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Author Topic: Gays and blood donation
morganlh85
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Do you think it's fair that gay males are not permitted to donate blood? Sure there is an AIDS risk, but there is one for everybody. Also, a straight person who has had unprotected sex is still permitted to donate, and gay women are allowed. Also, blood is screened for HIV something like three times and for other diseases four times. Do you think this perpetuates the promiscuous gay men stereotype or is unfair?
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Dzuunmod
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This has been an issue for at least 15 years.

I don't, for the life of me, understand why. It's about time to get over it. If the blood is tested, you don't really need to do anything else, now do you?

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Milke
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I sort of suspect this is one of those things that no one's gotten around to changing. With so much else going on, and with attention right now being on gay marriage, rather than something most people do no more than once or twice a year, I can see how that could happen. Doesn't make it right, though.

There'd be no harm in asking about it next time you give blood, or even calling up the agency that deals with blood donations in your area, and saying it bothers you. One person complaining isn't worth much, but when other people do it too, and it starts to become a pattern, someone's got to at least wonder about it, and maybe find a better way to ask questions that need to be asked.

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Dzuunmod
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I dunno, Milke. I know for a fact that this was an issue during blood donor clinics at Canadian universities back in the early to mid-'90s. At most, if not all schools, the protests were so loud that a policy change was made by the agency responsible for this back in the day (the name at the time escapes me).

If blood collection agencies were paying attention in 1992 or thereabouts, to what was happening up here, I can't imagine why they wouldn't have quietly changed their policies back then, so as to avoid the big scene that happened here.

I think that if this is still the policy at any North American clinics 10 or 15 years out, it's quite deliberate.

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BruinDan
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quote:
Originally posted by Dzuunmod:
I think that if this is still the policy at any North American clinics 10 or 15 years out, it's quite deliberate.


Wow, that really is incredible. Until I read this, I had no idea that gay males were not allowed to donate blood! Not only have I never heard any outcry out here about it, but I've never read anything about it either. How bizarre is that?

Does it depend on who you donate for? I was never asked if I was homosexual when I donated blood, are there specific agencies who ask and some who don't care?

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Gumdrop Girl
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if i may throw in something i picked up in class.

Whether we like to admit it or not, numerous studies have shown that MSM's (in health, we aren't allowed to say "gay" or "homosexual" because a lot of "straight" men refuse to identify with those groups -- we call them "men who have sex with men" or "MSM's" for short) are a very high risk population when it comes to infections like HIV and Hep B. Unfortunately, because HIV has an especially long incubation period, it can go undetected for up to 6 months. Whole blood doesn't last that long, and should the processed blood products (Factor 8 and so forth) become infected, the potential for an outbreak amongst tranfusion patients would be massive.

I'd love to see the donor pool expand to allow MSMs since not nearly enough people donate as it is, but the rising rates of HIV, Hep B and syphilis infections simply do not make the odds favorable.

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Heather
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However, as I understand it, men who identify as heterosexual and who sleep with men aren't being screened out, men who identify as homosexual and honestly cop TO sleeping with men are.

(And while I don't know of solid studies done, I'd be willing to bet practice safer sex more often than closested MSMS, since studies have shown that sexual shame does tend to decrease safer sex practice)

I do agree that it IS okay to acknowledge high-risk groups as such, especially when you can't accurently screen blood for certain diseases on the spot. In all honesty, being able to donate blood isn't really a civil rights issue.

Heck, I can't donate blood myself, because I lived in the UK in '91 during the unknown period of mad cow... despite the fact that I'm vegetarian and still was during that time.


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Milke
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The form I saw, but this was several years ago, and Canadian, asked if you were a man who'd had sexual contact with another man, or a woman who'd had sexual contact with a man who's had sexual contact with men. Slightly awkard phrasing, but it didn't specifically ask if anyone was gay. What would make more sense would be to list high risk activities, and ask if any of them applied to you, though not which specific ones. Homosexuality and specific kinds of sex often get linked, even though people of any orientation can do them.

