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re: hiv+behavior
May 24, 2005

Come on Dr. Pierone, this guy claims to have contracted HIV from one instance of heterosex? Why is everyone too impotent (yes I'm calling you impotent) to come out and say there is no way this man is telling the truth about his mode of infection? This is such a crucial part of HIV prevention - to be totally honest with the people about the actual risks. Lending credence to stories like the one this man is telling focuses attention and prevention away from the real modes of transmission - men having sex with men, and women have sex with men who have sex with men (and shared needle users). We know these are the only at risk individuals in the developed world. It's enough of the political game where you're not allowed to say this because it offends certain people. Or because it challenges anecdotal and suspicious reports like the one this man is putting forth. Is it that difficult to see he has a profile suspicious for "down low" behavior? He's a body builder and he habitually uses extacy. That combination is extremely suspicious for down low lifestyle habits. And anyone who thinks it's absurd to assume this is really living in a different world, has no exposure to both gay and hetero communities, is in denial, or is simply playing the devil's advocate. This is serious - it is likely that this man lied about his mode of infection. And stories like this add up. Before you know it, every bisexual men in America who would prefer to keep is homosexuality a secret will claim he was infected by a woman, and then refer to the growing number of female to male transmission stries if his own is challenged. That is why you must not dignify a story like this. You should give him advice on his health, but then make sure the post only gets published on this site with your own reference to how unlikely his story is - if even just to explain how "unlucky" he is. In conclusion, if you would like to talk hard science, and not suspicion, have a look at the only controlled study of female to male transmission, and you will see that heterosexual men run an absurdly low risk of getting HIV from a confirmed HIV positive woman, even after repeated unprotected exposures to her vaginal fluid. Nowhere has any other study contradicted these findings.

The nonsense has to stop.

Response from Dr. Pierone

Bi-directional transmission of HIV infection between men and women has been established based on a mountain of observational data. Heterosexual men are at risk for acquiring STDs and HIV in both the developed and developing world.

I would be happy to have a look at the "only controlled study of female to male transmission", but this comment is from fantasy-land. We certainly do not "randomize" subjects to have unprotected or protected sex with HIV+ partners. All the data is observational and within this context one looks at "control" groups for comparison. There is not one such study, but many from all over the world which demonstrate low, but measurable, rates of transmission related to heterosexual exposure. Granted, men do transmit HIV infection more efficiently to women than the converse.

I thought this nonsense had stopped at least a decade ago. In the early days of HIV this argument that women really did not transmit infection to men was believed by some. Then in the face of mounting evidence, the argument was changed to "HIV is not transmitted from women to men in America, just in the third world". In fact, there was a publication from that era called "The Myth of Heterosexual AIDS" by Michael Furmato. This genius now is one of resident fellows at the Hudson Institute, a neoconservative organization that appears to be committed to prevent global implementation of generic HIV medication programs. It is time to move on.



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