Validity of DR.HHH'S Comments

Dear All,

Please read the following thread, especially what Dr.HHH says in his 2nd response..

http://www.medhelp.org/forums/HIV/messages/1044.html
"The question is the ultimate hair split. There is no precision to that statistic. Maybe it's really in 1 in 5,000, 50,000, or 100,000; nobody knows. But all these figures mean 100% efficacy for practical purposes. Think about what 1 in 10,000 means. Your risk of dying in an auto accident in the next week probably is at least that high. It also means sex with an HIV infected partner once a day for 27 years before you would expect to catch it."

The DR also mentioned somewhere else that in case of unprotected vaginal sex with an infected woman is 1 in 1000. Which means having sex with that person once everyday for xyz period before u can expect to catch it.
DOES ANYONE ELSE THINK THIS IS AN IRRESPONSIBL STATEMENT?

Please lets discuss.

[exww]

Yes,i do

I raised the frist post where he said you can have un-protected sex for 5 yesrs with out getting infected.

But me did not get much reply.

I think a resposible preson can not do that.

It is also happented that one person oppoesed it in the same post(Dr.post) and he got warned and his responce removed from the forum

[freak_2007]

He pretty much deletes all the messages from people who don't agre with him or question his logic. I respect him for his expertise and service he is doing but saying something like that is outrageous. Imagine the false assurance people might feel thinking they can not be infected for 5 more years and so they are sae to practice unsafe sex with whomever they want. Oh God...thats frightning..

[exww]

Yes, i think the best way to stop HIV at this time is to stop unprotucted sex. So
people should be advised like that.

Even through statistics have the value it's interpretation should be done cleraly.At that point i think he fails.

It will be a disaster if one start/continue unsalf sex after reading that comment.

I too have a resonable responce to him. That i git from reading many of his replays.

But recently some replay acually leads to wrong direction.

I am sure that this discussion here may help some people or this may alao leads to banning me from med help.

ANy way we should say the truth . It is like saying king is naked.

S

[ExtremelyWorried21]

I can see why it's easy to misinterpret some of Dr HHH's answers.

Of course he's not saying that you can go and have sex with a HIV+ person for years and you won't become infected. What he means is that it's POSSIBLE to have sex with that person for years without infection.

For example, Insertive vaginal sex is like playing Russian roulette with a 2000 chamber revolver and 1 bullet. It is POSSIBLE for you to keep pulling the trigger, then spinning, and then pulling the trigger and never actually shoot yourself in the head.
On the other hand, it's also possible you could be unlucky enough have the bullet land in front of the pin on the first spin. You never know.

With respect to him, I think he could have worded his response in the post's you motioned a little better, as not to cause confusion.

It's important to remember that Dr HHH is the professional here and we should not criticise his word if we do not understand where he's coming from.    

[monkeyflower]

Well, statistically speaking, it isn't quite accurate to say that a 1 in (insert appropriate number) risk means that you can do (insert activity) that many times before you contract it. But that's not what he means. Extremelyworried 21 has the right interpretation.

I think that guilt, negative messages about sex, lack of accurate info, whatever, are leading you to nitpick and obsess over every single word, every single perceived discrepancy. I also understand that under those circumstances, you find these kinds of comments "irresponsible". However, they're an accurate representation of reality.

I think it's safe to say that almost no one on this board has anywhere near a realistic view of sexuality and/or STDs. Sure, there are some who behave irresponsibly on a regular basis. But MOST use condoms, get tested once a year, and don't think anything of it. Of course, I guess that probably seems irresponsible to people who are freaking over kissing or fingering.

[Teak]

"It's important to remember that Dr HHH is the professional here and we should not criticize his word if we do not understand where he's coming from."

If there is any time that you disagree with your physician, either you have them explain their reasoning  or you go get a second opinion. You don't agree with them just because they have an M.D. after their name. Physicians make mistakes just like everyone else, but their mistakes can be more life threatening and forever.

[amiscrewed]

He is an expert alright, he is a professional in what he does so therefore he should advise and choose carefully how he advise people!!! a lot of his replies are very disturbing and give people a false sense of security. One of the post where he said that SW in thailand have a low hiv percentage, WTF??? Anyways, you have to donate $15 for his advise, i rather keep that 15 bucks and buy me a bottle of vodka. I find better response here in the forum than his comments.

[freak_2007]

To Extremely worried,
"Of course he's not saying that you can go and have sex with a HIV+ person for years and you won't become infected. What he means is that it's POSSIBLE to have sex with that person for years without infection."

