"All the world's a stage we pass through." - R. Ayana

Sunday, 28 August 2011

Very Hard to Catch: AIDS – The Real Story 2

AIDS – The Real Story
 Section 1 Part 2 – Very Hard to Catch


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 It’s long been known that, compared to most sexually transmitted diseases, HIV/AIDS is very hard to catch. There are a number of reasons for this; one is that retroviruses such as HIV use RNA for their core genetic material, not the more robust DNA used by other life forms. RNA-based organisms will not survive for long outside a culture medium (such as blood) as their genetic material will rapidly break up and dissolve.

        While around 27% of Australian hospital workers accidentally pricked with hypodermic syringes contaminated with hepatitis-B contract that disease, HIV infection occurs in less than 1% of those stuck with HIV-contaminated needles. 

            A year-long Canadian study involved accidental exposure to HIV in health workers from more than 200 hospitals and laboratories, including needle-stick and scalpel injuries, eye-splash and open wound contamination. No cases of HIV contamination were found in the study, which matched a U.S. survey by the CDC of 1,116 health care workers who were directly exposed to HIV-contaminated blood. One of the only two workers who tested positive was thought to have contracted the virus outside work.[i]  

Long Odds
 
While the transmission rate for sexually transmitted diseases (STDs) such as syphilis and gonorrhea is between 20% and 50% (depending on the disease and whether it’s transmitted from male-to-female or female-to-male), the infection rate for AIDS by heterosexual (vaginal) transmission was estimated at “probably less than 1% per contact” by the U.S. Centers for Disease Control (CDC) back in 1986.  [ii] 


            This figure was subsequently reduced to about one in a thousand per heterosexual encounter with an HIV-infected person – and this from males to females only. This Berkeley University study (released at the Third International Conference on AIDS in June 1987) concluded that this one in a thousand chance only relates to male-to-female transmission. In the reverse case, too few men had shown any sign of infection to calculate a man’s risk of sex with an infected woman. The study was based on a survey of 96 women who had varying degrees of sexual contact with HIV-infected men. [iii] 

            But the odds of transmission could be more like one in a million – or less.



“Whether it’s one in a million, or one in a hundred thousand, or one in ten thousand, or one in ten million, I don’t know,” said CDC Head Statistician Dr Meade Morgan in 1988. “But the risk is very low in any given instance.”
 
        
[iv]

              AIDS transmission is divided into three categories:  
Primary transmission is to a member of a high-risk group – homosexual, bisexual, intravenous (I.V.) drug user, haemophiliac etc – by direct blood-to-blood or semen-to-blood contact.  

Secondary transmission occurs when these people pass the HIV retrovirus on sexually (including anally) to a member of a non-high risk group. Most secondary recipients who have been studied are the steady female partners of I.V. drug users. The spouses and regular sex partners of many regular I.V. drug users are also I.V. drug users. That this fact is not allowed for in these studies makes questionable widely-quoted sexual transmission figures for I.V. drug users.  



Tertiary transmission is said to occur when the secondary recipient then passes on the virus to another person heterosexually. People can be forgiven for assuming that it’s been proved that this is happening, other than by the anal route. But no such proof exists.
  
            Tertiary transmission isn’t happening, except perhaps in some very isolated cases. AIDS began showing up among U.S. homosexuals in 1979; in early 1981 the CDC documented AIDS cases among I.V. drug users, and, in June of that year, their heterosexual partners. If it existed, tertiary heterosexual (vaginal or oral) AIDS would have started showing up by late 1981. By 1982 the first fourth-generation, purely heterosexual cases would have started. By 1988 AIDS would have been decimating the US population. This didn’t happen - and there is, as a result, no possibility of significant or actual tertiary heterosexual transmission. 

Abovementioned blood bank and US Army reports show that the level of HIV infection remained low in the general population (See previous - AIDS – The Heterosexual Myth). 

Body Fluids

Female-to-male transmission during vaginal intercourse is believed to be virtually non-existent and researchers have long reached general agreement that the miniscule amounts of HIV  occasionally isolated in the teardrops of infected people is not enough to cause transmission. HIV in vaginal secretions is present in roughly the same proportions as in tears – when it can be isolated at all. Dr Robert Gallo (credited as co-discoverer of HIV) stated in 1987 that despite repeated attempts, he could not isolate the retrovirus in vaginal fluids. In February 1987 Gallo told a reporter he did not know of a single case of female-to-male sexual transmission.
[v]

              With the female-to-male transmission rate so low as to be actually or practically non-existent – as research indicates – there is a natural ‘firebreak’ for heterosexual transmission of AIDS, making it virtually impossible for the syndrome to spread horizontally through the heterosexual (non-I.V. drug-using, non-anal sex practicing) community. HIV’s RNA structure makes it very susceptible to rapid breakdown by substances in human saliva and other enzyme-rich bodily secretions.
 
