Talk:HIV/Archive 3

This archive page covers approximately the dates between 23 October 2006 to 28 October 2007

The role of spermicide in HIV transmission

Under the transmission heading, I appended the sentence which said unprotected sex allowed HIV transmission to include the new research that condom protected sex used with spermicide negates the benefit of condoms, probably due to inflammation of the females mucous membranes. It could probably do with a better source though.

It was removed from where I put it without explanation. I readded it to the bottom of the section, along with the other info about condoms and circumcision.

I reverted your changes, and it was not removed without explanation. My edit summary was this: "condoms + spermicide doesn't = riskier, it is when spermicide alone is used (thus unprotected sex)". Your source was this [1] which I read carefully. It states correctly that use of spermicides alone do not prevent HIV; in fact, it tends to make it a little easier to transmit due to the vaginal inflammation it causes to a female (no studies for males, but the membranes of an anus could be a similar situation). The source also goes on to say how it isn't useful with vaginal contraceptives like cervical caps and diaphragms.

When using spermicide with a condom, it is a bit of a different story. Condoms prevent semen from reaching a vaginal or anal wall whatsoever, while diaphragms/cervical caps are strictly cervical barriers. The semen still reaches a mucous membrane with these vaginal contraceptives. The irritation with the spermicide is present if used with a condom, but contracting HIV while using a condom is soooooo small that adding spermicide isn't going to increase the chance of contraction significantly. And DEFINITELY not enough to support your edit that "...the majority of HIV infections are acquired through unprotected sexual relations, or when condoms are used with spermacides."

As for circumcision, see below for my comments on it and HIV. JoeSmack ^Talk(p-review!) 16:25, 23 October 2006 (UTC)

Sorry, I didn't realise that there was somewhere else that people could put comments about edits. I see that I worded my original edit incorrectly. I didn't mean that the majority of of infections were caused by spermacide condoms, I just wanted to add that unprotected AND poorly protected intercourse could lead to transmission. To be honest, the infomation that spermacide + condom leads to an increased risk of HIV transmission compared to condoms alone was from a lecture I attended. I will have to speak to the lecturer to try and obtain the reference.

This language has terms that are unfamilar to me. Is it possible to provide a glossy or terms, or would that be redundant to the hot links in the article?

I take it you have failed to keep tabs on the information that was released showing that a certain chemical found in the spermicide actually negates the supposed protection offered by the condom and actually increases the users chances of catching and transmitting the virus??? Which casts the actions of the world health organization under a new light when you look at the condoms they were supplying to africa in their supposed aids prevention and awareness projects or does that sound too much like a conspiracy theory for you enlightened souls??? After all why would the world health organization knowingly give thousands of people condoms claiming it'll lessen their chances of infection when the truth was using those condoms would increase their chances. ???

Merger with the AIDS article and renaming it to HIV/AIDS or HIV-AIDS

I think this article should be merged with the AIDS article and be renamed to HIV/AIDS since that is the name commonly used by scientists and both refer to same disease. Troop350 18:38, 6 September 2007 (UTC)

As to the merge, no real opinion here. As to "refer to same disease", no; "are used to refer to..." yes. HIV != AIDS, and what kills you is AIDS not HIV (HIV alone would probably not be fatal. Debilitating, but not fatal). This might be taken as suggesting against a merger, as would general length.

Perhaps a peer review of both instead, to compare for consistency, exchange refs etc? HIV should focus on the "organism" and medically discuss the primary syndrome (Th4+ leukopenia mainly) foremost. AIDS should focus on the secondary medical condition. PCP for example should be in both, but as a key example in HIV's summary of AIDS, and as part of a major section in AIDS. DC-SIGN has no real place in AIDS, but needs to be in HIV, etc. Dysmorodrepanis 07:32, 11 September 2007 (UTC)

• There seems to be much content forking and duplicated content between pages HIV and AIDS and AIDS origin. Anthony Appleyard 11:26, 12 September 2007 (UTC)

Disagree with the merger proposal for the reasons given by Dysmorodrepanis (sp?!). Also agree with suggestion for a review of both articles.GiollaUidir 14:57, 12 September 2007 (UTC)

A documentary has been released about the current debate in science on the HIV-AIDS link, and how real it is. http://www.moviesfoundonline.com/aids_inc.htm —Preceding unsigned comment added by 89.205.23.76 (talk) 04:59, 16 September 2007 (UTC)

Disagree. AIDS is the illness, HIV is the virus. Current AIDS article is huge, merging would be bad. - Bob 08:51, 17 September 2007 (UTC)

Oppose merger. Because there is a common misconception is why article needs to be improved so all can freely become better informed. Potentially a spin-off article like "Treatments for HIV/AIDS" or "HIV/AIDS economic impacts in Southeast Asia" can re-bundle the two as they are treated the same but our job is to concisely and clearly explain what the differences are and what implications those differences might entail. Benjiboi 08:23, 19 September 2007 (UTC)

Oppose merger, per Bob -- mcshadypl ^TC 01:50, 20 September 2007 (UTC)

Oppose merger. While I do feel there is a lot of cross-over between the two entries, I believe it would be a mistake to merge them because it could lead to many, culturally based, misunderstandings. I believe the real issue is that in the developed world, HIV is now very distinct from AIDS. In the developing world AIDS represents more of a POSSIBLE late term stage of the disease that may never even be faced by those on effective treatment. In the developing world HIV *IS* more often regarding in the same terms as AIDS, because of the lack of availability of sustainable treatment resulting in mutation, AIDS is far more "inevitable". ZacWolf 17:19, 20 September 2007 (UTC)

Oppose: Whilst the issue of duplicated content should be addressed (as should the fact that AIDS is by no means a universal definition, nor indeed a definition that is universally used for diagnostic purposes); the fact remains that AIDS is a syndrome, whereas HIV is a virus, and that a merger would only add to the confusion by which so many people ignorantly consider the terms to be interchangeable .. and that one is the inevitable consequence of the other. Orpingtonian 08:46, 24 September 2007 (UTC) —Preceding unsigned comment added by Orpingtonian (talk • contribs)

Oppose: While many might believe that HI(V) and AIDS are completely related, this are entirely incorrect. There is NO substantial proof to show that HI(V) is the only known cause for the syndrome known as AIDS. AIDS is not an infection, virus nor disease, rather, as its name suggests, the collected name given to a certain set of ailments, symptoms and infections relating to the depletion of one's immune system. It is important to note that the symptoms attributed to AIDS CAN arise from other medical complications and that AIDS can almost be classified as a state that one's body is in. Just likethere is no disease called 'ill,' there is no disease called AIDS. This article SHOULD NOT be merged with HIV. —Preceding unsigned comment added by 41.243.166.252 (talk) 14:34, 25 September 2007 (UTC)

Oppose: As a user of wikipedia, when I look up HIV, I want information on its bio-chemical properties as a virus, origins, effects on the body and soforth. Similarly for AIDS, I want its definition, the list of opportunistic infections that fall under the heading of AIDS, mortality rates etc. Also, the tying of HIV and AIDS together adds to the stubborn confusion that they are somehow the same, statments like "I got infected with AIDS from my sexual partner" are conjoured up from the treatment of their relationship as interchangable. For example, If its winter and I have the cold, I dont say im infected with runny-nose or a contracted runny-nose from my workmate; I say i'm infected with the flu virus and have developed a runny-nose. —Preceding unsigned comment added by 89.100.179.253 (talk) 22:19, 26 September 2007 (UTC)

How many know they are HIV positive?