This is what you said. But this is what doctor said
"Your risk of dying in an auto accident in the next week probably is at least that high. It also means sex with an HIV infected partner once a day for 27 years before you would expect to catch it."


So, of course the doctor IS saying that you CAN have sex with an HIV+ person for 27 years or whatever before you can be infected"
So for a person looking for meaningful answers (especially after paying 15 bucks) this doesn't sound like just a "POSSIBILITY". it sounds like a CERTAINITY. I understand the Russian Roulette analogy but thats just an analogy that makes it easier for the doctors to explain the situation to a layman (like us). But is it not more prudent for the doctor to advise the patient NOT to play Russian Roulette rather than telling him he can play it for 1999 times before expecting to be shot?

To monkey flower

"I think that guilt, negative messages about sex, lack of accurate info, whatever, are leading you to nitpick and obsess over every single word, every single perceived discrepancy. I also understand that under those circumstances, you find these kinds of comments "irresponsible". However, they're an accurate representation of reality"

Looks like you have made a judgement about me after reading one post from me. Anyway, lets not get into guilt and other things because we all are part of that ordeal, i am no exception. But what caught my atention was "lack of accurate info".May I ask, what "Accurate info" do you have? Are you a doctor? Have you read any journals about? I am guessing your info is as accurate as mine which we both acquired from the internet. And this is not a single perceived discrepency, incidentally, the Dr. had said the same thing a few times before which means thats what he believes. I mean all of us ARE in those "Circumstances". And can you please clarify which accurate reality you are referring to? HOw does th doctor's comments represent an accurate reality? So is it a reality that people don't get infected for a long time when they are having sex with them unprotected?

I am sorry but I am not being confrontational. This is just a rational arguement. nothing personal. God bless all......

[rational_irrational_fears]

Extremely woried,

I guess I understand the Russian Roulette thing but isn't it better to advise people not to play Russian Roulette rather than assuring them they can play 1999 times before they can get shot?

Monkeyflower

[rational_irrational_fears]

Extremely woried,

I guess I understand the Russian Roulette thing but isn't it better to advise people not to play Russian Roulette rather than assuring them they can play 1999 times before they can get shot?

Monkeyflower
From your comments and judgements (guilt, lack of accurate info, etc. etc..) I was wondering if you are an infectious disease specialist and if you are aware of all the HIV info in the world, like for example, the exact factors that lead to viral transmission and exact way a person's immune system reacts to it and the growth patterns of the virus in thebody or for that matter, why does the virus does not transmit so many times even if you have sex with an infected person, but suddenly one fine day it does.. I know you will start quoting the statistics and stuff but you couldn't even explain those things either (in your discussions with amaravatiboy on the other forum, he was coming up with a very accurate mathematical details of the statistics and you kept citing this one link which has one table..I wonder if you have evenbothered to decipher that table..
I empathize with you on many things and I respect you for the great work you are doing here and i also understand that you are a sex educator but don't you feel little odd when everybody who posts here becomes an xpert on the subject within such a short time? Please refrain from making judgemental statements and demeaning others analytical capabilities. We are all here for the support and as many facts as possible. false information doesn't help.

Cheer
s

[monkeyflower]

I'm not providing inaccurate information. And I stand by my position. I also stand by my characterization of the average poster on this board. It's not just you. It's a description of the worried well in general.

I'm not a scientist or infectious disease specialist. But then, neither is anyone else on this board (Dr. Handsfield, however, IS, despite the fact you disagree with his advice. I would argue that his advice is rational, based on real-world statistics and experience, and yours (the collective you) is derived from personal anxiety, lack of information, and discomfort with ambiguity). But I do okay. I'm reasonably rational, well read, and able to think and read critically. Apparently a vanishing art.

"To start with the probability figure is 1 in 1000 exposures...(this assumes that 1 person is infected and others not)
Now after the first infection ..there would be 2 people infected so the cummilative probability would be 2/1000......still low!!
...this would continue to remain remain low initially..but after a while. the cumulative probability value would start getting into the "not so low" region."

His interpretation of the data is wrong, and that's what I was pointing out. The CDC table I quoted (and despite the fact it's the government, I think we can trust their methodology) clearly states that the risk is PER ACT with a known HIV infected person. The way that works is just that every act of (whatever) with a known HIV infected person results in (whatever) chance of infection. Of course you could be the one out of a million. But chances are you won't be... and that's my point.

