A Hypothetical Question

[RayKay]

Well, as icemotoboy has wonderfully pointed out, I am aware that the rates of transmission are not guaranteed anytime you have sex, and I am quite aware of the risks, and my decision is not based on ignorance or paranoia. Despite growing up at the time where HIV/AIDS paranoia abounded, I also knew in high school a few students whom got infected from one another through unprotected sex. That hit me quite hard, as they were MY age, in high school and despite growing up at time I did with the awareness of HIV and AIDS we were all witness too, still were not protecting themselves.

 

HIV infection is actually on the rise again here in the young population, most of all among young heterosexual women. Maybe some more awareness and caution is needed again. Interestling, cases of syphillis (thought to be almost "eradicated" around here) are also rising.

 

Anyway, I do know people whom live with HIV, and are healthy so far, but for me, I do take care to protect my health in all other ways - eating well, exercise, vigilance for reducing breast cancer risk through exposure to toxins, diet, regular screening, and so on. For me, protecting myself by reducing exposure to something else that would threaten my health is right for me, and makes sense for me. To me it makes sense to not go there, but of course I have also never been in the position where I had to decide to sleep with or not with someone whom told me they had HIV (and of course, maybe at some time I DID sleep with someone whom had it and did not know it.....this is why condoms and protection are mandatory folks!).

 

I am also aware that sex has an inherent risk for other serious STI's as well. Including HPV, which yes, 80% of women will have contracted it by the age of 50. However, it is important to note there are many strains of HPV, the one that causes genital warts and is transferred by skin to skin contact is not the same as the one that causes cervical cancer for example. This latter one can be tested for in women, but not in men whom can transmit it to many women and never know it. It can lead to cervical cancer, and other serious complications if not caught early.

 

However, I still stick to my decision that I would not knowingly have sex with with someone with HIV or AIDS, nor would I having it have sex with them.

 

Even with the great advances in treatment that allow longer lives, there is no cure. And there are even new, stronger variations of the virus that have emerged in North America that are resistant to the current treatments, and that are turning into full-blown AIDS within weeks.

 

I do think a vaccine is possible at some point however. There are populations of women in Africa (they have studied women prostitutes) whom have shown a resistance to the virus, even after many, many exposures.

 

As for testing - I get tested for all STI's annually at my gyno exam/pap smear, and while I no longer get regular HIV tests (I am in a long term monogamous relationship) my blood is tested everytime I donate blood (3ish times a year).

[FoxLocke]

I have a difficult time wrapping my head and heart around being in a situation like that myself. It must be very difficult, and the love would have to be strong. HIV/AIDS is not something I am well educated about.

 

I agree it's all grand. I used to believe that you could contract HIV through open mouth kissing. But, through much research, that isn't even a possibility(unless you are bleeding profusely into someone else's mouth, which is unlikely)...

I think it all comes down to each individual, as IceMotoBoy says, educating his or herself on the disease. An ounce of prevention is worth a pound of cure...

 

Myself, I am practicing abstinence until I can find a career with medical benefits. I don't want to place myself at risk for any STI's or STD's until I know I have proper health care. Thankfully, due to annual check ups, I am a healthy person.

[kadvati79]

HIV infection is actually on the rise again here in the young population, most of all among young heterosexual women. Maybe some more awareness and caution is needed again. Interestling, cases of syphillis (thought to be almost "eradicated" around here) are also rising.

Yep, its on the rise for a number of reasons, many of which aren't really understood by those in decision making positions. The problem with many safe-sex programmes is that they are designed by people who ALREADY make "sensible" decisions surrounding safe-sex. Its the same with drug education, anti-smoking etc... Much of the time, the issue relates to self esteem. I know thats true in my case.... why take precautions when you can't bothered living in the first place?

 

I am also aware that sex has an inherent risk for other serious STI's as well. Including HPV, which yes, 80% of women will have contracted it by the age of 50. However, it is important to note there are many strains of HPV, the one that causes genital warts and is transferred by skin to skin contact is not the same as the one that causes cervical cancer for example. This latter one can be tested for in women, but not in men whom can transmit it to many women and never know it. It can lead to cervical cancer, and other serious complications if not caught early.