In a UNAIDS publication, AIDS epidemic update: December 2005, it says "of people living with HIV only one in ten has been tested and knows that he or she is infected." Click here for reference. That would mean 90% of people do not know they are infected right? --D1chow 06:58, 18 August 2006 (UTC)

See, when i read through that i heard that only 10% of the total population infected has been tested (and thus knows they are positive)....wait....is that the same thing? you might be right here - it is a UNAIDS/WHO report which is usually pretty tip top. JoeSmack ^Talk 07:16, 18 August 2006 (UTC)

A CNN article and a BBC article would also seem to support that 90% do not know they are infected.--D1chow 07:24, 18 August 2006 (UTC)

Allow me to turn back the hands of time - reverted. Although the sources are credible (and i mean the UNAIDS/WHO one more than BBC or, ick, CNN), i think some original research or at least one with a sample size should be found for better support, especially if this is new data. JoeSmack ^Talk 07:41, 18 August 2006 (UTC)

It seems that using a high number is contentious. However, Peter Piot, executive director of UNAIDS, has used the number 90% before. Data on HIV testing is hard to come by. The main focus of data is on how many and what groups have HIV and have died as a result of HIV. There is some data on country and group specific awareness of HIV infection, which I assume are used to come to the global awareness of HIV infection. There are no graphs or tables that summarize the data like prevalnce rates. After a lot of searching, this seems to be the best source of data. I used Indicator 5.1. It can show you how many came back to get their HIV postive results in multiple countries. Of course, you have to do the math if you want the regional numbers. Most experts do seem to agree that well over 50% do not know they are HIV positive. I think at least "vast majority" should be used to describe the number of people unaware of their HIV infection. D1chow 00:09, 19 August 2006 (UTC)

What percent of the entire population is infected with HIV. Lots of number are bandied about but I have never seen this one. 50%-90% etc mean nothing if we don't know the % in the universe. It could well be that 50%-90% of everyone has HIV. Does anyone have a link to this study - if this study hasn't been done then why not. If HIV is spread by sex then the number should be approaching 100%. —The preceding unsigned comment was added by 159.105.80.219 (talk • contribs).

How accurate are UNAIDS numbers? Does a reliable HIV syntax exist?

There are many barriers to obtaining useful data, and getting accurate data from UNAIDS is especially difficult. NotAIDS! Some of the reasons for this are inherent to data-gathering itself. However, the UN makes the task almost impossible due to its erratic policy on how to diagnose HIV. Each continent, and even each country will use different tests (Western blot, or ELISA).

In Africa, it isn't necessary to actually test for HIV to be diagnosed with AIDS, but then these "cases' are then counted in the UNAIDS' HIV numbers. "Circular reasoning scandal of HIV testing" Making it even more complicated is the fact that while a test may be interpreted as positive in one country, it is negative in another.

Finally, the test makers themselves do not claim that their test kits diagnose "the presence of HIV" in the body, only antibodies thereto. "HIV tests becoming less accurate?"

Until these hinderances to a common vocabulary describing what HIV is and how it is diagnosed are resolved, it seems that estimating how many people have HIV, know they have HIV, or know they don't have HIV are questions without answers.--Worldprideday 04:08, 29 December 2006 (UTC)

Comprehensive Risk Table request

I'd like to request that someone compile a larger PER-ACT risk table (similar to the one in this article), covering as many major STIs as possible, AND the with-condom (/dam /finger cot /etc) vs. no-condom risk. Also, I would suggest adding cunnilingus ("oral intercourse" should be "fellatio" as listed; the two are not identical, and I am editing to that effect) and manual intercourse (both genders). Lastly, if possible, please use a range of statistics if there is significant disagreement about what the risk is - e.g. for fellatio as mentioned below, perhaps tit would be better stated as "0-0.5 / 10k". Thanks! --Sai Emrys 18:32, 14 May 2006 (UTC)

Language in HIV Test section

The language in the HIV test section (HIV#HIV_test) is somewhat confusing. It makes an assertion that HIV and AIDS are synonymous. The article in general is pretty well written that it doesn't make this same mistake. I am going to make a change, to correct wording.

Currently, it says:

Approximately half of those infected with HIV do not know their HIV status until an AIDS diagnosis is made with an HIV test.

I'm going to change it to say:

Approximately half of those infected with HIV do not know their status until a positive test result is made through one of many HIV tests.

If there are any questions, let me know. --Bsheppard 02:54, 9 July 2006 (UTC)

I'm pretty sure the important destinction here is that half of HIV-positive folk don't know their infected until they've become dianosiable with AIDS. AIDS is usually when you'd start to show opportunistic infection, thus see a doctor, thus get an HIV test, thus become aware you are positive. In order to keep the message of the sentence, I'm changing it to:

Approximately half of those infected with HIV do not know it until an AIDS diagnosis is made with an HIV test.

...that should things a little less confusing, but mentioning that there are more than one set of HIV tests isn't important for this sentence as to mention that an HIV test is the thing identifying HIV-positive status. JoeSmack ^Talk 07:13, 9 July 2006 (UTC)

i've seen this fact thrown around before so i'm pretty sure it has ground, thus i'm keeping it there; it does however need a citation, of which i've tagged in the article itself.JoeSmack ^Talk 07:18, 9 July 2006 (UTC)

I changed it back to Bsheppard's version for now, since the other text implied that HIV test positivity resulted in a diagnosis of AIDS. This of course discounts all the people who are discovered through screening for STDs, on blood donations, et cetera. Of course, further refinement may be needed. — Knowledge Seeker দ 07:30, 9 July 2006 (UTC)

Approximately half of those infected do not know their HIV status until it has progressed to an AIDS diagnosis. At this point many people tend to show opportunistic infection, who then see a doctor, get an HIV test and discover they are HIV positive. Alright, it's a little more bulky, but thats ok. It is important that two things are highlighted with this passage, 1) That half of people with HIV don't discover it until an AIDS diagnosis and 2) This diagnosis is often made with the results of an HIV test that proves with high accuracy that an person is HIV positive. If someone can turn what i've written to prose that are easier on the eyes, please change.

{{fact}} can't be used, but still...

The article says under transmission that "many experts believe that it is premature to recommend male circumcision as part of HIV prevention programs". "Many experts" is an unstated amount, and I think that if it's only the WHO and various other UN segments who advocate that opinion, "many experts" is a bit exaggerated; instead, it should be mentioned which experts (or their affiliations) advocate it, and it will be up to the reader to decide if it indeed is many experts. Ghent 23:43, 11 July 2006 (UTC)

This interests me.. Transmission describes means by which you can be infected with HIV, they all require direct contact with blood or bodily fluids from infected persons.
Am I missing something, or are they trying to say that simply being circumcised reduces your chances of being exposed to HIV positive blood or fluids?
I certainly hope I'm missing something, because the notion that being circumcised reduces your chances of meeting infect people seems completely ludicrous to me. --NoEvidenZ 17:51, 18 October 2006 (UTC)

Man, the jury is still really out on this one (although I can think of a few people on wikipedia who are diehard for AND a few against it). UNAIDS still thinks it's too early to decide, and evidence has been very conflicting. On one hand maybe yes, on one hand maybe no, on one hand the process of circumcision itself with unsterilized/reused tools may lead to more infections - and on and on and on. JoeSmack ^Talk(p-review!) 18:04, 18 October 2006 (UTC)

NoEvidenZ: you're missing something, but that's just because it's not in the article. The theory is basically that if your penis is exposed to HIV-infected body fluids, having a foreskin might make it somewhat easier for the virus to enter your system. There are two plausible reasons why that might be: the surface under the foreskin could be more physically permeable to infected fluids, because of (a) tiny skin breaks from the foreskin sliding around during intercourse or (b) irritation from other infections that can take hold there; and, the presence of Langerhans cells in the foreskin could make that tissue more susceptible to HIV. I don't think this all needs to be in the article, but some general notion would be helpful. This issue might even deserve its own linked sub-article, because there's been some fairly well publicized discussion with multiple opinions on what the evidence says and what if anything to do about it. ←Hob 02:30, 27 October 2006 (UTC)

I was told by an AIDS clinic worker that fluids build up under the foreskin. More fluids making contact means more chances for the virus to be transmitted. --Cryptic C62 · Talk 11:53, 2 May 2007 (UTC)

