Talk:HIV/Archive 6

Archive 1

←

Archive 4

Archive 5

Archive 6

Archive 7

I hope I'm doing this right... (first timer)

Shortly after the viral capsid enters the cell, an enzyme called reverse transcriptase liberates the single-stranded (+)RNA genome from the attached viral proteins and copies it into a complementary DNA (cDNA) molecule. The process of reverse transcription is extremely error-prone, and the resulting mutations may cause drug resistance or allow the virus to evade the body's immune system. The reverse transcriptase also has ribonuclease activity that degrades the viral RNA during the synthesis of cDNA, as well as DNA-dependent DNA polymerase activity that copies the antisense cDNA strand into a sense DNA.

Hans von Trevor (talk) 01:40, 2 March 2010 (UTC)

Welcome, first timer!! I assume that you meant to suggest that the words "sense" and "antisense" were reversed in the cited text. I've fixed it now, I believe (please let me know if you think the result is not correct). Also, I removed the semiprotection template - I think you added that in error. -- Scray (talk) 04:16, 2 March 2010 (UTC)

Verified?

How can you verify the date of the first observation of HIV? That seems like conjecture. That needs to be clarified for a variety of reasons. The testing necessary for this kind of confirmation was not available for the timescale presented, and don't see any links to significant sources. Considering the sensitive nature of this topic, it's worth it to be as thorough as humanly possible, and this seems too much like an easy answer to buy it.—Preceding unsigned comment added by 71.90.27.175 (talk) 17:46, 4 March 2010 (UTC)

On what part of the article are you commenting, and what do you suggest as an alternative? -- Scray (talk) 01:42, 5 March 2010 (UTC)

Questions about the article

There are a couple of statements I do not understand in the article:

"Most people infected with HIV eventually develop AIDS."

Does that mean HIV does not cause AIDS in every one? How many? Is that known?

"Treatment with anti-retrovirals increases the life expectancy of people infected with HIV."

I found conflicting statements when looking this up, including studies that state clearly that ARV's do not prolong life but cause organ failure. Can any one point me to the latest studies regarding this?

"Clinical latency can vary between two weeks and 20 years."

How was this researched? HIV/AIDS has been around for soem 25 years and everytime i look this up latency seems to increase as well. Does that make sense? —Preceding unsigned comment added by 145.101.181.59 (talk) 09:34, 5 March 2010 (UTC)

Clarification

In the table given at HIV#Transmission, it appears that intercourse with an infected source, yields in HIV transmission less than 50 out of 10,000 times without condom use. Does this mean that if an HIV infect individual has unprotected sex, he/she will transmit the disease only 0.5% (or less) of the time? This seems to be against common belief, which holds that there is a high risk of getting HIV when having unprotected intercourse with an infected individual. 0.5% is not 'high' at all.VR _talk 15:46, 13 October 2009 (UTC)

Yes, that's right. Whether it's high or not is subjective, but the figure is per exposure, so it can soon add up! Greenman (talk) 16:30, 13 October 2009 (UTC)

Wrong. Statistics do not work that way. The risk of transmission in each exposure is unaffected by the number of previous exposures. Therefore, if you don't contract the virus on one exposure, you're essentially in the clear, and subsequent exposures still carry a 0.5% rate. By your logic 200 exposures would guarantee transmission, which simply is not the case. —Preceding unsigned comment added by 116.240.129.19 (talk) 08:59, 21 October 2009 (UTC)

While it's absolutely true that the risk of contracting HIV does not strictly "add up" with repeated exposures, I believe that Greenman meant (and correct me if I'm misinterpreting your comment) that the total risk of infection (not risk per exposure) increases as the number of exposures increases. After 200 exposures, there is about a 63% chance that HIV has been contracted. While this is not a guaranteed transmission, it's nothing to scoff at either.Buddy431 (talk) 05:44, 6 November 2009 (UTC)

I feel it is a disservice to all viewers (especially those who are overly paranoid about HIV) to view a table such as this that clearly lists below-actual facts of transmission rates. It is extremely dangerous to list that unprotected intercourse results in infection on average only 0.5% of the time, especially considering the many real-life contradictions such as in this article, the man in Canada charged with murder/sexual assault for infecting other women 7 out of 11 times. This indicates that he would have had to have sex with each woman about 200 times on average before they were each infected. —Preceding unsigned comment added by 68.150.35.98 (talk) 06:27, 14 November 2009 (UTC)

The article gives the figure of .04% or .05% for the chance of a man contracting HIV after having vaginal sex with an HIV positive woman one time (insertive vaginal sex). So the likelihood of having contracted HIV after having sex 200 with a woman that is already infected is very slightly less than 10% (assuming a .05% risk per sexual act). But for receptive anal sex with an HIV positive man the cumulative risk for 200 sex acts is close to 63%. Of course, these statistics are all averages. He may have an especially high viral load, those women may have had other STI's that left lesions on their anus, and/or their immune system may have been compromised from meth or other drugs or diseases. They also refer to the women who died as his "former girlfriends". He may have had sex with each of these women many, many, many times.

