99% Chance

[StillAnxious]

If I were told that today there is a 99% chance that I would die in a car crash, I would not leave my house. Or, if I were told that if I spent $100,000 on the lottery that there is a 99% chance I would win, I would spend $100,000. I can go on forever about what 99% means to me, so why did I worry so much about HIV.

Ok,

I just want to talk about HIV from a scientific perspective. I am not trying to downplay things and I know that some of you on this forum are living with this every day.

As you all know, I was a worried well. I'm still here even though I have a negative 12 week HIV test. Because HIV is on my mind regularly, I tend to research the topic a bit.

Here is the discussion:

In America there are roughly 1.1 million people that are infected with HIV and this number includes the 25% that don't know they have it.

As you can see that is less than .06% of the U.S. population. Based on these numbers alone, there is a 99% chance that any random partner that I am with does not have HIV. Even if I fall in the 1% and become involved with someone who has HIV, the transmission rate for F to M vaginal intercourse is 5/10,000. That is also much less than a 1% chance of contracting HIV.

With that said, there is more than a 99% chance that I will not contract HIV by having unprotected vaginal intercourse.

Now, I know that HIV does not care about statistics and reality is very different from statistics, but with these types of figures how is HIV so prevalent? I guess from a scientific perspective what I'm really asking is how can this virus continue to impact 56,000 people per year with these types of statistics? That would be an astronomical amount of exposures per day.

[nursegirl6572]

You were doing great till the end.

using your own words...I'll answer your own question for you:

**how is HIV so prevalent?**
ANSWER?  It's not!

WHY?......
As you can see that is less than .06% of the U.S. population


The #'s are VERY important in realizing that the actual # of people infected in the US is TINY compared to just about every other illness and disease out there......which, btw....the other diseases/illnesses being MUCH easier to get/develop.

Bottom line...HIV is a VERY DIFFICULT virus to transmit, period.  As soon as people stop over-dramatizing HIV, then these irrational fears will cease.

Protect yourself during sexual intercourse, and you have nothing to worry about.  It's as easy as that.

(Now..you were wondering why a thread of yours got pulled?  B/c you cannot move on despute your clearly NEG results.  I suggest for your OWN mental health, you do so.  You are still over-thinking this WAY too mucj)

[nursegirl6572]

Picture HIV transmission as having to hit a 1 cm bullseye from 20 miles away, with trees and shrubs concealing most of the target.... plus, you are blindfolded, and having to shoot with your toes.  Not very likely huh?

If people were to worry themselves sick about the possibility of hitting that bullseye under those conditions...you would think that is silly, no?

[StillAnxious]

Thanks nursegirl,

I don't know why the topic interests me so much. I'll move one.

[Thankful613]

Your stats for f to m transmission are bs and outdated.  They were compiled from long term serodiscordant couples.  In those type of situation the infected individual had chronic infection, was likely on meds so the vl was low and there were no other stds.  The lancet recently published a report saying that the transmission risk in the general pop is much higher.  Also, your population analysis is wrong.  Less than 1% of the poplulation is true, but if you consider that a large % of the population is either not sexually active, or married then that removes a whole chunk of people.  The real question is what % of sexually active people who you are likely to sleep with has HIV.  That number is much greater than .06%.  Just be safe, and you wont have to worry.  It isnt worth it!

[wonderingaloud]

my two cents, 12 week test conclusive.....period regardlessof your risk. In addition if you want to feel better about numbers 51% of HIV is caused by sexual encounters of those 35-6% MSM, another 11% hetero sex but Male giving to female leaving about 5% from female to male.  It is difficult to transmit the virus to begin with and Female to male the most difficult way as evidenced above.  trust the results you are negative period there is no ifs and buts if you did not have any other risks during the window period you are negative. I know it is hard to believe many people already plan their lives living with HIV during the window period I am no exception and despite the feeling you should be punished because you are guilty of something get over it thats not what this is about.  This is science baby and the science says negative tests outside the window are definitive without exception.  All the best.