Did your clinic also tell you that it very much depends on the climate? .. and that studies in Europe have shown that circumcision in temperate climates (where there is less of a tendency to develop wetness beneath the foreskin) actually seems to increase the risk of transmission amongst high-risk groups? .. or that that almost all those developed countries with high rates of circumcision actually have higher rates of HIV transmission than those developed countries where non-medical circumcision is actively discouraged? Orpingtonian 09:09, 24 September 2007 (UTC) —Preceding unsigned comment added by Orpingtonian (talk • contribs)

Overlapping with AIDS article

There is a lot of overlapping between the AIDS article and this one. Whole paragraphs, tables and figures are identical in both articles. This needs to be revised: information specific to the disease, should stay in the AIDS article (should as infection risk?) and information specific to the biology of the virus should be kept in this article (should as the origin of the virus). Dycotiles 16:29, 25 July 2006 (UTC)

Obviously there is overlap, but this is kept to a minimum and as such is ok as is. Infection risk is an important part of both articles, and specifics of the disease are talked about, and specifics of AIDS is expanded in the AIDS article. Symptoms of HIV infection and AIDS are two different things and the distinction and expansion in both articles is thus warranted and seen. --Bob 17:03, 25 July 2006 (UTC)

Reference suggestion

I just read through this article, after hearing a radio program (available online - [2]) on the topic of HIV, which included Anthony Fauci, Joel Gallant (Johns Hopkins School of Medicine), and Helene Gayle (International AIDS Society) as guests. This article seems to have the major points covered that they brought up. But, thought the program might be of interest to people working on this article, maybe useful as a reference? Anyway, great job on this article. --Aude (talk contribs) 01:44, 18 August 2006 (UTC)

Links

I'm not an expert at this topic but the links section was way too long and unorganized. Per WP:EL, I've trimmed ones that only provided brief information (not much or anything beyond what's already mentioned in this article), broken links, and others that I though didn't meet the external links guidelines. In all honesty, I think the links need to be trimmed further to just the first group, along with the PBS and New Scientist links, and probably keep the online textbooks (they seem informative). Though, perhaps people working on this article would consider some of the other remaining links informative and worth keeping? I also trimmed the three "News" links, thinking that these should either be used as references, or perhaps incorporated with the external links:

• Nov 2005 - Progress in HIV vaccine research -Recorded interview with Prof. Robert Gallo (HIV researcher)
• Jan 2006 - 3D structure of HIV is revealed - 3D map of AIDS causing virus revealed
• May 2006—HIV origin 'found in wild chimps'—HIV origin 'found in wild chimps'

The lengthy, unorganized links section would have been my one FAC objection, so hope this helps take care of that. --Aude (talk contribs) 16:20, 18 August 2006 (UTC)

contact with mucous membrane enough to transmit HIV?

"HIV is transmitted through direct contact of a mucous membrane with a bodily fluid containing HIV" Is this a new discovery? For years people were saying you needed at least small injuries in your mucous membrane to catch the virus. It would be great if there was a reference for this statement. --345Kai 12:54, 22 August 2006 (UTC)

It's not the mucous membranes per se that get in contact with the virus, it's the APC's, dendtritic cells, and T helper cells that have to get into contact with the virus. These are present in lesions (hence the danger of blood - blood contact and anal intercourse) and vaginal and urerthral membranes (hence the danger of vaginal intercourse).

HIV-2

I think an ideal article would say more about the differences between HIV-1 and HIV-2. HIV-1 may be more viral, but it doesn't say anything about which is harder to cure or which is more lethal. If it's about the same that should be in there too. Mackan 07:02, 4 September 2006 (UTC)

A small minority remain healthy for many years, with no noticeable symptoms

Eventually, most HIV-infected individuals develop AIDS and die; however a small minority remain healthy for many years, with no noticeable symptoms.

This statement is very vague. What order of magnitude is this "small minority" ? Is it like 10% (then it wouldn't really be "small") or 1% or 0.1% or about how much ? Taw 17:34, 15 September 2006 (UTC)

Indeed, one in ten. Data added with reference. TimVickers 18:15, 15 September 2006 (UTC)

"Eventually, most ...." Eventually 100% die of something. Gay men with AIDS(whatever that is) die in their early 40s and without AIDS they die in their early 40s plus 1 year. They lead a rough life. Has any study taken a random sample of the population and tested to see what % have HIV? I doubt it, but maybe it is out there. The reports I read seem to test for HIV when the immune system is dying. —The preceding unsigned comment was added by 159.105.80.219 (talk • contribs).

I took out the phrase "What goofy science" as it is extremely vague and doesn't provide any supporting comments on 'the science' to which it refers. --Worldprideday 04:48, 29 December 2006 (UTC)

OK. First of all, gay men without AIDS don't generally die in their 40's. Geez. As far as a random sample of the population, all blood donors are screened for HIV. They represent a generally healthy population in which the prevalence of HIV has been described. See the references here, at HIV test, etc for details, or just look online. MastCell 18:24, 29 December 2006 (UTC)

For a truly controversial question; what are the current theories on immunity cases or 'cures' - do we have any documented cases of HIV positive becoming HIV negative? Or someone exposed, and being immune - are these folk tales and unprovable? Jacketed 07:58, 4 April 2007 (UTC)

Not really controversial, it is very well trodden. No cures exist despite the same 'we've got a cure (maybe)' type news headlines. No one has become HIV negative (no viral load, no antibodies) from HIV positive that didn't have a false positive on their test first. There has been a good number of studies looking towards why some people are 'immune' or turn into longterm nonprogressors in certain ways. One is a genetic mutation - very rare. Another is comorbid infection with certain other strains of other disease like hepatitis. There is probably a more, but it has been a little while since I've seen the most current research. Hope this helps. JoeSmack ^Talk 12:24, 4 April 2007 (UTC)

WOULD SOMEONE PLEASE remove the link at the bottom of the page that indicates that HIV is a cause of death? That is an incredibly ignorant statement. HIV does not cause death by itself. HIV can be a precursor to AIDS, and AIDS-related complications can kill you, yes, but HIV (all by itself) does not cause death.

"Cause of death", at least as construed on death certificates in the U.S., includes conditions which are directly contributory to the immediate cause of death. So, for instance, a "cause of death" might be "Acute respiratory distress syndrome, secondary to Pneumocystis jirovecii pneumonia, secondary to Acquired immunodeficiency syndrome." It's accurate to describe AIDS as a "cause of death" in that regard, and it's also common sense. MastCell ^Talk 20:11, 8 August 2007 (UTC)

Lifespan of gay men and lesbians

One study of the homosexual lifespan is by Cameron, Playfair, and Wellum (1994) which used obituaries to compare the lifespans of gay men and lesbians to heterosexual men and women. A critique by Paul Cameron of this study discredits the results of this study.

The results of the Cameron study cannot be trusted. There are numerous reasons why obituaries are not a valid indicator of lifespans. One example is that there are more obituaries printed for heterosexuals than gay men.

There is an interesting essay that applies a mathematical formula to the CDC's statistics "Median lifespan of HIV positives 80 according to CDC statistics" that indicates 80 years is the potential average lifespan of an HIV positive. This is longer than that of the heterosexual.

--Worldprideday 04:48, 29 December 2006 (UTC)

That is an "interesting" finding, and about as scientifically valid as the other AIDS dissident arguments on the web page you cited. MastCell 18:26, 29 December 2006 (UTC)

Paul Cameron has made a life's work out of making...err... "questionable" unflattering statements about homosexuals. This study is no exception..... One must always be skeptical of studies made in pursuit of an agenda. - Nunh-huh 08:04, 16 January 2007 (UTC)

Experimental Treatment

I think there are a lot of research in HIV treatment. And some drugs are being developed or event tested now. Would nice to have some brief description of potential HIV treatment methods.

