The Briefing Room

man, reading all that makes me want to subscribe to your magazine, i've read your article on condoms being unsafe from Rhema's website though (www.rhema.co.nz)

Damn, and you didn't once accuse PC of designing shoddy structures that fall down all the time. I mean, why do I come here? :)

And just to clarify for Cresswell's sake, I have never argued that "soy milk causes homosexuality". I have written that it "may" be a factor, given the international studies now done...

This link http://www.westonaprice.org/soy/birthcontrolbabies.html reveals a baby being fed soy milk is recieving the estrogen equivalent of five birth control pills A DAY.

Aww man I want to see you king hit this guy in court please? I guess you get more integrity points for just rebutting him into the ground (and maybe into sublevels too).

Ian, you are doing a great job about challenging the safe sex myth. However, condoms are a lot more effective than you make out. With respect, you are misinterpreting the data. Please check out the website below.

http://www.globalchange.com/ttaa/ttaa%206.htm

If a condom is 80% effective against transmission of HIV that does not mean that a woman would have 20% chance of infection if she had sex with a HIV+ man. That is because if she had sex without a condom she would have roughly a 1 in 200 chance of infection. If a condom is used her odds of infection would be about 1 in 1000.

I like wine with a meal. Say I can drink 3 glasses of wine and be under the limit and 4 and I am over. Suppose I am marginally over the limit and have a short drive home. What are the odds of me killing an innocent person? Maybe Andy what’s his name from the MOT could tell us but I am certain the odds would be very much less than 1 in a 1000.

I would like someone from the MOH to explain why someone driving slightly above the alcohol limit is consider irresponsible yet someone HIV+ who has sex using a condom has a 1 in 1000 chance of killing a innocent person and they are considered responsible?

Chuck...I understand your point and it's one I tried to explain in the articles, although it could have been clearer. Of course a 20% failure rate does not of itself create a 1 in 5 chance of catching a disease, because other factors such as the level of infectiousness are relevant, as is the presence of the infection: ie, you won't catch anything if your partner doesn't have the disease.

But the studies the WHO refers to in its 2004 Bulletin are comparing the level of disease transmission in the general community against the level of disease transmission amongst those using condoms.

What the studies find is that while condoms have a level of efficacy, it is nowhere near being "safe" and still has worse odds than Russian roulette in many cases...this because the levels of general STDs in the community are now so high that over a period of time, condom or no condom, you'll catch some.

HIV is very hard to catch through vaginal intercourse.

"HIV is very hard to catch through vaginal intercourse."

as a man.

You forgot the 'as a man' bit.

Yes...as a male...females are much more vulnerable.

(How MCP of me...)

Ian, below is a response to my letter to the Herald from the AIDS Foundation.

Perhaps Investigate could do an article about this homosexual activist front organisation and the government funding they receive. It is outrageous how the homosexual lobby has managed to keep HIV off the list of notifiable diseases. If someone tests HIV+ their past sexual partners should be notified. Firstly, so that they can receive medically help which they can benefit greatly from. Secondly, so they at least have the opportunity to act responsibly. By that I mean informing any potential sexual partners of their HIV status.

HIV screening

Contrary to your correspondent Chuck Bird’s assertion, local and international experience has shown it is not easy to identify women at risk of HIV.

The universal offer of HIV screening to pregnant women reduces the number of babies infected to near zero. The cost is small compared with the cost, socially and financially, of caring for an HIV positive child. This is why universal screening has been adopted in countries like Britain and Canada, and now New Zealand.

As to contact tracing, the AIDS Foundation endorses the Ministry of Health policy of supporting and encouraging, but not compelling, people with HIV to advise their sexual partners.

Our experience is that the great majority of people fully participate in this process. Compulsory contact tracing has been proven to act as a deterrent to people seeking STD tests, including HIV.

The worst situation would be for anxious people to not test, and continue to transmit to others, because they fear being forced to tell their sexual partners.

With good post test counselling, the ideal of practising safe sex and telling their former partners tends to be met.

Rachael Le Mesurier, AIDS Foundation

Do NOT forget you owe me $40 for your share of the power. If you paid up when I told you I would not have post notes on the frig that allow rumours to start about our marriage.

Sorry, the above comment went to the wrong blog. It was met for:

http://generation-xy.blogspot.com/2006/03/suggest-caption-27.html

At least he doesn't claim that a mythical being created the universe...

Can you categorically prove the being is "mythical"? If so, how?

The onus of the evidence is on the person promoting the myth.
If I start promoting the myth of the green spaghetti eating monster as our creator, you can ask for my evidence then.

and the onus has been proved by many over many years. check out www.insidelook.co.nz for just a sample, or visit your local Christian bookshop and ask the store clerks for books providing the evidence. at the same time you have to have faith as well, for example science has no real proof for our conscience and evil

Green...you suggest the onus of proof is on us because it is a "myth".

How do you know it is a myth? Prove to me it is a myth, then I will argue the extraordinary proof to defeat your proof of myth..

How do you know that what exists is real, for example...how do you know life is not merely an illusion...

The argument is much more sophisticated than a bald statement, "myth".

Prove it.

Asking for proof of a negative Ian....? Tsk!

