Gay Marriage (and other Rights) in the U.S: Don't weary about it

[Koul]

He could, but empathetic people are very different to someone like Priran. For example archi has concerns about blood infection, but he's been willing to look into whether gay and bisexual claims of unnecessary discrimination have some basis, because he's empathetic. Someone like pririan though, as has been seen in this thread from the very moment he started posting, only ever cared to spit venom and vile all over the place. He never cared to find out if the grievances aired had any basis. He had a pre conceived notion (gays crying cause they are entitled and want to put everyone in danger of aids, in his little mind), and ran with it.

I guess it's up to ones interpretation because that's not how his posts came off to me. I read his posts with a gloss of sarcasm though so mabye that's it

[Kuya]

Kuya, completely serious question - do MSM Italian men have nearly the same prevalence of HIV infection as MSM American men (1 in 8 or so)?

Compiling a few figures here, and only talking about adult men.



Ok so 4.2 million MSM.


450k of which are hiv+

So like 11% of MSM or so.

The numbers vary depending on the survey:

MSM: three surveys were conducted in this population: the MODI DI. survey in 2005 [19], which showed a prevalence of 4%; the SIALON study in 2008 [20], which showed a prevalence of 11.9%; and the EMIS study in 2010 [21], which showed a prevalence of 9.6%.

http://www.hindawi.com/journals/bmri/2014/209619/

But i've also seen HIV prevalence rates for MSM in the USA higher than 11% too.

[archibaldcrane]

Yeah, it's hard to nail down exactly but 10+% seems likely.

[Koul]

I think in a country like the USA where we're just so freakin huge and to take into account the seriousness of the blood supply, it's important to be strict. Yes, it sucks but thems the breaks (in my mind)

literature: http://www.cdc.gov/nchhstp/newsroom/...DC-MSM-508.pdf

and this is how I feel on the subject: http://www.npr.org/blogs/codeswitch/...e-many-gay-men

Overall, do I feel like this is based on a paranoid fear that gay blood might be contaminated? Yes. I do. If human error was taken out of the equation and blood testing was always 100% accurate all the time, all blood donation bans should be lifted. But error in all it's forms exists and we should take that into account.

If someone used the fact I can't donate blood for a year as hate-ammo against me, that's not my problem. It's their problem.

[Kuya]

Oh don't get me wrong. A one year ban as opposed to a lifetime ban makes much more sense and is much better even if in practice it means most gay and bisexual men still cannot donate. I just hope that in the future, the policy continues to get more sensible.

[Priran]

Nice. Gay and bisexual men who are mad about blanket bans against them based on AIDS scares from the 80s despite advances in biotechnology and examples of better blood donation risk assessments are now hypocritical sociopathic entitled pieces of shit.

I wasn't saying anything that general, I was talking specifically about you. I'm pointing how hypocritical your risk assessment is between risks posed by others to you (people cheat [or whatever your rationale is], so you wear condoms when having sex with your only partner so you don't get HIV) and by you to others (the idea that gay men are at risk of having HIV is 30-year old hysteria, so you lie to screeners so you can donate blood).

[Kuya]

So to summarize our engagement in this thread:

You made a flippant comment about gay and bisexual men's grievances about US blood donation policy by making this comment:

On the other hand it hurt some people's feelings so you can really see how it forced their hand.

Presumably you felt that the grievance gay and bisexual men had about blood donation policy had no rational or empirical basis.

I then proceeded to show you a scientific study that shows an example of a blood donation policy that is in line with what gay and bisexual men are asking for and has shown not to lead to higher incidences of blood donation caused HIV contamination.

Because you seemed to have ignored this or because I did not quite understand your rebuke, I asked you in two separate occasions to clarify your position or concede that your initial comment was out of place:

I already gave you medical and statistical facts. You chose to ignore them, because you don't care to see them.

I didn't understand the first part of your post. It's not quite clear to me whether you are addressing the study I posted regarding blood donation policy in Italy.

I think what you meant to say was: While studies in Italy might show that a blood donation policy based on individual risk assessment rather than blanket bans on gay and bisexual men has not shown a higher incidence of HIV infection via blood donations, you still object to the applicability of the policy in America because of population differences. I think this is what you were trying to say. If that is the case, this sort of argument is used all the time when discussing policy from other countries being brought to a different country. The key here is if you're just going to use this argument as a shield to prevent changing blood donation policy into a more rational policy, or if you're genuinely interested in finding ways to adapt the Italy policy into a successful American one.

