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Exceptions That Prove The Rule

May 09, 2010 - 5 comments



Hiv anxiety




internet education

It seems that recently people have been compelled to post reports or publications of extraordinarily rare, isolated events in an attempt to "disprove" the advice of the HIV Prevention Community experts. Recent topics include delayed seroconversion, false negatives, and oral sex. Thanks to the Internet, publications of such freak occurrences can be easily found with enough searching. What is important to understand is that when you educate yourself about HIV through "Google University", you will inevitably misinterpret the significance of what you are finding.

The reason why these incidences are published in the first place, is because they are so unusual. The very fact that these are being published as case reports means that they fall outside of the scope of accepted medical knowledge. Nobody is going to publish a case report about somebody getting infected with HIV through having unprotected anal or vaginal sex, because we know that that these are established routes of infection. Using a journalism metaphor, these reports fall into the category of "man bites dog", rather than "dog bites man."

The doctors on the expert forum frequently talk about "exceptions that prove the rule". The fact that something that happens at a frequency of 1 in several million is reported does NOT prove your belief in delayed conversion, transmission through oral sex, etc., it simply reinforces the fact that it is completely contrary to the huge body of evidence that indicates that such events do not take place with any measurable frequency. In contrast to well controlled, repeated studies that prove the exact opposite, case reports are the weakest scientific evidence available by their very nature.

When you take isolated publications out of context in view of the MILLIONS and MILLIONS of cases in which seroconversion was detected within 12 weeks, etc., and argue that such exceptions PROVE that conventional wisdom is incorrect, you are completely distorting the picture. It is the equivalent of arguing that, because there was an incident where somebody died as a result of a plane hitting their house, living above ground is not safe, and therefore we should all live below ground.

Unfortunately, when you post this stuff in the HIV Prevention Community, all you are doing is fueling people's anxiety (not to mention your own). People with HIV Anxiety almost always have the irrational belief that they are somehow the exception. Anxiety distorts people thoughts and makes them think out "what if" scenarios; when you post crap about false negatives, etc. all you are doing is feeding into people's fears. The people who come to the HIV forums need to hear the TRUTH, not the rare exception. These reports do not provide relevant information for people's concerns, and can be very harmful.

I urge you to please THINK about the significance and consequences of what you are posting before you post links to articles in the HIV Prevention Community. Finding an article through a search engine does not make you an expert on the topic. If you want to educate yourself and others about HIV, your best sources of information are the repeated comments of MH's doctors.


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Avatar universal
by september198, May 09, 2010
thank you for what you wrote. i suffer of HIV Anxiety,and i have to tell you that it is makes me go crazy sometimes, and yes i`ve been reading a lot about HIV infection on the internet, and it made me feel that i am the exception... i could be tho...?!? i did my test after 6 weeks, it was negative, and now i`m just waiting for another few weeks so i can do it again- after 12 weeks... until than i will try to stop searching on the internet about this subject... i will sure go crazy if not...


Avatar universal
by Vance2335, May 10, 2010
Well done joggen...right on the money.

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by naveea, Aug 31, 2010
Nice Journal..

"The fact that something that happens at a frequency of 1 in several million is reported does NOT prove your belief in delayed conversion, transmission through oral sex, etc"

Dont you think if delayed serocoversion does happen 1 in several million ,dont you think that 1 person should also be considered while definining the window period

How do we know we are not the 1 in Million,,,,well we never know.....

Avatar universal
by Vance2335, Aug 31, 2010
No that person should not be considered while defining the window period. How do you know...because it never really happens. 1 in a million is a bad estimate, try 1 in a billion. You want to worry about 1 in a billion go right ahead and drive yourself crazy but the HIV forum will not, nor will any Dr.

Avatar universal
by joggen, Aug 31, 2010

Worry about more realistic scenarios- like getting hit by lightning.

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