wrong" with them.



Actually, yes. People who do heroin and cocaine have something wrong with them, the disease of addiciton. Self preservation is kind of ingrained into most living things. That doesn't mean that they're bad people, they just have a problem.


Simply because some risky behaviors are the result of a larger problem doesn't mean that all are. See graffitipassion's response above.
I'm bewildered by your bewilderment re: curable stds. Barebacking does feel better, condoms are a pain, and if the worst I had to worry about was taking a pill or getting a shot in the asparagus, I'd have been doing it a long time ago.

As for the "no matter how minute....something wrong" statement, I don't think that's accurate. Every time you leave the house, there is a chance, no matter how minute, that you will be involved in a fatal car accident. Eating anything solid, there is a chance, no matter how minute, that you could choke and die, especially if eating alone. Life is full of things that could, hypothetically, happen but are so far outside the realm of realistic possibility that we don't even think about them, much less take precautions against them.

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 Post subject: Re: My partner may have been exposed to HIV.
PostPosted: Wed Feb 02, 2011 2:32 am 
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But I can't avoid leaving my house or eating. You can easily avoid risking infecting other people.


I never thought i'd have to excuse myself from a thread, but this is forking ridiculous.

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 Post subject: Re: My partner may have been exposed to HIV.
PostPosted: Wed Feb 02, 2011 2:36 am 
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mrsbadmouth wrote:
But I can't avoid leaving my house or eating. You can easily avoid risking infecting other people.


I never thought i'd have to excuse myself from a thread, but this is forking ridiculous.


Sure you can - I could provide examples of how, if you'd like, but the idea is that the chance of something bad happening is remote enough that you don't consider it a real risk.

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 Post subject: Re: My partner may have been exposed to HIV.
PostPosted: Wed Feb 02, 2011 2:42 am 
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Squeak wrote:
Could you provide some links establishing the difficulty, as well as the cases of reinfection with strict adherence? I'm intrigued.

Here's a link with some supporting information that alludes to the difficulty involved in establishing that reinfection has occurred:

http://www.thebody.com/content/treat/art2513.html

Quote:
Other cases of multiple HIV infection have been identified in the past four years, although the total number remains small -- only 16 apparent reinfections by one measure (a 2005 Medscape survey of the scientific literature done by a group from the Gladstone Institute of Virology and Immunology in San Francisco). The Gladstone researchers, however, did not consider cases of coinfection. In addition, dual infection rates may be higher than reported, since few people with HIV have been tested for multiple strains. Only larger future studies using more sophisticated technologies and better tracking of source partners can provide a clearer picture of the incidence (rate of new cases) and prevalence (total number of existing cases) of coinfection and reinfection in a given population.


For an example of transmission among those receiving anti-retroviral therapy, see the first study described here:

http://i-base.info/htb/10502

Quote:
It could be a concern. So could people being turned down for actual health insurance due to a pre-existing condition. Neither of these are something I think about when someone opts not to use condoms with me, though, because the first thing that would need to exist would be a plausible chance for me to pass it on.

I'm having trouble with the word plausible there. I wouldn't disagree that transmission isn't likely under those circumstances.

But I don't want the larger point I was making here to get lost, which is that there's value in using protection even where you deem the risk to be low, akin to the value I see as a vegan in not eating a roast beef sandwich that would otherwise be discarded.

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 Post subject: Re: My partner may have been exposed to HIV.
PostPosted: Wed Feb 02, 2011 2:51 am 
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just mumbles wrote:
I'm having trouble with the word plausible there. I wouldn't disagree that transmission isn't likely under those circumstances.

But I don't want the larger point I was making here to get lost, which is that there's value in using protection even where you deem the risk to be low, akin to the value I see as a vegan in not eating a roast beef sandwich that would otherwise be discarded.


Thanks for the links - I'll read them.
I'm not deeming the risk to be low. I'm deeming it to be either nil or so close to zero that it might as well be. See the posted link to the Swiss study.
I'm not seeing the link in your analogy. A vegan who eats a roast beef sandwich is not a vegan, and the person in your example would be a freegan, I suppose.

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 Post subject: Re: My partner may have been exposed to HIV.
PostPosted: Wed Feb 02, 2011 3:09 am 
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Squeak wrote:
I'm not seeing the link in your analogy. A vegan who eats a roast beef sandwich is not a vegan, and the person in your example would be a freegan, I suppose.

The link is in the fact that no direct harm befalls any animal, nor do I provide any direct economic pressure to harm animals, if I eat the sandwich. The risk to animals from that activity is, at first blush, non-existent. If addressing such harm is my sole motivation in being vegan, it would seem that there's nothing wrong with eating the sandwich.

There is, however, value in leading the life of a public vegetarian. It conveys a seriousness and sense of commitment to the issue that would otherwise be lost. And that kind of cohesion is necessary to building a collective response.

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 Post subject: Re: My partner may have been exposed to HIV.
PostPosted: Wed Feb 02, 2011 3:30 am 
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just mumbles wrote:
The link is in the fact that no direct harm befalls any animal, nor do I provide any direct economic pressure to harm animals, if I eat the sandwich. The risk to animals from that activity is, at first blush, non-existent. If addressing such harm is my sole motivation in being vegan, it would seem that there's nothing wrong with eating the sandwich.

There is, however, value in leading the life of a public vegetarian. It conveys a seriousness and sense of commitment to the issue that would otherwise be lost. And that kind of cohesion is necessary to building a collective response.


I could point out some differences between the two, but I see your point. I suppose I could be a pioneer in the + community, insisting on condoms regardless of the status of my partner, and frequently getting turned down because of it. I did that for a long time, actually, both before seroconversion, since I didn't want to get HIV, and after, since I didn't want to bring even curable stds into my relationship. I got HIV anyway, and I'm sort of done sitting on the sidelines watching all the other kids play. Although I think on it sometimes, the idea that a 3rd party will see me as having a blast because of hiv, instead of despite it, is just not enough for me right now.

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