I think the general feeling here is that covering developing treatments is closer to news coverage than it is to encyclopedic material. So many potential treatments are tried, and so few of them come to fruition, we'd be covering lots of things that wind up having no impact. The noise/signal ratio is high, and maintenance would be a headache.- Nunh-huh 22:59, 21 October 2006 (UTC)

f what you say is true then what is the purpose for this patent -- patent number 5676977 or is this one of those conspiracy theories you refuse to acknowledge? —Preceding unsigned comment added by Ezpariah (talk • contribs) 06:23, 18 December 2007 (UTC)

SIV and pathogenesis

This new bit in the Genetic variability section has me scratching my head:

SIV infection of its natural hosts (African green monkeys (AGMs) or sooty mangabees (SMs)) results in very high levels of the retrovirus in the blood for the natural life of these monkeys without the development of simian AIDS. The immune systems of AGMs and SMs mount at most a very mild immune response to SIV, even though the destruction of naive CD4+ T cells is comparable to that observed in HIV infected patients [emphasis added]

The footnoted article (Kurth & Norley) is not readily available to me, but other articles I found on the same subject (PMID 11842258, PMID 10423122, etc.) seem to state clearly that the strains of SIV-1 native to these monkeys do not cause significant destruction of CD4+ cells, and are therefore not pathogenic in their native hosts; in other hosts, they do destroy CD4+ cells and therefore cause disease. Of course viral load isn't the same as pathogenicity, but I don't understand how you can have loss of T cells "comparable to that observed in HIV-infected patients" and not have progression of disease; if that is indeed true then it needs to be much better explained than this. The same editor added a similar claim to the SIV article, and I've deleted it pending a clarification. ←Hob 06:21, 27 October 2006 (UTC)

OK, I went ahead and edited Genetic variability a bit, removing the confusing part about CD4+ destruction and focusing on the interesting facts that SIV in its natural hosts is relatively benign and also doesn't seem to mutate so much, while in other hosts it behaves more like HIV. The previous version of the text was, I think, too ambitious in stressing the possible link between those facts, a conclusion which isn't sourced to any of the cited studies and therefore looks like editorial opinion - so I softened that part; we can let readers draw their own conclusions, until the science is better. ←Hob 17:24, 28 October 2006 (UTC)

(Just to be even nitpickier: is it really correct to say that SIV in its natural hosts doesn't undergo extensive mutation? Presumably it has the same not-very-accurate reverse transcriptase as always - the mutation happens in the transcription process. I haven't seen any proposed mechanism for not generating mutants; if you don't find lots of mutants in the blood, wouldn't it be more a matter of their relative fitness in a particular host - that is, they're generated, but most of them don't thrive? But I don't have references for this.) ←Hob 17:41, 28 October 2006 (UTC)

(added after a few weeks) ...Did anyone have an opinion about any of the above? I've been at an impasse with User:Clarkgf who still feels my edits were inappropriate. ←Hob 01:22, 14 November 2006 (UTC)

Life cycle of HIV needs major rewrite

A new study came out saying that most HIV patents will live 24 years, not 10. as people newly infected with HIv view this page, it should be updated promptly by someone qualified to update it. The article I learned this on is here: http://www.cnn.com/2006/HEALTH/11/10/hiv.costs.ap/index.html —Preceding unsigned comment added by 75.35.144.195 (talk • contribs)

Well, no offense, but CNN doesn't always have their facts straight. They don't reveal the explicit studies used in their article, but I'd love to see em. JoeSmack ^Talk(p-review!) 05:51, 12 November 2006 (UTC)

I dug it up; i don't have access to it, but what do others think? [3] 05:56, 12 November 2006 (UTC)

As it is projections, and they have no actual human cohort, it is just a projection. how much faity do we put in projections? Do projections from one group constitute worthiness for an encyclopaedia? Should we not instead rely on actual reported clinical data? --Bob 21:46, 13 November 2006 (UTC)

I prefer hard evidence in this case personally. This is also very new info, so its reliability isn't 100% JoeSmack ^Talk(p-review!) 22:27, 13 November 2006 (UTC)

Text has been (quickly) modified accordingly. (May need a copyedit) --Bob 22:52, 13 November 2006 (UTC)

Is it possible to contract HIV infection from one intercourse only?

Is it possible to contract HIV infection by 2-3 mins of penis vagina contact? Is there any minimum duration for the contact to get a healthy body contaminated with HIV virus? —The preceding unsigned comment was added by 210.214.27.215 (talk) 20:20, 6 December 2006 (UTC).

Of course it is. But I would say that the longer the insertion period, the higher the chance of becoming infected. According to the table, the risk of infection for one standard non condom isnertive vaginal contact with an infected person is 0.05 percent or 5 in 10.000. The more you have such encounters with said infected partner, the higher the risk. Other variables are the infectiousness of the index case, the susceptibility of the uninfected partner, the presence of other STD's, Question is how accurate are those figures? -- fdewaele, 12 March 2007, 14:53.

Origin section

I've been looking at the origin section, and I think it could be improved a bit. For one thing, I don't think it's accurate to say that the Aids epidemic was discovered on that date, but rather something like: "Official investigation into what would eventually become known as Aids began with ..." . Does anybody else agree? I just think saying they discovered that it was an epidemic then is a tad much. Can't quite say I'd use discovery in regards to an epidemic anyway. FrozenPurpleCube 06:56, 25 December 2006 (UTC)

Proposed creation of page "Treatment of HIV/AIDS"

See the discussion on Talk:AIDS#Proposed creation of page 'Treatment of HIV/AIDS'" which involves moving the content of the "Treatment" section of this page onto a new page, merging it with content from the AIDS page and leaving a short summary here with a link to the new page. Discussion on this proposal will take place there. --Coppertwig 05:09, 10 January 2007 (UTC)

I also suggest putting "See also AIDS Treatment" in italics at the very top of the Treatment section of this page, and have made the corresponding suggestion at the AIDS talk page. I suggest that any discussion of this take place at Talk:AIDS#Proposed creation of page 'Treatment of HIV/AIDS'". --Coppertwig 00:57, 31 January 2007 (UTC)

Really?

I'm curious, about the risk section... is it saying that there is a 50/10000 chance of transmission through receptive anal intercourse assuming coitus interruptus is not practiced (ie seminal contact with anal tissues), or just the average risk for all receptive anal intercourse? If it's the former, that's a much smaller risk (1/200) than I had previously been lead to believe by activists. That doesn't mean I'm going to go engage in a spree of unprotected receptive anal intercourse, but it does mean that the panic in the gay community is exaggerated -- Assuming that only one in every 10 of your sex partners is HIV positive, and you are exclusively a receptive partner and each of them ejaculates inside of you only once (admittedly very simplified situation, but I am not a statistician so I don't know how to factor in all the over variables), if you had unprotected sex with a total of 2000 sex partners, you would likely only be infected by one of them.

That means that gay guys who get HIV are either incredibly unlucky, are bugchasers, are total whores (I mean, 2000 is a lot, and to not have at least one partner who wasn't OK with barebacking would be rare), the percentage of their sex partners who are positive is exceptionally high, or they engage in a lot of barebacking with only a total of 10 people (ie, if you had unprotected receptive anal sex 2000 times total, 200 times with each partner).

Of course, over time, the risk will probably grow as the %age of infected population grows (what's important here is that everyone engages in protected sex -- I'm not sure, but I think if even 50% of the population used condoms, the number of new infections would go down). --Node 10:27, 15 January 2007 (UTC)

read the associated reference. That is what it is there for. --Bob 14:38, 15 January 2007 (UTC)

Please don't insult my intelligence. I can't read it -- it's in a journal to which I don't have access. --Node 19:43, 24 January 2007 (UTC)

HIV

Is it possible to test negative for HIV 2 years in a row and still have the infection ? —The preceding unsigned comment was added by 206.148.144.63 (talk • contribs).

