Talk:HIV/Archive 4

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Is this graffitti?

In Tropism, the sentence "Dual-tropic HIV-1 strains are thought to be transitional strains of the HIV-1 virus and thus are able to use both CCR5 and LESTR as co-receptors for viral entry." appears to be vandalized; "LESTR" should probably be "CXCR4". 24.82.209.151 (talk) 10:19, 7 December 2007 (UTC)

Male circumcision recommendation not intended for all men, only those in South Africa, Kenya and Uganda.

After reading the article I felt it acknowledged most of the important information but misrepresented one particular point through a generalisation. Under topic 4 - Transmission, the following was written: "a panel of experts convened by WHO and the UNAIDS Secretariat has 'recommended that male circumcision now be recognized as an additional important intervention to reduce the risk of heterosexually acquired HIV infection in men.'[27]"

While this is true, I felt it was misleading to the readers as this implies that the panel of experts recommended that male circumcision be recognized as a method of intervention to acquiring HIV to all men in the world. However, their decision to include circumcision as a method of intervention was only applicable to the countries that they studied (South Africa, Kenya and Uganda). Extrapolating these results into a recommendation to all men, including those who live in very different places would not hold up to scientific scrutiny. Since this is the impression the article gives, I believe it should be changed to reflect that: "a panel of experts convened by WHO and the UNAIDS Secretariat has 'recommended that male circumcision now be recognized as an additional important intervention to reduce the risk of heterosexually acquired HIV infection in men [who live in South Africa, Kenya and Uganda]'.

To provide greater strength to this point, I came across an article that has been published in several newspapers and online (I am not sure if it has yet made it into a journal) about a study done on HIV infection in America, again, with the variable tested being circumcision status (http://www.medicalnewstoday.com/articles/90869.php). This is just information about the study which mentions that circumcision status did not appear to be statistically significant in this study.

Incorporating the fact that the experts findings only extended to the countries they studied would remove some of the pro-circumcision bias from this article. Ty.schof (talk) 23:13, 9 December 2007 (UTC)

So be bold and make the changes you'd like to see. It's perfectly reasonable to say this technique worked in three African countries and failed in the USA. WhatamIdoing (talk) 04:16, 10 December 2007 (UTC)

Actually, Ty, I just looked at the cited source, and it does not specify that the recommendation is limited to these three countries. It actually says that it applies to "Countries with high rates of heterosexual HIV infection and low rates of male circumcision" -- a description that applies to basically all of sub-Saharan Africa and not at all to the USA. WhatamIdoing (talk) 20:21, 11 December 2007 (UTC)

Myths

Can we also add myths relating to HIV infections on this page? There are a plenty of them floating among people. —Preceding unsigned comment added by Gvshukla (talk • contribs) 13:02, 10 December 2007 (UTC)

There is already an article for this: HIV and AIDS misconceptions. Is that what you were thinking of? JoeSmack ^Talk 16:39, 10 December 2007 (UTC)

Minor Semantics

Why does it say "HIV was classified as a lentivirus"? To my knowledge HIV is STILL classified as a lentivirus. I could be wrong, but if so the article should say what HIV is currently classified as.Orb4peace (talk) 09:05, 17 December 2007 (UTC)

I think you're reading too much into a historical past tense, but it's easily fixed, "Is" is less wordy, too... - Nunh-huh 09:12, 17 December 2007 (UTC)

Transmission risks

Although the box listing transmission risks lists "receptive anal intercourse" as causing five times more transmissions than receptive vaginal intercourse (50 per 10,000 acts as opposed to 10), the different risks are not mentioned in the text of the article. If these transmission statistics are true, then it would be more specific to say "Receptive, unprotected, anal intercourse is the primary cause of transmission" rather than just "unprotected intercourse". Also, discussion about reasons people choose anal intercourse (such as a method of birth control when condoms are not available) would be useful as well. Link from NIH:

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=10743535&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus Just-unsigned (talk) 17:03, 26 December 2007 (UTC)

I think the sole phrasing 'unprotected intercourse' was chosen for being the largest subpopulation of those infected with HIV in terms of sheer numbers and not chances of infection. As you probably know HIV is spread through three modes: sex, blood and mother-to-child - it is important to emphasize that unprotected sex is the 'big' one. As for the link, we've discussed that it is long in the tooth in places above, do you have any new and replicated research on the subject? Knowledge and research on HIV changes a LOT in 8 years. Hell, it has only been researched for about 25 years. It's not that the study is useless or anything, but the alarms are going off in my head, you know? JoeSmack ^Talk 17:37, 26 December 2007 (UTC)