Of course, the difference is the former doesn't care what gay and bisexual men have to say and the latter is genuinely interested in attending the grievance this group is trying to make. The latter is constructive criticism as opposed to pure obstructionism.

I suspect you are the former, but you have a chance to prove me wrong in this thread. Do you have any ideas on how we can adopt Italy's policy into the USA successfully? Do you have specific concerns on the applicability of this policy and how we could overcome them?
.

I'd like to remind you that you just purposely avoided addressing the study I posted. I'll repeat this to you again, please stop ignoring it. What suggestions do you have for applying Italy's policy to the USA? What specific concerns do you have about applying the policy? You never contested the veracity of the results, so i assume your only concern is a public policy one and one not based on science. So please, try to stop disparaging gay and bisexual men for one second and answer the questions i'm posing to you.

I am only left to assume that the reason you silently refused to address the study I posted and shifted gears to complain about my own personal behavior is that you do not want to admit you made a mistake with your initial flippant statement.

This kind of behavior is unfortunately an example on why more modding was asked for in this specific section of the forum. If you are going to make an ignorant and insulting statement, the least you could do is respond when somebody gives you a rebuke instead of silently ignoring it, and then proceeding to shift your complaint about something else. If you were wrong, just admit it. If you still think you are right, then prove it.

[Priran]

I didn't refuse to address your point, I addressed it and then refused to enable your deflection into an argument about my motives. If you have any evidence that just IV drug use+prostitution covers the bases for high HIV risk in the US as well as it does in Italy I'd be interested in seeing it, but until then I'm still opposed to basing these kinds of decisions on political pressure. GMOs upset a lot of Americans, and European policies about those are fucking stupid too.

[Kuya]

I didn't refuse to address your point, I addressed it and then refused to enable your deflection into an argument about my motives. If you have any evidence that just IV drug use+prostitution covers the bases for high HIV risk in the US as well as it does in Italy I'd be interested in seeing it, but until then I'm still opposed to basing these kinds of decisions on political pressure. GMOs upset a lot of Americans, and European policies about those are fucking stupid too.

If you already addressed, then clarify it. Like I said here:

I didn't understand the first part of your post. It's not quite clear to me whether you are addressing the study I posted regarding blood donation policy in Italy.

.

If your complaint about the the study was that it only classifies IV drug use and prostitution as high risk, then you misread. Certain MSM behavior is classified as high risk in Italy's policy:

"High risk" behaviour is intended as a behaviour exposing the donor to a high risk of acquiring transfusion-transmissible infections and includes: usual/recurrent (occurring repeatedly) sex with more than one heterosexual or MSM partner whose sexual behaviour is unknown, receiving or exchanging sex for money, use of injecting drugs, usual/recurrent sex with a partner positive for syphilis and/or HIV and/or HBV and/or HCV.

I addressed your complaint. Are you going to change your stance now or do you have another issue with the study?

[Priran]

If you already addressed, then clarify it. Like I said here:

If your complaint about the the study was that it only classifies IV drug use and prostitution as high risk, then you misread. Certain MSM behavior is classified as high risk in Italy's policy:



I addressed your complaint. Are you going to change your stance now or do you have another issue with the study?

I didn't miss those parts, it's just giving a 4 month deferment for an infection with a potentially 6 month incubation period. It shouldn't require explanation about why that's stupid and those lines can be generally understood to, in practice, be in place to screen out Hep B and C, which both have incubation periods of about 2 months.

[Kuya]

I didn't miss those parts, it's just giving a 4 month deferment for an infection with a potentially 6 month incubation period. It shouldn't require explanation about why that's stupid and those lines can be generally understood to, in practice, be in place to screen out Hep B and C, which both have incubation periods of about 2 months.

High risk categories are lifetime deferments and at risk categories are 4 month deferments.