            Several studies of gay men have failed to find any HIV-positive cases which could definitely be linked to oral sex. Oral sex has never been definitely linked to any cases of HIV transmission


 I.V. Drugs and AIDS

 


 I.V. drug users who share needles and/or syringes face a much greater risk of infection than hospital workers who accidentally prick themselves on infected syringes, as the full contents of a syringe is dumped directly into a vein along with the contaminated blood of other users.

 
             One 1987 Australian study indicated that 2% of Australians had injected themselves with a drug at least once in the previous 12 months.[vi]

             I.V. drug use is the major IV transmission vector aside from anal sex. Three Australian studies showed the rising prevalence of HIV infection in the I.V. dug-using community, based on rates of contaminated syringes. In 1985 the rate was 0.5%; in 1986 the figure was 1% and in 1987 some centers reported a 10% infection rate. These figures could be slightly inflated by the regular return of syringes to needle exchange centers by a few heavy users, but by 1988 one of the centers alone was giving out around 2,500 needles a month in Sydney’s King’s Cross. In February 1988, 10-15% of 1,500 returned needles in three inner-city suburbs were infected. [vii]

              “These kids are homeless and routinely take serepax, alcohol, speed, heroin or combinations of all these drugs,” said the director of the King’s Cross Kirketon Road Centre. “They are living very dangerous lives anyway.

 
             “They view AIDS as just one concern and probably not as important as having a full stomach or somewhere to stay. A virus that will not appear for three or four or five years… well, it’s very difficult for them to grasp.”

             The New South Wales State Government started a pilot needle exchange at one centre in November 1986. In the first nine months of operation 14,000 needles were handed out, so the scheme was expanded.[viii]

 
            In New York and many other places it’s still (on writing) illegal to for non-insulin users to possess a hypodermic syringe, which has meant that some users hire their used syringes out to other users, often using abandoned buildings as ‘shooting galleries’.

             Mainly as a result of such outdated legislation, 1988 figures from the Bronx indicated that half of the estimated 30,000 to 40,000 I.V. drug users there may have been infected with HIV.

             “A quarter of these AIDS victims are women,” according to Dr Ernst Drucker, an epidemiologist who ran the Montefiore Medical Centre’s community health and drug addiction programmes.
[ix]

              1988 New York City Health Department figures show that 52 out of 650 homeless youths under the age of  21 who came to the Covenant House crisis centre were infected with HIV. 

            “Fifty-two people tested positive, but the most startling statistic we have come up with is that the incidence of antibodies to AIDS among the males and females (in these 52) is exactly the same,” said medical director Dr Jim Kennedy of Covenant House, located two blocks from Times Square.

             “What has already happened with AIDS in New York is very interesting. First the incidence of AIDS in gay men has peaked and is going down. The incidence of I.V. drug users getting AIDS is going up and up,” said Dr Kennedy.[x]
 
            The demonstrated prevalence of I.V. drug use in the U.S., Australia and the rest of the developed world shows how easily I.V. drug users can account for most HIV cases classed as ‘heterosexual’ or ‘other/unknown’ (see AIDS – The Heterosexual Myth). When added to the reported and unreported incidence of anal sex and bisexuality (see part 3), most – if not all – cases attributed to possible heterosexual transmission of AIDS are accounted for.


- R.Ayana



[i]  Communicable Diseases Intelligence Bulletin (Australia) No. 87/7 April 1987
[2]  Drs Curran and Peterman of the CDC, Journal of the American Medical Association, October 1986
[3]  Nancy Padian, Berkeley School of Public Health, AP, The Australian 6-6-87
 [iv]  AIDS Backlash, The Bulletin (Australia), 22-3-88
 v]  Sydney Morning Herald, 3rd August ‘87
[vi]  Study quoted by Professor Ron Penny, NACAIDS Acting Chairman, The Australian 25-3-88
[vii]  Dr David Cooper, Director of NHMRC’s Special Unit in AIDS Epidemiology, Sydney Morning Herald 21-5-88
[viii]  Ibid
[ix]  Ibid
[x]  Sydney Morning Herald 21-5-88

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