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One in 20 gay men living with HIV as infection rate hits record high

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  1. Truly horrific figures. People need to have more respect, not only for their own bodies but for others as well!

  2. Whilst these are, at first glance, very disappointing figures – the growth in MSM infections appears to have returned … we need to consider two facts allied to this information …

    Firstly, has the increase in rate of diagnosis in MSM who have HIV actually come from an increased awareness of the need to seek testing (and arguably an element of increased sense of responsibility). Sometimes, in health conditions there is an increase in prevalence because education works – ie more people get tested, therefore, more people get detected.

    The second point seems to reinforce this comment … the rate of late infection in heterosexual men and women is much higher than in MSM – suggesting that MSM are more aware of their need to get tested (or more willing to be tested – given GUM figures suggest 20% of all patients (with a higher rate in heterosexuals) decline an HIV test). Late testing means increased risk to yourself and others and treatment is less effective.

    So, whilst this ….

    1. … is bad news – perhaps part of it is down to the success of a better awareness amongst MSM of the need to be tested?

    2. I can assure you many of these increases come from more people testing and being diagnosed – and you are right the figures then rise –
      But until a generation of men are encouraged to practise using condoms when they masturbate to gain confidence using them during sex Gays and St8s – they will not risk loosing their boner as they struggle to put one on during sex – the fact is most men when asked don’t use condoms – and the reasons or rather the excuses are – loose sensation, allergic to them (which is bollox) too big or too tight etc…
      Second most important application is that of lube – gay and str8 – most condoms fail because of dryness – they are certainly strong enough – just look at all those dickhead who blow condoms up over their heads -

  3. It’s also due to the fact that MSM don’t view HIV as a death sentence any more.

    They are correct in this of course,

    Because with proper treatment a HIV diagnosis is no worse (and actually probably easier to manage) than a Type 1 diabetes diagnosis. It’s only the stigma attached to a HIV diagnosis which is worse. A few tablets a day as treatment is a lot less invasive and manageable than a regime requiring 4 injections, 4 bloodtests, constant monitoring of exercise and food intake to avoid collapsing.

    An annoying chronic illness is a lot less scary than a death sentence.

    What confuses me is that the anti-HIV charities are still behaving like it is 1990, when we all know that it is not.

    A HIV diagnosis should be avoided and we know how to avoid 1. But the reality is that it is not the end of the world.

    The best way to persuade people to avoid sero-converting seems to be frightening them.

    But that does not really happen as by doing that it just stigmatises the already positive.

    1. @dAVID

      I think it is a combination of a number of factors – the increased willingness to be tested (and be tested early) in MSM and (as you have stated) a view that HIV is not a death sentence any longer (which, by and large, is correct) – of course there are other factors involved too.

      I do not want to have type 1 diabetes, my mother is a type 1 diabetic and I have treated many patients with diabetic emergencies and chronic problems. To combat this I exercise, eat well and don’t smoke.

      I don’t want to have HIV either – so I engage in safer sex, do not use IV drugs and at work adopt universal precautions in terms of infection control and, even though the risk is negligible, ensure that I am tested once or twice a year unless an event occurs which requires an earlier test.

      The best way of encouraging testing and decreasing risky behaviour is a combined approach which encourages safer sex AND encourages appropriate testing (and relevant follow up if needed). It is key to this …

      1. But all the HIV charities and medical experts already encourage safer behaviours and regular testing. Nothing new there.

        But the infection rate is still rocketing.

        There was an article on the BBC website yesterday about the hardhitting ad campaign in Britain in the 1980’s. Spain, Italy and France did not have these scare campaigns and (perhaps) as a result for many years these countries had much higher infection rates.

        The fear campaign seems to have worked in modifying people’s behaviours.

        There are no longer these fear campaigns because a)They would no longer be accurate and b) apparently the stigmatization of positive people must be avoided at all costs.

        1. @dAVID

          The programmes encourage regular testing.

          Increased testing inevitably leads to increased diagnoses.

          Ergo, (at least in part) the programmes are working …

          Its a false idea that suddenly everyone will start being responsible and get tested and there will be no rise in diagnosis rates …

          1. But this study does not state that more people are getting tested.

            it simply says that more people are testing positive.

            Perhaps it’s true that the increase in testing is leading to an increase in positive diagnoses, but you can’t jump to that conclusion from this report.

          2. The full report does report an increase in testing by 2.4% in 2009-10.

            The Department of Health funded 8 pilot projects examining the most successful ways to increase HIV testing. The pilots took place in a variety of hospital, primary care and community settings. Additional pilot projects are also being conducted around the country. In collaboration with the Department of Health the HPA is conducting an overview of these projects and further aspects of HIV testing in the UK. All the test projects demonstrated that there was an increased acceptance of testing. The number of HIV tests undertaken by pathology services has also increased

          3. So there was a 7.8% increase in infections (6660), but only a 2.4% increase in testing.

            The theory that more people are getting testing positive because more people are getting tested does not really ring true.

            Infections are growing at a rate 3 times higher than the growth in people getting tested.

          4. dAVID

            I suggest you peruse this publication which provides a balanced and informed explanation as to why testing is hugely important and significant:

            http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1316424799217

            There is no one reason as to why infection rates change but increased testing is a factor in that

    2. … that we do not stigmatise people who are HIV positive – both because that has a negative impact on the health and well being of HIV positive people and also because this frightens some from being tested.

    3. True, so what a shame it is to read in various reports today, including the HPA’s official report, that it costs well over £1million to treat one HIV infected person here in the UK. That could pay for a new hospital or school.

      HIV is something that – in the vast majority of cases – can be preventable. No one can say nowadays, “It’s not my fault” (unless they were raped). It’s not like most deadly illnesses, which people contract through no fault of their own. I think one way of stopping the spread of HIV in the gay community would be to make those infected pay for their own treatment. It’s not fair that a handful of selfish, irresponsible hedonists can hold the whole country to ransom – especially as the poor and needy are being affected by Government cuts.

      Abstinence is the only 100% safe sex
      Condoms do break and are not some 100% effective force field
      Those who cannot control their sexual behaviour and thus get infected should be made to pay for treatment

      1. @John

        So the natural extension of your argument is that the expensive treatment should not be given .. because the illness is “avoidable” in most cases …

        Would you extend your philosophy of delivery of healthcare to lung cancer patients who smoked (who have expensive chemotherapy and radiotherapy), diabetic patients who were obese (a condition which costs the NHS £1m per hour), liver disease patients who have alcohol problems etc etc …

        Your approach reinforces stigma and is both callous and irresponsible and has no legitimate place in public health

        1. Peter S. (formerly 'FengLong') 29 Nov 2011, 12:37pm

          Well not that I agree with making HIV patients pay for their care, because that would be impossible, but his thinking actually does play a considerable part in public health.

          Of the three things you mentioned as examples, smoking is the one which carries the greatest associated health risks, and they DO make smokers pay for their own health care in the form of heavy taxation on tobacco products. I’m sure I’ve also heard ideas bandied about regarding higher taxation on confectionery and the like, and also about making alcohol more expensive. So it’s not as though the basic principle of his argument is utter madness.

          1. @Peter

            To be fair you could only say that smokers pay more for their health care if the taxes on tobacco were ring fenced (which they are not). There is a public health element to the tax on tobacco products, but this is as a deterrent not to fund care for smokers. How you would tax people to deter them from participating in less safe sex, I am not clear …

            Just because there have been discussions about taxes on confectionary etc does not make this either likely or legitimate …

            As for public health – its not just about deterring people, its about protecting people – burying our head in the sand and assuming people will respond to shock and horror tactics is both inadequate and irresponsible. We need to recognise that we need people to be tested, to adopt safer sex practices and that assuming everyone will respond to a psychological fear message – we need to target all people and the psychological cues that work for them. We also need to adopt a responsible approach towards…

          2. … those who are HIV Positive and ensure we do not stigmatise them.

          3. Peter S. (formerly 'FengLong') 29 Nov 2011, 2:23pm

            Tobacco tax revenue doesn’t need to be ring fenced in order to justifiably say it helps fund the health service. That’s silly~

            Treating smoke related illness is a drain on tax funds. Exorbitant tobacco tax helps compensate for this by increasing the money made from those who cause that problem. It’s as simple as that.

            They may not ring fence the exact money made from tobacco tax, but they don’t need to~

            Hypothetically, if you only charged regular VAT on tobacco but without increasing the number of smokers at all.. The NHS bill for treating smoke related illness would be a greater burden on the overall national tax revenue.

            I wasn’t saying the fat tax was either likely or legitimate or otherwise. I was meaning to say that it isn’t an uncommon point of view that those who drain excessive resources unnecessarily should pay towards their care, you said it had no place in public health.

            And you can’t just promote safe sex without a compelling reason why.. Or else… cont.

          4. Peter S. (formerly 'FengLong') 29 Nov 2011, 2:25pm

            What’s the incentive~~?

            Remember sex drive is a powerful force. You can’t overcome that without a powerful reason why~

          5. @Peter S

            If smokes were genuinely paying more for their NHS care than non smokers to compensate for smoking related illness, then there would be an identifiable correlation between increases in tobacco taxation and NHS spending in lung cancer care, COPD etc etc and there is not.

            The tax on smoking is to act as a deterrent not to fund (necessarily) the NHS.

            The safer sex campaigns (often but not always) promote the impact of STIs and HIV. However, “scare” tactics need to be honest and based on real clinical and scientific experience not evidence from the 1980s or ideological views.

          6. Peter S. (formerly 'FengLong') 29 Nov 2011, 3:16pm

            I’m not actually denying that they try to put people off smoking with the high tax.. But it’s also undeniable that smokers as a group drain money from the system due to smoking, and also pay money into the system due to their smoking. Don’t tell me there is no element of compensation there.

            They put the tax on tobacco up each year as much as they can possibly get away with! That there may not be the exact correlation you mentioned is meaningless, there are other counter balancing considerations against increasing tobacco tax such as the tax disproportionately targeting the poor.

            I mean, let’s say the tobacco tax isn’t intended in any way whatsoever to compensate for smokers draining health service funding and is just meant as a deterrent, that it never once crossed anyone’s mind. That means we could do away with it and the country wouldn’t be any worse off for it right?
            Maybe we should do away with all non-ring fenced taxes since they supposedly don’t help anything in particular ye?

          7. Smokers may not be spending more on their NHS care than non-smokers, but it is indisputable that they are paying more of their disposable income in tax.

            Therefore whether the tax revenues raised by tobacco sales is used for the NHS or for education or defence or tourism is largely irrelevant.

            Smokers pay more of their income on taxes than non-smokers, so effectively they are paying for their NHS care, even if it is indirectly.

          8. Peter S. (formerly 'FengLong') 29 Nov 2011, 3:43pm

            Thank you David, that is exactly what I am trying to say here.

            Stu just can’t bear the idea of it, and so he denies it.

            It’s only because he’s such a nice guy; but he can be nice to the point of self delusion~

          9. @Peter

            Whilst I appreciate your compliment and am happy to be called a “nice guy”, that is not something that I think everyone would agree with …

            I would prefer to be called fair, as I can and will be assertive and intransigent when necessary … but equally am usually willing to listen to the other side of the argument …

            No where have I said that smokers do not pay more tax … this probably is the case with many smokers … to then extrapolate this to suggest this means smokers therefore directly or indirectly pay more for the NHS is speculation (something you seem keen to reject when it comes to HIV infection but keen to endorse when its fiscal) …

            Exorbitant tobacco tax? Lets hope it rises again soon. I welcome the smoking bans and tobacco tax as public health measures in similar ways to which you passionately seek to froth about HIV …

          10. Peter S. (formerly 'FengLong') 29 Nov 2011, 5:57pm

            I fear we are treading water by now.. Bottom line is, smokers take more money from the system as a whole by way of their smoking, they also pay more into the system as a whole by way of smoking. I see a link there, you don’t.. Ok – that’s that really.
            I’m a smoker, and this year my bundle of 100 cigarettes rose from £25 to £30. True story.. And I’m fine with that. If and when i get lung cancer, I will expect treatment for it. It’s a health risk I bring on myself that other more sensible people don’t have, and I am prepared to pay for that through taxation of the offending article.

        2. An extremely scary prospect to consider here – and as good a reason as any to reinforce the safe sex message loud and clear – is that there have already been quite open discussions to minimise NHS treatments for people who do make a choice to indulge in risky behaviours, such as smoking and over-eating. Only a fortnight ago the mainstream media reported how some HIV patients are now being asked if they would consider switching their treatment to a lower cost alternative.

          This may not sound like a major threat right now as patients are still being given a choice, but we could be at the top of a slippery slope where austerity measures are cited more and more as reasons for slashing the annual HIV drugs bill, just as excuses are being made to deprive cancer patients of life-prolonging drugs. Only today The Guardian reported:

          “If the 3,640 UK acquired HIV diagnoses made in 2010 had been prevented, between £1bn and £1.3bn lifetime treatment and clinical care costs would have been saved.”

      2. John – it is not the job of the medical profession to act as the moral police for the nation. Their job is to provide healthcare to those in need regardless of circumstance (no doctor refused to perform a liver transplant on George Best, even though the press were calling for him to be kicked out on the street).

        It is inhuman in the extreme, to expect the doctors to start refusing treatment to patients because they cannot afford it. That would make British healthcare as monstrous as the US system where profits and cost take precedence over patient welfare.

        And I suspect that your curtain-twitching, Daily Mail style moralising is motivated by your own homophobia.

        It does not matter HOW someone was infected. We live in a country with universal free healthcare. So trying to financially penalise someone for being careless (or for trusting their cheatring partner) is really quite nasty. And I do not want to live in a country like that.

        1. @dAVID

          I absolutely agree with you.

          As a clinician, I am paid and expected to treat people regardless of what my own personal viewpoints or judgements are on the situation.

          As a paramedic I have treated terrorists in high security prisons, paedophiles in police cells, new born babies elderly war heroes, a couple of celebrities and journalist from News of the World (!) … I hope all received the same standard of care and dignity from me …

          I would find it reprehensible to have to make such decisions if a government or campaign group were to set them in place. I take great pride in being independent and have the needs of my patients at the centre of what I do.

      3. John hi,

        Can I refer you to the HPA press release http://www.hpa.org.uk/NewsCentre/NationalPressReleases/2011PressReleases/110901HIVdiagnosesdata/ at a cost of £484 million / 91,500 = £5,289.62 per person / per year

    4. Spanner1960 2 Dec 2011, 9:02am

      Well, as a Type I diabetic myself, I know it is a damn sight more difficult to manage than HIV+ people I know that simply drop one tablet a day.

      That said, both illnesses reduce longevity, and will ultimately shorten one’s life.
      As I have said in previous comments, there needs to be a balance where people realise the gravity of the dangers of HIV, yet not to a point where it stigmatises those already infected.

      Unfortunately talking gently and being nice quite obviously has no effect and people become complacent. The only way is to frighten people to such a degree that they think safer sex automatically, in much the same way as seat belt and drink driving campaigns.

      1. @Spanner1960

        Whilst it is different from patient to patient in both conditions, there is more likely to be more frequent problems with consistency of the condition with type 1 diabetes …

        Both have a potential to reduce longevity (although not in all cases)

        There does indeed need to be a balanced approach to health promotion, education and management for both conditions. Neither should stigmatise – yet some will need to be strident and challenging in their approach.