[joggen]

Drs. Hook and Handsfield repeatedly quote 1/2000 risk for f to m transmission. Given their credentials, I would trust that they are on top of the medical literature, and not bandying about statistics that are "BS" and "outdated". In science, one study is usually not robust enough to suddenly throw out the conventional wisdom like a Copernican revolution. Also, most of the studies that these estimates were based on were pre-HAART, FYI.

Further, the chance that someone outside of the major risk groups (MSM, IV drug users, etc.) has HIV is far less than 1%, including those who are sexually active.

Please read the Archives in the Expert forum on these topics before you post about them again. Unfortunately, it is your post that smells of non-scientific BS and is unnecessarily alarmist. Thank you.

[ECN44120]

Nice discussion wrong statics, first there si aprox 1.1 million americans with hiv in the US, but there is not 300 million sexual active people in the US, without the kids, older people, nuns, ect, there would be around 150 million of sexualy active people so the prevalence on a random sexual partner is almost 1%, so then when the risk of transmission where calculated they where calculated in "normal" circunstances, and they can be much higher or much lower depending the case.

As for your question "but with these types of figures how is HIV so prevalent? I guess from a scientific perspective what I'm really asking is how can this virus continue to impact 56,000 people per year with these types of statistics" Well thats easy

First of those 56.000 more than 30.000 are gay or bi men, lets asume that from the 150 million sexual active americans the 10% are gay or bi men, so there are 1.5 million gay or bi american men , and from them aprox 600.000 has hiv, so the prevalence among gays or bi men is 40%. from the 900.000 not infected with hiv, lets asume the 10 % (90.000) do receptive unprotected anal sex, (infection chance 1 in 200) 75 times in one year, then you have 90.000 x 75 x 1/200 = 33750 infection among gays or bi men per year, the same aplies to all, in their respective category.

Anyway it doesnt matter if the prevalence or infection chance is low, the important thing is that is REAL, and using a sinlge latex or poliuretane condom can prevent it.

[Thankful613]

Here is the article.  It is about a study posted by the Lancet, which was presented in Mexico City.  http://****.***
I have read the archives.  I just dont rely on them as my only source of info.  

Dont believe me.  I am an anon poster on the internet.  But I actually cite to my sources.  If something is published in the Lancet and presented at the international hiv conference, I think it should be taken seriously.

I totally agree with ECN's final comment.

[Thankful613]

Ok, got ***'ed out.  Try googling
HIV risk from heterosexual intercourse may be underestimated

[lesbin]

If you have experienced the following symptoms either over a long period (such as over six months) or for a shorter duration with greater intensity, you should seriously consider seeking professional assistance for possible problems relating to anxiety. This is particularly the case if you think that the symptoms are not clearly related to HIV or some other physical condition.
Have you felt excessive anxiety and worry, occurring more days than not, about a number of events or activities?
Do you find it hard to control the worry?
Do you feel at least three of the following symptoms: restlessness or feeling keyed up; being tired easily; having trouble concentrating or feeling your mind go blank; being irritable; feeling tense; having difficulty falling or staying asleep or having restless, unsatisfying sleep?

[regularjoey]

No, the statistics you are mentioning are not an underestimate.
The risk of transmission from female-to-male is relatively low, around 1 per 2000 exposures.
It still takes only ONE time to get infected though.
Because there are factors that increase the risk substantially (high vl, bacterial stds, drug use etc.)

[Thankful613]

Joey:
I agree that under ideal conditions the risk of transmission is low (infected partner has a long time infection; no other stds etc etc.)  However suppose the infected female only recently contacted the virus.  In that case, infection would be much much more likely.  So, because in the typical one time real exposure with an unknown status partner, you really dont know whether an exposure occurred under 'ideal' conditions, transmission statistics are really useless.  But like I said, this isnt really just my opinion.  It is all in The Lancet study.