Ian maybe Peter's choice of words was bad. "Extremely selective with his facts" is probably more accurate. But then he can use something like "it could have been clearer" as his defence.

Also,
This, by the way, is why I'm the journalist and you are an architect

But certainly not a scientist, so why meddle with stuff you just can't seem to get quite right.

Ian a woman rang up zb talkback on pat Brittendens show and suggested as you are very religous you could be a Brethen. Ian what religion are you. Love your magazine keep up the good work Joan J

Joan: Anglican...

Andrew: I'm not an ingenue in regards to science...if someone wants to attack me on scientific grounds then let's genuinely debate the science rather than indulge in name calling.

I have in fact challenged Peter to fisk key articles thoroughly...so far he hasn't done so.

My overarching point in all this was simple: can you not see the irony that I'm being attacked as a numbnut Christian fundamentalist journalist who can't get his facts right, by somebody who is by the same objective test a numbnut secular fundamentalist who can't get his facts right.

In the condom effectiveness articles you appear to badly mangle what at least one study actually says (the first and only one I checked).

"AMERICAN JOURNAL OF EPIDEMIOLOGY, 2004; 159: 242-51: A study of 4314 participants who visited STD clinics found consistent use of condoms still resulted in an infection rate of 82% compared against those who didn't use condoms"

To start off, "an infection rate of 82%" isn't mentioned in the study at all. The number you appear to have invented that statistic from is the prevalence odds ratio of 0.82 of the group with unknown parter infection status. The whole purpose of the study was to show that the effectiveness is underestimated in certain types of studies, and when they included known parter infection status in the stats they found a prevalence odds ratio of 0.42. Even that is very likely to underestimate the true effectiveness.

Whatever value exists in your articles is undermined by getting some of the basic figures wrong.

Not impressed - you may have to explain odds ratios.

Maybe Ian should explain it, he's studied stats and I haven't :)

But here goes... an odds ratio is a measure of association. It is the ratio of the odds of a disease among the cases (for example) and the odds of the disease among the controls. Using this table as an example, http://aje.oxfordjournals.org/cgi/content/full/159/3/242/KWH044TB2 -

(Male&Infection / M&~I) / (F&I / F&~I) ~= (854/1822) / (407/1660) ~= 1.9

The measure that Ian was thinking of seems to be the Relative Risk. That would be (31.9/19.7) ~= 1.6 for this example, but as I understand it, that measure isn't applicable to this study.

Anyway, the main point is that it was not a study of 4314 participants, but actually 4743. Those extra 429 participants make up the crucial part of the study.

Yeah, I was trying to keep it simple but probably oversimplified it.

The issue is the relative rate of infection in different control groups...ie, of those who were surveyed, was there a measurable difference in infection rates between those who regularly used condoms and those who didn't.

The studies are not saying that if you use a condom there's still an 82% chance of catching a given disease...clearly that's insane. But what they do show is that condom users are still 82% as likely to catch the particular STD as non users.

In other words, what the studies show is that the sample using condoms still had infection rates 82% of the size of those who didn't use condoms...in other words, not a huge difference and certainly not enough to call it safe sex.

This is the key point...safe or safer sex implies to most people that barring outright condom failure, they're safe. Unfortunately the relative rates of infection show condoms cannot be relied on to prevent most STDs.

Thus, an odds ratio of .82 against a control group reveals that the prevalence of the disease in the sample is 82% the rate of prevalence in the control. You would expect if condoms were genuinely effective to have a ratio down at maybe 0.05 (5%) reflective of condom failure and human error.

Now the overall disease rate in a given area might be 10% of the total population. What the study indicates is that of that 10%, a sizeable chunk will be people who used condoms and caught it regardless.

Did you actually read and understand the study? Your fixation on all things 82% (odds ratios are not percentages!) suggests not.

It may seem odd that condom use in the group with unknown exposure to Gonorrhea/Chlamydia didn't appear to provide much protection. But if you read the study you will see that the nature of that particular group works against finding an effect. Various limitations of the findings are mentioned, one of them being: "condom users may be several times more likely than nonusers to have infected partners, and the underestimate of condom effectiveness in most studies may be quite large."

The group of 429 participants was designed to reduce the problem of differential exposure to infected partners. The adjusted POR for that group was 0.42, and that finding is what is important in the study, because the design of that group is much more likely to demonstrate condom effectiveness (if it exists) than the other group. The study mentions that this result could still underestimate the true effectiveness, due to limitations such as a likely biased selection of participants towards those who use condoms ineffectively and end going to a clinic and participating in a study :)

It is useful to point out that the number of unprotected sex acts was strongly associated with infection in the group with known exposure, but not in the group with unknown exposure. This shows the usefulness of controlling for differential exposure. If you keep going on about the unknown exposure group, will you also say that the number of sex acts isn't strongly associated with infection rates?

Here's the final paragraph,
"Our study results indicate that knowledge of partner infec-
tion status is critical when evaluating condom effectiveness
for prevention of gonorrhea and chlamydia. Consistent
condom use likely provides greater protection against trans-
mission of these STIs than previously reported in the litera-
ture, a finding that holds important implications for public
health recommendations and practice."