        Some issues do need to be talked about gently with some people (and it works), the same issues (or others) may need more dynamic approaches to have the same or better impact.

        We do need strong, encouraging (whatever form of psychology is appropriate to both the message and audience) messages that tackle safer sex in connection with HIV and in connection with unhealthy diets, lack of exercise and other issues in terms of diabetes …

  4. Peter S. (formerly 'FengLong') 29 Nov 2011, 10:41am

    Whilst I approve of these figures as a scare tactic..

    In actuality it’s pretty ridiculous to say what proportion of gay men have any given thing, since the number of gay men cannot be known.

    This is especially obvious to any closet case such as myself..

    When the HPA and others put out figures like these, they *should* really add some sort of qualifier to acknowledge that fact.

    But still, as a scare tactic, it’s probably a good idea to make the prevalence seem as high as the flawed figures will allow~

    1. To be fair to the HPA they do actually state in their report on HIV in 2011 that determining the exact population of MSM in the UK Is very difficult. They use a figure of approx 3.6% – acknowledging that the proportion of MSM is higher in London.

      Not sure how they derive their figure – but it is an issue they acknowledge in their report.

      As for scare tactics, that stigmatises people and makes them adopt an “ostrich reaction” (head in the sand) and this deters people from being tested, which can lead to late diagnoses and more infections. It also stigmatises those who have HIV themselves (whatever the cause) and that is not a responsible approach for a health agency to take.

      1. Peter S. (formerly 'FengLong') 29 Nov 2011, 12:15pm

        I realise they do usually add that rather understated caveat whenever they make claims regarding the number of gay men.. But if they were truly concerned about accuracy they would in fact concede that it is ‘impossible’ to know, and not merely ‘difficult’.. But then they wouldn’t be able to release any figures at all; and it’s better to release meaningless figures than to release none at all… right?

        There are only two possible ways to ascertain the number of gay men in a population.. The most accurate method is to consult your omniscient crystal ball. Failing that, the next best method is to randomly put out optional questions and fish for a response from a self selecting group of people. Neither method yields results of any scientific value~

        As for scare tactics~~~ Fear is the only thing that keeps people from engaging in unsafe behaviour. As far as I see it, there are 2 forces as work in deciding whether people will play safe or not… cont.

      2. Peter S. (formerly 'FengLong') 29 Nov 2011, 12:18pm

        On the one hand there are sexual urges. On the other there’s fear. I feel to keep people acting responsibly, the fear must outweigh the libido.

        It may not sit well with your wish to be kind to those who have HIV, but in my opinion it’s a necessary evil~

        1. How would you scare people though?

          The 1980’s adverts simply wouldn’t work – HIV is a lifelong, chronic but manageable illness when properly controlled does not adversely affect life expectancy (like type 1 diabetes). It is not a killer in the manner that it was in the 1980’s and 1990’s. And people know this.

          What would the fear campaign look like? ‘Be safe, or you may have to take tablets every day for the rest of your life’.

          1. Spanner1960 3 Dec 2011, 3:51pm

            dAVID: “when properly controlled does not adversely affect life expectancy”
            Please do not make sweeping statements like this when it cannot be proven.

            Results of a study released last month, showed life expectancy of those with HIV who are on anti-retroviral treatment, has improved. In 1996, when such drugs were starting to become widespread, the UK Medical Research Council estimated a 20-year-old with HIV, who was receiving treatment, could expect to live to an average age of 50.

            By 2008, this group could expect to live to an average age of almost 66 – a 16-year improvement.
            http://www.bbc.co.uk/news/health-15853743

          2. @Spanner1960

            dAVID is correct about near normal life expectancy …

            Consider this comment:

            “People diagnosed with
            HIV today can expect a near normal life expectancy
            if they start treatment early and take it correctly.
            Research published in the Lancet in 2008 showed
            that a patient diagnosed today at 20 can expect to live
            to nearly 70. At 35, the average age of diagnosis in
            the UK, life expectancy is over 72. And it is believed
            that life expectancy will only continue to improve.”

            from The National Aids Trust

          3. Peter S You obviously have big issues and having the sort of protracted argument you have had here is not helpful to anyone least of all you – unless all you want to acheive is to point score. You are yourself creating internal stigma within yourself no one else is doing that. It sounds to me like you could use some counselling as your conflict with your sexuallity is really not healthy, neither is your statment that it is impossible for you to have HIV or any other STI. As I have noted in another comment you are someone who does not feel the need to get checked out regularly, which at best is arrogant and at worst putting you and others in a dangerous situation – unless you get tested you can never be 100% confident that you are not harbouring HIV or an STI or other blood borne virus. Your “tests”, previously mentioned in assessing people you have sex with & meaningless, you really are at risk despite your low level of sexual activity – many individuals have had a suprise test result!

        2. @Peter

          As Disraeli is reputed as having said “There are lies, damn lies and statistics …”. In order to evaluate anything be it opinion polls, levels of infection, number of rapes in society, prevalence of drug use etc etc there has to be an element of quantitative and qualitative analysis. One would hope that quantitative research was less subjective, but nonetheless there will always be room for some subjectivity in analysis of trends, thoughts and perceptions.

          If we were to ignore figures and trends etc then we would not know how to develop and improve services and end up stuck in a rut.

          The HPA figures may not be accurate, but they are the best guess I have seen.

          1. Peter S. (formerly 'FengLong') 29 Nov 2011, 2:41pm

            Only statistics which are true have any real value. Made up numbers from some circle jerk of analysts have no basis in truth or reality and can be of no help to anything.

            There are some things we can know, and some we can’t. Bogus made up figures are just as good as no figures at all, and so are only worthy of being ignored~

            Just because you would like to have an accurate statistic about something, doesn’t make it worth inventing one.

            If you think these HPA figures are such a great guess, attempt to justify it~ How did they come to this one in twenty gays have HIV conclusion?

          2. @Peter

            To be fair to the HPA, rather than just guess at how they established the 5% figure of HIV infection in gay men then I need to go back and reread portions of their entire document, which I will do.

            However, taking another area where statistics are difficult to establish with real certainty about their accuracy would the level of rape in the UK. It is an accepted fact in the criminal justice system that rape (and in particular male rape) is very much underreported to police. The government have accepted that efforts need to be made to improve conviction rate including encouraging complaints, better investigative techniques, better support in court etc etc. Given that all of this requires financing there needs to be an understanding of the level of demand etc then statistics are required which may require assumptions to be deployed.

            There is a similar approach to the methodology of consideration of statistics in some public health scenarios.

          3. Peter S. (formerly 'FengLong') 29 Nov 2011, 3:57pm

            So to summarise: If you have the sneaking suspicion that a group of people are under reporting something, yet have no means whatsoever of knowing, but need funding to help out said group.. Make up a sensational statistic and make it public in order to get the funds you suspect you need. Excellent.

          4. @Peter

            Please do not misrepresent what I said …

            If I wanted to try and misinterpret you, I could suggest that you think statistics do not matter and therefore this could be extended to mean you do not care if HIV awareness, treatment etc or rape prosecution and support etc etc improve or not – because they are difficult areas to get verifiable statistics for you will just rubbish any such figures and thus lead to those wishing to be humane from being unable to justify public spending … of course, I wouldnt be so bold as to misrepresent you …

            However, you seem prepared to misrepresent me …

          5. Peter S. (formerly 'FengLong') 29 Nov 2011, 4:16pm

            Not to be rude Stu, but no thanks. If you have a point to make about how the HPA have the confidence (some would say gall) to estimate what proportion of gay men have HIV, then make it.

            But I’m not altogether too fussed about making that point for you~

            My belief is that the number of gay men isn’t even knowable by any means whatsoever. *You* can attempt to disprove it if *you* care to~

            Though it sounds like an exercise in futility to me.

          6. Peter S. (formerly 'FengLong') 29 Nov 2011, 4:28pm

            I’m not trying to misrepresent you Stu~

            You’re saying sometimes we have a suspicion of something we cannot adequately quantify but that needs funding to combat. I agree with that~

            But simply stating that suspicion, and that funding is needed is all we can really do. To me it seems like poor form to try to be any more specific than is possible in order to achieve funding. That’s fraudulent.

          7. @Peter

            But you do misrepresent me …

            and I suspect deliberately so …

            it makes me question the integrity behind your arguments (and given your recent outrageous statements, which I have tried to understand, re George Michael – its perfectly clear why one should hesitate before accepting your commentary as reasonable)

            I have never tried to justify the HPA statistics, I have explained what they have said … It is not my place to defend someone elses report. I have looked into the validity of the figures and provided you a link to see the manner in which they have evaluated the statistics and why – if you choose not to read it, that is your choice …

            I believe it is reasonable where statistics can not be fully verifiable to get an impression and provide some evidence to support this (whether circumstantial, correlative or otherwise). Where evidence is difficult to develop fully, then some explanation as to the adequacy of the data needs to be provided. HPA did this.

          8. Peter S. (formerly 'FengLong') 29 Nov 2011, 6:18pm

            More circles~ I’m getting dizzy.

            I say it’s impossible to know how many gays there are in the country, let alone how many of them have HIV and don’t realise it.
            These are impossible things to estimate with any degree of accuracy whatsoever. You Simply cannot know the utterly unknowable no matter what you base it on. Any attempt to create such a statistic makes gay men look bad.

            How am I ever meant to do the ‘coming out’ thing with rubbish like that being thrown about? I don’t find it helpful for anything other than to help keep the authors of the report in a job.
            That is my position.

            But you’re obviously convinced they have some mumbo jumbo formula that makes it worth publishing such wild claims, and that’s great for you~

            It’s just too bad you cant at least give me a rough idea though.

          9. @Peter

            You clearly think I am backing the approximation and estimation by the HPA … and that I fully endorse it as a real measure to determine things by – I do not. I thought I had made it clear – please try reading my first comment to you to try and establish some context.

            I agree with you that accurate portrayal of the exact number of people who are gay or do not know they have HIV is impossible (and I am pretty sure the HPA would also agree).

            Where I disagree is that estimating can be a valuable tool – you appear to disregard any figures if there is no certainty in their accuracy. I suggest if there is a reasonableness to their legitimacy in terms of how the estimation has been formulated then it should be considered (whilst bearing in mind that the correct figure may or may not be that stated).

          10. Peter S. (formerly 'FengLong') 29 Nov 2011, 7:53pm

            Aha, that was much clearer to me and sounds much more agreeable.

            And so we have found the bit we actually disagree on. You’re right, I don’t view false statistics as worthwhile in the slightest.

            I don’t see the ‘reasonableness of their legitimacy’ in any way shape or form.

            They could just as well have said it’s 1 in 30, or 1 in 10 and it would be just as ‘helpful’.. It’s all baseless and therefore helps nothing as far as I can fathom.

            The estimate is based on surveys of self selecting group of people, and those who regularly attend STI clinics and such.

            It doesn’t capture people like me or the (admittedly few) other gay people I know and am friends with at all. It just represents a certain clique who they use to make assumptions about the wider gay population – to the detriment of people like me.

            And what does that help anyway? Can you tell me? What is it they will do that they couldn’t have done without the bogus statistic?

          11. @Peter

            The report makes it perfectly clear what they will do.

            They are not made up figures – they are estimates.

            You may feel they dont reflect you – that does not mean they do not reflect other people from a wide range of backgrounds.

            Its not about manipulation of people views its about hard quantitative data that is applied – as happens in many sociological situations.

          12. Peter S. (formerly 'FengLong') 30 Nov 2011, 9:12am

            That’s right, it may take a select group of others into account.. but not people like me.

            That is exactly what makes it bogus.

            And maybe it is of some help to be aware of that select and known group of people most at risk, and if that was the purpose of it, you certainly wouldn’t think it from the headline~

            If people like me were able to be taken into account, the figure of gays with HIV would be much lower.

          13. @Peter

            Have you ever had an HIV test?

            Have people like you ever had an HIV test?

            If the answer is yes – then the HPA figures should take account “people like you”

            If the answer is no, one presumes you and “people like you” either are celibate or have some other miracle way of ensuring certainty of no risk ….

          14. I am of the opinion that all gay men who are sexually active should take their sexual health seriously and have a complete STI checkup which includes an HIV test at least annually if not more frequently dependant n how many partners they have.

            It is very worrying that the Sentinel residual blood tests reveal so any undiagnosed HIV infections in individuals who have had a sexual health screen but did not request an HIV test – why is this?

            No one should be so arrogant to think that an HIV test is not essential even where they consider themselves to be at low risk. It’s better to know than guess in my view!

          15. Peter S. (formerly 'FengLong') 30 Nov 2011, 3:05pm

            I haven’t ever had an HIV test, because it’s impossible for me to have HIV~

            But my friend who is very similar to me had a full blood test for absolutely everything, which included HIV. But never went to a sexual health clinic nor divulged his sexuality.

            So ye. We really are off the radar~

          16. Peter S. (formerly 'FengLong') 30 Nov 2011, 3:07pm

            Oh, and if and when I do go for a sexual health test, I will count as straight on the record if asked~

            I am a closet case.

          17. Peter S – you obviously have some big issues about your sexuality, and from what you have said with regard to sexual health screening I am assuming that you are not sexually active to make such a bold statement that it is impossible for you to have HIV – how about any other STI? They can all be very damaging if left untreated!

            What is the problem about looking after your sexual health? I know men are notoriously bad at not wanting to get things checked out but you seem to have an extreme view on sexual health screening. To want to remain annonymous is one thing, but how is a sexual health Dr going to assess your risk if you pretend to be straight? What a silly situation to be in……..and you have the nerve to comment on HIV infection figures when “you are a closet case” as you put it.

            I am very sure that not acknowledging your sexuality is not going to protect you from getting HIV or any STI, in fact it may just add to your level of risk! You and your mate neet to get realy buddy!

          18. @Peter

            So if it is impossible for you to have HIV then you would be irrelevant to the HPA statistics because you would not be in the testing population

            The only way I can perceive of it being impossible for you to have HIV is for you never to have had sex, IV drugs, blood transfusion, blood products or been in contact with another persons body fluids …

            If you have done any of these things there may be a remote chance of infection …

            As for being a “closet case” thats your call – qualitative research and personal experience is that there are fewer and fewer people who are not willing to disclose their orientation (to at least some people) … so the margin for error for “people like you” would be small in terms of the HPA statistics

          19. Peter S. (formerly 'FengLong') 30 Nov 2011, 7:03pm

            The point is there definitely *are* gay men who still have sexuality issues and remain off the records, yet am still lumped in with the statistic that 1 in 20 gay men have HIV. My point is still that the statistic is worthless for that reason.

            Weasel words about some mystical research are meaningless to me, as is your personal experience~ Some of us live entirely outside of the gay bubble. I have told my Mum about me, and one other gay person just like me in real life, the rest is all on the internet only.
            We do exist I’m afraid, we are just hard to see. I know you think it’s rare, but it isn’t.
            I have had enough personal experience of my own at luring them out to know that.

            And just so you know, I have never had anal sex yet, and have only ever given a blow job once to someone I know and trust very well indeed. Also, I don’t need to disclose my sexuality to anyone in order to get STI tests.