But really, I guess it depends on what you feel comfortable with, and that's something only you can decide. For some people, 1 in a million feels very scary. For others, 1 in 100 feels okay.

[freak_2007]

Hi all,

the above posts from freak and rational_irrational fears are all from me. I changed the ID because my first reply with freak id did not get posted for a long time so i thought may be my id has been blocked.

But I will be posting with this id.....

My 8 weeks was up yesterday....am going for a test this saturday

Cheers and God bless all...

[Teak]

Then what you are saying, if one feels comfortable about not having protected sex, there is no need to test? Is that what you are saying? A piece of paper with statistical figures should never gauge if one should or should not test. If one has unprotected sex outside of a monogamist relationship, they should test. When it comes to testing it is not a guessing or statistical game, you test, that is the only way you will know your status. The best way to avoid the issue is to always wear condoms and use plenty of water base lube or not have anal or vaginal sex at all.

[dumbo]

WTF is wrong with you people?  Let me explain the reason why people "question the validity" of Dr. H's advice....it is very simple.  Because he tell the truth that nobody is used to hearing and some do not "like" hearing, such as Teak and special interest groups.  Period.  End of story.

I have said this 2,322,155 times but will say it again.  Dr. H would have had his licence revoked and would have been sued many times over if he was wrong in his assessments.  People would be dropping like flies in "His" clinic, that "he" runs and has for many many years, if he was wrong in his approach to assessing and acting on potential risky behavior.

I highly suggest you people think very hard on this.  It would be well known he was a quack if the above happened.  People just can't handle his assessments because he is so confident and people just simply are not conditioned to hearing that about HIV.  Plain and simple.  

I am still amazed at how all of you ask him a question, he answers, yuo are so happy, then you start reading in here, and become convinced he is wrong simply because you hear a repetitive message from one single individual.  You are all sheep and obviously cannot use your own heads to think.  You just follow the herd wherever they may venture that day.  

If this whole website disappeared, people would be sitting in their house living in fear because they have lost that comfort of reading actual responses from a REAL Dr. with a lifetime of experience in STD's and HIV transmission/risk.  These same people would be crying to bring it back and would promise to "love" the Dr. this time if he would just come back and help them.  That is FACT.

really, "think" about it......it is simple repetition.....like brainwashing, if yuo hear the same thing over and over as you do here everyday from Teak, then you start to believe it, such as what is happening to posters in this specific forum.  You start to question the Dr. simply because he is not responding numerous times to a thread.  Teak "teaches" by fear, the Dr."teaches" by fact.  I can see why people lean to the fear "teachings" though, I mean it is a fear based society now.

carry on.

[ExtremelyWorried21]

Well said

[monkeyflower]

It is not as black and white as you (collective you--all fear-based ed proponents) seem to think. Saying that an activity is low risk doesn't mean you should just throw caution to the wind. Of course you should use appropriate protection, choose partners wisely, etc. Why do you think it has to be one or the other? I believe in the low risks I quote. Yet I still use condoms for all but oral, and I still pick my partners reasonably. I would say that's completely true for everyone I know, and for most people in the real world.

The problem is that these fear-based strategies really only impact people who are at low/no risk, who are by nature conservative and probably anxious around sex in general. As you can see, virtually all posters here are in a panic over VERY low/no risk encounters (kissing, fingering, unprotected oral, one instance of unprotected vaginal). It is very, very rare to see anyone with a real risk post any kind of question or request for support.

Fear-based sex ed is a total bust. It doesn't impact the right people, and it actually triggers the behavior it attempts to prevent. If someone is afraid of STDs/whatever, they aren't prepared physically or emotionally to be with someone else. Yet sex is a mighty powerful urge, so maybe they're out drinking, their inhibitions reduced (or even not), and they make incredibly bad decisions to pick up the wrong partners, in the wrong places, and have unprotected sex. The whole down-low phenomenon is all about fear and shame, and it results in (guess what) really unsafe sex. And you know what unsafe sex leads to? An increase in the STD/HIV rates!

Now, imagine what it would be like to know the real risks around sex, and know and accept that being sexual is important and okay. You would have condoms, for one thing, and you would be able to THINK rationally about partners, situations, activities. You could comfortably walk away from a risky situation.