The statistics cited are found in the box listing causes of transmission (in the article). I assume that they come from cases studied and represent human beings that have contracted HIV. Are you questioning the validity of the statistics shown in the box, or just saying that it would be better not to include what they mean in the text?Just-unsigned (talk) 20:23, 26 December 2007 (UTC)

I have to agree with JoeSmack here. The infobox is a compilation of the probability of getting AIDS through each of those methods, and says nothing about how many worldwide AIDS cases are actually caused by each of those methods. That "unprotected sex is the main source of infections" is what is literally sourcable (an explicit source can be found in the AIDS article). Only if there is a reliable source that specifically says "most HIV infections are caused by anal intercourse" could you actually say that. Someguy1221 (talk) 22:01, 26 December 2007 (UTC)

I already provided just such an article from NIH. The only response I got was that the NIH conclusion was published in 1999 and therefore invaled because it was 8 years ago. The person making that comment offered no other info to refute the NIH proposal. A strange criticism condering the fact that almost all the references for this article are from before 1999. As far as the infobox being a compilation of "probability", the risk factors are based on surveys of HIV postive patients willing to provide information about their sexual history- the same way all human behavioral related studies are done.The only relevant question is "How large was the sample group?"Just-unsigned (talk) 14:28, 27 December 2007 (UTC)

Whoop, I'm sorry, the way you go back and edit what you've already said logged in and not logged in makes it hard to follow conversation. 'Almost all references for this article are from before 1999' is not true at all, look at the refs section again. Also, look how many older studies are cited in pairs or triplets with newer ones so a person can trace back in the research. Some older studies as mentioned somewhere on this talk page do not need to be current as it doesn't reference medical science but progression of thought about the disease, history, important discoveries in important time periods, etc. There are some lone medical science references that are dated and old, and if you can find better references for them, by all means please do. But in a 'from now on' type stance, I'd rather information only be added if it is current. JoeSmack ^Talk 18:15, 28 December 2007 (UTC)

In fact, more than half of the references ARE older than the link that I posted. You simply use the age card when you have no other basis to dissagree. Either show that NIH has changed their opinion based on newer studies, that NIH is wrong based on newer studies, or prove that NIH doesn't know as much about HIV as you.Just-unsigned (talk) 17:02, 31 December 2007 (UTC)

It doesn't really matter since from what I can tell (having read the abstract and skimmed through the full text article) the study doesn't support your claim and nothing in this HIV article does as well. The transmission risk for receptive anal intercourse is much higher then receptive vaginal intercourse (which is higher then penetrative anal intercourse which is slightly higher then penetrative vaginal intercourse), that's quite correct (it's also true BTW as the article mentions that blood transfusion is a very very high risk, it doesn't mean most people with HIV got it from a blood transfusions). And the study appears to have found in the areas researched, the risks of anal sex are not well understood, condoms usage infrequent, more common then many people appear to believe and also a highly predictive factor. However none of this equates to your apparent suggestion that the primary cause of transmission is infection is receptive anal intercourse. To put it simply, the fact that people who engage in receptive anal intercourse are most likely to get HIV from an infected partner does not mean that the most common route of transmission is receptive anal intercourse since there are so many potential confounding factors. You meantioned a table but the only one I see in the Halperin article you mentioned discusses the frequency of anal intercourse in the population survyed (which is a rather small population) not the route (to link the two is classic OR). The only thing which remotely supports your inclusion that I've seen is the conclusion in the abstract which firstly, only says a "significant proportion" not the majority (for example 20% would probably be a significant proportion in some contexts). With the information we have at hand, it's possible for example that oral sex is the cause in 80% with anal sex in 20%. While these figures are almost definitely wrong, I use them simply as an example since it is easily possible (if people with HIV engage in oral sex a lot lot more then anal sex and nearly no vaginal sex). Secondly, it was a conclusion in an abstract of something which wasn't even studied in the study which hardly counts as a reliable source in my book. BTW, I agree that 1999 is quite old for transmission data. If you find any other figures relying solely on such old data except in a historic context I encourage you to discuss and remove them. P.S. It's a bit misleading to call that a NIH study. While it was funded by a NIH fellowship, that doesn't really make it an NIH study. Perhaps your confused by the fact that the abstract is on PubMed. This is of course not surprising if you know what PubMed, but it doesn't in any way mean that the NIH supports the conclusion of the study. Indeed it would be very scary if the NIH are relying on the conclusion in the abstract of one study which didn't even really study what the conclusion was about. P.P.S. Just to be clear, I'm not saying that the study is flawed simply that you have misunderstood it. The study shows that the risks of heterosexual anal intercourse are not well understood by the population and not well addressed in HIV prevention campaigns dispute the fact it a highly risky behaviour for HIV transmission and reasonably common and it suggests that given these factors things need to change. It is not in any way intended to suggest that HIV transmission is most commonly caused by anal sex. If you still don't understand think carefully and perhaps try using an analogy. For example, drunk drivers are generally a high risk factor for accidents (who thankfully are well addressed by campaigns and it is well understood as a risk factor by the population in many countries). This doesn't mean most accidents are caused by drunk drivers this probably isn't the case in most countries since the number of drunk drivers is relatively small but it also doesn't mean the campaigns and public understanding is flawed. (Just to be clear, I'm not trying to make a perfect analogy and not suggesting that the proposed solution is to try and stop anal sexual activity) Nil Einne (talk) 15:57, 23 March 2008 (UTC)

