Tuesday, December 23, 2014

politicizing the blood supply (X rated)

The decision to "allow" gay and "bisexuals" to donate blood was a purely political decision.

True, they might be HIV positive, but the testing will find that out. And the one year prohibition should catch the danger of spreading HIV before the screening test turned positive.

The problem? People lie....

But it's not the sexual orientation that is the problem: It's the anal sex.

This survey of people in "high risk" areas for HIV of "heterosexuals" suggest that anal sex is a major problem in the spread of HIV: And 30 percent of both men and women admit to anal sex...

but the main danger is drug use: 50 percent admit to using drugs (not necessarily IV, mostly oral).

and I found this interesting:

blacks or African Americans (hereafter referred to as blacks) and Hispanics/Latinos are disproportionately affected by HIV. Estimated rates of diagnosed HIV infection in 2011 were 9 times as high for blacks and 3 times as high for Hispanics or Latinos compared with the rate for whites.

in Latin cultures, sodomy is a way of humiliating women.

But the "high risk" areas apparently included a lot more African Americans than other groups.

Participant Characteristics

Approximately half (58%) of participants were aged 40–60 years. The majority of participants reported black race (72%) or Hispanic/Latino ethnicity (21%); the sample was evenly distributed by sex (Table 1). The majority of participants (64%) had never married and were not cohabiting. Most participants reported no more than a high school education (men: 86%; women: 83%) and very low incomes. For instance, most participants (87%) reported annual incomes of <$20,000, which is lower than the federal poverty guidelines for a family of four; approximately one in three (36%) reported annual incomes of <$5,000. Nearly three out of four (men: 72%; women: 73%) reported both income at or below poverty and no more than a high school education (data not shown). Approximately one third (31%) of participants were currently or had been homeless in the 12 months before the interview, and nearly half (46%) were uninsured.
With the exception of homelessness and health insurance, the demographic characteristics were similar for male and female participants. Approximately one third of male (35%) and female (27%) participants had been homeless at some time in the 12 months before the interview.  

and they tried to exclude high risk behaviors, but found some participants had done these things more than 12 months earlier

Although the analysis sample excluded data from participants who reported they had recently (within 12 months of interview) injected drugs or had male-male sex, 14% of male participants reported that they had injected drugs or had sex with another man >12 months before the interview; 5% of female participants had injected drugs >12 months before the interview (data not shown). Each participating area contributed an average of 442 interviews (range: 131–565) to this analysis. 

the number of average sexual partners was low: 3 for men, 2 for women.
And then you come to this:

A total of 4,467 (90%) female participants reported having vaginal sex without a condom with a male partner in the 12 months before the interview, and 1,420 (29%) reported having anal sex without a condom with a male partner (Table 3). The percentages of women who had vaginal sex without a condom were similar among women in all categories of education and income. Anal sex without a condom was more common among those with lower levels of income. 

anal sex requires a stronger better lubricated condom than vaginal intercourse.

and unprotected vaginal and  anal sex was more common when it was with a casual contact, and by white men.

 Vaginal or anal sex and vaginal or anal sex without a condom with female casual partners were less common among male participants who were married or cohabiting and among those with higher incomes and were more common among white men. 

another variable was lack of health insurance.

yet 70 plus percent had been tested for HIV, about 30 percent within the past year and most in community clinics or health centers.

much of the rest of the survey is about routine (one third got free condoms) (remember that some people overreport good behavior and underreport bad behavior).

the reason I bring up anal sex is that the passive partner is more likely to catch HIV, and in Africa, non vaginal intercourse was used during lactation to prevent pregnancy in some tribes (although in south Africa, intercrural intercourse was traditional to keep the girls virgins).

a broader cdc population survey suggested that 35 percent of women admit to having anal intercourse, and the average number of sexual partners lifetime was 4 for women and 6 for men. No link: A pdf that crashed my browser.

this estimate of anal sex is a lot higher than that found by Kinsey's survey, which was mainly in teens.

No, I'm not an expert on anal sex, mainly because it was not that common among the groups I worked with.

But one wonders why there is no outreach to people about this risky form of intercourse.

Finally, this caught my eye:

 Use of crack cocaine has been associated with HIV infection among heterosexuals in the United States (7,10,42). These results highlight opportunities for drug use prevention efforts among low-income urban populations. 

I've read anecdotes about homeless women trading sex for crack cocaine, and wonder how many traded anal sex for this (note the lower rate of anal sex with regular partner suggests it might be more common in those trading sex for money etc.).

So what does this have to do with the blood supply?

Well, if you don't want to offend the "gay" activists, just continue asking about anal sex for everyone. And ask about the past year.

But remember, the type who do such things often lie about it.

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