The odds over two years of testing a false-negative twice is extremely extremely small. See HIV_test#Accuracy_of_HIV_testing for what extremely small fraction of a fraction it is to get it even once on a test, let alone twice over two years. Hope that helps. JoeSmack ^Talk 06:00, 7 February 2007 (UTC)

Questions about the window period......

Hi! It says in the article that the window period is usually 3 months, yet a month can be 28,29,30 or 31 days.

So my question is, does '3 months' translate as 12 weeks? I know i'm being picky but can anyone help with that?

Also out of interest, roughly what percentage of people have tracable antibodies after 11 weeks?

Thank you very much to anyone who can help with this!!!!!

Jamiboxer 16:03, 13 February 2007 (UTC)

One doctor I talked to said consider all months to be 30 days in length (he understood that not all months were equal.) Take that as you like. With modern tests, at 11 weeks over 80% would have detectable antibodies, and at 12 weeks+ the percent goes up to the higher levels; and at 129 days the percent of detection is around 95% (that's about 18-19 weeks.) And finally, to quote a doctor on Medhelp.org "The antibody tests almost always are positive within 4-6 weeks of exposure, and always positive within 2 weeks of onset of symptoms." (http://www.medhelp.org/forums/HIV/messages/838.html) So, anything past the double-digit mark in weeks is pretty convincing, all in all. Yes, I know these are in a little bit of conflict, but HIV is a highly complicated organism and you really can't tie things down nicely for all cases. Sad as that sounds. 206.156.242.36 15:49, 2 March 2007 (UTC)

IMOD

IMOD is already being marketed. And it is not a "cure". Rather a treatment.[4].

So it wouldnt hurt to mention IMOD in the treatment section.--Zereshk 19:52, 15 February 2007 (UTC)

See the AIDS talk page where this is currently being discussed. JoeSmack ^Talk 19:10, 17 February 2007 (UTC)

Treatment

I would also like to highlight a few areas of concern about the text in the ‘TREATMENT’ section of this article:

1: After mention of the US study on survival times, can I, in the interests of balance, suggest the inclusion of something along the following lines:

“A separate Danish study [Lohse N et al. Survival of persons with and without HIV infection in Denmark, 1995-2005. Annals of Internal Medicine:146: 87-95, 2007.] has suggested that in settings where there is easy and free access to care and HIV medication (commenced at 250 cells/mm3), a young adult diagnosed with HIV (but without HCV) has an estimated median survival rate of more than 35 years and that, whilst this is still 10 years short of general life expectancy, death is now unlikely to be directly related to HIV.”

The reference to HCV may seem trivial here, but it is important. HCV is a complicating factor and HCV infection rates are quite significantly lower everywhere in the world, outside of the USA.

2: The article states: “In developed countries where HAART is available, doctors assess their patients thoroughly: measuring the viral load, how fast CD4 declines, and patient readiness. They then decide when to recommend starting treatment.”

Department of Health and Human Services gudielines are then refernced; but thankfully most of the world does not follow Department of Health and Human Services gudielines and definitions (nor indeed does the Department of Health and Human Services represent the international gold standard, or follow WHO and UNAIDS agreed guidelines and definitions … even on something as basic as what constitutes AIDS).

In reality, viral load has little, or no, upfront influence on the decision to recommend the commencement of HAART therapy. The important factors for consideration would be CD4 cell count and CD4 cell percentage (as an indicator of the rate of disease progression) and and the actual symptoms being experienced by the patient. Monitoring of viral load only assumes a position of any real importance once HAART thearpy has commenced.

This is simply not true. I'm speaking from personal experience here. After four months and three order of magnitude increases in my VL, even with steady CD4 abs and %, my doctor and I decided to initiate HAART. The reason was because there was starting to be an impact on non-CD4 cell counts. Initiating HAART is not just a numbers game limited to a single data point. There are many data points that go into that decision, and many factors that help make that decision. This is why it is highly recommended to seek advice from a specialist in the field, vs. a general practitioner who may not have experience with the multitude of data sets involved in the decision to start HAART. If anything the statement you quote should be expanded to cover an even greater set if tests are are involved in the decision to start HAART, but I believe that in relationship to the rest of the article these points do cover the focus of testing. --ZacWolf 17:12, 11 November 2007 (UTC)

3: The article also states: “most national guidelines say to start treatment once the CD4 count falls below 350”.

THIS IS NOT CORRECT (and isn’t even supported by the references given). Internationally (even in the developed world) “most national guidelines” currently state that you should consider treatment once the CD4 count falls below 250 cells/mm3 (not 350 cells/mm3 as stated) and before it falls to 200 cells/mm3.

There is indeed a rapidly growing body of evidence for commencing treatment once CD4 falls below 350 cells/mm3 (not above 350 cells/mm3 as stated); but far more significant is the fact that the same body of evidence is also showing that the focus needs to shift away from CD4 counts and that irrespective of what the CD4 count may be, treatment needs to commence once the CD percentage falls below 15% (for example, a person whose CD4 cell count is 350 cells/mm3, but whose CD4 cell percentage is 14%, is far more likely to experience HIV disease progression than a person whose CD4 cell count is 200 cells/mm3 and whose CD4 cell percentage is 24%).

4: Finally, the mention of IMOD (in my opinion) reduces the article to nothing more than a press release service. There are entire new classes of HAART drugs that receive no mention at all (but are currently being tested on far more than the paltry 200 patients who have, to date, taken IMOD). These are drugs that are the subject of published scientific data and are being subjected to international scientific peer review .. exactly the sort of review that IMOD has not yet been subjected to. IMOD isn’t even being marketed yet. There are even quack Chinese herbal remedies that are taken by hundreds of thousands of people that receive no mention at all (nor indeed should they). Surely the inclusion of IMOD does not live up to the standards expected on Wikipedia .. unless it is included under a new heading alongside the dozens of other hopeful (but, as yet, totally unproven) advances in both primary antiretroviral, and secondary prophylactic, treatments (and it is, after all, simple prophylactic administration of antibiotics, rather than herbal remedies, vitamins and advanced antiretrovirals, that has stopped something like PCP being the predominant AIDS killer that it was 15 years ago).

Apologies if these comments aren’t in the accepted format, but I am new to this and still learning. Orpingtonian 10:33, 18 February 2007 (UTC)

HIV TESTS

Where do you get home hiv test kits? I have all the symptoms of HIV and was tested in the past but i don't trust my doctor even if HIV showed up he wouldnt tell me because he don't like me. —The preceding unsigned comment was added by 142.167.240.144 (talk • contribs).

Er... if you don't trust your physician to be honest with you, find another doctor. MastCell 21:57, 18 February 2007 (UTC)

HIV MIMICS OTHER DISEASES

What are some other conditions that have the same initial symptoms of HIV? such as FLU, fever, orah thrush(white tongue), chronic skin rash? (unsigned question)

For more on the symptoms of primary HIV infection, see Are the Most Common Symptoms of Primary HIV Infection?. Other diseases that have some symptoms similar to HIV during the primary infection include the cold, flu, and mononucleosis. However, realize that this is only true for the signs and symptoms of the brief "primary infection" phase of HIV. HIV infection can be reliably distinguished from other diseases during that "primary infection" phase and after by techniques like PCR to count HIV viral load, antibody testing once the individual has seroconverted, and the distinctive immune profile. Says [5]: "[T]he specific immunologic profile that typifies AIDS--a progressive reduction of CD4+ T cells resulting in persistent CD4+ T lymphocytopenia and profound deficits in cellular immunity--is extraordinarily rare in the absence of HIV infection or other known causes of immunosuppression." (They cite Fauci AS, "CD4+ T-lymphocytopenia without HIV infection ..." N Engl J Med 1993;328(6):429-31. Laurence J, "T-cell subsets in health, infectious disease ..." Ann Intern Med 1993;119(1):55-62.) AIDSvideos 11:47, 14 July 2007 (UTC)

Question about the main image

Is it just my imagination or does the number "2" appear twice in that image? Is this some kind of joke, or is it an illusion? Dionyseus 06:58, 20 February 2007 (UTC)

It is neither. What you see is simply a stylised representation of the A-form geometry of RNA’s single helix.
You will see a similar representation here: http://www.aidsactioncoalition.org/images/hiv_virus.gif
.. or a more conventional representation here: http://www.med-ars.it/virus/hiv.jpg
Orpingtonian 07:35, 20 February 2007 (UTC)

undectable strains of hiv?

is there any strains of hiv that can go undeteced on a blood test? —The preceding unsigned comment was added by 142.167.245.18 (talk • contribs).