Hoping To Help (talk) 14:01, 23 December 2009 (UTC)

Common misconception (Gambler's_fallacy). Every time of the 200, the odds are still .05% or whathaveyou. It doesn't become cumulative. Ever flip a coin and have it come up head 5 times in a row? JoeSmack ^Talk 18:28, 23 December 2009 (UTC)

No, 10% is right, it just looks small because .05% is such an improbable odd. Subtract the chance of *not* being infected 200 times in a row from 1. 1-(1-5/10000)^200 = 0.0951852102 Raucanum 13:28, 31 December 2009 (UTC) —Preceding unsigned comment added by Raucanum (talk • contribs)

Nope, the chance of NOT being infected is still 99.95 every time. Sorry, that's just not how the math of probability works. JoeSmack ^Talk 17:16, 31 December 2009 (UTC)

In this case, though, the effect of multiple exposures can be additive if the period of time is relatively short. We're talking about several thousand viral particles at each exposure here, not a single coin being tossed. If the period during which multiple exposures occur is relatively short, sufficient numbers of virus particles may survive each time (lability is up to 72 hours outside the body; inside it could be much longer), building to a level at which sufficient exist to create a full-blown infection. Only when the period between exposures is so long that all virus particles can be assumed to have been destroyed before the next exposure, will the probability be as you describe. AncientBrit (talk) 06:37, 10 March 2010 (UTC)

Add number needed to harm in per-act risk table

I think we should add the number needed to harm in another column in the table of per-act risk for acquisition of HIV. For instance, if 10 per 10,000 people are "harmed" by receptive penile-vaginal intercourse, then, if I'm correct, the number needed to harm is 1,000. I think it's more telling. Mikael Häggström (talk) 05:02, 12 March 2010 (UTC)

I don't recall having seen it reported this way - usually it's per n acts. Could you cite a reliable source for the "number needed to harm" approach to infection risk? -- Scray (talk) 12:01, 12 March 2010 (UTC)

Actually, it doesn't need to be specified as number needed to harm. Rather, it would simply be more telling to also say that the risk is about one in one thousand by receptive penile-vaginal intercourse. Mikael Häggström (talk) 04:20, 15 March 2010 (UTC)

There are advantages to the Number needed to treat approach. It is widely understood as being more easily grasped by average readers, although it is criticized for exactly that reason: people who know the actual numbers will often make the "wrong" choice from the POV of public health. For example, if you know that baby aspirin will prevent "only" one heart attack for every 500 older men who take it for a full year, then you may decide not to take any aspirin, since it will provide no benefit to 499 out of 500 men.

Most medical sources standardized (decades ago) on a "per 100,000" (or whatever scale is helpful) system, which allows trivial comparisons and is simpler for people generating the new numbers, so more of our sources use that. WhatamIdoing (talk) 23:36, 25 March 2010 (UTC)

HIV Risk Table

I deleted this section because:

1) Plays down the risks. In its sources there are info like this which were omitted in wiki:

“ For example, at a per-act risk of 2 per 100,000, a rate of engagement in sex of once a day (assuming constant risk) would result in infection of more than 7% of people within 10 years [2] ”

Or this:

“ RESULTS--Overall, 19 (12%) male partners and 82 (20%) female partners were infected with HIV, suggesting that... ”

[3]

2) WIKIPEDIA DOES NOT GIVE MEDICAL ADVICE

3) Also there are contradictory info: [4] Phoenix of9 23:46, 21 March 2010 (UTC) NOTE THAT this study is from 2010, while the sources in the table uses studies from 1992! Phoenix of9 05:18, 25 March 2010 (UTC)

(1) I don't object to sourced commentary being added to help readers make sense of the table; you're welcome to help with that.

(2) The page you linked doesn't prohibit providing sourced information about diseases. We're not telling people what to do here, just doing our best to provide unbiased information.

(3) I don't see any inconsistency between the table you removed and the article you linked. The table gives 50 infections per 10,000 exposures to an infected source for receptive anal intercourse without a condom, corresponding to a rate of 0.5%; this is within the 95% confidence intervals given by the article regardless of whether withdrawal occurs prior to ejaculation. For insertive anal intercourse, the table gives 6.5 infections per 10,000 exposures corresponding to a rate of 0.065%; the article you linked gives a higher rate for circumcised men and a lower rate for uncircumcised men, so presumably the average rate for all men is somewhere in between.

Based on the above I've restored the table. Adrian J. Hunter^{(talk•contribs)} 11:41, 22 March 2010 (UTC)

1) Then you will have to come up with a table that incorporates those and similar info.