[joggen]

Thanks for providing the link (or a way to find the article anyway). I didn't realize it was so recent.

I've skimmed the article and I don't see anything earth-shattering. I have never seen (at least not on the M.D. forum) the 1:1000 estimate that is commonly quoted purported to be a "one size fits all" risk as the authors suggest, but an average risk that assumes no other risk factors. I agree it doesn't apply when factors that increase transmission risk such as other STDs, acute infection, absence of male circumcision etc. come into play. The study's basic findings, that infectivity is higher in people with one or more of these risk factors is nothing new and has been discussed repeatedly over on the M.D. forum. I think what needs to be examined more critically is some of the infectivity estimates that their number crunching came up with based on the individual risk factors.

I'm hardly an epidemiologist, but it seems that a major flaw in their study was not limiting the studies in their metaanalysis to serodiscordant couples (index cases). The studies that are the outliers with much higher estimates of infection such as Baeten, Cameron, Mastro, and Satten relied on estimates of prevalence to determine the infectivity estimate. It looks like all but one study (Hira) of discordant couples had an infectivity in the range of .17-1.39/ 1000 exposures. Yet they appear to rely mostly on the cohort studies, rather than index cases, in their estimates of infectivity according to transmission cofactors such as circumcision and genital ulcer disease.

So, I think it is wrong to conclude, for example, that infectivity is 10-100x higher in people with genital ulcer disease, because of the weakness in the methodology of the studies that were used in the meta-analysis. And I don't agree with their conclusion that 1/1000 is a "lower bound"- it is an average that applies to the majority of people who don't have other risk factors.

[Thankful613]

I suppose that it comes down to the difficulty of doing these studies.  As you say, the ones that are most scientifically sound are the ones involving long term serodiscordant couples.  But, I think those are also most likely to give the most optimistic results.  Such situations such as the recent questioner about a gf who has had hiv for 7 years, and another recent poster from South Africa who slept with an HIV+ women for 3 months are usually monogomous, with relatively healthy people who have long term infection and low vl.  In those cases, the stats on infection seem to be pretty right.  
On the other hand, it would be impossible to do a study finding how many one night stands where one partner is positive end up in infection.  Those are probably the situations with the highest other risk factors though, and also are much more common questions on this board then questions about just finding out a long term partner is positive.
I guess my major problem with giving out stats makes it seem like it is ok to have unprotected sex because of odds.  While the people who post on this board are generally more worried than they should be about infection (how many questions about 'insertive masturbation' do we really need) the general population is probably less worried than is warranted (55k infections per year is just heartbreaking.)
Interesting discussion though.

[regularjoey]

People here commonly do not interpret the "1:2000" statistic correctly. That's an AVERAGE, that's all that is. The "average" includes everything: partners with high vl and partners with low vl, partners with std and partners without std, intercourse lasting 30 seconds and intercourse lasting 30 minutes, etc., etc. Of course, if you have sex for 30 minutes with a woman who has high VL and chlamydia, your risk of infection is not 1 in 2000, it's much much higher. Like I said, it only takes 1 time to get infected, not 2000. So the "1:2000" odds does not imply that anyone should feel good about practicing unsafe sex with streetwalkers, not at all!

I agree with you that results from studies involving serodiscordant couples tend to be very optimistic, for the very reasons that you mentioned. That's why nobody puts too much weight into those studies.

[Teak]

There are a lot of weight put in those studies. Those studies are the only ones that can be verified.

[Mick1981]

I think you should be way way more worried about HSV than HIV....

About 80% of the American population alone have HSV and it is way way more easier to catch than HIV...

I contracted HSV1 by reciving oral sex for not even a minute from someone who was not even displaying any visable sores, but had one that cleared 1-2 weeks prior.  :-(

[LIZZIE LOU]

who are you talking to?  that post is 10 months old

[Teak]

You should be looking at the date before replying to a thread.