            Where is this even going anyway? Feel free to stop responding whenever you like~

          20. Peter S
            Why are you concerned with the HPA statistics – you know they do not apply to you, so what is the big deal. There are many many monogamous partnered guys who are also outside of these statistics.
            As for disclosing your sexuality this is am important feature of the STI / HIV screening process because without this information a Doctor or Health Advisor is unable to accurately determine level of risk as from what you say you will be presenting as a hetersexual male, therefore some of the screenig tests may not be thought appropriate for you.
            I am affraid to say that it is “the closet cases” that are more likely to be passing on STI’s either to their heterosexual female partners or “others like them” who feel they are outside the risk bubble to you one of your words! I have had sex with married men several times, and one man had to go for an STI test because when I went for my usual blood tests I had syphilis, did he give it to me, or I give it to him………….

          21. ……….either way a test was required and treatment given. Had I not informed this guy about my syphilis infection would he of ever got it checked out I wonder, would he of infected his wife, how would he explain all these things? It is a very dangerous game that some “closeted men” are prepared to play, yet is the open and honest guys that seem to bear the brunt of stigma, poor attitude and being accused of having unprotected sex etc etc.

            I really do dispair!!!!!

          22. Peter S. (formerly 'FengLong') 30 Nov 2011, 8:32pm

            Of course the statistics about gay men do apply to me, I am gay. The wording of the HPA statistic as presented in the media applies to me. I may not let other people know it (gee, I wonder why..), but I know it.
            I do accept that closet gays like how you describe do cause a lot of problems.. and I wouldn’t even want to defend their wild misadventures – But I am not one of those..
            I have only been fruitlessly trying to convince Stu that closet gays exist in significant enough numbers to make the HPA statistic meaningless. All it does is stigmatise the likes of me by lumping me in with a vile crowd, and I take offence by it, basically.
            As for the disclosure to medical professionals, I.. just couldn’t~ It gives me the most terrible feeling of humiliation just thinking about it now~~ I’ll just have to take the tests I’m given. As long as I was to get tested for all the main STIs, that will have to do me – If and when the time ever comes.
            I still hope my next sex partner will be the last.

          23. @Peter

            I am merely explaining that I see a value in estimation in many areas …

            Just because some people are hard to find (eg rape survivors) does not mean that any research about rape survivors is irrelevant because it can not feasibly consider every issue people may encounter …

          24. Peter S. (formerly 'FengLong') 30 Nov 2011, 10:20pm

            And it’s still a shame that you can’t define that value without the use of weasel words :'(

            Oh well~

          25. @Peter

            Its a shame you seek to attack the LGBT communities and reinforce false stereotypes

            Some of us are in (or seek) long term monogamous relationships …

            You patronising and damaging approach of describing gay men undermines and aspect of integrity you have in your argument …

          26. Peter S. (formerly 'FengLong') 1 Dec 2011, 11:21am

            Don’t be silly Stu.

            You know full well I was actually defending *against* an unjustifiable and patronising attack on gay men from the HPA~

            And don’t say what they made up wasn’t an attack, they might as well estimate the proportion of gay men who are paedophiles, or the percentage of people in the country named Stu who argue for things they cannot explain, or some other such utterly unfounded rubbish that no one can possibly know about some other group.

            The next thing you say should either expain how a statistic without the slightest modicum of truth can be more useful than no statistic at all, or nothing.

          27. @Peter

            When I compare some of your words on here and some of the horrendous words you used in your “guessing” about George Michael – I know I see the HPA as being more honourable and appropriate in their language and approach.

            I am all for reduction in stigma and stereotyping, you seem to swing the pendulum to an entirely polar opposite form of stigmatisation and stereotype that is as damaging.

          28. @Peter

            I’m not going to be bullied into answering specific questions that you pose for me. I will put my point across in the manner that I deem appropriate.

            There are numerous ways that estimation theory (be it of the LGBT Population or number of rape survivors, number of people with drug abuse issues, number of people who have used corporal punishment on their child etc etc).

            One example is the statistical estimation by HMG that 6% of the population is LGBT. This was established in research by the Treasury and Cabinet Office when considering whether to endorse civil partnerships. It helped the government consider a cost benefit analysis.

            As a health professional, myself, it saddens me (but does not surprise me) that some people are unwilling to trust the confidentiality and respect they will (should in some cases I accept) be shown. Orientation, race, religion, criminal record, age, gender, political persuasion etc make no difference to me as a clinician. Of course, it is…

          29. … for each person to decide if or when and to who they wish to disclose any of those matters. There will be occasions however, if the patient is not honest with me that my help may not be as good as it could be with better knowledge. It could be that the patient then does not receive the best advice/treatment or support.

          30. Peter S. (formerly 'FengLong') 1 Dec 2011, 6:36pm

            Google ‘civil partnerships five years on, autumn 2011′, and look at the ONS page that comes up.

            Here’s an exerpt for your convenience:
            Number of civil partnerships
            The total number of civil partnerships formed in England and Wales between the Act coming into force in December 2005 and the end of 2010 is 42,7787. This is equivalent to 85,556 civil partners. This is much higher than the number estimated in the Regulatory Impact Assessment on the Civil Partnership Act 20048 where it was suggested that by 2010 the estimated likely take-up of civil partnerships in Great Britain would be between 11,000 and 22,000 people in civil partnerships9.

            Estimate of civil partnership uptake: 11k – 22k. Reality: 43.8k HAHA~ Nice example there Stu.

            What about when they estimated the number of Eastern European migrants who would come in to this country since they joined the EU… How did that one go?

          31. Peter S. (formerly 'FengLong') 1 Dec 2011, 6:41pm

            And I’m not bullying you Stu.. I made a point, which you have been trying to deny with no justification at all.

            You make claims of the benefits of producing lies and passing them off as statistics, but you cannot explain them.

            In an argument about one specific thing, I am only interested in discussing that one specific thing until a logical conclusion is drawn.

            If you can’t do that, then you forfeit. Bullying doesn’t enter into it~

            But I will indulge you a bit: I can’t deny things would be better if everyone could be open about sexuality… but we can’t. But that’s a separate issue. From what this thread has been about.

          32. @Peter

            You are so trapped in a mindset that statistics are lies that its ridiculous to even debate with you …

            How on earth do you think Emergency services plan … we have to, and we do …. but we can never, ever know what demand will be for ANY of the services we provide – be they hate crime investigation, asthma attacks, road traffic collisions, etc etc …. but it would be wrong for a service not to seek to plan … that requires either use of analysis of information that is available to try to predict demand, possible skews of demand, and worst case scenarios … or we state it is not possible to predict and put our heads in the sand and respond on a panic basis to every emergency situation … what do we do? we plan for the worst (eg major incident) and how we would respond to that, we plan for what we can predict is likely to be routine and determinable, but we ackowledge the limitations of our statistics … As a paramedic I may never decompress someones chest, but I ….

          33. @Peter

            I had just begun a response to you – but it appears to have disappeared when my browser crashed … so firstly apologies if it reappears …

            You seem to have a mindset that statistics are lies … and it is difficult to get you to move beyond this mindset, because with this set of statistics, you feel they are irrelevant to you, therefore they are irrelevent … and that seems to mark them as lies in your view … Its an interesting peception to have which (if I was one of the researchers, I would find your extrapolation offensive and demeaning).

            Statistics are not always lies, even if they can in some cases never be certain.

            For example, the emergency services have to plan. Like any service provision there have to be plans as to how to provide resources and deliver the service. In the 999 services this includes major incident planning for worst case scenarios and day to day expected patterns of demand etc etc. However, it is impossible to predict the number of murders, rapes, road traffic collisions, hate crimes, asthma attacks, fires, industrial accidents etc etc that will occur. We have to model and predict on the facts that we can establish, acknowledge the weaknesses in the assumptions and data and then plan for the likely, and be able to respond to the worst.

            As a paramedic, I have had to decompress a patients chest – its a skill I have, but most of my colleagues have not had to do it. Its a rare scenario (but life saving) for a UK paramedic. However, because it might be needed we are trained to do it. I have used the skill twice in my career. Given the likelihood we could say we shouldnt have the skill, but it could save a life so we plan for it.

            Just because data can not be predicted easily does not mean we should not try to plan for what might happen.

          34. Peter S. (formerly 'FengLong') 2 Dec 2011, 4:26pm

            I agree this so called debate is ridiculous, but only because you disregard the crux of the argument by use of smoke and mirrors.

            Most of the service planning you speak of can be planned based on data that we can look back on from previous years.

            And if they had made an HIV prediction that was based on something we can know such as the proportion of positive HIV tests from people who identify as gay, that would have been acceptable and more useful than pretending to know how many gay people there are in existence and how many of them have HIV – which is just a stupid lie, there’s no other word for it.

            It would be like estimating the proportion of men who ever contemplate committing rape. You can’t predict what is in people’s minds. You can only predict things for which you have actual data to analyse.

            But when it comes to estimating something (especially something negative) which you can never even remotely possibly know about a specific group of people, that will never be helpful.

          35. Peter S. (formerly 'FengLong') 2 Dec 2011, 4:27pm

            And when it is something negative, it is merely an unfounded slur against the group.

            Was the prediction for uptake of civil partnerships useful? Did it help anything at all to make up something so unknowable and be (surprise surprise) so far off from reality? This is not a rhetorical question, I actually want to know if you think that one was in any way worthwhile in retrospect.

            I don’t mind them predicting things for use in planning services, but they could word it in a reasonable way. ‘1 in 20 gays have HIV’ is an unnecessary slur for use in planning services. Why can’t they talk about the numbers of gay identified people who test positive each year and work from those trends instead of making up a LIE like they released to the media? It’s irresponsible.

            Although.. if it is intended as a scare tactic, then I could take it a little better. But the way the media reported it was ‘offensive and demeaning’ to me~!

          36. Peter S. (formerly 'FengLong') 2 Dec 2011, 4:42pm

            Oh and by the way, I know you’re just going to say we have to fabricate slurs about numbers of gay men with HIV in order to better direct services toward them.

            But tell me how or you automatically forfeit. No more smoke and mirrors please.

            Last chance, how is it helpful to pretend you can estimate how many gay men there are in existence within the country with any statistical significance, when you simply cannot?

            What is achieved? By this point, that is the only thing I am interested in hearing. I want a justification for that particular slur made against me by the HPA – or nothing.

            NB. Remember the wording of the HPA slur was *about* me, but cannot be used to target services *for* me. Your justification should address this crucial point in your reasoning behind it’s usefulness (though I know it won’t)~

          37. @ Peter what a load of hot air and total crap you have rambled on about, it’s pure rubbish you are spouting. Go and have you pissing contest with someone who is interested!

          38. @Peter

            The reason the debate is pointless is your blinkered opposition to an open debate. You make it crystal clear through your wording that you feel you are not included in the statistics therefore the statistics are irrelevant. What a huge ego!

            Major incident planning is all about planning for the unpredictable – and it uses statistics (some based on assumption models).

            Public health and crime planning requires the use of some assumptive models. In fact all areas where is a possibility of fear, shame, embarrassment etc etc means that accurate figures are an impossibility. In fact, in all statistics there are rooms for error because the entire population is never asked.

            You mention it is impossible to know how many men (I would add women too) who may have contemplated rape. This is true. Equally, because of shame etc it is impossible to know the number of rapes that may have occurred due to significant underreporting – my experience as a sexual offence liaison officer…

          39. … is that there is significant underreporting. Thats my personal experience, professionally – but equally there are many pieces of academic research that demonstrate as high a figure as 90% of cases of rape NOT being reported in the UK.

            HIV and sexual orientation are also issues which cause emotive feelings of shame, fear, embarrassment etc etc and thus make obtaining accurate information from everybody difficult, but not some data that can be extrapolated.

            Society has a responsibility to support people who are raped, fight crime, deal with major incidents and public health scenarios.

            I have been involved in a number of unpredictable events, professionally – but we had planned for “what if” scenarios and some of this was informed by extrapolation of our own experiences (individually and statistically) and some by experience elsewhere.

            It seems you are taking the PN headline in isolation and not considering it in line with the rest of the HPA document … The HPA document …

          40. … is very clear where assumptions have been made, where data is extrapolated and where figures are forecasts. They are not lying but using consistent statistical models.

            I find it very offensive that you feel I would endorse fabrication of slurs to ensure appropriate action in any segment of society. I never would, and your suggestion is demeaning to your argument. I believe in appropriate forecasting, scientific analysis of data, honesty and integrity – not convinced you do, given some of your comments.

            If your argument is with the media reporting – why pick on the HPA figures …

            I have tried to give you many examples where estimation and extrapolation are important in statistical analysis both in terms of service delivery and trying to resolve problems.

            You say they could never impact on you – I hope you are right … even if your sexual involvement remains at a low level – you could be raped and HIV research and service delivery may then matter to you …

          41. I am not going to respond with strawman demands on specific sets of statistics.

            I know in my work I have valued HPA estimations and forecasts. I know in my work in the police the use of data extralpolation has meant that my service has met the needs of both potential and unexpected events with more robustness.

            To me, this is more about your stigma of being gay and your fear of HIV than whether the media are reporting this accurately – and much more than the relevance of HPA statistics and forecasting

          42. Peter S. (formerly 'FengLong') 3 Dec 2011, 5:24pm

            That’s the same answer you’ve given many times now, it doesn’t address the arguments. In a debate you have to respond to the individual points made by the opposing party, and if you can’t – you lose.

            Planning for the unpredictable is best done from real data from previous years, not things that cannot be guessed with even the slightest degree of accuracy whatsoever (This can NEVER be useful). There are NO statistical models which can predict the number of gay men – none.

            I’m talking specifically about statistics which attemp to mind read, that is what this debate between us is about. If you do not address the points, and instead just ramble on like a tool about things not central to what is being discussed; you automatically forfeit – which has already happened by the way~

          43. Peter S. (formerly 'FengLong') 3 Dec 2011, 5:26pm

            Harping on about the need for statistics to help people is superfluous. Statistics are good. I don’t decry statistics per se. Only the ones which slur and yet serve NO benefit. This point of yours has been answered.

            Even if it wasn’t a huge unfounded slur, how does it even help anything to try to guess the proportion of ALL gay men who have HIV? Unanswered.

            If it doesn’t help with rape crime to predict proportion of all men who contemplate rape, and predicting the number of all gays who want a civil partnership doesn’t help plan that service, and it doesn’t help plan services by estimating the number of all eastern europeans who would want to migrate here.. Then how can it help HIV rates to predict number of ALL gay men who have HIV. Unanswered.

            Why can’t they use data we know of about Proportion of gay identified HIV positive test results instead of going so far as to make up slurs and lies which pretend to be about all gay men? Unanswered~

          44. Peter S. (formerly 'FengLong') 3 Dec 2011, 5:27pm

            Predicting something about ALL gay men unjustly includes and slurs clean, responsible die hard closet gays like me, but cannot be used to help or plan for people like me, so how is that HPA wording justified? Unanswered.

            Making up statistics that pretend to read what is in people’s minds would be all well and good if thats what they want to do. That is IF it didn’t put us down as a group.

            And the HPA document didn’t acknowledge the weakness of their estimate. Not by a long shot. It isn’t difficult to read peoples minds, it is impossible. They didn’t acknowledge this at all.

