MSM, IDU, and HIV / AIDS

dukkillr read this and wrote about it on his website. Below is that Daily Limit post, including an HIV/AIDS epidemiologist's italicized comments. I know that I'm Sean Penning this issue, but I feel that Mr. Dukkillr made some poor conclusions from the data - my two cents couldn't change his view, so maybe the words of an expert will:

44% of AIDS (HIV and AIDS combined) cases (are presumed to) come directly from gay sex, 16% come from IV drug use, and 4% of infections come from both (both as defined by someone who both injects drugs and is a MSM [Man who has Sex with Men]). 34% come from heterosexual intercourse, but that intercourse is with a "High Risk" individual. What constitutes a "High Risk" individual? Individuals who have had past gay relationships and/or were an IV drug user. (this is also not 100% true, because the true definition includes heterosexual contact with a person known to be HIV positive regardless of their risk for infection, sex with an IDU [Injection Drug Use], sex with a bisexual male, or sex with transfusion/transplant recipient with HIV)

So only 2% of AIDS cases come from "other"� places such as getting infected platelets (Ryan White was infected this way) or "dirty sticks" in the healthcare field (a constant concern while I was working in the hospital). (dirty sticks are extremely low risk, there is very little chance that a person will become infected with HIV via needlestick, Hep B maybe, but not HIV. Some of the reduction in the number of cases associated with any type of contamination is due to the existence of pep and improved testing of blood banks, etc. Because these numbers are cumulative numbers divided by risk they will naturally become a smaller proportion of the cases as time progresses and measures are taken to prevent such infections. This is a simple intervention and has obviously been more effective here then in other areas of the world where hospital acquired HIV remains a problem.)

So to summarize:

98% of AIDS cases in the US = from risky behavior. (While this may appear true with these statistics it isn't completely true because while the original source for the heterosexual cases may have been IV drug defining the secondary infection was via heterosexual contact.)

"Risky Behavior" = Using IV drugs, having homosexual intercourse, or having heterosexual intercourse with someone who uses IV drugs or has homosexual intercourse.
(or having unprotected sex with someone whose infection status you do not know or someone who doesn't know their status. The definition of risky behavior seems to be rather judgemental. All people are responsible for themselves and themselves alone, we can not completely control the actions of our partners and what we don't know can hurt us.)

AIDS cases caused by homosexual contact outnumber the infections by IV drug use by a 3:1 ratio.

2% of AIDS cases in the U.S. = bad luck. (or unsafe procedural action)

Key Point: If we assume that the disease is a "gay and IDU disease" then we will not adequately protect ourselves from infection. It is not difficult to imagine that as the disease becomes more prevalent in the heterosexual community (as the current statistics nearly everywhere indicate) even currently monogamous relationships could encounter the disease through behaviors from previous partners. The old adage that says "when you have sex with someone you have sex with all of their previous partners and their partners, etc." is relatively accurate at least for diseases that remain active for a lifetime. It is crazy to believe that the disease is only a disease for any group, because the possibility of cross-over is likely. There are always people secretly or openly playing on both sides of the "plate." I would also like to reiterate that the statistics he is quoting are likely based on estimations that redistribute risk (i.e. move those whose risk is unknown into categories based on historical proportions) which could potentially overinflate those groups which have been historically over-represented.