So, my interest here is in lessening some of the fear and maybe, just maybe, triggering a more rational view of sex and STDs, so that people can actually begin to have enjoyable, fulfilling sex lives--or at least have the potential to do so, anyway. Because it really IS possible to enjoy sex without hysterically spinning out of control afterward. Believe it or not, sex really is fun :-)

[Teak]

Those three are examples why HIV continues to spread. "Pick your people? If you are comfortable?" When you post your remark Monkey you didn't explain to people that you meant oral when you stated "comfortable."  I want any of you three to go to any other website and make those assumptions and post them. You don

[monkeyflower]

Sorry--do it on WebMD all the time. And I do not, ever, knowingly post inaccurate info. In this case, my information is indeed accurate. You may not agree, but then you don't have to.

In fact, you and I are never going to agree on any aspect of HIV risk, prevention, transmission, anything. We both have an agenda--yours is based on having HIV, and mine is based on wanting to help people have reasonable sex lives. I've clearly stated my case and my rationale.

I fully realize your view appeals to the overly conservative, frightened, uninformed poster, because it only confirms what they believe and are most afraid of. You also have what they most fear. My posts offer another, real-world perspective. If they only ONCE help someone stop this cycle, and start thinking and making rational choices for him/herself, I will be happy.

None of us are experts on this subject. So, I'm not going to continue these kinds of unproductive discussions. I will, however, continue to post my opinions and the supporting documentation. You will do the same. People reading our posts will continue to decide for themselves what they want to believe.

[freak_2007]

I guess that id suits you very well. Anyway, after reading your long post, there was not one thing that anyone could use for any purpose. Anyway, before you accuse other people about being sheep and following the herd and not being able to think on their own.....I wonder what is it that you are doing. All you do is read Dr's comments and take them as God's words. You don't even have the rational mind to question a discrepancy. That is because you are devoid of any rational thoughts. that shows how incapable you are of thinking on your own. No wonder you chose the right ID.

You say teak talks fear and the doctor talks fact?

*A majority of sex workers in Thailand  don't have HIV
*The question is the ultimate hair split. There is no precision to that statistic. Maybe it's really in 1 in 5,000, 50,000, or 100,000; nobody knows. But all these figures mean 100% efficacy for practical purposes. Think about what 1 in 10,000 means. Your risk of dying in an auto accident in the next week probably is at least that high. It also means sex with an HIV infected partner once a day for 27 years before you would expect to catch it"
*A sexworker's mentrual blood on the penis is no/little risk"

Which of these statements appear facts to you? The plain and simple truth is he may be a very experienced doctor but he is careless sometimes when it comes to giving opinion. It has happened thousands of times when he gives a wrong reply and then corrects himself later saying he didn't read the whole post. That SHOWS how negligent he is.
THE DOCTOR IS AN EPIDEMIOLOGIST AND NOT A MEDICAL PRACTITIONER. HE DOESNOT SPECIALIZE IN MEDICATION/TREATMENT OF HIV PATIENTS.

You come here, read a few posts and think you are an expert. Thats your problem but go **** yourself if you think other people are not capable of thinig for themselves. Your posts are as irrational as some of the doctors comments.

[dumbo]

I am not going to use up energy on this same old debate again, but again, you take comments out of context.  NOBODY here has ever said go **** someone without a rubber....ever ....and be irresponsible about our health.  The fact is, is that unprotected sexual activities happen in the millions every single day, yet few become infected with hiv unless they follow certain behaviors, again as the actual stats show time and time again.

Yes we all know it only takes one time, but it could (and ususally does) take many times of risky behavior, or of course it could be the first.

Your fear based teaching is wrong and if you truly want to help others, fear is not the way to do it.  Give people the info, the "right" and honest info, and let them make their own decisions.  You try to scare people into not enjoying sexual activities, and that is wrong.

I completely understand why you do this, you do not want others to go through what you are.  But the fact is, it is like children, they need to learn on their own and make their own mistakes.  A parent would never teach their child using fear tactics, that child would never function well in society.  Teach them how to do things properly and hope they learn from that and make the right decisions.  Teach them how to look for cars before crossing the street in a calm rational manner, not by scaring them so much they cry everytime they see a walklight........ I am sure you see what I mean.

[Teak]

Who asked you for your opinion? If someone wants statistical numbers then they will ask you. If they want to know their status they TEST, pure and simple. Numbers have no bearing on people's risk or status; it's just a bunch of numbers that were compiled by the way, by PEOPLE TESTING.  As for people fearing HIV, THEY SHOULD.