            Seriously now Stu, don’t send another message about statistics in general being useful unless you address these counter points which have come up during the course of debate. I have laid out why making up such scurrilous lies is not good, if you cannot specifically rebut what I have said then stfu and gtfo stooge.

          45. Peter S. (formerly 'FengLong') 3 Dec 2011, 6:23pm

            Just to be clear..

            That whole 4 message mess you sent was all about the need for planning services, and the value of statistics to help achieve that. Which is nothing I disagree with.

            Address the points we are actually in disagreement over, or dont waste your time.

            I suppose while I’m at it I might as well address the other off topic drivel you spouted:

            HPA are to blame and not the media because HPA created the lie. If I get raped and infected, this statistic won’t have helped me in any way. Disliking lies made up about me (as one of ‘ALL gay men’) in the media is not about my ego, it is about the hubris of statisticians to claim something with NO basis in truth. I have gay stigma, but is it any wonder with lies like this about me (and yes, it was about me). Also it wasn’t just PN, it was all over the media – reported with the lie worded in the exact same way. And your personal experience proves nothing about anything, those are weasel words.

          46. Peter

            Stu is a very respected commentator who you are trying to slur with your pissng contest, because that sall it is, with references to “you forfeit”.

            What effing planet are you on dickhead, honestly you as you do not identify as a gay man to anyone but yourself and your sexual partners (and even then I bet you identify as bisexual – nothing wrong with that, and by the way the HPA always refer to MSM).

            And as I and Stu ave both said lets hope you don’t become a statistic or are already one that is currently unidentified, which are the most dangerous to the continuing forward infection of STI’s and HIV

          47. @Peter

            Its pointless trying to discuss sensibly with someone who has clearly made up their mind and decided they have been wronged and adopted a victim mentality that can not see a bigger picture beyond themselves.

            Weasel words as a type of argument is junior school level.

            I value the work of the HPA in the difficult field they work in, which requires stats – some based on prior experience and some based on experience extrapolated to consider issues and areas where it is acknowledged that some level (not complete) of knowledge is known.

            If I am a bed linen manafacturer and I open a shop in a town. I don’t know how many double, queen, single, king beds etc there are – but I can estimate. I dont survey every house – but I extrapolate from the data I have.

            HPA are not making you a victim, you are choosing to be one. My debate with you is over. I wish you well – but I suspect you need to find someone to talk your issues through with.

          48. Peter S. (formerly 'FengLong') 4 Dec 2011, 10:09am

            Stu come on now, my mind can be changed if given actual reasons.

            I told you the reasons why what they did with this particular stat was unhelpful, hurtful and wrong, and you are unable to deny any of them.

            All you can say is ‘statistics are important and I value them’, which I agree with and disproves nothing I said about the harm vs. benefit of this particular statistic.

            In your bed linen analogy, estimating number of sheets of each size that you will sell at your shop(s) is equivalent to estimating the number of people of each sexuality who will test positive for HIV at your clinic(s) – This is reasonable, and a fair prediction can be made.

            Estimating the proportion of all gay men in the country with HIV is equivalent to estimating the proportion of all bed sheets in the country which are single. This is not reasonable, nor even in any way possible to calculate with any statistical significance. And even if it was, what would it help?

          49. Peter S. (formerly 'FengLong') 4 Dec 2011, 10:10am

            Stu, if we could ask some god or genie if 1 in 20 gay men really do have HIV, and it actually turned out to be true.. What use is this? I really wish you could at least tell me this, otherwise.. why would you believe in it so strongly. It doesn’t make sense.

            Whenever number of gay people with a particular feature is estimated, it turns out to be wildly incorrect. The civil partnership estimate (which you yourself used as an example) was out by a factor of between 50-75%. In what way is such a wildly inaccurate stat useful? Please tell me Stu! Is it worth scandalising an entire minority group who have enough stigma already for an accuracy as low as that?

          50. Peter S. (formerly 'FengLong') 4 Dec 2011, 10:11am

            At least estimating bed linen sales doesn’t involve reading people’s private thoughts and feelings. The most similar analogy is estimating number of all men who ever contemplate rape and using this for rape crime prevention. Would this wildly inaccurate and impossible prediction be useful? Would it be a baseless attack on men? Even if we could be sure it was accurate, would it be useful in any way?

            We both know these things are unreasonable, and cannot be justified, and yet you stand strongly behind it for no reason other than that the HPA said it.. and that you love and trust them.. That is what we call being a tool Stu.. I’m not merely insulting you, that’s the truth of the matter.

          51. Peter S. (formerly 'FengLong') 4 Dec 2011, 10:18am

            BTW, ‘Weasel words’ isn’t junior school name calling.. Look it up, it has meaning:

            ‘A weasel word (also, anonymous authority) is an informal term for equivocating words and phrases aimed at creating an impression that something specific and meaningful has been said, when in fact only a vague or ambiguous claim, or even a refutation has been communicated’.

            This is all you seem able to do..

          52. @Peter

            I will come back to your response, one final time … but no matter how much you try and ridicule and offend me in any response to this comment – I will not be prolonging this debate. It is prefectly clear that you are unmoveable in your views despite your claims to the contrary and that you have a perception that you are being attacked when nothing of the sort is happening.

            For the record, I do not “love” the HPA. As a health professional, I have a great respect from the wide ranging work which they do. I recognise the value of the work they do. It is not for me to defend their work or have all the answers about their work. If you have a legitimate concern about the appropriacy of the HPA’s work – raise it with them, explaining exactly why you personally feel the way that you do – including the reasons why you feel that way. If you feel as passionately as you claim you do about this, will you have the courage and responsibility to raise your point openly with them?

          53. Peter S. (formerly 'FengLong') 4 Dec 2011, 11:29am

            Good god… I just read.. They based their estimate for number of gay men on the National Survey of Sexual Attitudes and Lifestyles..

            The last one of which was from over a decade ago (2000)… And as suspected, the figure comes from – wait for it – asking people about their sexual behaviour! Genius, no?

            It’s unashamedly based on the assumption that there is no such thing as ‘the closet’.

            There were no adjustments made on the figure for the number of gay men in the UK.. The percentage from that survey was simply taken directly and applied to the whole UK population.

            The more you read, the worse it gets~

          54. Peter S. (formerly 'FengLong') 4 Dec 2011, 11:32am

            Stu I’m not trying to insult you or anything like that by any of my arguments.

            The whole point is you challenged my original point, and have as yet had no good reason for your defence of it.

            There is a reason for that Stu.. It is indefensible.

          55. I have no need to look up weasel words – its a definition I am more than familiar with. I find its use in debate as a red herring, generally, and lacking any evidential value. Of course, thats irrelevant to you – as my experience and impression (and you have already stated) are of no value.

            As for the use of statistics – my comparison would not be the number of men (or women!) who contemplate rape (although there are clear uses for such data were it available) but more the number of rapes that occur – given that many are underreported (a fact accepted by police, criminologists, CPS, the fiscal and many others – although establishing hard data is difficult). With knowledge (whether that be extrapolated or otherwise) of the number of rapes then allocation of resources eg number of specially trained counsellors, police liaison officers, forensic examiners, prosecutors etc could be better arranged – along with consideration of the impact of rape trauma syndrome on health …

          56. … services and the need for specialist psychology services etc. Consideration can also be made at measures to try and prevent (by public education, deterrent, reassurance and other methods) rape or serious sexual assault.

            Extrapolation in the case of estimating the proportion of gay men with HIV has clear value in public health in terms of directing appropriate level of funding into care, education and prevention. Clearly, there are elements of the gay media (like Pink News and others) that can be utilised but public funds need to be used with care and where needed.

            Forecasts and extrapolations are statistics that need to be used in many situations.
            Take for a moment an assumption that we did know (with certainty) that (for arguments sake) 2% of the UK gay male population has HIV. Would this be an attack on you any more than an extrapolation from self declared gay guys who have tested positive (adjusted for those who will not declare their orientation correctly, like you) ..

          57. … I perceive not – I suspect you would perceive otherwise …

            I did not start by attacking you, nor did I challenge you. I started by pointing out that the HPA themselves recognise there are uncertainties in some areas of their work in statistics due to lack of fully verifiable information. One of those areas is the number of gay men (which is relevant to some of their work).

            I agree with the HPA that there is value in estimating the proportion of gay men with HIV. If you want details or to challenge their collection of statistics, speak to the HPA.

            I can not share your view that this approach stigmatises any gay man. Even if HIV was a “stigma” then who is to say that just because a proportion of the population are HIV positive, that this suggests that you are? A proportion of the entire population has HIV – does declaring this mean you are stigmatised because you are human being? Sheesh!

            You constantly tell me in your retorts what I think, what I believe etc – even …

          58. I do not think it is defensible that the HPA abandon prediction models to help combat an important disease purely on the basis that some people who are dishonest about their orientation when asked might be offended.

            Public health should try to honest and reputable and respect people. You can not easily do this if people are dishonest. Nor can you respect people who find offense in stating that a proportion of the population have an medical condition.

            A proportion of the population have asthma, diabetes, herpes, anal warts, epilepsy, endometriosis etc etc – and (for some of these conditions) some will be gay men … stating this is either a fact or an extrapolation from facts … it is not offensive; and to be frank those that find it so need to get their head out of the sand and realise that public health is not about their feelings but public safety

          59. Peter S. (formerly 'FengLong') 4 Dec 2011, 12:45pm

            Ok I accept your justifications for stats such as number of unreported rape cases if we could know for sure they were anywhere near the truth. Although I’m still not sure why it is better to know the *percentage* of all gay men with HIV as opposed to simply the *number* of gay men who have it. Any further thought on that for me?

            But given that the number of unreported rape cases, as well as the proportion of gay men with HIV, or number of gay men who will enter into a civil partnership are not knowable beyond an accuracy of between plus or minus 50-75%. Is this useful for planning services? You don’t need to list the services involved, but please tell me.. is an estimate really useful with an accuracy such as that?

          60. Peter S. (formerly 'FengLong') 4 Dec 2011, 12:46pm

            There are no adjustments made to the HPA figure taking into account those who do not declare their sexual orientation truthfully. In the NATSAL survey, 3.4% of respondents admitted to being MSM. Of todays population this is around 852,700 men.

            They then predicted the number of MSN with HIV to be 40,100 (which is fine by me) and applied it as a percentage of the sham survey! 40,100 is 4.7% of 852,700, rounded to 5% = 1 in 20…

            How is that any more accurate/worthwhile than the civil partnership prediction? How can that help anything? Are you able to explain that rationale for me?

            Also, they used the term MSM whilst discussing their calculations for how they got this statistic, but in the list of main points at the top of the document they used the word gay! Why oh why~

          61. @Peter

            Phew … at last … we have some commonality …

            Whilst I would dispute your variance of 50-75%, as this is merely a presumption – since the extrapolation of data is based on uncertain statistics …

            I am grateful you can see the value in extrapolation in some scenarios. I see no other way of planning services, effectively prioritising funding etc other than using some level of data analysis. The number of MSM with HIV will be no more accurate than the percentage estimates … no any less offensive to those who find such estimates as offensive …

            I do wonder how you would estimate a “more accurate” number or proportion of MSM in society?

          62. Peter S. (formerly 'FengLong') 4 Dec 2011, 2:42pm

            The civil partnership estimates were out by exactly 48.6 – 74.3% (11000-22000 predicted, 42778 actual). I am using it to highlight the futility of predicting something about all people who are gay – it is proof of what I am saying, but you’re ignoring it. It wasn’t that they were just a bit out, they were thoroughly clueless. Yet they still made the prediction, and it didn’t help. I argue that when such a prediction is also scurrilous, it isn’t right to publish it in that form as a ‘main finding’.

            I many times stated that I support use of statistics in planning services.. To state that (by way of hypothetical example) the percentage of gay identified positive HIV results is 45% of all tests which equates to 3000 new gay HIV cases this year; and that from this they did some wonderful calculation to predict that by now 40,000 gay people have HIV, this would be fine.

          63. Peter S. (formerly 'FengLong') 4 Dec 2011, 2:45pm

            Predicting the percentage of all gay men who have HIV based on a survey which asked people 11 years ago if they have same sex attraction makes us as a group look far worse than simply predicting the number of gay men with HIV. Many people think the proportion of MSM is more like double the 3.4% used by HPA.. If you used that statistic, then the proportion of all gay people with HIV drops by half. This would be every bit as valid (or not) compared with the HPA estimate and wouldn’t make us as a group seem so artificially bad.
            You CANNOT estimate the number of MSM with ANY degree of accuracy worthy for any scientifically based purpose. But if the relative levels of consumption for different types of pornography could somehow be considered, then even that would give a better result than asking people.

          64. @Peter

            Purely because one (wide ranging and authoritative) piece of statistical research turned out inaccurate (on one measure – and it may merely have been timing that early requests for CPs were higher initially) does not mean that you should use the variance in this measure to determine the variance of other statistics – aprticularly when the statistics used in the measure you question bear no relevance to those you seek to apply that variance then to.

            If you have issues with how the HPA have determined their statistics – raise them with the HPA. In the meantime, I do not consider them lies, I consider them an extrapolation which by the nature of extrapolations have risks in terms of accuracy. I also consider them useful.

            I consider it wrong and inappropriate for the HPA to abandon determination of statistics by extrapolation or other means relating to HIV incidence in the LGBT communities purely because some people who are dishonest about their orientation are offended.

          65. HPA have a responsibility to the whole of society, not just to those who are offended by appropriate action of theirs. Offence partly due to their dishonesty (in any event)

          66. Peter S. (formerly 'FengLong') 5 Dec 2011, 11:38am

            Of course it bears relevance – they’re both based (at least in part) on pretending that you can know how many gay people exist with any degree of accuracy. And if that one was meant to be ‘wide ranging and authoritative’, then that is proof of the futility of it.

            I can make a point about bogus gay statistics on a public gay comments page if I feel like it. You are the one who took it upon yourself to challenge me, maybe you should keep that to YOURself. Or just maybe, like me, you can do what you want~

            When there are surveys each year about how many gay people there are and they always throw up a figure of anywhere between 1-10%, then using one particular questionnaire from over a decade ago is never going to be accurate.

          67. Peter S. (formerly 'FengLong') 5 Dec 2011, 11:40am

            In actuality, the NATSAL 2000 survey found out the percentage of people ‘willing to admit’ to same sex attraction 12 years ago – reporting this as the number of all gay people that exist in 2011 IS disingenuous and a lie as far as I consider.

            And no, adjustments were not made for closet gays, the figure assumed we do not exist. And if you think closet gays are so few in number that they don’t matter, then you really do live in a sheltered gay bubble.

            Maybe we should use the latest ONS figure from last year of 1.5% gay pop. and make our group look more than twice as bad, it’s no more or less meaningless afterall. Who cares about how closet gays feel anyway; Someone of my persuation certainly would never expect any sort of support from the so called ‘gay community’. Speaking to you only serves as a reinforcing reminder of how disconnected and disassociated people like me are with that whole concept.

          68. Peter S. (formerly 'FengLong') 5 Dec 2011, 11:42am

            I can live with the defamation, I have done so far. I may not like the idea of having statistics about me based on the fewest most vocal and most vile core of gays, having to wait for them to get their act together before I can be free of their grotesque statistics. But as long as no one knows they are being applied to me, it hardly matters really.