New (2007) Link on Risks per act

Anal sex- 1 in 1300. Vaginal sex 1 in 100,000. This information needs to be a topic in the article.

http://aids.about.com/od/hivaidsstats/f/infectionrisk.htm —Preceding unsigned comment added by 67.62.23.202 (talk) 21:38, 26 December 2007 (UTC)

Please dig up their source, about.com is not an AIDS researcher. JoeSmack ^Talk 00:12, 27 December 2007 (UTC)

Notes and References Section out of date

I noticed that more than half of the notes and references are older than 1999. Some are even from the 80s. I agree with Joe Smack- these are too old to be trusted and should be deleted.Just-unsigned (talk) 17:34, 27 December 2007 (UTC)

There is no expiration date on scientific data. If you can find better studies, then that's great. Unless you're talking about epidemiology work (e.g., how many people in which countries have this disease), then the age of the study is really quite unimportant. Duesberg's 1988 "I think AIDS is caused by poppers" paper has significant historical interest, even if it was written before many WP readers were born. WhatamIdoing (talk) 18:50, 27 December 2007 (UTC)

I agree. Hey- check out this link from the NIH. It is their opinion that most women contracting HIV are actually getting it from anal intercourse and not vaginal. Just-unsigned (talk) 19:42, 27 December 2007 (UTC)

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=10743535&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus —Preceding unsigned comment added by 67.62.23.202 (talk) 19:24, 27 December 2007 (UTC) ==

I've tried to update the German scientists “cure” HIV-infected human lymphocytes link to a specific study, but the poor quality reference make it tough to see which specific study is being referenced in this google search[1]. -Optigan13 (talk) 07:05, 5 April 2008 (UTC)

Anal Sex Overlooked in Heterosexual HIV studies

This topic should be addressed in the artcle: —Preceding unsigned comment added by 67.62.23.202 (talk) 19:26, 28 December 2007 (UTC)

http://www.aidsonline.com/pt/re/aids/fulltext.00002030-200103090-00017.htm;jsessionid=H1JcbpVLkw81vrxGGZtyT05R0LpGTwZtHGWtTByF6W5YZcnf6BZX!1390229169!181195629!8091!-1

Archive?

This page is pretty long. Should we archive the older discussions on this page, and try to start the new year with a clean slate? WhatamIdoing (talk) 19:42, 28 December 2007 (UTC)

A "cleaner slate"? Maybe create an archive page for Summer 2006 to Summer 2007 and archive the threads that have not been added to since last Summer. --JWSchmidt (talk) 20:12, 28 December 2007 (UTC)

Done. --Bob (talk) 21:55, 31 December 2007 (UTC)

Content fork

There is much more information about the transmission and prevention of HIV on the AIDS page than there is on this page. I have proposed that we fix this content fork by moving the information from AIDS over to this page (on the grounds that you can transmit and prevent transmission of HIV, but not really AIDS), and that the AIDS transmission information become a very short "go look at the HIV article" note. If you have any thoughts on this, please feel free to join the discussion on the other page. WhatamIdoing (talk) 19:14, 3 January 2008 (UTC)

Is this already covered in here?