New info from WHO

http://abcnews.go.com/Health/wireStory?id=2897109

And a pretty good quote: ""This is an extraordinary development," said Dr. Kevin de Cock, director of the World Health Organization's AIDS department. "Circumcision is the most potent intervention in HIV prevention that has been described."" 206.156.242.36 19:20, 23 February 2007 (UTC)

... and the guy's name is Dr. Kevin de Cock? Awesome! You couldn't make this stuff up. MastCell 19:53, 23 February 2007 (UTC)

Origin of AIDS

The chapter begins by stating that: "According to research of old bloodsamples HIV did not exist before year 1978 in United States of America" but later in the chapter it is clearly stated that "HIV found in tissue samples from a 15-year-old African-American teenager who died in St. Louis in 1969.[19]" Further more the London Times-theory is presented nearly as a truth "HIV-infections is still officially unexplained phenomenon but HIV-infections appeared exactly the same time in different areas of world and they also matched exactly the smallbox vaccine program of World Health Organisation (WHO)" even though the later studies have made this highly unlikely: by an analysis of genetic mutation in primate lentivirus strains that indicates with 95% certainty that the origin of the HIV-1 strain dates to about 1930. I think the chapter needs a major rewrite. In the main article (AIDS origin) the small pox theory is not even mentioned. --Joonasl 13:02, 27 February 2007 (UTC)

Alternative views

The current phrasing of the alternative views section represents consensus. If one would like to alter it, please discuss here FIRST, rather than reverting again and again with an edit summary saying "SHOULD BE NEUTRAL!" Thanks. MastCell 18:33, 16 March 2007 (UTC)

Hi sorry for reverting, i still don't know very well how to work here, forgive me! ;-)

So about the HIV dissident theory, i think it should be treated in a neutral way, because the people who believe that theory are not crazy, but scientist and some of them are even Nobel prize winners, and they believe that the "official" theory on HIV is pseudoscience. Also in the Duesberg studies there are many well documented arguments on the topic, so i think that how the voice is now is not correct, but there should be a neutral and fair exposition.

Also about the picture on the page it says "Stylized rendering of a cross section of the human immunodeficiency virus" but there is no image of that retrovirus at all! so that is just a fantasy picture, in this case i think is absolutely inappropriate to call the picture like that! both for the "virus definitions" (is a retrovirus) and for the fantasy picture (we should say that there are no pictures of any virus or retrovirus). Of course is just my point of view. But i think reading http://www.virusmyth.net/aids/index/pduesberg.htm it would be a good help. bye LIUTOMAN —The preceding unsigned comment was added by Liutoman (talk • contribs).

It's probably worth nothing that Wikipedia's definition of a neutral point of view holds that beliefs should be described in relation to their acceptance and representation among experts in a field. Duesberg's beliefs are widely considered disproven and outdated by the scientific community, so they should be represented as such. To present his views uncritically, as if they had equal validity with the scientific consensus on HIV, would be violating the neutral point-of-view policy. As for the picture, it is a "stylized" representation - this means it is not a photograph, but an artist's representation of HIV. Electron micrographic images do exist, and can be seen at the National Institutes of Health website, among other places, if you're of the belief that HIV has never been visualized. There are pictures of many viruses, including HIV, taken via electron microscopy. MastCell ^{"Mistakes were made"} 05:13, 17 March 2007 (UTC)

Well, there was a guy called Galileo Galilei who's beliefs where considered wrong and crazy by the mainstream scientific comunity...anyway for me you can leave all the point of view that you like, is not gonna change my life ;-) but i belive that Deusberg together with many Nobel Prize winners, and respected scientist and doctors are not crazy, and they are for sure competent in the field, so their point of view should not be treated in that way...also because the scientific community is not really as you say "all" against the alternative views on HIV...not at all. And anyway HIV retrovirus as never been visualized. But if everybody is ok with this way for me no problem, life is nice because we all have different points of view ;-) --Liutoman 03:04, 18 March 2007 (UTC)

Interestingly, a comparison to Galileo is one of the fastest ways to rack up points on the Crackpot Index... :) Seriously, as for the scientific community, look at the peer-reviewed literature on HIV/AIDS in MEDLINE, for instance. How many papers reflect a "dissident" viewpoint, and how many are based on the concept that HIV causes AIDS? While a scientific consensus can certainly be wrong, the existence of such a consensus as regards HIV/AIDS is quite clear. MastCell ^Talk 04:31, 18 March 2007 (UTC)

"The fact that some geniuses were laughed at does not imply that all who are laughed at are geniuses. They laughed at Columbus, they laughed at Fulton, they laughed at the Wright Brothers. But they also laughed at Bozo the Clown." - (Sagan, 1979) <grin>. -- MarcoTolo 04:36, 18 March 2007 (UTC)

Such wise words... and yet his ex-wife is an AIDS dissident, if the "reliable sources" (blogs and an Amazon.com book review!?!?) cited in her Wikipedia article are to be believed. Stranger than fiction. MastCell ^Talk 04:49, 18 March 2007 (UTC)

"Not only is the universe stranger than we imagine, it is stranger than we can imagine." Sir Arthur Eddington English astronomer (1882 - 1944)....Doubly so for human behavior, eh? -- MarcoTolo 04:57, 18 March 2007 (UTC)

Well i don't know if alternative theories are right or wrong, but i think they should deserve just some attention. Of course when Bozo the Clown will be awarded with a Nobel prize for some scientific research, well then I'm not gonna think about it anymore! ;-) --Liutoman 07:27, 18 March 2007 (UTC)

They already receive an undue amount of attention at the content fork article AIDS reappraisal. MastCell ^Talk 16:18, 18 March 2007 (UTC)

Small boxes

What's with all the boxes being small at the top? Ugly. Tayquan ^holla_{My work} 16:18, 5 April 2007 (UTC)

I'm talking about all the WIkiProject boxes. Tayquan ^holla_{My work} 12:42, 8 April 2007 (UTC)

I have nothing to do with it, but think it looks good. Much better than taking up pages of scrolling with inane messages.. |→ Spaully°τ 15:09, 8 April 2007 (GMT)

Possible error in describing proportions of infections

The top 4 elements of the table in this article read:

Blood Transfusion 9,000 Childbirth 2,500 Needle-sharing injection drug use 67 Receptive anal intercourse 50...

next to the article, which states that

"The majority of HIV infections are acquired through unprotected sexual relations"

This doesn't appear to make sense... Have I misread it? Jddriessen 20:11, 14 April 2007 (UTC)

You probably have. What part doesn't make sense to you? The table lists acts by order of associated risk, not by how often or how frequently they occur. Millions of people have sex for each time a blood transfusion occurs, so the millions of times makes up for the lower per act associated risk. - Nunh-huh 21:56, 14 April 2007 (UTC)

fyi, news

http://news.google.com/news?hl=en&ned=us&q=hiv%20blocker&btnG=Search+News ¦ Reisio 23:01, 20 April 2007 (UTC)

This article has no information about the ecological and societal effects of HIV/AIDS. -Guest, 2 May 2007

Vandalism in the references

Based on this diff, there are still at least two bits of vandalism in the references for this article.

Can someone with more time than I have please track these references down in the article and fix them?

Thanks!

Atlant 12:42, 10 May 2007 (UTC)

Got em, thanks for keeping an eye out. JoeSmack ^Talk 12:50, 10 May 2007 (UTC)

Thanks!