I actually read about the new HPV vaccine that is 99% effective. I believe it is in second stage trials, and that the FDA has approved funding for it. Unfortunately I can't cite a reference and I'm on my PDA so its a pain to try search for it.

 

However, I still stick to my decision that I would not knowingly have sex with with someone with HIV or AIDS, nor would I having it have sex with them.

Once again, I think its one of those issues that falls down to individuals and situations. Certainly, before I met the HIV positive guy I slept with and dated... I would NEVER have thought I would sleep with someone in that situation. Despite what some people think of me on these boards, I'm actually a bit of an a***hole when it comes down to it! But I guess when presented with the situation, it just made sense. It wasn't even like there was a decision to be made really, it just felt right. I mean, who WOULD say they would sleep with someone HIV positive, say they WOULD expose themselves to that risk, until they are actually put into the situation? Nobody I guess because it wouldn't make any sense!

 

And there are even new, stronger variations of the virus that have emerged in North America that are resistant to the current treatments, and that are turning into full-blown AIDS within weeks.

Hmmm, not sure where you read that. The only currently medically proven evidence is that anti-retroviral drugs aren't working in some people and HIV is progressing on. A couple of hypothesises include:

1. People aren't sticking perfectly to their drug regimes
   
2. They have multiple strains of HIV, each requiring different anti-retroviral drugs
   
3. There is an "X" factor involved in the progression of HIV to AIDs
   
4. There is a new "superaids" strain
   

Now, those familiar with the great concept of link removed will join with me and go with options 1 and 2, as these are the most likely and simple explainations. 3 is highly theoretical and there is really no tangible evidence of it. And number four, is plastered all over the media but again .... it is an unproven theory.

 

The aledged "super aids" strain link removed resulted from a 40 year old man in new york, who regulary used methamphetamines and engaged in unprotected anal intercourse. It would appear he developed AIDs within 20 months of sero-converstion.... but this is the absolute FASTEST recorded time of progression, and even then, its subject to much conjecture. People progressing into AIDs within "weeks" is absolute and complete boloney without any medical, scentific, or epidemiologic basis. It is entirely fabricated, although often presented as fact. But is simply presented that way to sell papers... Unfortunately the media do not apply "Occam's Razor", they apply the "most exciting and terrifying story sells" rule.

 

To quote from the article I linked above:

There is no evidence that the virus is readily transmissible, and there is also uncertainty over whether the bug detected is really a single, highly resistant strain of HIV, or possibly many subtypes of the virus in the same patient -- each resistant to some drugs, but not to all.

And...

San Francisco AIDS physician Steven Deeks said in an interview that he believes that "host factors" -- traits of the patient rather than the virus -- are almost certainly the cause of his rapid deterioration in the face of a multidrug resistant virus. However, he said the case still underscores the danger of unsafe sex in an environment populated by a still-dangerous virus.

 

So just to recap, nobody progresses from HIV to AIDs within weeks, or even months. It takes YEARS. A median of TEN YEARS without medical treatment. Thats why the virus is dangerous. In fact, any "super strain" that killed within weeks would actually be BAD for the virus. It would seriously effect its curious traits in epidemiology. Given that it is not "very high contagious", and that it is, in a statistical sense at least, not particulary easy to catch - the virus needs alot of time to expose itself. It needs many, many chances to infect. Thats why the epidemic is hanging around. You don't see people walking around with Ebola in the NYC substations... If a super-strain of HIV/AIDs does come out that kills fast, well, that strain will kill itself out. Because it won't get the chance to infect enough people.

 

The spread of virus and disease is really a system of patterns and mathematics. Viruses have no "memory" or "thoughts", they don't "learn". Its just that its only the methods of transmission and traits that "work" that last. Its only the strains that provide the opportunity to transmit the virus to many, many people that actually prolong the virus.

