The low down on the uptick in AIDS

The newest JAMA isn’t available to me yet, but for the typical New York Times hysterical editorializing of health information news, see yesterday’s paper. I read about the "big government cover up" (subtext: it’s all Bush’s fault) story at the coffee shop this morning.

Opening paragraph: “The AIDs epidemic in the U.S. is about 40% worse than the government has reported.”

First of all, there is no epidemic in the U.S. AIDs or HIV affect a tiny percentage of the population--mostly promiscuous, young, risk-taking gay men and IV drug users. Studies as early as 15 years ago in public health journals showed that after all the valiant efforts of the gay community to clean up their behavior or die (and many of them did both), the younger gay men rushed right back to the bath houses and sex without condoms once the drug cocktails became effective in extending their lives, but they also spread the disease and picked up other STDs which lowered their resistance. You don’t find out the role of gay men in this story until about paragraph 15 (53% of new infections are in young gay men, an extremely small demographic).

Second, you find out if you read far enough, more accurate measures account for the increase changing the results and numbers. There’s no government plot folks, move along. The CDC, which did the most recent study and all the previous studies, IS THE GOVERNMENT (think FEMA with a little black bag and clip boards) .

Third, the author of the NYT article attempts to hint at a conspiracy to keep this quiet because 2 peer review journals returned it when it came out in October 2007. That’s not the least bit unusual--I used to be a peer reviewer. Often they are sent back because the statistics or procedures are not clearly explained, they exceed the word limit, the citations are incorrect, or the data false or misleading. The redo improves the piece. That JAMA will report it is also not unusual--its editorial policies are about as liberal as the NYT. It was embargoed so it could be presented at a conference, but someone violated that--all in the public’s best interest, of course (sarcasm alert).

Fourth, in true NYT fashion, President Bush is faulted for the billions spent on AIDS in foreign countries, rather than attacking the epidemic at home. The guy just can't win.

Fifth, here’s the best line in the article. Someone in CDC is quoted as saying “We’re not effectively reaching men who have sex with men and African Americans to lower their risk.” Yeah, like no gay man knows that gay bars and bath houses and downlow (closeted homosexual) with the ladies is risky behavior. And I just know that gay teens and 20-somethings would most certainly stop having sex if CDC just put out enough posters, TV ads and brochures. Just the way the government has successfully controlled smoking and obesity.