            In conclusion; f*** the world, f*** the HPA, and especially.. f*** the ‘gay community’.

          69. @Peter

            At last your petulence rears its ugly head completely …

            Thankfully, the HPA and most of the gay communities have a wider sense of responsibility than you have …

            It is not all about you … or your right to be dishonest about your orientation … or your views that declaring (honestly) that a proportion of gay men have HIV is stigmatizing to you (that takes a great deal of paranoia to extrapolate – something you criticise – so much) …

            My concern is not ignoring closet people (indeed I would prefer they were confident in their orientation) … but to pursue with vigour the bigger picture of public health … and if that offends you – tough

          70. Peter S. (formerly 'FengLong') 5 Dec 2011, 2:26pm

            Using the figure for number of people who admit to same sex attraction around 1998-2000, and passing it off as the actual number of gay people in 2011 is not honesty. It is naive or disingenuous at best – fraud at worst. Fact.

            You’re right, it isn’t all about me, it is about all gay men not comfortable with their sexuality.

            You can pursue public health just as easily by presenting the statistics in an honest way. (ie. talking about the number of men who admit to same sex attraction/behaviour.

            It offends me, and yes it is tough. I’m well aware that I must live with this stigma from misinformation, like it or not.

          71. @Peter

            It would be “nice” to be able to consider everybodys insecurities, discomforts, and make them feel good about themselves at every opportunity …

            That just is not possible …

            So, with a choice of fighting an epidemic or risking offending people who are uncomfortable with their orientation … I choose to fight a global pandemic … sorry, if that seems harsh to you – but whilst I would like you to feel comfortable in your own orientation – ideally with a monogamous and committed partner that loves you as much as you love him (because I hear this is your preference (mine too!)) – I prioritise trying to stop new infections and transmission over your comfort …

            I wish you well in finding the right partner and being more comfortable in your skin.

          72. Peter S. (formerly 'FengLong') 5 Dec 2011, 5:49pm

            How many more times with this falsehood..

            Statistics in general = good.

            Fighting disease = good.

            %age of people admitting same sex attraction =/= %age of people who are gay or MSM.

            Claiming it to be such = lie of null accuracy.

            Lies of null accuracy cannot help toward anything positive.

            I don’t need to be considered for anything. Only for statistics we have to be reported truthfully.

            Now QUIET, YOU!

          73. @Peter

            Clearly we can agree on trying to promote public health is a good thing and that statistical modelling has a very useful place in doing that and in service planning etc etc

            We are not going to agree on the value of the HPA statistics that you disagree with. Your passion that they are wrong, is matched by my ardent belief that they are right to be used in the manner that they are.

            Please don’t shout at me though – its not necessary ;-p

          74. @ Peter For me your whole argument has been based upon the premise that the number of “MSM” is incorrect & that it is under estimated. This under estimate in your view makes the HPA figures relating to HIV infection rates seem much worst. This suggests to me that you do not wish to be associated with a ” highly diseased group” in society – my words not yours, buts that how you come across. I beleive this is very much linked to your irrational fear of HIV and other STI’s. I have witnessed similar conversations during HIV helpline interventions and your obsession with trying to discredit the stats is your way of dealing with the thought that HIV is out there, & you really do not want to acknowledge the level of risk that could be present when engaging in sexual relations with another male. Sticking rigidly to one point and having a circular conversation about this one point suggests an avoident personality trait which is causing you difficulties.

          75. Peter S. (formerly 'FengLong') 6 Dec 2011, 3:36pm

            @Stu – The difference between our ardent beliefs is that the following actually makes my ‘belief’ factually true:

            ‘%age of people admitting same sex attraction =/= %age of people who are gay or MSM.’

            Now be silent and be gone or I shall shout at you a second time!

            @W6_bloke – In fact, the reason I have been discussing this at all is because Stu has been challenging me. When someone tries to deny something I am saying which is factually true, it gets me going enough to respond.
            And it isn’t that I deny MSM as a group have a very high risk of STIs, not by any means!!!
            But at the same time, I don’t like false claims made about my group either.. Especially when they are so demonstrably false (see above).

        3. I would advise you to just look at the absolute figures – both the number of recorded new HIV infections are accurate, as are the estimates as they are based on the Sentinel surveillance method I have already described. The figures for the STI’s are also accurate, so rather than get concerned about percentages or “1 out of 20″ or “1 out of 11″, you should be aware that both HIV and STI’s are out there and growing at a very fast rate especially chlamydia and gonorrhoea which can both be transmitted during oral sex. Your comments that you find gay men as a “vile crowd” are quite frankly laughable as in one breath you want to be included as a gay man “Of course the statistics about gay men do apply to me, I am gay” and in the next breath you do not want to be included, sounds to me like you have some serious issues. As for your next sexual partner if he is of your ilk then how will you know he does not have any STI’s / HIV – it is impossible to know for certain unless you both tested

          1. Peter S. (formerly 'FengLong') 30 Nov 2011, 10:02pm

            Oh mate, you’re just diverging too much from what I was talking about..
            I don’t doubt they know the percentage of people who have tested positive for HIV and who say they are gay..
            I was disputing the proportion of ALL gay people in the country who have HIV, which is literally impossible to know by any means whatsoever. I have said this time and again in this thread..

            I would always get to know my sexual partners very well before doing anything at all with them. But I can’t be bothered to describe the tests I apply to work them out~

            And all the rest of what you said there was just illogical and silly, I can’t be doing with that.

          2. Good luck with your so called “tests” of sexual partners, let’s hope you never become part of the statistic of late HIV diagnosis, which last year contributed to approximately 640 unavoidable deaths.

            I am a very pragmatic person and the absolute numbers speak volumes, you sir could be part of the problem and are demonstrating very poor judgement

          3. Peter S. (formerly 'FengLong') 30 Nov 2011, 10:22pm

            -_-‘

          4. Read “unavoidable” as avoidable

      3. “As for scare tactics, that stigmatises people and makes them adopt an “ostrich reaction” (head in the sand) and this deters people from being tested…”

        Stu, I have respect for a lot of what you say, but there’s absolutely no evidence that harder hitting tactics deter people from being tested. How do we know that? Because there hasn’t been a truly hard hitting campaign around HIV in almost 25 years!

        Those earlier campaigns shocked many, many gay men into practising safe sex or abstaining altogether simply because not enough was known about HIV in 1987 and there was a genuine fear that it was easily contagious with a 100% fast-moving mortality rate. Of course there was a stigma in those days based on HIV (or HTLV-3) and HIV testing.

        But we are in a different environment now. All evidence now suggests that an appropriately levelled graphic campaign today *would* deter some gay men from unsafe behaviours, but please stop peddling the myth that it would deter people from testing.

        1. @samuel

          I also have gained some respect for you over the last few days and there is a lot of commonality in some of our approach …

          If you read all my comments on this thread you will see that I concur that a robust education campaign does have its place…

          There is evidence that there can be stigmatisation from hard hitting campaigns (not only in the UK but elsewhere). Now, I will try and restate what I have already said on this thread – There must be people working collaboratively between health professionals, education and advertising that can use their creativity, ingenuity and other skills to find a robust campaign that does not have the issue of stigmatisation.

          Ideally I want four strands to HIV education work. 1) Encourage safer sex 2) Honesty (in terms of the implications of engaging in risky behaviour and exposing some of the myths too) 3) Encouragement of testing 4) Destigmatisation … You will see in point 2 this can include some education which is robust

          1. Stu: “There is evidence that there can be stigmatisation from hard hitting campaigns (not only in the UK but elsewhere).”

            Ok, so we are agreed that there may be some stigmatisation with any HIV campaign that depicts a reality of living with the HIV virus – a reality based on living with HIV in 2011 as opposed to the 1980s, of course – but surely the risk of causing some offence to some people with HIV is far outweighed by the need to get HIV infection rates down?

            Fear is a proven deterrent factor, but any element of fear has all but been airbrushed from the HIV sector’s campaigns for two decades now in favour of often highly sexualised HIV campaigns that evidence has shown can serve as an incentive for gay men to start barebacking when it might not have previously occurred to them to do so.

            Let’s be clear here. When this approach has even been condemned in the House of Lords it is time to wake up and smell the coffee, and public momentum is growing for a return to basics.

          2. @Samuel

            You clearly are not listening to me …

            I have clearly said that it is not beyond the ingenuity of people to devise a robust and strong education message that portrays the factual real and potential impacts of HIV linked to a safer sex message that does not stigmatise …

            I want some of the health education message to be strong …

            I want the entire message to be balanced.

            If you disagree with me on that, I can only presume that somehow you do want to stigmatise … despite your comments to the contrary recently …

            Its not about offending HIV positive people – its about not stigmatising which is a little more than being offensive …

          3. @ Samuel one of the problems I have noted with your commentary is that it is often based in selective reading with very little self analysis of the detail. You seem to take many articles at face value and then add your own often ill informed interpretation on them. This was demonstrated in the cheaper meds discussion we had. Also like a good tabloid newspaper you seen to sensationalise many things, blow then up out of proportion.
            I still believe much of your difficulties with HIV are related to your poor understanding of HIV and this is clouding your perception.

  5. I am confused. On the BBC web site today there is an article headlined “HIV/AIDS – WHY WERE THE CAMPAIGNS SUCCESSFUL IN THE WEST” (http://www.bbc.co.uk/news/magazine-15886670) which hails the original eighties tombstone/iceberg campaigns as the most successful ever, and which were used as a model for the rest of the western world’s AIDS awareness campaigning. Even Nick Patridge of the Terrence Higgins Trust speaks of his involvement on the campaigns – “They got everybody talking about sex and safer sex” – yet his comments fly in the face of all the reasons the THT give today for NOT running harder edged HIV campaigns, namely “They don’t work”, “They stigmatize” and so on. Are today’s record infection rates not proof that today’s THT campaigns are not working, and that a return to harder hitting basics are urgently needed? We need to get back to basics, that much is clear.

    1. @Jon

      Part of the reason for the difference in approach is that at the time, the iceburg and gravestone approach was seen as effective because HIV/AIDS was seen as a death sentence. The reality of how the syndrome was perceived is very much different to how it is seen with decades of experience.
      At the time there was no priority to destigmatise people – because people did not live long with HIV/AIDS. People now live approaching normal or normal expected lifespans provided there is early diagnosis and effective treatment available. There are now approaching 100,000 people (in the UK alone) living with HIV – thus an element of destigmatisation is necessary, and the reality of the condition is somewhat different to the fears of the early 1980s.
      Todays figures are in part to me proof that THT (and other) campaigns ARE working. If we test more people (the aim of many campaigns) then the likelihood is more people will be diagnosed. We want people to get tested and take responsibility.

  6. Once again figures that cant be supported. Any article that says ….% of … Is wrong unless a national survey has been done and evey person asked.

    I put it they have no idea how many people are gay and hiv could very well be higher. But to read these figures as accurate is wrong.

    Its like when you hear iunno 19% of people find the colour blue depressing… Thats not true, i wasnt asked… Thats only 19% of the number you asked then your saying this group is the same as everyone else.

  7. estimated 91,500 in 2010, with a quarter of those unaware of their infection
    Nice , should be in the Daily Mail. Firstly the word estimated is used, and if they dont know they are infected, then nor do the people estimating.

    1. Swainnyyy 2 Dec 2011, 5:59am

      The people estimating do know the status of the people they test, that is how they estimate it. They take a cross section of gay people and test them for their HIV status and also ask them what they believe it is.

  8. Lots of denial on here…

    Maybe people don’t like to stare truth in the face?

    Talk of scare tactics is ridiculous – gay men should be scared. The HPA report stated that 1 in 12 gay men in London are HIV +. Most experts agree, though, that it’s more like 1 in 7. Yet the sex clubs and saunas are probably packed out every night.

    The whole thing makes the homosexual population seem irresponsible at best.

    1. No denial from me …

      HIV is an illness gay men should be very aware of and adopt safer sex approaches, ensure they have regular testing and act with responsibility (Please see above the actions I personally take) …

      However, I also approach these statistics with an element of quantitative and qualitative analysis and read the entire HPA report (not just the segments chosen by PN or other media). It is clear that one of the reasons for increased diagnoses is increased numbers of people being tested. The reason for the increase in testing is (in part) people being more responsible, maybe due to campaigns by THT and other organisations.

      Even if the sex clubs and saunas are “probably” packed every night. (Not my experience on the rare occasions I have attended one), that does not equate to safer sex not being adopted.

      Judging people on their sexuality on the basis of a segment of the population who frequent sex clubs and saunas (whether occasionally or regularly) is as …

    2. … prejudiced as presuming all black people have dreadlocks, all Muslims are terrorists or all Conservatives are homophobic … They are not and nor are all gay men promiscuous or unsafe in their sexual behaviour.

      I am pleased that people are being tested. I am pleased that the public health message is getting through. I hope more people will continue to be tested. That requires both continued campaigns with regards safer sex and testing and ensuring that stigma is not raised. Some people will seek to negatively interpret these statistics as meaning that stigmatisation is necessary (such as John) – thats inhumane, wrong and dangerous.

      We want figures to come down, to do that three things need to happen – increased awareness, safer sex as a norm and increased and continued testing. We have to accept that if the testing regime is to be increased and sustained – for some time the diagnosis rate will be likely to rise

    3. Yes they should be scared.

      But the reality is that they are not.

      I’m really not trying to cause controversy here, but how realistically do you scare people with the threat of a serious but manageable condition?

      HIV IS a manageable condition, easier to control and manage than Type 1 diabetes.

      The ONLY effective way of frightening people about HIV is to tell them they will be shunned and stigmatised if they contract it.

      And that’s not the truth either.

      I personally favour HIV as being compulsory for every doctor’s hospital visit. Consent should not be required.

      This way it avoids a lot of late diagnosis, allows earlier treatment and will hopefully cause a change in behaviour by those engaging in unsafe practises while unaware of their status.

      1. @dAVID

        I agree with almost all you say …

        I note above your understanding that its ethically wrong to expect clinicians to differentiate between their treatment of people depending on moral judgement on cause of infection etc. I agree with this.

        Clinicians also have a duty to only do things which their patients consent to (or if consent can not be granted eg due to mental incapacity or unconsciousness etc then to act in best interests until consent can be verified). That means taking tests without the consent of a patient would not be an approach a clinician could/should endorse.

        I agree with the approach in a number of London A&E departments which considers routinely asking all patients to allow them to screen their blood for HIV … here consent is granted and support available in the event a positive result is obtained, but equally the legal and ethical issue of consent is complied with.

        1. Well the HPA is already calling for universal testing (although 20% still refuse) so I don’t see compulsory testing as that big a problem. If Foot and Mouth disease among cattle can restrict freedom of movement for people in Britain then I think addressing the infection levels of HIV is equally essential and more important than someone’s individual consent.

          Why is this not routine for every doctor or hospital visit? Especiallyu se

          I would also think that groups like Terrence Higgins Trust be relieved of all their prevention duties.

          As a charity the THT (among others) offers invaluable services and support to those affected by the virus,

          Buit the actual prevention work should be done by more pragmatic organisations.

          How can the THT (and the others) offer support to those infected while at the same time trying to prevent infection among at risk communities.