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And everybody's got to live their life
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summergoddess
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Besides gays, what about the rest of the GLBT community??? Bisexuals to be specific. They have sex with both men and women. If they have been tested and they are clean of STD's and etc, they should be able to donate blood, don't u think??

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~Jules


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Milke
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Those'd be those men who had sex with women and also men I mentioned earlier, right?


I think we all think anyone who's not got any communicable diseases should be allowed -- and encouraged -- to donate blood, I don't think anyone's going to argue there. But then again, people who've got recent piercings (and that includes the conventional lobe piercings, not just more unusual ones) and tattoos can't donate blood either. It's obvious we've some idea of where infections can come from, but perhaps the research behind that, or the words used to express it needs to be updated. The problem is in keeping infected blood out of the system, and how we effectively and inoffensively manage to do that.

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Milke, with an L, Mrs BD to you, RATS, TMNTP, MF, CWCD, WAOTA

And everybody's got to live their life
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ChitarraRegazza
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As I remember, the info sheets that you have to fill out when giving blood don't ask if you are a gay man. I think it asks if you are a man who has had sex with another man since 1978, or whatever year it is. That wording clears the issue of having to identify as gay or homosexual, but it's still sort of confusing. "Sex" is an ambiguous word, and I have to wonder if these men who engage in homosexual activity but don't identify as homosexual count those activities as sex.

I don't think that the Red Cross is trying to be either discriminatory or offensive, but those questions make me pretty uncomfortable too. They're pretty far reaching too; it isn't just gay men, it's every man who has had even one homosexual experience and all of their partners. That's a huge chunk of people right there.

However, I have read a lot recently about HIV rates rising among gay men. Especially considering what Gumdrop Girl said about it taking up to 6 months to detect, it makes sense to keep high risk populations out of the blood supply. I just wish the Red Cross could come up with a less offensive way of doing that. The one that they use now just reinforces the view that homosexual sex is dirty.

-Catie


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LilBlueSmurf
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quote:
Originally posted by ChitarraRegazza:
I think it asks if you are a man who has had sex with another man since 1978, or whatever year it is. That wording clears the issue of having to identify as gay or homosexual, but it's still sort of confusing.

I gave blood Oct 27 of last year ... And that's along the lines of what it said. Asking if i were male and had sex w/ another male, or have had sex w/ a male who had sex w/ another male ... since 1978 or something like that. It wasn't about being homosexual, or heterosexual having sex w/ men ... Just if you'd had sex w/ a man at all (if you're male), or were a woman who'd had sex w/ a man who had sex w/ men (confused yet?)

I'm not sure how they could word that any better ... I don't really think they're trying to offend anyone, or give off the wrong impression (that homosexual sex is dirty) ... Just that they have a public to protect, this is a high risk group, and it'll be their asses on the line if someone contracts a disease from a blood bank that's supposed to be 'safe'.


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Dzuunmod
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But, Smurf, don't they test all the blood to see if it's HIV-positive? And if that's so, why would they need to determine who's in a 'high-risk group'?

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PoetgirlNY
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I think it's silly that a woman who has had protected oral sex with one man who has had protected oral sex with one man, with all parties having tested negative for HIV years after the sex has occured, isn't allowed to donate blood, while a woman who has had unprotected anal sex with 500 men who have only had sex with women, is allowed to donate blood.

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LilBlueSmurf
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quote:
Originally posted by Dzuunmod:
But, Smurf, don't they test [b]all the blood to see if it's HIV-positive? And if that's so, why would they need to determine who's in a 'high-risk group'?

[/B]


As Gummy said ...
"Unfortunately, because HIV has an especially long incubation period, it can go undetected for up to 6 months. Whole blood doesn't last that long, and should the processed blood products (Factor 8 and so forth) become infected, the potential for an outbreak amongst tranfusion patients would be massive.


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Dzuunmod
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So, then, is testing blood pointless? Isn't this all terribly dangerous?