Atlant 12:53, 10 May 2007 (UTC)

Per act risk

The table in the "Transmission" section says for instance, that the infection rate per 10 000 exposures in "Insertive penile-vaginal intercourse" is 5 cases. If I'm understanding it correctly, that's a 0.05% chance of getting HIV from unprotected sex with an infected woman. How can that be true? Isn't that way, WAY too low?

I mean, I have no idea. Is that a truly correct figure? Anyone? -- Xompanthy 22:48, 19 May 2007 (UTC)

You're translating risk/10k exposures into percentage correctly. I'm not sure whether that statistic is citing the risk for the man of contracting from HIV+ woman, the risk for the woman of contracting from HIV+ man, or the net risk of HIV- partner contracting in either direction. I can't tell you how precise that number is (i.e. whether it should be 5, 10, or 20 per 10k exposures). What I can tell you: generally speaking, the risk of HIV transmission per incident in heterosexual vaginal intercourse is relatively low (lower than I'd thought before studying the issue), EXCEPT during the initial stage of HIV infection during which viral load is extremely high before the immune response gets HIV viral load down again; other factors like the practice of "dry" (less lubricated) sex, coinfection with other STDs, or violent sex as in rape may increase the risk of transmission; and a significant portion of sexual transmission of HIV may be due to transmission during that initial stage of HIV infection when viral load and infectiousness are high. CDC believes that if all HIV+ Americans were made aware of their status and changed their behavior to prevent transmission similar to those who already know their status, the rate of new infections per year in US might theoretically be reduced by up to 30%. This is the rationale for their new recommendation that all people be tested for HIV at a routine doctor office visit. AIDSvideos 09:54, 14 July 2007 (UTC)

Ok, I've checked the source on this (for those interested, its here: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5402a1.htm). The figures provided are not absolute numbers, but are relative, and they are based on a 'best-guess' not a firm figure. Apparently, they calculated the ratios, and then "estimated" (guessed blindly) that the risk of transmission from an infected male to an uninfected female was 0.1%. They even have a footnote saying "best-guess estimate." Quote: "We're not talking precision science here, but rather estimates based on assumptions based on guesses." (Couldn't have said it better myself ;) So, to answer your question, it's not a correct figure. If you don't like it, you can feel free to make up a new one- it will be as accurate as anything the government provides. —Preceding unsigned comment added by 128.189.169.204 (talk) 21:38, 8 December 2007 (UTC)

Circumcision protection now shown as irrelevant - "It's the prostitutes, stupid!"

New analysis shows that what was previously thought to be a definite increase in protection against the spread of HIV caused by circumcision is in fact "statistically irrelevant once the study controls for the number of prostitutes in a country". The AAAS provides the layman summary, and links to the freely available journal article hosted by PLoS. Circumcision, HIV, and other Wikipedia articles definitely needs to be corrected/updated with this information. Their ultimate conclusion:

"This paper provides strong evidence that when conducted properly, cross country regression data does not support the theory that male circumcision is the key to slowing the AIDS epidemic. Rather, it is the number of infected prostitutes in a country that is highly significant and robust in explaining HIV prevalence levels across countries. An explanation is offered for why Africa has been hit the hardest by the AIDS pandemic and why there appears to be very little correlation between HIV/AIDS infection rates and country wealth."

— BRIAN0918 • 2007-06-20 13:39Z

See discussion at Talk:Circumcision. Jakew 14:33, 20 June 2007 (UTC)

Medically performed male circumcision with counseling has been shown safe and effective for HIV prevention through heterosexual sex

I agree with Brian0918 that the HIV page's current discussion of circumcision as a means of HIV prevention is out of date, but primarily in a different way. The current language on the page: (1) mentions that trials are being done in Uganda and Kenya, but fails to mention that those trials have now concluded showed HIV risk reduction rates of 48% and 53% respectively and were halted early as a result. See Male Circumcision Significantly Reduces Risk of Acquiring HIV. (2) says that UNAIDS thinks it's premature to recommend circumcision as a means of HIV prevention. That statement in the wikipedia article is based on an 2006 WHO statement, but that statement was issued before the two trials were halted early in December 2006, at which point the WHO issued a December 2006 statement saying "WHO, the UNAIDS Secretariat and their partners will review the detailed trial findings and will then define specific policy recommendations for expanding and/or promoting male circumcision."

It is important that wikipedia's writeup include accurate, up-to-date information about these important recent findings that medically-performed male circumcision with counseling is a safe and effective means of preventing HIV transmission through heterosexual sex.

Note that Eurekalert article cited by Brian0918 is really addressing different questions than "is medically performed male circumcision an effective means of HIV risk reduction?" It's addressing how RELATIVELY important are: (1a) the rate of male circumcision, and (1b) the percentage of prostitutes in the population and their rate HIV infection ... as means of explaining the current HIV prevalence rate in the general population. It may well be true that (1b) is more important than (1a) in explaining how HIV came to be highly prevalent in some countries today. But that does not mean that medically performed male circumcision with counseling isn't an effective tool for HIV prevention in heterosexual sex. Controlled clinical trials have proven that it's effective.

The article also makes a strange statement: "reducing single encounter transmission rates alone cannot control the epidemic. The reason is that individuals in highly infected countries have multiple contacts with the infected so reducing transmission rates only defers the inevitable." Well, first of all, we know of NOTHING that alone can control the epidemic. Condoms alone can't control the epidemic (think for example about sex workers who choose not to use them), but they're still a useful tool for slowing its spread. And "deferring the inevitable" is in fact a highly useful thing because it buys time for us to come up with a vaccine or microbicides that could help prevent further spread better.

Nothing in the article changes these facts: (1) Controlled clinical trials in South Africa, Kenya, and Uganda have shown that medically performed male circumcision with counseling is a safe and effective way to reduce the risk of HIV transmission through heterosexual sex by 60, 53, and 48 percent respectively. (2) WHO "will review the detailed trial findings and will then define specific policy recommendations for expanding and/or promoting male circumcision."

AIDSvideos 13 July 2007

Just found a more recent statement: "the World Health Organization (WHO) and the UNAIDS Secretariat convened an international expert consultation to determine whether male circumcision should be recommended for the prevention of HIV infection. Based on the evidence presented, which was considered to be compelling, experts attending the consultation recommended that male circumcision now be recognized as an additional important intervention to reduce the risk of heterosexually acquired HIV infection in men."

AIDSvideos 13 July 2007

As in all stories involving circumcision, statements are generally being made based on ideology rather than established fact. The relationship between AIDS, circumcision, and prostitution is more complex than is being depicted here. Furthermore, the understanding of this relationship is still evolving [6]; it's inappropriate to merely parrot the latest study as if it were the final word, whether or not you sympathize with its conclusions. - Nunh-huh 01:33, 14 July 2007 (UTC)

Agree with Nunh-huh that there is too much POV pushing and ideology-based statements in discussions of circumcision. Not sure whether by "here" Nunh-huh is referring to the John Talbott article (which, it turns out, has since been sharply criticized by a subsequent article in Nature -- see the Talk page for Circumcision for more on that) or the edits I made last night to this article to update it with the results of the Uganda and Kenya studies and the subsequent statements by the WHO/UNAIDS panel of experts. In case it's the latter, note for the record that my edits simply cite the results of published controlled trials and statements by WHO/UNAIDS. AIDSvideos 09:22, 14 July 2007 (UTC)

Lengthy and problematic Intro

It's more than obvious that the "introductory paragraph" is far too long, as the Editorial staff make clear. Here's my suggestion on it: The first paragraph can be left there, but with a brief summary of the major points of the article included where it hassn't already been done, pursuant to the general encyclopaedic formatting of an article.