I'm not sure if this is already covered in this page: [2]
- 91.5.187.167 (talk) 16:44, 5 January 2008 (UTC)

Suggest presenting risks seperate from sexual orientation

I give up. Good luck with the article. Just-unsigned (talk) 20:27, 4 January 2008 (UTC)

http://www. associatedcontent. com/article/511395/some_myths_about_aids.html —Preceding unsigned comment added by 67.62.23.202 (talk) 17:58, 5 February 2008 (UTC)

The use of the term "persuasion" above suggests a non-neutral position on an important issue. The consensus, AFAIK, is that people are not persuaded to have a given sexual orientation. Separate from the issue of consensus, "sexual orientation" reflects a more neutral point of view.Scray (talk) 23:04, 3 May 2008 (UTC)

Detailed Information on methods of infection

I found a page on NCBI [3] that gives detailed information about how HIV actually infects cells. I think it should at least be added to the External links. —Preceding unsigned comment added by Ingenium (talk • contribs) 04:10, 3 February 2008 (UTC)

New pictures

I create two new pictures about reverse transcription and integration. Let me know if there are any reasons for changing the content. Wouldn't be a problem. --Crenim (talk) 19:16, 13 February 2008 (UTC)

Zero point six?

This article states: It is estimated that about 0.6% of the world's population is infected with HIV.

Yet in the AIDS article it states:

...an estimated 33.2 million people now living with the disease worldwide.

This corresponds to a near-exact 0.5%.

Both articles cite their respective figures, so I'm not suggesting that either one of these is baseless. However, this represents a pretty significant discrepancy of around 6 million people, or about 15-20% of the claimed HIV-positive population. Maybe someone should decide which number WP wants to go with. They can't both be right. Having a source is not the same thing as having a credible source. --70.131.112.41 (talk) 13:08, 15 February 2008 (UTC)

Then again, both are, as you say, estimates, and neither have to be right. I haven't even bothered checking the sources, as I guess I wouldn't be able to evaluate the validity of either, whether they use different methods for estimation, different underlying material or indeed different publishing dates (probably the easiest thing to check, and one could take the most recent one, if they're equally reliable.) So unless someone is knowledgeable enough to do this consideration, one could assume both sources are (potentially) equally right, both article could state the estimate to be between 0.5% and 0.6% and cite both sources.

I'm not currently delving into this, as I wasn't supposed to invest this much time on WP at the moment anyway (:P) but I just felt the urge to dispute the statement that two different estimates can't be right at the same time, when one can assume both to be equally relatively right to the same degree. We are indeed not talking about hard, 100% correct facts, but estimates with their own inherent fault-tolerance. Loial (talk) 02:44, 1 April 2008 (UTC)

Please REMOVE fellatio from per act risk table

Here's a quote from source #20: "We assumed that insertive fellatio was 10 times less risky than insertive vaginal sex and that receptive fellatio was 10 times less risky than receptive vaginal sex, per act (Table 1)." Fellatio per act risk was an ASSUMPTION in the study. Please REMOVE fellatio from per act risk table unless someone has a relevant source.—Preceding unsigned comment added by 206.55.180.50 (talk) 20:57, 10 March 2008

NIH link discussing risk factors

According to this link from NIH, transmission of HIV is 20 times greater for receptive anal intercourse than receptive vaginal intercourse.

http://gateway.nlm.nih.gov/MeetingAbstracts/ma?f=102239436.html

The relative risks are addressed clearly in the "Transmission" section, in the infobox. The figures there, from the peer-reviewed literature, suggest that receptive anal intercourse is about 10 times riskier (rather than 20 times riskier) compared with receptive vaginal intercourse. Since the link you cite is a meeting abstract, which are subject to significantly less stringent review than published articles, we should probably stick with the figures cited in the infobox. MastCell ^Talk 22:30, 12 March 2008 (UTC)

The infobox data is now out of date. —Preceding unsigned comment added by 67.62.23.202 (talk) 19:40, 21 March 2008 (UTC)

What does this mean?

In the genome section this text is found:

HIV-1 and HIV-2 appear to package their RNA differently; HIV-1 will bind to any appropriate RNA whereas HIV-2 will preferentially bind to the mRNA which was used to create the Gag protein itself. This may mean that HIV-1 is better able to mutate (HIV-1 infection progresses to AIDS faster than HIV-2 infection and is responsible for the majority of global infections).