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"Like a bat out of hell, time has come for you!"
-Ballad of a Comeback Kid, The New Pornographers


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Milke
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Well, no, because most people who've been infected with HIV haven't just done so in the past five months, and because blood transfusions can save lives. Basically, the benefits outweigh the risks, though it is still suggested that if you know you might need blood soon, you set some of your own aside.

And the fact that everyone who's seen the offending forms noted that they said 'since 1978' does suggest that they aren't updated often. I saw the same thing in 1998, at the time I assumed that that was because it was 20 years before then, but that isn't the case any more.

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And everybody's got to live their life
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00goddess
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quote:
Originally posted by Miz Scarlet:
However, as I understand it, men who identify as heterosexual and who sleep with men aren't being screened out, men who identify as homosexual and honestly cop TO sleeping with men are.

Actually, Heather, this isn't accurate. The question asked of blood donors is not "Are you gay?" but "Are you a man who has sex with men, or have you had unprotected sex with a man who has sex with men?"

The inequality still exists, because many MSMs are not willing to admit to the blood center that yes, they do have sex with men. So they donate anyway. However, they have the same choice that anyone donating blood has: they can choose to answer honestly or dishonestly. The questionnaire is not meant to protect the blood supply so much as it is meant to protect the blood banks- this way, if someone does become infected with something nasty through a blood transfusion or tissue reception, the blood handler can point to the questionnaire and say "See, look! We took every precaution!"

Incidentally, I can't donate either- because I have had plenty of sex with men who have sex with men, and my current partner is one of them.


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00goddess
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quote:
Originally posted by Gumdrop Girl:
if i may throw in something i picked up in class.

Whether we like to admit it or not, numerous studies have shown that MSM's (in health, we aren't allowed to say "gay" or "homosexual" because a lot of "straight" men refuse to identify with those groups -- we call them "men who have sex with men" or "MSM's" for short) are a very high risk population when it comes to infections like HIV and Hep B. Unfortunately, because HIV has an especially long incubation period, it can go undetected for up to 6 months. Whole blood doesn't last that long, and should the processed blood products (Factor 8 and so forth) become infected, the potential for an outbreak amongst tranfusion patients would be massive.


Gumdrop Girl:

Your classroom is still teaching you out-of-date, inaccurate information.

Here's a little something I picked up in my ten years as an HIV educator, most recently in social services at a non-profit, Ryan White funded HIV primary care clinic: MSMs are not at any more risk than are other people. Lifestyle is not the risk. Risks lie in behaviors.

Here's an example: it's commonly held that using IV drugs puts one at risk for HIV infection. This commonly held idea, however, is fallacious. Using IV drugs is not the risky behavior (although any drug use increases one's risk factor by dulling one's judgment.) Sharing needles is the risky behavior. I could shoot heroin for twenty years, and as long as I never shared needles, I would not be at rish for aquiring infection diseases in this manner.

The same goes for male/male sex. It is commonly held that 'gay sex' is riskier than 'straight sex.' This is inaccurate. Anal sex is riskier than vaginal sex, because of the greater likelihood of tearing, but MSMs aren't the only ones who have anal sex, (hets and lesbians do it too) and some MSMs don't have it at all.

If a man uses barriers correctly in all of his encounters with other men, he has reduced his risk factor to almost nil. The same, incidentally, goes for male/female sex or even female/female sex.

If a person talks to their partner and they agree to be monogamous, test and retest prior to sexual activity, and still use barriers even after this, they have reduced their risk even more.

If the donor exclusions were seriously meant to protect the blood supply, the questions would not be about partners but about behaviors. The question would not be "Are you a man who has sex with men, or have you had sex with a man who has sex with men?" but "Do you have anal sex or have you had sex with someone who has had anal sex?"

While in the 80s, when risk factors were not widely understood, and MSMs were still unknowingly engaging in risky behavior, the allegations you are making would have been correct, they are no longer so.