"Risk" sexual behaviour includes: having a new sexual partner whose sexual behaviour is unknown, having ever had one occasional sexual relationship with a person whose sexual behaviour is unknown, having had casual sex with an HIV- and/or HBV- and/or HCV-infected partner. A blood donor, whether MSM or heterosexual, having engaged in any of these behaviours is deferred for 4 months from the exposing event. "High risk" behaviour is intended as a behaviour exposing the donor to a high risk of acquiring transfusion-transmissible infections and includes: usual/recurrent (occurring repeatedly) sex with more than one heterosexual or MSM partner whose sexual behaviour is unknown, receiving or exchanging sex for money, use of injecting drugs, usual/recurrent sex with a partner positive for syphilis and/or HIV and/or HBV and/or HCV. A blood donor, whether MSM or heterosexual, having engaged in any of these behaviours is permanently deferred. The physician in charge of blood donor selection is responsible for adjudicating either "risk" or "high risk" behaviour.

And while the maximum incubation period of HIV is 6 months, most HIV can be detected in 3 months:

A few people will have a longer window period, so if you get a negative antibody test result in the first 3 months after possible exposure, you should get a repeat test after 3 months. Ninety-seven percent of people will develop antibodies in the first 3 months after they are infected. In very rare cases, it can take up to 6 months to develop antibodies to HIV.

http://www.cdc.gov/hiv/basics/testing.html

However, if 6 months is the max, then a 1 year deferral doesn't make sense either.

So, anything else?

[Kuya]

Oh, I almost forgot.

While it might take at most 6 months to detect HIV in rare cases via antibody tests, the FDA also requires RNA testing to confirm donated blood is HIV negative. RNA testing can detect HIV in blood after 10 days from initial infection:

RNA tests detect the virus directly (instead of the antibodies to HIV) and thus can detect HIV at about 10 days after infection—as soon as it appears in the bloodstream, before antibodies develop. These tests cost more than antibody tests and are generally not used as a screening test, although your doctor may order one as a follow-up test, after a positive antibody test, or as part of a clinical workup.

http://www.cdc.gov/hiv/basics/testing.html

Blood donations are required to be tested both for presence of antibodies to HIV and for HIV ribonucleic acid (RNA). RNA testing detects HIV at an earlier stage than HIV antibody testing.

https://www.aids.gov/hiv-aids-basics...rgan-donation/

FDA has licensed nucleic acid tests (NAT) as tests to screen blood donors for HIV-1 ribonucleic acid (RNA), and HCV RNA; and...

For HIV-1: To meet the requirement to use one or more approved screening tests, as necessary to adequately and appropriately reduce the risk of transmission of communicable disease, we recommend that you use an FDA licensed donor screening test for the detection of antibodies to HIV-1 (either a stand alone HIV-1 test or a combination HIV-1/HIV-2 test). If the FDA licensed test for detection of antibodies to HIV-1 is negative or non-reactive, we recommend that, as part of adequate and appropriate screening, you test the donation further using an FDA licensed HIV-1 NAT. Testing using the tests for the antibodies to HIV-1 and HIV-1 NAT may be performed concurrently.

http://www.fda.gov/BiologicsBloodVac.../ucm074934.htm

[Priran]

High risk categories are lifetime deferments and at risk categories are 4 month deferments.



And while the maximum incubation period of HIV is 6 months, most HIV can be detected in 3 months:



http://www.cdc.gov/hiv/basics/testing.html

However, if 6 months is the max, then a 1 year deferral doesn't make sense either.

So, anything else?

You know what's probably the biggest barrier to healthcare after accessibility/cost? Of course you do, look who I'm talking to, but for anybody who doesn't know, it's non-compliance. People who through ignorance or mendacity tell their doctors things that aren't true, like "Yes I am going to take this HTN medication" or "My name is Kuya and no, Red Cross lady who is going to be pricking my finger and putting needles in my arm, I don't have any HIV risk factors to speak of".

You know what you get when you make a 6, or even 9 month deferral for exposure to an illness with a 6 month incubation period? Lots of people checking "no" after 3 or 4 months because most people aren't Rain Man who can double check some eidetic mental calendar. The 3 months they make you wait after donating before you can donate again is similarly overboard for the sake of minimizing danger when people overestimate the time since their last donation.

And can you explain a "lifetime deferral" for "recurrent sex"? Does it stop being a lifetime deferral if you settle down or does that mean if you had recurrent sex with strangers over a period of months several years ago, then you're still deferred for life? Because in the former case that isn't "lifetime" and in the latter case I don't see how that's any different from the previous US policy except for being a more ambiguous class to opt into, which is bad.