 

I do think a vaccine is possible at some point however. There are populations of women in Africa (they have studied women prostitutes) whom have shown a resistance to the virus, even after many, many exposures.

A vaccine is entirely possible. But the problems of mutations of strains and multiple infections make it problematic. Yet the real crux of the problem, the reason AIDs and HIV is such a problem... is that it "becomes" your immune system, which is what you need for a vaccine to be effective. In many ways, your body doesn't know its infected with HIV/AIDs. Hence, there are few HIV/AIDs "symptoms", the symptoms relate directly to opportunistic infections and disease and complications.

 

As for testing - I get tested for all STI's annually at my gyno exam/pap smear, and while I no longer get regular HIV tests (I am in a long term monogamous relationship) my blood is tested everytime I donate blood (3ish times a year).

I think testing, like any medical treatments, is a matter of lifestyle, risk, and impact balancing.

[highonyou]

The thing about AIDs/HIV that really sucks is that it doesnt matter what expensive treatments a person get, it can only be contained to that person, it can NEVER be cured. The damn retrovirus has worked its way into your DNA and essentially every cell in your body.

 

For that reason, i would not risk exposing that to anyone.

[BrokenWingedFaery]

And dang the treatments ARE expensive. To be perfectly honest and possibly a bit...well, I'm sure someone will say I'm something for saying this. Paying for the treatments is the primary reason I don't wanna get HIV.

[highonyou]

AZT is i think the first AIDs treatment, the cost of it should plummet soon because of something about how long its been in use since its patent.

 

My friend Scott (almost a Dr!) mentioned the price of crugs are very expensive when first brought out, after 30 years or so in use they become dirt cheap, probably because of competition from newer drugs.

[kadvati79]

The best analogy for any new product is the PlayStation2, or other game consoles. The reason they are so expensive is that in order to reduce the risk of failure to recoup investment, a company plans on recovering what it has spent within the first 6-24 months of a product. Pharmacutical companies are no different. Despite how much it costs to MAKE the products, its the cost to DEVELOP them, and the financial risk the company has to collect on, that means they are very expensive initially. Particulary as you Americans love your litigation, thereforeeee as long-term effects of drugs aren't known for many years... there is a risk factor associated with long-term gains to be made from drugs. Not to mention using money gained to increase effectiveness of the drugs and aid in future drug research.

 

Here in NZ, the government funds approved drugs for all conditions as part of our public health system. So its "free".

 

The thing about AIDs/HIV that really sucks is that it doesnt matter what expensive treatments a person get, it can only be contained to that person, it can NEVER be cured. The damn retrovirus has worked its way into your DNA and essentially every cell in your body.

At this stage, the virus cannot be cured. The future holds alot of possibilities, gene therapy, nanotechnology, to name but a few. But thats no concern to most of us for the next decade anyway.

 

Remember, there are many, many, MANY viruses that cannot be cured. HIV/AIDs has a DIRECT association with morbidity, so people freak out about it. But viruses like HPV, some strains of which are much more contagious, have casual and unknown morbidity rates and complications. HPV (althought there is a vaccine in trials) is currently not curable.

 

The thing to remember is that this is all nothing new. We have proof current strains of HIV were around in 1959. Since the late 1990's research has indicated that the virus transferred to humans from SIV in primates as early as the 1930's. Examples of articles describing this search are link removed, link removed, and link removed.

 

Remember, retroviruses have an important role to play in human biology. I think 8-10% of the human genome is made up of "Junk DNA" left over from endogenous retroviruses. No research that I can find or that I know of has been able to prove any casual role in diseases such as HIV. In fact I remember reading somewhere that nearly half of the human genome is derived from ancient transpositions. Our DNA is always getting mixed up and mutating. Thats what we are designed to do. If it wasn't for retroviruses and all sorts of other bizarre DNA problems - we wouldn't evolve the way we do.

 

Most people, of course, know retroviruses from the movie "Resident Evil" (damn good movie IMHO

[BrokenWingedFaery]

I love that movie.

 

Now, please don't flame me, but death is natural too...whether you die of a heart attack or something you get because of a compromised immune system.