All donated blood in the US is tested for the presence of Hepatitis B, HIV, and Hep C. All of these virii have a window period, and therefore all of them can elude a core antibody test (which is why responsible health care workers and advocates are pushing for better viral antigen testing and the wider use of these tests.) Eliminating MSMs from donation does not protect the blood supply.

Also, you might want to speak to your teacher about the use of phrases such as 'we aren't allowed to say "gay" or "homosexual" because a lot of "straight" men refuse to identify with those groups'. I saw the same sort of phraseology in my professional environment, and it is very disrespectful of patients' right to self-identify. It's not that the patient 'refuses to identify with those groups;' it's that they don't identify with those groups, and the insistence, on the part of healthcare workers, that they should so identify is disrespectful and discriminatory.


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00goddess
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quote:
Originally posted by LilBlueSmurf:
As Gummy said ...
"Unfortunately, because HIV has an especially long incubation period, it can go undetected for up to 6 months. Whole blood doesn't last that long, and should the processed blood products (Factor 8 and so forth) become infected, the potential for an outbreak amongst tranfusion patients would be massive.



But Gummy was wrong. HIV very, very rarely goes undetected for six months. That's an almost unheard of seroconversion time. The very concept of a 'six month window period' is considered outdated on the front lines of HIV care.

The idea that HIV would go undetected for six months was developed in the early years of HIV awareness, and is no longer considered current.


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00goddess
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quote:
Originally posted by Milke:
And the fact that everyone who's seen the offending forms noted that they said 'since 1978' does suggest that they aren't updated often. I saw the same thing in 1998, at the time I assumed that that was because it was 20 years before then, but that isn't the case any more.

It never was the case. 1977 is usually the date used on forms. This is because HIV is first known to have entered the US in 1976.


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Milke
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Er, it was the case that 1978 was 20 years before 1998, but it's good to have an explanation for that all-important year.

And while it is good for people to stay up to date with their information, it simply isn't appropriate, nor accurate, to accuse someone of being wrong when they're erring on the side of caution, not stating that something is a universal truth.

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BruinDan
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quote:
Originally posted by 00goddess:

Gumdrop Girl:

Your classroom is still teaching you out-of-date, inaccurate information.


(You'd better contact the dean of one of the top Med schools in the nation and let them know that, darlin'.)


quote:
(hets and lesbians do it too)

You know, you did a good job of asking Gummy to confront her professor about potentially offensive statements, and then you went and used the term "het," which is often taken as derogatory by heterosexuals. It's not "breeder," but it's not exactly smiled upon either.

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Heather
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00goddess --

In terms of what you're pointing out about what Gumdrop may be being taught (her post was pretty breif, so I don'[t think it's safe to assume it sums up the whole of what she's learning on this entire, nor a lot of nuances), here's the thing: yes, it's about behaviours. Which I'd certainly be willing to bet she is being taught, and I know that she has been taught or already does know a good deal of the information you've shared here.

But some behaviours ARE common among certain groups, no? For instance, in your heroin example, the fact of the matter is that quite a lot of serious junkies stop caring about a whole lot of things, including needle safety. And someone who uses NO IV drugs at all is at a FAR lesser risk of using an infected needle of someone who does, no matter what.

Given, that's far more murky with homosexual men and more importantly, with men sleeping with men and engaging in anal sex as a whole. And as I think I already said at some point, I haven't noticed heterosexual couples being any safer about anal sex than queer men (as may be obvious, I can only guess on the habits of men who sleep with men secretly), and in many cases, far more reckless.

Per most recent seroconversaion rates, I'll be sure and do another check-in on that with my epidemiology consult (AKA, my Mom , but I can say that there is often LOADS of variance in what given clinics, hospitals, doctors, etc. say about those rates, and that six-month rate has been stated FAR more recently than 10-20 years ago. In other words, I still have yet to get a clear standard answer across the board -- perhaps that's recently changing. Never hurts to take a new look and see what the answers are this time.