[Teak]

Good, starting backing up your claims with scientific facts and studies. You continue to make HIV look like it's a common cold and all is well and I'll continue to educate  people with the facts of how to protect themselves and testing. Yes, what you state is your "opinion" what I state is "FACT." So let's see if you do your part and post scientific facts.

[dumbo]

freak says"I guess that id suits you very well"

Oh, gee, that's the first time I have ever heard that.  Did it take you all day to come up with that one?

LMAO....puppets on a string man, puppets on a string......

[Teak]

At least that puppet is knowledgeable dumbo, unlike yourself.

[freak_2007]

Well it took you more than a day as well to come up with your response, which of course as I expected, is the best possible "Scientific" and "rational" response you could give. You know there is something called time difference in different countries. But, don't think about it, you will sprain your brain.

[dumbo]

I wonder if it's because I don't sit here 24/7 like you freaks???lol

http://www.imdb.com/gallery/ss/0372588/TA-DF-01744.jpg.html?seq=37

puppets......

[kentucky08]

ok reading this discussion has me scared even more about the "do and don't" the "no risk", "low risk", "high risk" of hiv.  can a man receiving oral sex contract HIV and should he get tested?  i have asked this several places but after reading this discussion i am worried about all i have heard.  I am the scared, conservative, and all the other adjectives you used above and I am just looking for advie and truth i can depend on.

  I am asking the "stats" person, the "real world" person, the "dr", i don't care, but this whole discussion has me doubting the "truth" and advice that i have been getting during the scariest 2 weeks of my life.  

please help!  I am so confused

[LIZZIE LOU]

move on

[Wear/a/Jimmy]

The problem is that these fear-based strategies really only impact people who are at low/no risk, who are by nature conservative and probably anxious around sex in general. As you can see, virtually all posters here are in a panic over VERY low/no risk encounters (kissing, fingering, unprotected oral, one instance of unprotected vaginal). It is very, very rare to see anyone with a real risk post any kind of question or request for support.

Fear-based sex ed is a total bust. It doesn't impact the right people, and it actually triggers the behavior it attempts to prevent. If someone is afraid of STDs/whatever, they aren't prepared physically or emotionally to be with someone else. Yet sex is a mighty powerful urge, so maybe they're out drinking, their inhibitions reduced (or even not), and they make incredibly bad decisions to pick up the wrong partners, in the wrong places, and have unprotected sex. The whole down-low phenomenon is all about fear and shame, and it results in (guess what) really unsafe sex. And you know what unsafe sex leads to? An increase in the STD/HIV rates!


Paragraph one and two looks to me like pure opinion, any facts to support the above claims?  

[regularjoey]

Fear-based sex ed is a bust, that's a well-accepted fact. Preaching abstinence fails to stop the spread of HIV, that is known. Teaching people how to use condoms and the importance of testing on the other hand is much more effective.

[nursegirl6572]

I just think education, *period* is lacking.  I am constantly amazed at the people in this day and age that STILL think HIV can be transmitted via casual contact, from environmental surfaces, etc.  NO matter HOW much reassurance you give....they still want to know if testing is in order?  It just blows me away.

I understand the "fear factor" and the fact that some educational programs prolly ARE responsible for the way over-inflated viwes that people have, which is so sad.  It needs to be taught in EVERY school, openly and honestly.....and I also agree that teaching about proper condom use is needed as well.  How many people come here with..."I was wearing 10 condoms, a biohazard suit, my grandma's babushka and a hefty bag, why did I have an exposure?"

;0)

Ack!

[panther77]

People whether the risk is 1 :1000 or 1:10000000 the FACT is that there are people dying from AIDS and getting infected with HIV today more than ever ... and we are talking about millions around the world ...
Therefore, people should test if they put themselves in risk ... any risk even if it is minimal and 1 over a billion it is still a risk.
this is the only way we would be able to put an end to this virus ... people should think about puting an end to this virus at this stage and not only protecting themselves ...
TEAK God bless you for what you are doing ... I think you are putting people on the right track ...
The right information is anyone who does unprotected sex is at risk .

[nursegirl6572]

AIDS and getting infected with HIV today more than ever

Actually, that is not entirely accurate.  There has been a decrease over the past decade in the amount of new cases being reported.  Of course it is still out there and a very big problem, but fortunately with the exposure it has gotten since the 80's.....people HAVE started protecting themselves....and the "spread" per se has levelled off.



The right information is anyone who does unprotected sex is at risk .

That I couldn't agree with anymore.  Anyone that has sincerely placed themselves at risk needs tested.