Tuesday, August 15, 2006

More ignorant dissident ramblings about Padian

I'm astonished, although I shouldn't be, that the dissident fold has not only tried to rebut the Padian article on AIDStruth, but has done so by simply repeating the same tired lies, and indeed with some of them not even reading the Padian article...!

A quote from the Barnesworld site:

"Padian could be an outlier, but are there other epidemiological studies that show higher rates of transmission?"

Oh my God.

Padian did indeed find transmission events, just not in that specific study. She quotes several papers outlining HIV transmission risks, some of which she herself was involved with. One of them documents infection risk of up to 20% per exposure!

  1. Downs AM, De Vincenzi I. Probability of heterosexual transmission of HIV: relationship to the number of unprotected sexual contacts. European Study Group in Heterosexual Transmission of HIV. J Acquir Immune Defic Syndr Hum Retrovirol. 1996 Apr 1;11(4):388-95.

  2. Wiley JA, Herschhkorn SJ, Padian NS. Heterogeneity in the probability of HIV transmission per sexual contact: the case of male-to-female transmission in penile-vaginal intercourse. Stat Med 1989;8:93-102.

  3. Gray RH, Wawer MJ, Brookmeyer R, Sewankambo NK, Serwadda D, Wabwire-Mangen F, Lutalo T, Li X, vanCott T, Quinn TC; Rakai Project Team. Probability of HIV-1 transmission per coital act in monogamous, heterosexual, HIV-1-discordant couples in Rakai, Uganda. Lancet. 2001 Apr 14;357(9263):1149-53.

  4. Ellerbock TV, Lieb S, Harrington PE, et al. Heterosexually transmitted human immunodeficiency virus infection among pregnant women in a rural Florida community. N Engl J Med 1992;327:1704-9.

  5. Hunter DJ. AIDS in sub-Saharan Africa: the epidemiology of heterosexual transmission and the prospects for prevention. Epidemiology. 1993 Jan;4(1):63-72. Review.

  6. Venkataramana CB, Sarada PV. Extent and speed of spread of HIV infection in India through the commercial sex networks: a perspective. Trop Med Int Health. 2001 Dec;6(12):1040-61.

  7. Adimora AA, Schoenbach VJ, Doherty IA. HIV and African Americans in the southern United States: sexual networks and social context. Sex Transm Dis. 2006 Jul;33(7 Suppl):S39-45.

  8. Latora V, Nyamba A, Simpore J, Sylvette B, Diane S, Sylvere B, Musumeci S. Network of sexual contacts and sexually transmitted HIV infection in Burkina Faso. J Med Virol. 2006 Jun;78(6):724-9.
Do these people even bother to read what it is they're criticising? Also I hear repeatedly the myth that these couples were followed for 10 years. THAT IS FALSE!

It was a 10 year study but, on average, the couples were followed for less than 7 months each.

Yes, less than 7 (seven) months each.

442 couples, 3000 couple-months of data, 6.8 months per couple. It's staring them in the face. Would 10 years of no seroconversions in a huge study be interesting? Sure. But that would be over 53,000 couple-months of data. 6-7 months of no seroconversions, in a study population told to use condoms and practise safe sex, is that interesting? Not really. It just says that prevention works. Padian herself says that "The sentence in the Abstract [about no seroconversions] reflects this success -- nothing more, nothing less."

I see from the comments at Barnesworld that many are suggesting the article is mere "info-ganda", which ironically is precisely what the dissidents use to spread their ideas. The sad fact is, for many of these dissidents, that these are plain simple truths supported by solid evidence that cannot be refuted. HIV is spread sexually and causes AIDS. In comparison the dissident myths are a house of cards and, as this site and others repeatedly demonstrates, it comes down with the slightest breeze.

Fixed error - confirmed data 8/21/06


Blogger Tara C. Smith said...

I even pointed out in my own post on Padian the length of time the couples were followed. Not that it made any difference to those who don't put accuracy at the top of their list, anyway...

9:45 PM  
Blogger Bennett said...

I've seen that figure quoted online a couple of times but frankly it's a mistake or typo that's simply been cut-and-pasted across the web.

Padian's original work estimated that the per contact risk for male to female transmission was 0.0009 (i.e. 0.09%). It sounds as if someone added on a percent sign.

Padian's original abstract can be found here:

But yes, I also wouldn't be surprised if either Eleni DID say that either without checking or (worse) intentionally. My experience with the PG in the BMJ debate left me with an extremely low opinion of their scientific integrity.

7:51 PM  

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