Good to know the forms are changing, though I know I have seen med. forms without that phraseology here in MN and in Wisconsin and commented on it to those clinics -- is it possibly regional?

(Incidentally Dan, I had no idea the term "het" was felt to be offensive myself, either -- I've never had anyone say anything about that to me, and it's really common among groups who work in sexual populations to shorten groups down to het/hetero/homo/bi, so I know I hear all a lot, esp. used by clinicians and other workers of all orientations as shorthand.)

[This message has been edited by Miz Scarlet (edited 02-07-2004).]


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Gumdrop Girl
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because i honestly don't have the attention span to read really long posts (I admit it, I avoid them, but since i was addressed specifically, I gotta speak up), i'll just answer what i can.

The 17th edition (most recent edition, published 2000) of the CDC Control of Communicable Diseases Manual by Dr. James Chin MD, MPH (bible of the American Public Health Association) lists the incubation period for HIV as usually between 1 and 3 months, BUT does stipulate that the incubation period can go as long as 6 months, with the period before the development of symptoms taking as long as 15 years to develop.

And yes, I understand that the underlying cause of the infection prevalence is in behaviors. but rather than inflict more jargon on the good folks at ST, I'd prefer to spare them the stuff about Transtheoretical, Health Belief, Reasoned Action and whatever other behavior theories.

As for the stuff about MSM and gays and what not, in this part of the field it's not about social identifications, it's about identifying what practices these people engaged in. If he says he's straight, but he had anonymous unprotected anal sex with another man, then in clinical terms he is a MSM, a high risk one at that. Sorry, but political correctness cannot cover up everything that is unfair but decidedly real in practice. If excluding a few high-risk individuals from donating blood protects thousands of transfusion patients from infection, then continuing the practice is the greater good. Is it fair to the people who behave safely and responsibly? no, it's not. however, I'll agree with Miz S in that blood donation is not a civil right.

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ChitarraRegazza
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I think the Red Cross does address the issue of risk behaviors. Everyone who gives blood has to read a booklet containing information on various diseases involving blood, including AIDS and its risk factors. Following the paperwork and physical, the donor is given a pair of bar code stickers, one meaning that the blood is safe, one meaning that it may not be. After sticking the appropriate one on the form and throwing the other one out (in privacy), the donation takes place. I think this is great, because people can choose the safe way without having to be uncomfortable.

This is a great thread, by the way... something thats been bugging me for awhile. It's good to see other people's thoughts on it.

-Catie


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00goddess
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quote:
Originally posted by Gumdrop Girl:

The 17th edition (most recent edition, published 2000) of the CDC Control of Communicable Diseases Manual by Dr. James Chin MD, MPH (bible of the American Public Health Association) lists the incubation period for HIV as usually between 1 and 3 months, BUT does stipulate that the incubation period can go as long as 6 months, with the period before the development of symptoms taking as long as 15 years to develop.

Above, you spoke of the window period, and now you speak of the incubation period. I think you may misunderstand- these are two different things.

The "window period", properly kown as the seroconversion period, is the time between initial infection with HIV and the widespread development of HIV antibodies. Seroconversion is the time when your body as a whole is becoming infected with HIV. YOur immune system begins to create antibodies, which will eventually reach such a volume that you will test positive for those antibodies.

The "incubation period" is the time between infection with the HIV virus, and the development of AIDS symptoms. You are correct- this period can in fact be decades long. However, the incubation period and the window period are not the same thing, and thus should not be equated.

quote:
If he says he's straight, but he had anonymous unprotected anal sex with another man, then in clinical terms he is a MSM, a high risk one at that.

Thanks, I love it when someone argues with me by restating my own argument! What I said was that it he says he is straight, he's straight- even if he is an MSM. (I certainly didn't say that he's not an MSM.) Implying that he is just 'refusing to admit' that he is gay or bisexual is disrespectful.

quote:
I'll agree with Miz S in that blood donation is not a civil right.

I agree also. However, I think it's sad that the blood suppliers are denying a valuable supply to those in need.