          These are 2 separate and equally important tasks and I think it would be better if they were performed by different group.

          1. @dAVID

            I’m not clear on what the HPA’s definition for compulsory testing is. I will see if I can find something on this. I would be very surprised if they wanted to require clinicians to breach their ethical standards and enforce something which the patient does not consent to. This would have far more wide ranging impact on the clinician-patient relationship which could undermine many many other forms of public health.

            As for THT – I have no problem in them being able to both support and engage with HIV positive people (which I agree they do so with significant success) AND being able to campaign to try and prevent HIV transmission. GUM centres try to promote safer sex whilst treating positive patients.
            Road traffic police educate to encoourage safer roads and enforce the Road Traffic Act.

            I can’t see the coalition government changing the arrangements on trying to encourage safer sex, as they seek to use market forces increasingly in the NHS.

          2. In my view there is a clear contradiction between the THT’s prevention work (which is clearly failing on a grand scale considering the infection rates) and their support work.

            How can 1 organisation fight stigma towards HIV and offer support and advise to positive people, while at the same time trying to frighten non-infected people into not becoming like the people they are supporting.

            They are 2 separate tasks.

            And seeing as this situation has failed (7.8% increase in infections last year) then I think the THT should no longer be in the prevention field.

            There’s a conflict of interest going on..

          3. I would argue that a 2.4% increase in testing is arguably a sign of success in the THT (and other) campaigns

            I do get your argument … Just not convinced about the incompatibility

          4. @dAVID

            I found this quote on universal testing re HIV from the HPA which suggests to me that they don’t intend to recommend compulsory testing, but are seeking to try and encourage clinicians not to be reticent in suggesting testing and ensuring that patients are aware of the consequences of choosing to be tested AND the consequences of not being tested:

            ““We want to see increased access to HIV testing routinely offered in clinical settings such as new registrants at GPs and hospital general admissions, in areas of the country where rates of HIV infection are high,” said Dr Valerie Delpech, Consultant Epidemiologist and Health of HIV Surveillance at the HPA.

            “We are also urging sexual health clinics to ensure that HIV testing is offered as part of a universal sexual health screen at every new attendance.

            “Research by the HPA has shown that routine and universal testing is feasible to undertake and acceptable to patients. Increased testing and greater access will help reduce the …

          5. … of people who are unaware of their HIV status and increase the chances of early diagnosis, when treatment is more successful.”

            I agree its not crystal clear on what they mean by universal/compulsory … but my interpretation is that consent will still be necessary.

          6. Stu – how can you argue that a 2.4% increase in testing, resulting in a 7.7% increase in positive diagnoses as being successfful?

            Those sound like fairly appalling results to me?

          7. @dAVID

            The number of tests is around 1.5million. The number of diagnoses (total cumulative) is just over 90,000. 2.4% of 1.5million is a huge numeric increase.

            There is not an expectation or rationale saying that if you test blood of x number of patients (for whatever virus, infection, clinical test etc) that y number will be positive or outside normal limits etc etc. It depends on factors individual to each individual patient. Thus whilst testing more patients is likely to lead to more diagnoses we can not predict how many more.

            Over 30,000 additional HIV tests last year is a success to welcome.

          8. As dAVID points out, there is a clear conflict of interests in the roles that THT is funded to perform. The annual infection rate among gay men is effectively its business plan for the next 12 months, as funding is awarded based on the increase in the number of HIV client services it will be required to provide. It simply is not cost effective for the sprawling edifice that the THT has become to want to see HIV prevention rates collapse, as its bread and butter is its client services on which its income depends.

            Now that the THT’s HIV prevention efforts have been criticised in the House of Lords, and having suffered the humiliating rebuke for effectively self-evaluating its own HIV prevention by collaborating with its CHAPS partner Sigma in its own surveys, it is long overdue that THT give way to a new broom with new ideas to sweep away 20 years of HIV campaigns that have no proven efficacy.

          9. @Samuel

            I think we can probably agree that THT have done some great work in supporting those with HIV and related work.

            Clearly you and others do not value the work they have done in terms of prevention. Part of that will be due to your desire for alternative methods to be utilised in attempting to engage in protection.

            I probably endorse some of the tactics you would like to see developed.

            I would also disagree that THT have not been effective. We will never prove this one way or another. You can throw the current stats and claim that shows a lack of success, I would ask how it would have been if THT (and others) had not performed some (or all) of the work they have done. We don’t know that the alternatives would have worked better, or indeed not doing some of the work THT have done would have made infection rates worse …

  9. I read something interesting not long ago: HIV- people assume that the people they meet are HIV- as well and only agree to unsafe sex because of it. People who are pretty sure that they are HIV+ will have unsafe sex because they assume that others who are willing to have unsafe sex will only do so because they already are HIV+ themselves.
    Pretty frightening assumptions going on.

    Couldn’t we have positive ads highlighting the massive relief you feel when you test negative? That you’re then more likely to have safe sex and therefore protect your partner as well as yourself?
    It would be heck loads more motivating in order to go get tested.

  10. Suddenly Last Bummer 29 Nov 2011, 12:03pm

    Perhaps immigrants from non European countries to the Uk should be mandatory tested? I can imagine vast swathes of Africans are infected, what with the infection figures in their homelands and also their beliefs that contraception is against their faiths etc.

  11. Patrick Mc Crossan 29 Nov 2011, 12:28pm

    Why is it that we as a community do least to stop the rise in HIV?
    The increase in bareback contact sites, the rise of dvs’s that only have bareback sex is something that we as a community should accept adds to the rise in HIV.
    I am not HIV+ i do get tested, but whilst out to certain venues I get annoyed at the rise of bareback sex I see before me.
    New guys on the scene see what they see and I feel are fiollowing what they see to fit in.They in my mind get into bareback sex because they want to fit in.
    On some contact sites I speak to guys who say they are neg and are interested, but when I use my made up profile days later chatting to the same guy and say Im into raw only they state they are poz and love bareback.
    We need to accept that we ourselves despite the weekly adverts in the gay press, posters and flyers in venues, the free supply at almost every venue of condoms too many of us are uncaring about our attitude to safe sex.

    1. There’s nothing wrong with bareback sites Pat
      I use em more than most and i’m a condom user.

      Try blaming the people having unsafe sex outside a relationship that don’t get tested, they’re the ones causing this outbreak.

  12. To quote: Paul Ward, Deputy Chief Executive of Terrence Higgins Trust, called the figures a “serious wake up call for gay men… Thirty years ago, AIDS devastated gay communities across the UK, but also gave rise to an unprecedented community response.”

    Of course these figures are a serious wake-up call, but they need to be a serious wake-up call for the likes of THT who are funded to prevent the spread of HIV. Ward cites the “unprecedented community response” to the virus 30 years ago, yet THT remains unaccountable for the failures in HIV prevention that have occurred since and which have been cited in the House of Lords.

    Again THT’s rallying call in answer to alarming new HIV infection stats is More testing! More testing! More testing! as if that is the answer. Of course it is not. The answer is to step up the prevention rallying call and start reminding people *what* HIV is, *what* sets it apart from other STIs, and *why* it needs to be avoided at all costs.

    The latest THT…

    1. …campaign, whilst undoubtedly a step in the right direction compared to THT’s other HIV campaigns of recent years, only tells gay men to wear condoms, period. Wasn’t this the very message THT used to cite as being ineffective because it claimed that gay men suffered “condom fatigue” after years of being told to slap it on? Of course the message is going to wash over gay men’s heads if they’re not given stark reasons – a deterrent factor – as to *why* they should always wear condoms.

      At least new HIV prevention charity Status is more open about the risks inherent in contracting HIV, though it could go further. Nobody wants a return to tombstones and icebergs, although they proved effective at preventing the spread of HIV at a time when not enough was known about the implications of infection. However HIV ads *can* be harder hitting without causing stigma. Indeed, pos guys themselves are now saying loud and clear they no longer want to be used as scapegoats for soft HIV campaigning.

      1. @Samuel B

        Not surprisingly I take a different slant to you …

        Overall I think there has to be a combined approach that increases testing (When some people remain reticent about being tested, then it is evident that more testing is needed. This is particularly true about heterosexuals as the new diagnoses in a heterosexual are more likely to be a late diagnosis in a heterosexual according to HPA figures) and also includes effective education.

        Whilst I think care needs to be taken to not stigmatize HIV positive people in education, it is possible to have some striking messages that positively link safer sex etc to good reasons to behave in that manner.

        I think most of us would agree that knowledge of HIV is significantly different to that in the early 1980s and thus an iceberg style of health promotion campaign is neither appropriate nor honest. It was probably very appropriate at the time given the information that was available then.

        1. Tombstones and icebergs would be false advertising.

          It would be a barefaced lie to have such a campaign.

          1. @dAVID

            Tombstones and iceburgs are not appropriate or relevant in 2011 … they were in the early 1980s …

            Clearly, it should not be beyond the ingenuity and creativity of advertising, health education and other professionals to devise a factual and direct campaign which avoids stigmatisation

          2. Of course icebergs and tombstones would be a bare-faced lie. But there are various implications and hazards that are associated with HIV infection which are not, but which are seldom discussed in the gay media and therefore young gay men increasingly consider HIV to be no more serious than the clap.

            I find it frustrating the amount of energy and resources being poured into encourage gay men to get tested – at the expense of HIV prevention – at a time when our “turn a blind cheek” acceptance of barebacking has never been greater.

            On the one hand we have THT pleading with gay men to be tested while on the other refusing to speak out against the sale of bareback porn and being the recipients of fundraising nights at sex clubs where condom use is not mandatory.

            A year or so ago Paul Burston arranged an open public forum to discuss such matters yet THT didn’t bother to show. If it won’t even engage with gay men about such major issues, why should we have faith in its prevention work?

          3. @Samuel

            One of the joys of PN is being able to agree to disagree with people on here.

            I agree bareback sex (outside a committed monogamous relationship) is risky and ill advised.

            I agree there are some implications of HIV that are infrequently discussed in the LGBT media or publicity from THT or others. This could be remedied in a thoughtful and responsible manner.

            Whilst I can see the attraction of prohibiting bareback sex in sex venues, I am not sure how it can be effectively enforced. Are you really expecting staff at locations such as Hardon to check that every customer who engages in sex is wearing a condom? From advertising in Boyz and other magazines, many endorse safer sex and encourage it – not sure what more managers can do.

            I think increased testing is responsible and essential but that it can go hand in hand with a safer sex message, part of which is honest about some/all of the risks that can be encountered by HIV (as well as other STIs). Some of those …

          4. … honest facts could be strong and challenging -… and ensure that stigmatisation is avoided. Its not beyond the imagination of people to devise such a campaign.

            No one approach to HIV reduction and avoidance etc will have all the answers. If we adopted all your suggestions then some things would improve, some people would benefit and possibly others would be missed – likewise if we adopted all my approaches there would be gains and losses. Thats why a balanced approach is needed that rememebers that prevention is good, we need to care for those who are positive and not everyones psychology is the same so there needs to be some variation in techniques and tactics. We also need to try to identify those who need treatment which requires testing and promote and nermalise safer sex.

          5. Stu, do you mind if I ask your status? I think a key problem is neg and pos men each trying to protect and defend their respective statuses.

            I often hear how new HIV campaigns are concocted by bickering committees of neg and pos men in the sector working to ensure that a list of PC requirements is ticked, and which results in the willfull dilution of the core message, yielding the endless stream of sanatised campaigns lacking any iota of impact we have endured for years.

            Some who are pos seemto assume a militant stance in wanting to protect the feelings of other pos men, and their insistence that HIV campaigns lack any reference of the real consequences of living with the virus to protect their feelings is indirectly yet perversely ensuring new conversions.

            It’s this victimhood “pity me” mentality among some wielding this agenda that I find unsettling when most pos men I have met take ownership of their status and are appalled at being used as the scapegoat for PC HIV campaigns.

          6. @ Samuel If we are asking personal questions (which I think are rather irrelevant with regards to a person’s status) havew you ever taken an HIV test Samuel? I seem to remember you saying that you enjoy lots of sex with other men when you have the time – of course the higher the number of sexual partners the greater the risk of acquring both HIV and an STI. How frequent do you like to test Samuel?

          7. Where does your experience come from with regard to how advertising campaigns are developed Samuel – I have no experience in this area, but I doubt very much is it as you describe it – perhaps you can give me the benefit of your references and reading literature from which you have formed this point of view, or even better your practical experience would be even better!

          8. @Samuel

            Whilst part of me is with W6 on this and feels that my own personal status is an irrelevance in terms of sensitive and honest engagement with the complex issues of HIV infection rates, education, treatment etc etc … I am prepared to answer you – at my last HIV test in late August I was negative and I have no reason to suspect it will have changed since then.

            I would hope, regardless of my status now or in the future, that my attitude towards HIV treatment, testing, education and prevention would be the best clinical interests of as many as possible – recognising that there are a wealth of needs that need addressing (different viewpoints, different primary needs etc etc) and this requires a range of approaches.

            As a health profession, I am prepared to offend if thats necessary to make a patient understand issues that are important to them. I am not prepared to stigmatise.

            Devising education campaigns should predominantly be the work of health, education and …

          9. … marketing professionals – there does of course need to be some evaluation of new campaigns but people who are both independent of those producing the campaigns and aware of the issues that the campaign is concerned with. Therefore, if you are targetting MSM re HIV then gay and bisexual men and men with HIV would be an appropriate test group for reviewing campaigns. How much impact their review has will vary on the issues raised by each contributor.

            I have to say I have rarely encountered (either patient or friend) who has HIV who has a “pity me” mentality. Most HIV patients have been more aware of their clinical conditions that your average diabetic, epileptic or COPD patient (for example).

            I will again say, some robust, honestly worded and presented education campaigns that are constructed in an intelligent and striking manner whilst are developed with ingenuity to ensure stigmatisation does not happen are key parts of effective HIV education in the community.

        2. @ Stu: “There is evidence that there can be stigmatisation from hard hitting campaigns (not only in the UK but elsewhere).”

          Ok, we’re agreed there may be some stigma with any HIV campaign that depicts a reality of living with the HIV virus – a reality based on living with HIV in 2011 as opposed to 1988, of course – but surely the risk of causing some offence to some people with HIV is far outweighed by the need to stop gay men sero-converting and get infection rates down?

          Fear is a proven deterrent factor, but any element of fear has all but been airbrushed from the HIV sector’s campaigns for two decades now in favour of often highly sexualised HIV adverts which, evidence has shown, can serve as an incentive for gay men to start barebacking when it might not have previously occurred to them to do so.

          Let’s be clear here. When the soft approach has been condemned in the House of Lords it is time to wake up and smell the coffee. Public momentum is clamouring for a return to basics.

          1. @Samuel

            Again, I do not disagree that one aspect of education should be robust and striking education ….

            You seem to suggest that I do not believe this

      2. Having contacted Status to ask them what they would be doing in the run up to WAD, I didnt really get an answer – apart from the fact that they want money to fund future campaigns – all well and good, but this year they promised everything and delivered very little.

        I for one would not contribute to an organisation that is not prepared to say who the members of that organisation are,its a simple question, why are they not transparent about it? Their arrogant replies to enquiring emails do not fill me with confidence at all. I am now more concerned about their lack of regard for public opinion than their stance on prevention messages. This is very poor in my opinion!