However, it is, IMPOV, very unclear. Does HIV-1 and 2 mean the HIV-1 and 2 virion, genome or transcribed proteins? Mikael Häggström (talk) 07:02, 14 March 2008 (UTC)

History

I find it appealing that nobody ever mentions the discoverers of the virus behind AIDS. I think Prof Montagnier and Gallo could be mentionned in this page!

Anne-Caroline Sieffert —Preceding unsigned comment added by 128.230.56.132 (talk) 01:46, 22 March 2008 (UTC)

Info box image

Good riddance to that cartoon, but will readers realise that the HIV particles are those tiny, tiny, circular objects and not that Alien3-like blob? Graham.--GrahamColm^Talk 21:57, 22 March 2008 (UTC)

Not sure, Commons:Category:HIV has ample images to work with, so it can be changed to many other available images. A different electron miscroscopy (EM) image might be in order. There are multiple EM images at commons, although some don't specify transmission or scanning, and I'm not knowledgeable enough to tell the difference for certain. Influenza is the only virus featured article aside from AIDS, so that may give some indication how to lay out the different magnification images. Influenza, Rotavirus, and AIDS are all FA virus articles for reference on image layout on multiple magnification levels. I went through and moved and removed the images based on comments at the featured article nomination. -Optigan13 (talk) 22:13, 22 March 2008 (UTC)

Thanks for the quick response. Please forgive the lack of modesty but my Rotavirus article is featured. I wasn't criticising you at all. The scanning electron microscopy image is much better - but it needs some arrows. It's getting v. late in the UK. Please leave the image for now. On Sunday I will either upload a new, modified version with arrows (?spelling) pointing to the virus particles emerging from the lymphocyte or switch it for a TEM, thin section image. Graham. --GrahamColm^Talk 22:29, 22 March 2008 (UTC) P.S. If they look semi 3D with lighter edges to the objects, they are scanning; if they look flat they are transmission, if they look like a Thunderbirds model; they are computer reconstructions.--GrahamColm^Talk 22:29, 22 March 2008 (UTC)

It might be useful to take a look at the same image, although not so zoomed in at http://www.cdc.gov/hiv/topics/basic/index.htm#aids. The caption is somewhat helpful just to show the relative size of the virus compared to the blood cell. -Optigan13 (talk) 02:26, 11 April 2008 (UTC)

Maths

Quote: ""The Options Project found that 7.8% (8 of 102) of recently infected men who have sex with men in San Francisco were probably infected through oral sex. Most of these men believed that the risk was minimal or non-existent." Even if the risk is small, an act done over and over again multiplies the probability by the number of times performed."

Isn't "an act done over and over again multiplies the probability by the number of times performed" mathematically incorrect? According to whoever has written this you would only need to have unprotected oral sex 12.8 times (1/0.078) to be certainly infected. —Preceding unsigned comment added by 78.150.73.254 (talk) 10:36, 29 March 2008 (UTC)

Your statistical assumptions are false. If you roll a dice six times you are NOT certain to roll a 3, you know? It's called the "gambler's fallacy". As for the source, it offers the highest rate of infection for oral sex I've ever seen. The link isn't to a study, but to notes taken from a poster at the 7th National Conference on Retroviruses and Opportunistic Infections, held January 30-February 2, 2000. Got a study link? I'm gonna remove the factoid from the article if it cannot be found. JoeSmack ^Talk 12:30, 30 March 2008 (UTC)

Removed. JoeSmack ^Talk 10:28, 3 April 2008 (UTC)

intro change

Ok, I changed a bit at the end of the introduction section. It was...

...which I changed to this. I added some on death with and without antiretrovirals with cites. Notice how I also changed the wording from 1 out of 10 individuals 'remain healthy' for 'many years' to what I feel is a little more representative - that 9 out of 10 individuals DO progress to AIDS after 10-15 years (I believe the study says 8% with 500+ CD4 after 10 years, 5% with 200+ after 14 years).

...I don't like that the long-term nonprogressor study (author is Buchbinder) is from 1994. Does anyone have more current research we can use instead? JoeSmack ^Talk 14:05, 6 April 2008 (UTC)

Slightly better is a 1999 review by Buchbinder (PMID 10572315), which pegs the long-term non-progressor prevalence at anywhere between 0.5% and 25% of the HIV-positive population depending on what definition of "long-term non-progressor" is used. Also PMID 18219363 from 2007; pegs the prevalence of LTNP's at 1% of the HIV-positive population. MastCell ^Talk 22:53, 3 May 2008 (UTC)