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Gumdrop Girl
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Well, if i'm reiterating the exact same thing that you said, 00goddess, then you and I were never in disagreement in the first place.

as for seroconversions and incubation periods, the point i'm making is that i still have recent literature documenting that there is a 6 month "window period" during which persons infected with HIV may not show up positive with a test.

Anyway, I'm not one to perpetuate internet arguments as internet tradition demonstrates that Usenet, message board and email arguments result in one person accusing the other of being a Nazi. If anyone else cares to interject and correct me, I welcome it, but between me and 00goddess, it's becoming very circular. Or I'll do some more research because PubMed and AJPH will give me plenty of papers to read without the attitude.

addendum: I asked the chief epidemiologist in the HIV epi program at the Los Angeles County Department of Health Services (she was doing a guest lecture in class) whether it is still accepted as fact that it can take 6 months from time of infection for a test to show up positive. she said it was indeed possible and acceptable as fact, and therefore, I'm right.

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[This message has been edited by Gumdrop Girl (edited 02-24-2004).]


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jordopolis
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quote:
Originally posted by 00goddess:

But Gummy was wrong. HIV very, very rarely goes undetected for six months. That's an almost unheard of seroconversion time. The very concept of a 'six month window period' is considered outdated on the front lines of HIV care.

The idea that HIV would go undetected for six months was developed in the early years of HIV awareness, and is no longer considered current.


Actually this is untrue. The standard course of an infection goes as follows. For the first 1-12 weeks, the patient is most infectious and is deemed as having Acute Clinical Syndrome. During this time, the immune system actively fights the infection. The standard infected person then enters a period of "Clinical Latency" for the period of 6-10 years in which the immune system cannot destroy the virus but nevertheless keeps it in check. The period that follows is called Overt AIDS and lasts roughly 1-2 years. It is then that the immune system fails and those with HIV are at greatest risk.
In the acute stage, it takes roughly 6 weeks for there to be enough HIV antibodies produced to be measurable by the standard ELISA test. There will be, however, enough HIV in the blood to make one positive and infectious to others within a period of two weeks.


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feefiefofemme
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To my understanding having anal sex puts you at a higher risk for HIV/AIDS transmission. I believe it's because tissues are more likely to tear that way. Therefore, it is plausible that MSM are at a higher risk. I could very easily be wrong as I don't quite remember where I read that, but all the same.
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Heather
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While yes, the delicacy of rectal tissue DOES make transmission from anal intercourse more common than via vaginal intercourse, that isn't orientation specific. Anal sex is common between both men and men and men and women. (And plenty of gay men don't engage in anal sex, just like plenty of heterosexuals don't.)

And given that women are more suceptible to HIV transmission (and other STIs), AND that worldwide half of all people with HIV are currently women, with that figure rising 10% in less than ten years, we can pretty much toss the theory out tha gay men pose/are at greater risks in this regard.

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00goddess
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quote:
Originally posted by jordopolis:
Actually this is untrue. The standard course of an infection goes as follows. For the first 1-12 weeks, the patient is most infectious and is deemed as having Acute Clinical Syndrome. During this time, the immune system actively fights the infection. The standard infected person then enters a period of "Clinical Latency" for the period of 6-10 years in which the immune system cannot destroy the virus but nevertheless keeps it in check. The period that follows is called Overt AIDS and lasts roughly 1-2 years. It is then that the immune system fails and those with HIV are at greatest risk.
In the acute stage, it takes roughly 6 weeks for there to be enough HIV antibodies produced to be measurable by the standard ELISA test. There will be, however, enough HIV in the blood to make one positive and infectious to others within a period of two weeks.

Jordopolis- you say that what I wrote was untrue, but what you have written here nowhere contradicts what I wrote last year. In fact, you confirm that I was correct.

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love_lust
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wow, im am totally shocked, i didnt realise any of this. So because of my bf's sexual past .... if i have sex with him then i can't donate blood! Even if he has been tested and is clean?
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