Oh, I almost forgot.

While it might take at most 6 months to detect HIV in rare cases via antibody tests, the FDA also requires RNA testing to confirm donated blood is HIV negative. RNA testing can detect HIV in blood after 10 days from initial infection:

Note the word "recommend" and the guy in this thread who does it for a living saying they only do it if the screening makes them suspect it.

[kuronosan]

Oh, I almost forgot.

While it might take at most 6 months to detect HIV in rare cases via antibody tests, the FDA also requires RNA testing to confirm donated blood is HIV negative. RNA testing can detect HIV in blood after 10 days from initial infection:



http://www.cdc.gov/hiv/basics/testing.html



https://www.aids.gov/hiv-aids-basics...rgan-donation/



http://www.fda.gov/BiologicsBloodVac.../ucm074934.htm

That's great. I specialize in immunochemistry testing, hematology, and immunohematology. No lab will do RNA PCR testing unless the screen is positive or there is sufficient reason to believe it will be positive. There is a whole world of paperwork and liability to take into account with state and federal-reported diseases. If it's positive, it better stay positive.

Blood products require a prescription, a and thus require FDA approval and certification. Since blood has a maximum shelf life of anywhere from 2-5 weeks, it would simply cost too much time and money to collect blood that could potentially be discarded before they can even test or get test results on high risk factors.

So yea, keep complaining to someone who's perfectly healthy and deferred for life for being born in the wrong country at the wrong time. I know my job. Buttsex is a bullshit reason, as I said, but don't mistake that for an illogical one. Working in health care I can tell you that eliminating ANY risk, even those less than 10%, is a top priority.

Now that isn't to say homosexuals have a higher incidence of STDs because of their lifestyle, but please don't call this discrimination. It's precautionary. Unless you've seen what tainted or reactive blood can do to someone, you have no room to talk.

[archibaldcrane]

I hope you know that "buttsex" isn't the reason. They don't ask about anal sex specifically at all.

Source: I give blood to the red cross 3-4 times a year

[kuronosan]

I hope you know that "buttsex" isn't the reason. They don't ask about anal sex specifically at all.

Source: I give blood to the red cross 3-4 times a year

I'm sorry, why does it say refraining from sex for a year? I thought all the butthurt (sorry) surrounding this had to do with anal sex?

If it didn't, then it's bullshit and really has no place as a factor. Sounds a lot like the "HIV is the gay disease" thing that plagued the 80s and 90s and the tea party.

Edit: Never mind, I read back again. It says within the last year, which makes absolutely no sense.

[Mazmaz]

There is a whole world of paperwork and liability to take into account with state and federal-reported diseases. If it's positive, it better stay positive.

Can you expand on what you mean by this?

[kuronosan]

Once again, it's about epidemiology. Scientific pathology and how a country (specifically America) reacts to a disease, how funding is distributed, and announcements of outbreaks heavily relies on accurate data.

How would you feel if you were contacted by the health department and told you had a life changing disease and had to take thousands of dollars worth of medication to avoid spreading it, potentially wrecking your relationships or health, only to find out they were acting on a false positive?

People have been and are sued daily for mistakes like this. What's even worse is when you report someone as negative for an infectious disease when they're really positive. Tests are sensitive enough to where this never happens, but imagine you were tested for Ebola and had a false negative.

[Mazmaz]

How would you feel if you were contacted by the health department and told you had a life changing disease and had to take thousands of dollars worth of medication to avoid spreading it, potentially wrecking your relationships or health, only to find out they were acting on a false positive?

People have been and are sued daily for mistakes like this. What's even worse is when you report someone as negative for an infectious disease when they're really positive.

So hypothetically, how much shit would they be in if they did both of these? i.e. mixed 2 people's results

[kuronosan]

So hypothetically, how much shit would they be in if they did both of these? i.e. mixed 2 people's results

They would be fired immediately (depending on the severity), likely to lose their license or certification, and would probably find it incredibly difficult to get a job in the future.

We lost a coworker not too long ago because of this. Person turned out to be positive and was reported as negative.

Mistakes can happen but in the medical world word travels fast of serious mistakes. Generally people are given a chance to explain what went wrong. Sometimes, even if it was an honest mistake, it's too serious a mistake to let slide.