        I look forward to their campaign early next year which they are currently working on – bit late if you ask me! There was a blaze of glory this time last year, and 12 months on we see very little from this arrogant and secretive organisation! I hope they do get some Government funding – I will be scrutenising big time!

    2. I would be interested to know what your perceptions are in terms of what HIV is, what sets it apart from other STI’s and why it needs to be avoided at all costs.

      When you strip it right back HIV is just an additional piece of unwanted genetic code that has become embedded in the CD4 lymphocyte cells. It is a retrovirus that is very basic yet very effective at hiding from the immune system, and over time if left untreated results in serious immuno suppression and eventually death, note I said UNTREATED!

      There are many genetic abnormalities that cause life threatening illnesses, yet they are not viewed in the same way as HIV is, and many of these genetic illnesses are also passed on via a sexual act. Flippant maybe but is an accurate picture I think.

    3. Why do you use condoms Samuel? Im interested to know what your motivation is for using condoms – might seen a silly question but that will depend on the answer I guess.

  13. How can you claim 1 in 20 gay people have HIV without knowing how many there is?
    It’s probably accurate for all i know, i’d just like to know where the figure comes from.

    1. Peter S. (formerly 'FengLong') 29 Nov 2011, 3:36pm

      It’s easy, they can claim it simply by flapping their heads. Of course they can’t legitimately make such claim because as you say, its an unknown. But they don’t let a silly technicality like that stop them!

      1. Sentinal testing provides the data for undiagnosed HIV – these are ammonymised unlinked residual blood samples taken from STI screenings where an HIV test has not been carried out. In 2009 32% of MSM leaving an STI clinic did not know they are HIV positive – why oh why would you go for a sexual health screen and not include an HIV test???? It’s a no brainer it really is!

        It is better to look at the absolute numbers as statistics can easily be viewed in many ways – the HPA has a very good data set and our HIV surveilance is extremely good in the UK and is an important tool to guide prevention campaigns and health care planning.

        1. Peter S. (formerly 'FengLong') 1 Dec 2011, 1:10am

          I agree with all that. And bloody hell I didn’t know about the post-visit residual blood sample testing.. That is terrifying.

          However your point doesn’t counter the point me and Tigra were making.

          I think you need to learn to read more slowly, and not gloss over so much.

          1. ………..and you Peter S need to grow up and get over your pedantic knit picking about statistics and face the realities in life. I was making a comment about how figures are arrived at for undiagnosed infections, the method by which this information provided. I did not make a comment on the 1 in 20 gay people did I??? as stated I actually I do not find it helpful to use statistics in the way of 1 in 20 or 1 in 7, lets deal with absolute numbers, so if that is the point you are trying to make then I would agree. But you really are splitting hairs, which maybe deflection tactics to avoid facing up to things as they really are!

            Why are sentinal blood tests terrifying?? Beggars belief paranoia springs to mind!

          2. Peter S. (formerly 'FengLong') 1 Dec 2011, 12:23pm

            You and I just aren’t on the same wavelength at all..

            “I did not make a comment on the 1 in 20 gay people did I???” <— That is why your message didn't counter what me and Tigra were saying…

            And I'm still agreeing with everything you're saying here. It just wasn't relevant to what you were replying to~

          3. @ Peter

            From what I have read of all your postings the real issue you should be concerning yourself about is that HIV is out there and is very real – no matter how you want to try and use deflection tatics and bury your head in pedantic knit picking about how statistics are used to identify the very real problem of HIV and other STI infections amongt gay men.

            I guess you enjoy trying to make a point that in the grand scheme of things in is rather irrelevant to this article – Go sort out your sexual identity problems, then come back when you have something useful to add to the debate!

          4. Peter S. (formerly 'FengLong') 1 Dec 2011, 1:10pm

            Jesus H… What are you talking about~

            Certainly nothing to do with what I was…

          5. Why is post visit residual anonymous blood testing terrifying????

          6. Peter S. (formerly 'FengLong') 3 Dec 2011, 6:50pm

            Because it means that a lot of people are walking out of the clinic with HIV and refusing to find out about it…

            Strikes me as really scary~ 0_o

          7. @Peter

            I will partly agree with you and add a little bit of perspective to one aspect of sentinel testing.

            Firstly, where I agree … it is scary that there are probably a significant number of people who feel the need to get some advice from GUM or other services regarding possible STI but (for whatever reason) decline an HIV test, even if there is a risk. I have personally found it frustrating that a number of patients have declined HIV tests despite there being good clinical reasons to recommend it. (Although I know you believe my experience is worthless).

            Secondly, with regards sentinel testing … this does not come solely from GUM tests etc, but from blood donations etc etc and is anonymised – so this could mean that the number of people leaving a GUM centre without knowing their status is actually lower than we might be concerned about, but perhaps more scarily, there seem to be people in the population who either have not even gone for GUM help or feel no need – but …

          8. @ Peter, I would refer you to Stu’s second point in relation to Sentinel Testing, from my analysis of your ramblings it would seem that you are one if the population who feels no need to access GUM services, which at best is extremely arrogant in my opinion and as Stu says is very scared, as you yes you could be harbouring undiagnosed STI’s or HIV and other blood borne viruses.

            Clearly it would probably take someone like you to bece symptomatic or even extremely unwell before you accessed the help you need, you Sir are an example of those who could die through ignorance – if you never test you can never ever be 100% sure, how’s that for scare tactics?

          9. Peter S. (formerly 'FengLong') 5 Dec 2011, 3:23pm

            W6_bloke

            I have never had anal sex in my life, and have only ever given one blow job to someone who I know and trust well.

            And even he had a full health check, including comprehensive blood tests, and he has the same views on sex and relationships as I do (or else it wouldn’t even have happened).

            I would die of fear alone if I ever put myself in the position to get diseases like that, even before I could get to the test!

            I don’t sleep around, AT ALL. EVER. I only look for my life partner to be. And it takes many weeks for me to even get close to doing a sex act, even if/when I do find a suitable candidate.

            If I ever did feel the need for a random sex encounter (which I won’t), it would be nothing beyond mutual masturbation.

          10. @Peter

            I have to say I do feel for you.

            Your use of language is interesting. Your admission of fear, “diseases like that” … Suggesting somehow that HIV is a worse disease than any other … Clearly, it is something that the vast majoirty (if not all) people would prefer not to have – but I have seen far worse illnesses as a health professional …

            I am not here to act as a armchair psychologist, but I do wonder if you would benefit from some counselling due to your possible fear of intimacy and the manner in which your phobic behaviour skews your perception of issues.

          11. @Peter

            Are you aware if you have ever met anyone HIV positive?

            How did you react?

            I don’t ask these questions to be provocative … but merely to try and understand some of your mindset

          12. Peter S. (formerly 'FengLong') 5 Dec 2011, 6:08pm

            ‘Diseases like that’ referred to STIs really. The incurable ones give me the worst feeling in the gut because it’s like a vile taint inside you for the rest of your life, and it doesn’t fit at all with how I see myself.

            And yes I am aware that sounds like some sort of STI bigotry or whatever, and I’m not saying it’s *entirely* rational. I’m explaining my feelings which I can’t help, and in this case at any rate – don’t even want to~

            You asked, I’m answering honestly.

            Whether I *need* counselling or not, I don’t know. But I don’t want it and couldn’t accept it anyway~

            When I find my guy, I think I will be a lot happier then. I will adore him and be proud of him, and not at all ashamed. Maybe that will allow me to get over my issues.

            Here’s hoping~

            I never knowingly met someone with HIV, but I would feel very sorry if I did/do~~

          13. @Peter

            I can see it logical that STIs (like all illnesses) should be avoided.

            Clearly, as you have identified, the cureable forms are (in a sense) less serious than those that are incureable – provided those who may be exposed seek treatment …

            I query your perception (although clearly it is the view you have) that being infected with an STI taints a person. I have to think this through logically and I do not view someone who is raped and as a result gets HIV or syphilis as tainted. I do not view someone with diabetes or epilepsy as tainted. So, I would not view someone who has an STI (regardless of type) as tainted no matter how it was transmitted. Although, I suspect for you it is less about how others caught HIV etc and more about your fear of that happening to you. I may be wrong.

            I don’t think it is entirely rational. Not sure I would describe it as bigotry … irrational, unfair, maybe but not bigoted (in my view).

            I hope you do find your guy. I think its a …

          14. … that you are not keen to explore counselling (although you should make the decisions that are right for you) as it may enhance any relationship you establish with “your man”, by enhancing the intimacy and fulfillment that you establish and enjoy.

            I hope you do find you man, that you love each other, adore each other and are proud to be together and share each other – and be known for being together.

            Thanks for your honesty in debate. You wouldnt expect me to agree with all of your views. Some of your views are very pertinent – some I profoundly disagree with.

            Look forward to debating more with you in time.

    2. Well the HPA says there are 40 000 men who have sex with men living with HIV:
      http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317131685989

      40 x 20 = 800 Thousand. SO are there 800 000 gay men in the UK ???

    3. Whenever there is funding to apply for it seems any figures plucked out of thin air will do. It should be noted, for example, that the reason there has not been a Gay Men’s Sex Survey of late – and possibly never will be again – is because it was discovered that the THT commissioned its CHAPS partner Sigma to run the annual survey, which they then colluded together to evaluate and manipulate the survey results to the advantage of the THT.

      Whether or not any of THT’s lucrative funding was ever secured on the back of skewing or misrepresenting statistics to provide a predermined outcome isn’t known. But either way the covert evaluation of one’s own work – akin to an A-level student marking their own exam papers – is tantamount to fraud.

      The allocation of government funding is an industry rife with corruption and opportunism, so you are correct to take such stats with a pinch of salt.

      1. @Samuel

        There was a gay mens health survey this year which considered sexual activity, depression, drug use, and general health issues together

  14. Having worked with the MSM community here in the Caribbean I know the reasons for the increased infection rate are directly linked to homophobia and criminalization. There are more clandestine, casual sexual encounters. Men with internalized religious/family/societal hatred and are not empowered enough to put their health first and too scared to get tested. There is irresponsible drug use, sexual exploitation of young, homeless gay men and a kind of “death wish” as life is hard and unfortunate anyway. Desperate environments lead to desperate actions. However, I do not understand why in the UK where there is prosperity, freedom, civil rights, education and support, the problem is still so rampant. What you boys doing with your lives? It’s like you’re a freed slave who does not realize they are FREE! I want to hold you and shake you and tell you that you have SO MUCH to live for!

  15. In the same breath, the most passionate, purposeful, open, compassionate, community-oriented gay men I have met are HIV+. Why? I do not think it is a gay thing but a MALE thing. Men always seem to wait until mortality becomes visceral before enlightenment hits! You have this combination of invincibility with an underlying fear of being vulnerable (you hate going to the doctor PERIOD). It’s a “Live fast, die fast” evolutionary trait that helped your ancestors charge down mammoths and now it makes you bareback multiple partners while high on E. In the midst of your adrenaline rush, you forget self-preservation. Survival seems to be a feminine trait. Women face their own pain, blood, mortality every 28 days and during childbirth. Biologists observe that female offspring fight harder to survive and are more likely to do just that, in the wild. But my gay brothers are supposed to be more in touch with their feminine side. Perhaps you need to tap into this aspect of it, not just the superficial ones.

  16. I always question statistics like this. 1 in 20 gay men are positive. How do you know how many gay men there are in the uk? The more ridiculous statement that a quarter do not know they have HIV. How do you quantify this? It could be a lot more or a lot less. I have read before that a third don’t know they are infected!?!? So which is it. I agree with other posts, is get tested on an annual basis really the answer? It kind of suggests that you are having bareback sex on a regular basis and you will get HIV eventually so lets find out quickly and get you on drugs. The inevitability that you will get HIV and the lumping it in with other STIs is where these charities are failing the community, along with the blaze attitude that its treatable with drugs. Yes it is but with horrendous side affects.

    1. Wherever there is funding to apply for it seems any figures plucked out of thin air will do. It should be noted, for example, that the reason there has not been a Gay Men’s Sex Survey of late – and possibly never will be again – is because it was discovered that the THT commissioned its CHAPS partner Sigma to run the annual survey, which they then colluded together to evaluate and manipulate the survey results to the advantage of the THT.

      Whether or not any of THT’s lucrative funding was ever secured on the back of skewing or misrepresenting statistics to provide a predermined outcome isn’t known. But either way the covert evaluation of one’s own work – akin to an A-level student marking their own exam papers – is tantamount to fraud.

      The allocation of government funding is an industry rife with corruption and opportunism, so you are correct to take such stats with a pinch of salt.

      1. I think you will find that the HPA are an Independent organisation who have a very detailed data set of HIV prevelance in the UK. This is used for health care planning.

        At the end of the day the UK spend a pittance on HIV and STI information and prevention work, this has also been detailed in the HPA report, but seems to have been missed by many commentators. X percent of nothing is nothing in my view.

      2. The HPA are the organisation responsible for public health, which includes collating the figures for all notifiable diseases (including HIV) … thus many aspects of their statistical analysis are much more reputable than those of many other organisations when concerned with public health in the UK

      3. @Samuel

        Again, I will repeat what I said earlier – there has been a gay sex and health survey this year …

  17. Here’s another article (“Few in U.S. with HIV have virus under control: CDC”) focusing on how few HIV+ people in the US manage their condition well:
    http://www.reuters.com/article/2011/11/29/us-usa-hiv-idUSTRE7AS1V420111129

    I don’t understand the arguing about the UK study numbers on here: you either both have safe sex and get tested, or you don’t. If you don’t then ask yourself why. Arguing is pointless.

    Regardless of what the numbers are and how reliable they are, we need to each take responsibility for ourselves. That’s the only conclusion to come to.

  18. Most of these numbers have been available for some time, so I find it interesting the level of postings this story has generated!

    Also it is interesting that many commentators just look at the headline grabbing figures without looking at the detail – and as they say the devil is in the detail.

    The new diagnosis figures cannot be looked at in isolation – as other STI’s are rapidly increasing amongst MSM http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317131685989 this is fuelling HIV infection rates, and as many STI’s can be caught even where condoms are used, it suggests to me that MSM are not very engaged in their sexual health in general let alone HIV.

    We must also remember that increased testing rates will filter through to increase new infections, & for those who say testing is not dealing with the problem I am afraid you need to understand population viral load figures, how how VL impacts on infectiousness, Treatment as prevention works and has been found to be 96% effective.

    1. To answer the point about how the undiagnosed figures are arrived at – this data is collected using the Sentinel unlinked annonymised blood sampling – which are often taken from blood samples from GUM clinics where an HIV test has not been done. http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317131685989 These figures reveal that in 2009 32% of MSM were infected with HIV but were not aware of it because they did not request an HIV test…………we have to ask the question why people go for STI screenings and do not include an HIV test as standard screening – this to me is just plain stupid.

      It is these undiagnosed individuals who are more likely to pass on the virus because they are likely to have high viral loads, which is directly linked to infectiousness. So again testing is essential as part of the answer to reduce forward transmission of HIV.

