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Friday, February 25, 2005

"It's condoms that are responsible for keeping the HIV rates stable in Uganda. Not abstinence."... (continued from here; pls. comment at original post)

According to the abstract from the presentation about which this article is written, on the one hand, they say that,
"Between 1994/1995 and 2002/2003, age-standardized HIV prevalence declined significantly in all adults (17.6% to 11.4% [p = 0.007]) and in young adults aged 20 to 24 (16.9 to 7.7%), but not in adolescents aged 15 to 19 (3.6 to 3.2%)."
"Prevalence" means "pervasiveness." I take it to mean “the number of cases.” If something is pervasive, it’s "everywhere," there’s many, many cases of cases of it. So if prevalence went down significantly, the total number of cases went down. Except in teens, where HIV prevalence did not go down significantly. This wasn't reported too well in the story. Not at all in fact.

How all that relates to the next observation is fuzzy--at first. They said in the next sentence,
"Incidence did not decline overall (1.3/100 person-years in 1994/1995 and 1.7/100 person-years in 2002/2003), in young adults (1.1/100 person-years and 1.5/100 person-years, respectively), or in adolescents (1.3/100 person-years and 1.2/100 person-years)."
"Incidence" means "rate of occurrence" or "“percentage."

They also wrote,
"In the same period, age of sexual debut declined in both sexes, and the proportions of young adults reporting sexual activity, non-marital relationships, and multiple partnerships increased. However, condom use with casual partners rose significantly, particularly at younger ages (for example, from 19% to 38% in males aged 15 to 19)."
That means that, from 1994 to 2003, Ugandans started having sex younger than before, having more of it and with several partners and outside of marriage, and that they used condoms significantly more often with casual partners. (They don't say anything about use with one steady partner or spouse)

Yet the number of cases of HIV contraction among adolescents did not decline significantly, while they were all having more sex much earlier and with multiple partners and using more condoms.

Hmmm.

And the rate of HIV incidence overall and in YAs and in teens did not decline during the same time that they supposedly attribute a "decline" in HIV cases to condoms.

The incidence rate--the percentage of the population obtaining HIV—stayed relatively the same?

Well, the researchers said it did not decline, but is that the same as staying the same? Apparently, no.

Here's how we figure the truth out. The article gives the answer as to how that might happen while "prevalence" simultaneously declined:
"Her team also found that mortality was keeping prevalence down. In other words, so many people die of AIDS that the number of new infections cannot keep up, thus keeping the percentage of HIV-infected people in the population constant."
So they're claiming that more people died off, keeping the incidence rate the same.

But the percentage wasn't constant.

The study also says that "Mortality among HIV+ persons was 13.3/100 person-years." We don’t have access to exactly how many were infected through the life of the study, so we can’t calculate how many died by 2003. If there were considerable numbers of people who died, of course, the number of cases would decline.

But they themselves reported (in that second study quote from the top) that the rate of infection didn’t decline and in the case of both the overall rates and the young adult rates: those each increased by four-tenths of a point, or 31% and 36% respectively.

So although there were fewer people in the study by its conclusion, the rates of contraction of HIV had in fact risen substantially for the overall population and for YAs.

And that coincides with an increase in condom use? Shouldn’t using more condoms have reversed the rate and the number of cases of HIV??

The researchers think “it’s the condoms keeping the rate from going up”?

I don't see how they can even report that with a straight face--and to an international conference of experts on AIDS no less--when the overall and YA infection rates went up 31% and 36%. They instead should have not drawn attention to this and should have been satisfied with simply attributing the "decline" in HIV "prevalence" to AIDS-related deaths having reduced the population from which to glean statistics.

And we're supposed to trust those researchers just because some of them work for Johns Hopkins and Columbia?

PS: I tried to do some calculations about how many had died and how many cases of HIV/AIDS there were at the start and end, but without certain data, I realized it was impossible and inaccurate and edited that out of this analysis.
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Obama On Abortion: A Summary 1990-2009

1) Obama Is 2nd-Highest-Paid Politician by Fannie Mae, Taking $126,346 in only 4 years as Senator; Now Derides GOP/Bush for Allowing Fannie Mae/Freddie Mac To Do Business, When It Was Democrat Presidents Bill Clinton & Jimmy Carter Who Passed The Law Requiring Fannie & Freddie To Give Out Bad Subprime Loans To Those Who Couldn't Afford Them, Which Caused The Entire Financial Meltdown … 2) Jim Johnson (Obama VEEP vetter and former Fannie Mae executive who made millions there) Backpedal … 3) Obama's hiring, connection, support of ACORN, which supported that very law and whose staff have been involved in voter fraud … 4) Rezko's Favor A "Boneheaded" Mistake … 5) Jeremiah Wright Backpedal … 6) Fr. Michael Fleger Backpedal … 7) NAFTA Backpedal … 8) Campaign Financing Backpedal … 9) Mr. "Negotiates-With-Terrorist-States" … 10) Bittergate … 11) Hamas' Chief Political Adviser Hopes BO Will Win Election … 12) Banning Handguns Backpedal … 13) Who Exactly Are "The Rich" He's Going to Sock it to? … 14) Flag Pin Backpedal … 15) Once Open to School Vouchers That Work, Now Deadset Against … 16) Now OK with residual force in Iraq...up to 50,000 troops. … 17) First voted against a law protecting babies who survive an abortion procedure, then lied saying he didn't, then finally forced to admit that he did vote to deny such born babies protection. 18) … "For the first time in my adult lifetime, I am really proud of my country." ~ MO

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