As far as the remaining three paragraphs are concerned, I looked reviewed their content and concluded that paragraphs 2 and 4 of the intro fit belong in the Transmission section, although there's a good possibility that alot of what was said in the earlier may have already been covered in the latter, thereby rendering it superfluous altogether, but in any case those two paragraphs quite clearly belong in Transmission. In regards to Paragraph #3, I couldn't locate one precise Subject to relegate it to, but a larger, two-fold problem exists in that in an article which is supposed to be about HIV, it seemingly randomnly interjects - without references or sources - that AIDS is one of the greatest pandemics in history with 25 Million deaths. How did we get to talking about AIDS? And has the author attempted to verify such a statement regarding a subject which is irrelevant to the article to begin with? An article like this cannot be taken lightly. Thanks, Alan. --24.184.184.177 00:38, 19 July 2007 (UTC)

Protection status

I think the tag (lock symbol) has been removed from the article, because I was wondering why it wasn't protected and noticed while editing that there is a notice saying the article is semi-protected. If no-one contests I would like to put the symbol back up.--Kkrouni 01:21, 1 August 2007 (UTC)

Trasmission via Barber's Straight Edge Blade

Is it possible for a barber's traditional blade to spread aids, afterall it tends to draw blood when it goes over a pimple or other inperfection and barbers don't disinfect between customers? —Preceding unsigned comment added by 82.69.113.120 (talk) 19:07, August 27, 2007 (UTC)

Table of transmission rates

I'm a little concerned that the references used in the table of transmission rates, here and at AIDS, don't always seem to support the numbers in the table. I checked the references for "Receptive penile-vaginal intercourse", and none of the three references seem to have much to do with a 10 in 10,000 transmission rate, unless I'm missing something really obvious (it's happened before.) It's very important that these are referenced properly, as, well, that transmission rate is a lot lower than I thought it would be given the rate at which the disease has spread. Perhaps that discrepancy could be discussed more in the article as well. Thanks for your help, Grandmasterka 02:22, 17 September 2007 (UTC)

The table reproduces figures found at <http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5402a1.htm#tab1>. Your personal incredulity aside, these figures are in line with those published elsewhere. - Nunh-huh 01:43, 1 October 2007 (UTC)

Thanks, that's all I needed. A few of the numbers still don't make much sense to me, but... It doesn't get much more reliable than the CDC. Grandmasterka 01:48, 1 October 2007 (UTC)

That reference, by the way, was already in the table. This article has been looked at and edited by people with some expertise in the matter, and it's unlikely that information that's been in the article for a long period of time is going to be out-and-out wrong. - Nunh-huh 01:54, 1 October 2007 (UTC)

I know, I know... I checked the references next to each number first, didn't really find what I was looking for, and then didn't scroll down far enough on the top reference. Sorry about that. I edited that top reference to jump directly to the table, I hope it helps. Grandmasterka 08:42, 5 October 2007 (UTC)

Occupational Exposure External Link

I propose an external link to the National Institute for Occupational Safety and Health's Bloodborne Infectious Diseases Page where users can find info on needlestick and sharps injuries, universal precautions, research, regulations, legislation, etc. —Preceding unsigned comment added by Tisdalepardi (talk • contribs) 20:16, 12 October 2007 (UTC)

Per-act Risk Table

I believe there is an error in the per-act risk table in the article. The first two acts are fine (9000 and 2500 cases of infection per 10000 cases), but the rest seem to have been calculated in percents rather than in actual number of infections. If you compare the table with the one here (http://depts.washington.edu/hivaids/post/case5/fig1d.html) you'll find that the numbers match exactly, only the numbers in the table I linked to are calculated in percents.

Someone please review this to make sure I'm not in error and edit if possible. I believe this is giving people seriously wrong information and potentially creating dangerous misconceptions.

~Slava, 14/10/07 23:50 GMT —Preceding unsigned comment added by 217.132.200.206 (talk) 21:45, 14 October 2007 (UTC)

The numbers match exactly, and they all are risks per 10,000 exposures to an infected source. They also exactly match the source cited [7]. (The source you give is probably taken from the source we used, so that's no surprise.) What makes you think "the rest seem to have been calculated in per cents"? - Nunh-huh 01:02, 15 October 2007 (UTC)

I'm not Slava, but they seemed to be calculated in percents because of the scale on the x-axis of the graph (0..100). The graph is slightly confusing that way, especially with the two largest risk factors absent. The table on the wikipedia page is better. 24.82.209.151 (talk) 10:29, 7 December 2007 (UTC)

HIV Group O

Under the heading on genetic variability, it might be nice to mention HIV group O, which is a blanket grouping for subtypes other than 1 and 2 that do not show up on diagnostic tests. It is *extremely* rare and has not been seen outside of Africa (as of 2007) to my knowledge, but some of the newer test kits can detect it. Blood donors are screened for possible exposure by asking about travel or other exposure to countries where it has been seen (Chad, Central African Republic, Congo, Niger, Nigeria, and a few others). Given the length of the article, it might be appropriate to create a separate article for HIV subtypes.

150.148.0.27 17:35, 19 October 2007 (UTC) (hah!)

New Developments

Recently, there have been massive improvements not only in the treatment of HIV, but also in the possible cure. Perhaps the treatment section of this article should be revised to include the most recent developments?

Citing ScienceDaily,

"ScienceDaily (Oct. 21, 2007) — With the latest advances in treatment, doctors have discovered that they can successfully neutralise the human immunodeficiency virus (HIV). The so-called ‘combination therapy’ prevents HIV from mutating and spreading, allowing patients to rebuild their immune system to the same levels as the rest of the population."

http://www.sciencedaily.com/releases/2007/10/071020103343.htm —Preceding unsigned comment added by 76.86.140.54 (talk) 05:36, 25 October 2007 (UTC)

Jackandmeg2001 00:43, 26 October 2007 (UTC)jackandmeg2001

Though the press has hyped it, there's really not much that's new there. (PMID 17659333) Other studies have been more cautious in their conclusions. - Nunh-huh 01:34, 26 October 2007 (UTC)

Circumcision Neutrality

The section on circumcision is very pro-, and my citiations of criticisms and the increased likelihood of transmission to women by circumcised men is repeatedly deleted. This is not a neutral presentation as long as it does not deal with the criticism of the circumcision recommendation. --Scottandrewhutchins 15:35, 26 October 2007 (UTC)

As I pointed out to you on your talk page (rather than on the talk pages of three separate articles you were inserting identical boilerplate into), you were relying on a webposting of an AP report of an oral report of a preliminary study that reached no statistically significant results, and which will probably never be printed in a refereed peer-reviewed journal, which is an unreliable source. Furthermore, your summation of that source was (and is) incredibly misleading, reflecting either a lack of understanding or intentional deception. The report simply does not say what you wish it said. The current article incorporates all points of view that are supported by reliable sources with emphasis according to the numbers of people holding those views. Reporting a preliminary study with no statistical significance as though it were conclusive gives undue weight to a fringe view and is incompatible with a neutral point of view. - Nunh-huh 15:48, 26 October 2007 (UTC)

Sentence sense

Under section 7.1 (Cell entry) the following sentence needs a verb somewhere : "The interactions of the trimeric envelope complex (gp160 spike, discussed above) and both CD4 and a chemokine receptor (generally either CCR5 or CXCR4 but others are known to interact) on the cell surface.[48][49]"

Fixed now, I think, though it would be good if others double-checked. - Nunh-huh 17:17, 27 October 2007 (UTC)

Is this new?

If it is new, it should be included, but I'm not sure how important or valid this info is or if it's actually new. "Professor Jens Lundgren from the University of Copenhagen, together with other members of the research group EuroSIDA, have conducted a study, which demonstrates that the immune system of all HIV-infected patients can be restored and normalised. The only stipulation is that patients begin and continue to follow their course of treatment." http://www.sciencedaily.com/releases/2007/10/071020103343.htm The Lancet - Vol. 370, Issue 9585, 4 August 2007, Pages 407-413 —Preceding unsigned comment added by JavOs (talk • contribs) 04:05, 28 October 2007 (UTC)