      1. The gay community needs to overcome the divisions that result in sero-sorting, this practice is fuelling new infections, because it is not possible to guess if someone is HIV positive or not. How often do we see neg for neg only on gay dating sites? As there is a very high level of +ve MSM taking treatment and have an undetectable VL we should be asking the question why sero-sorting is occurring in the first place. What is better, to have sex with an undiagnosed +ve individual with a huge VL or have sex with a +ve guy on meds with an undetectable VL? Again this is a no brainer, but many gay men have a total block when it comes to having sex with diagnosed positive guys, this says something about the stigma that is also fuelling new HIV infections.

        I do not agree with the idea that service provision and prevention need to be separated, as this sort of separation will only result in further segregation, and I beleive the importance of STI’s in HIV infection rates will be lost.

        1. And to address the myth that taking HIV medication is “horrendous” where is this point of view coming from – mainly from HIV negative individuals in my view! Scaremongering about meds is not helpful and no matter how you look at it the meds that are used today are far less toxic than the early meds, which were taken in huge quantities that were very toxic and caused many serious side effects. This thankfully is not the case today – apart from some side effects when first starting treatment the majority of individuals taking treatment do not suffer serious side effects, most can be well managed, and if these side effects cannot be managed then I would encourage anyone in this position to seek an alternative therapy.

          I am aware that quite a few people are prepared to put up with unwanted side effects because they are not aware of the alternatives, or they somehow expect these side effects. Again as a community we need to talk openly about treatment and see it as a very positve thing!

          1. I should clarify that when I state “alternative therapy” I mean alternative ARV’S treatment regimen. This should not be confused with alternative complementary therapies instead of using ARV’s

            Sorry for any confusion

  19. A very scary prospect to consider here – and as good a reason as any to reinforce the safe sex message loud and clear – is that there have already been quite open discussions to minimise NHS treatments for people who do make a choice to indulge in risky behaviours, such as smoking and over-eating. Only a fortnight ago the mainstream media reported how some HIV patients are now being asked if they would consider switching their treatment to a lower cost alternative.

    This may not sound like a major threat right now as patients are still being given a choice, but we could be at the top of a slippery slope where austerity measures are cited more and more as reasons for slashing the annual HIV drugs bill, just as excuses are being made to deprive cancer patients of life-prolonging drugs. Only today The Guardian reported:

    “If the 3,640 UK acquired HIV diagnoses made in 2010 had been prevented, between £1bn and £1.3bn lifetime treatment and clinical care costs would have been saved.”

    1. ………….it doesnt take long for some people to return to type does it. This debate has been had and it was made clear then that the majority of individuals already on treatment are not being asked to change to less expensive options. People starting treatment are being given less expensive options where clinically indicated – no one is being given inferior treatments in the London clinics.

      Peter Tatchell tweeted yesterday that less expensive treatment options were not as effective – this is pure scaremongering it really is, and sends out the wrong message. All the durgs used in the cheaper regimens are well known tried and tested drugs – ok they may not be as handy as taking one pill a day, but how is taking 2 or maybe 3 pills once a day so difficult – it isnt! The realitiy is that we have to make the budget go further, but treatment effectivness will not be compromised as a result – we just have to work in a smarter way!

      1. I should add that the less expensive prices have been arrived at by economies of scale – by negotiating directly with suppliers to drive down unit lost based on volume uptake, surely this makes perfect sense. It is likely that procurment of HIV drugs will be much more centrallised in the future, thereby getting the best unit price, thereby ensuring more treatment for the same spend…………..if generic drugs are introduced as they may well be in the future they will be of equal effectivness to the originals.

        There are many studies looking at reducing the number of drugs taken once the viral load is undetectable – instead of taking 3 different drug classes we have ongoing trials of monotherapy using boosted Darunavir – this is all good news for driving down cost. Many newer drugs are prescribed at much lower levels and in the future this is likely to continue, which is good for patients which ever way you look at it……….

      2. Hi W6, with all due respect, what you may say may be entirely true but this is surely only the thin edge of the wedge if recent developments within the NHS are concerned. As the recession bites, can you seriously consider the NHS being able to defend outlaying billions on top end drugs when it is being forced to dish out cheaper generic drugs to cancer patients and so forth?

        And let’s not forget we have the Tory party in power for at least three more years. Yes, they may be courting the gay vote right now, but there are still those among their ranks who, if given access to the data of how many gay men are routinely choosing to abandon condoms and the community’s look-the-other-way acceptance of unsafe sex, will undoubtedly want to point the finger and insist that top end drugs are no longer and option in such circumstances and amid a deteriorating economic environment…

        1. We have discussed this Samuel very fully indeed. What do you mean by “top end drugs”? All modern HIV drugs are of equal effectivness – the 5 different classes of drugs attack viral replication at different points in the HIV lifecycle. The two most popular classes of drug are Non nucleoside reverse transcriptase inhibitors (NNRTI’s) and boosted Protease Inhibitors (PI’s) A drug from either of these classes is conbimed with 2 “backbone” nucloeside reverse transcriptase inhibitors (NTRI’s).

          As stated previously the lower cost drugs that are now being prescribed in London are well known and have been used for many years. To repeat very few people on successful treatment are being asked to change and it is only the PI class where this change may occur. Atazanavir has been around for a long time and is tolerable, effective and is taken once a day. Less cost does not = inferior!

        2. @Samuel

          We could throw what if questions at virtually anything with this government ….

          The current reality has been explained to you ad fininitum by W6 and I and others have explained this is how we also perceive the reality of the situation. There is also independent review of the London prescribing regime to ensure that the corrrect decisions that are both clinically appropriate to each patient (including effectiveness) and the most legitimate and economic choice for them is adopted, with informed consent from the patient. All prescribing should be both clinically appropriate and economic whether for HIV or tonsillitis …

    2. Jock S. Trap 15 Dec 2011, 11:43am

      Your point is?

  20. In terms of prevention messages having seen “we were here” it is impossible for the same prevention messages to be used……in the 80’s those guys had no clue about what caused the illnesses seen in gay men, this was real fear, lets not underestimate that!

    Today so much is known about HIV and its treatment so for me campaigns that focus on the fear angle are going to be of limited use – some may respond, but many will not.

    Education not creating fear and stigma will win the day, together with improved testing rates, early diagnosis and early treatment – the gay community needs to do more for itself to combat HIV, the information is out there it just needs to be used as we are a high risk group.

    1. But surely we should be educating gay men about the implications and realities of HIV infection via the very campaigns you insist won’t work? Where is the education around HIV infection?

      There is more to living with HIV than taking drugs, and to deny that is to deny thousands of clueless gay men the knowledge they need to make a truly informed decision over whether it is worth taking sexual risks.

      The truth is that gay men are not being educated about the risks inherent in contracting HIV and therefore are being deprived of empowering information to enable them to safeguard their health because the supposed HIV preventionists constantly use HIV stigma as a useful excuse not to do so.

      Support the fundraising efforts at The Yard, The Edge, Pulse et al over the next few days as their donations will be supporting the charity Status, which is finally putting common sense back into HIV prevention campaigning.

      1. We will never agree on this Samuel. What are the realities of living with HIV in 2011 do you think – I am interested to know, given that I am HIV positive & you are not. I also have many forum conversations with individuals taking meds, some just starting some for many years. I get points of view from straight, gay, female & male individuals – I think I can safely say I have a very broad point of view about people living with HIV. By all means give your money to Status if you want an arrogant, secretive organisation to take on some prevention work – good on them, but I for one will be watching very closely as any organisation that cannot be transparent about who they are worries me. From the emails I have received they are above suggestion of being questioned about their poor use of stats & that they only publish good responses to their ads – how transparent is that? I will stick with my local HIV charity River House, or set up my own organisation in the future.

        1. Why not check out the independent on Sunday where I am featured with a short interview about living with HIV – and I will be giving a radio interview sometime in the future with BBC 5 Live, I’m getting stuck in big time as I really want to make a difference to HIV infection rates and also those people who have to lead a double life becasue of stigma and marginalisation towards them – and beleive me there are many individuals who are like that – it is not a good state of affairs to be in.

          30 years have passed but attitudes have not kept up with improvments in treatment and care of HIV, this problem is fuelling new infections it really it.

        2. Nobody properly clued up about the realities of HIV would choose a lifetime of medication, which in itself is a major reason not to acquire the virus. Yet what HIV campaign has ever conveyed the arduous routine of adhering to a strict regime of pill popping?

          And while these pills keep you alive you will be accumulating a build up of toxicity over years of ingesting these synthetic compounds which will ultimately present their own problems.

          You may not be at that stage, W6, but research in the US conclusively shows that by age 50, after 30 years of ingesting such drugs, your body will be knackered and function like an 85 year old.

          It is all very well claiming the drugs work now, but the long-term effects of their use is only now be being evaluated 15 years after their launch.

          HIV – IS IT WORTH IT? would be the banner on a series of campaigns I would run around the multitude of negatives of being positive, and sorry if that offends your sensibilities, W6. It’s called tough love.

          1. And what are your realities of living with HIV Samuel, where do you get your perception of what it is like being HIV positive?

            We have had these discussions many many times on meds and their effects, and I get my information from the experts in the field. As for the build up of toxicities you mention this really is not the case in modern HIV care, patients are well monitored and action can be taken to change any component that is causing problems and a suitable alternative given. This is the reality of HIV care today, I know because I access this care!

          2. Being HIV positive not much offends me because I have quickly developed a thick skin to brush away the stigmatising comments and constant rejection tactics employed by uneducated gay men. I can agree that the phrase ” HIV – Is it worth it?” is a useful phrase to use, but where we differ in approach is that I am very clear that of what it is like being HIV positive, this is my reality not perception based on selective reading. Taking meds and sometimes feeling unwell is easy to deal with when compared to the social consequences of testing positive, stigma is a huge barrier to reducing new infection rates. I am very lucky to be confident about being +ve and I am very knowledgable that’s why for me I am not concerned about beng +” “it’s a virus so what” is my view on my own infection, it has happened &I take responsibility for it. I want to properly educate not use “sound bites” to try & scare people, HIV us complex and deserves more than lip service in so called harder hitting messages

          3. Where due to get the notion that taking HIV medication is an “arduous routine” Samuel – I take 5 pills once a day for HIV, usually with my breakfast, but sometimes like today I forget, and your comment has just reminded me to take them. Taking medication for life is a reality for many people, and as I also have to take medication for a psychiatric condition day in day out the worst it ever gets for me is a bit tedious, it really does not punctuate my day to day routine in any way. I barely think about taking any of my medications…………..this is my reality, not everyones, but again as I have previously mentioned I am in contact with many many individuals through HIV forums who beleive it or not, have a very similar unremarkable point of view on taking medications – we take them end of!

            Despite my poor time keeping I have never missed a dose of HIV meds in 2 years, not bad going – I dont stress over them, and modern drugs are more “forgiving” in terms of time adherence.

          4. @Samuel

            There may be some merit, for some audiences, in the use of a campaign along similar lines to HIV is it worth it? … depending on how the campaign was going to be framed, supported and directed … What things would be put in the audiences mind to question and endorse their safer sex choice? How would this be done? How would they be supported further if they had questions that arose from this? There are merits, but the simple tag line poses many more questions than it answers – and these need to be thought through carefully both to ensure those who may respond to the intent of the campaign to urge safer sex are fully supported and to make sure the information portrayed as facts – is true and honest. EVen campaigns like the one you portray require statistics to evidence its need – such as HPA MSM statistics …

  21. In the ‘old days’, you’d see the posters in the bars or the campaigns in Boyz and QX magazine, but in the age of the internet, I wonder how many people who use Gaydar, Manhunt, Adam4Adam etc have ever even seen a safer sex advert?

    1. In the days when I used gaydar then there were significant numbers of banner adverts promoting safer sex …

      There are still flyers and ads in Boyz, QX etc and specialist health promotions magazines targetted at MSM

      There are also campaigns on the net to try and target MSM with surveys, health promotion etc etc

      The work is there and some of the content is right – whether it is targetted fully appropriately or whether the balance of content is right is another matter – but work is happening …

      What is not happening is guidance in school or the home on safer sex for young gay people … either because parents/teachers are reticent or feel they are embarrassed to or lack the right knowledge OR because of a fall back to section 28 days or other homophobic issues … this does lead to some lack of safer sex awareness for some young LGBT people – although, it is also clear from the rise in STIs in the young heterosexual population that this is also a wider issue than that to LGBT people

      1. I use Gaydar from time to time as well as some other cruising sites and I can’t recall any adverts promoting safer sex. I never pick up the gay press these days, having been an avid reader of it in the past, so don’t see any of these campaigns either.

        I honestly don’t think my experience is untypical and if people aren’t going to gay bars, there is an issue of how MSM can be reached in order to keep the safer sex message alive and at the forefront of peoples minds.

        1. Gaydar have been running awareness campaigns with THT, the latest one being the drug resistant gonorrhea banner ad. I think there is also a problem trying to engage guys when they are online. As an HIV +ve individual I refuse to just limit my use of chat rooms to just the HIV room on gaydar, yet when I have tried to engage guys in my local chat room and provide some education and dispel myths there is no appetite for this and I have often been told to go chat in the HIV room with my “own type” and been openly referred to as an HIV freak who has “issues with HIV”!

          Gay men need to engage with sexual health information, there is plenty of it on the net and most young gay men are very internet savvy! A simple google search brings up plenty of useful sites and information. We need proper education that targets high risk groups such as gay men and the general population – balanced educational campaigns are nhow required to reduce infection rates, not sound bite scare tactics.

        2. @Isaac

          I went back onto gaydar this morning for half an hour out of interest to see if the ad’s there had changed dramatically since I was last on.

          Whilst many of the ads were commercially involved – there were 3 health promotion adverts that I saw.

          I also discovered that THT are doing some online community work through gaydar involved in HIV and STIs …

  22. We aren’t being real about the male primate here.

    He is not mongamous by nature.
    He ENJOYS risk, the hunt, thrives on it, seeks it as part of his testosterone fuelled need to prove himself.
    He has a voracious appetite for sex.

    Any stigmatization of this or persecution for this results in an exaggeration and over-celebration of all of the above traits to compensate for the unneccesary shame and guilt.

    Now with that in mind, tailor your safer-sex campaigns accordingly.

    1. "RANDY OLD 2 Dec 2011, 9:13am

      At last, somebody with a sensible and pragmatic outlook.
      What you failed to mention though is that most heterosexual males are controlled simply by the female, and it is they who define and decide on the frequency of sex, and the whole social stigma of a promiscuous guy being regarded as a “stud”, but a similar girl as a “slut”. This ultimately results in straight men having less casual partners.

      In the gay world, there is no safety valve, as men go with other men, so the simple fact of frequency and variation of sexual partners combined with the much more risky practice of anal sex puts gay men at the very top of the hit list.

      People may not like these facts, but they are simple evolutionary statements, and it is time everyone recognised them. Safer sex is down to you and you alone, and one must not rely on anybody else to maintain one’s sexual health.

      If you don’t know the full facts, find out or suffer the consequences.

      1. Spanner1960 2 Dec 2011, 9:15am

        Oops. The above was me by the way :)

  23. Jock S. Trap 15 Dec 2011, 11:41am

    Not good but I wonder if the numbers are due to an increase in people being tested that once feared doing so. We need to put these figures in the correct box. Is awareness increasing so therefore more being tested.

    Overall it’s better to know who is that who isn’t. Better for all concerned.

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