2) The current table is biased, ie: plays down the risks.

3) Again, intervals were ignored in the table. 2.85% is almost 6 times greater than 0.5%.

4) If you want to add a table, please make changes, dont let a biased table sit there. Phoenix of9 12:43, 23 March 2010 (UTC)

The information is accurate and properly cited. "Plays down the risk" is point of view and original research on YOUR part, which makes your arguments invalid. TechBear | Talk | Contributions 13:10, 23 March 2010 (UTC)

2.85% is almost 6 times greater than 0.5% is not POV, its numbers. The fact that certain info has been omitted from the table is not original research. It's against WP:NPOV to choose certain info over others. Phoenix of9 00:50, 25 March 2010 (UTC)

2.85% is the highest credible estimate in that source. Saying that it's "really" 2.85% misrepresents the risk by artificially inflating it. We could, with exactly as much credibility, choose the lowest credible number in the source. The 5% and the 95% numbers are (exactly) equally valid.

However, neither of the lowest nor the highest number is the best choice: the best choice is the source's preferred number, which is what we've been using. We chose it because the source chose it, not because it "downplayed" or "overstated" or did anything else. We're not trying to shape public health here: we're trying to accurately report whatever number the expert chose.

If you can make a credible case that the expert actually chose some other number, or if you have a concrete, specific improvement that you'd like to suggest, then I'd be happy to hear it, but so far, you just seem to be panicked that people will discover the actual facts, e.g., that unprotected penile-vaginal intercourse is about 100 times more likely to result in pregnancy than HIV transmission. WhatamIdoing (talk) 02:05, 25 March 2010 (UTC)

Can you not read? The source I was talking about is not even used in the table. So your claim "we chose it because the source chose it" is absolute nonsense. The number this source "chose" [5] is 1.43%, 3 times higher than 0.5 which is what is in the table. Phoenix of9 05:08, 25 March 2010 (UTC)

Oh and Adrian J. Hunter, for insertive anal intercourse, my 2010 source gives 0.11% for circumsized men. That is 1.7 times higher than 1992 sourced 0.065%. Perhaps those who cant understand basic math shouldnt edit this article. Phoenix of9 05:49, 25 March 2010 (UTC)

A discussion on whether there are better sources for the table are fine. But there's no legitimate reason to remove the table entirely while the discussion takes place. Someguy1221 (talk) 06:07, 25 March 2010 (UTC)

I'm removing the table because it is giving incorrect and outdated (year 1992 vs 2010) information. Phoenix of9 06:37, 25 March 2010 (UTC)

Poenix of9, five different contributors had independently reverted your removal of the table before your last removal... You might want to review the policy on edit warring. Your comments above to both WhatamIdoing and myself have the same problem: you're not comparing apples to apples. The table gives 0.5% for receptive anal intercourse; you are comparing this to 1.43% given by the 2010 article which is for receptive anal intercourse "if ejaculation occurred inside the rectum". Similarly, you're comparing the table's 0.065% for insertive anal intercourse with the 2010 paper's 0.11% "for circumcised men". So I still see no contradiction between the 2010 article and the table. The 2010 paper does, however, show that ejaculation prior to withdrawal greatly increases the risk of transmission through receptive anal intercourse, which the Wikipedia article presently does not mention. Perhaps you could incorporate that into Wikipedia's article? That would be a constructive edit that could persist in Wikipedia, in contrast to outright removal of the table which just gets reverted. Adrian J. Hunter^{(talk•contribs)} 07:09, 25 March 2010 (UTC)

Adrian J. Hunter, 1.43% is almost 3 times higher than 0.5%. 0.11% is almost 2 higher than 0.065%. Per act risk of HIV transmission for insertive anal intercourse in uncircumcised men was 0.62%. That is almost 10 times higher than 0.065%. What part of this do you not comprehend? Also, given that you did not change the homophobic wording here [6], despite editing that question, I should ask...Are you rejecting this source [7] on homophobic grounds? Phoenix of9 07:17, 25 March 2010 (UTC)

I've responded at your talk page. Adrian J. Hunter^{(talk•contribs)} 09:50, 25 March 2010 (UTC)

Table is wrong here because not all info could be neatly summarized:

1) There are contradictory info, like this [8] and difference between 0.11% and 0.62%. 2) There are additional info like this, "Overall, 19 (12%) male partners and 82 (20%) female partners were infected with HIV" which gives a perspective the table lacks. Phoenix of9 15:21, 25 March 2010 (UTC)

"Can you not read?"

— Phoenix of9 to WhatamIdoing

Phoenix of9, you are out of line here. You should be civil in your discussion with other editors. I also see that you took this dispute to Jimbo's talk page. Despite guidance from Bigtimepeace, you persisted. I am unsure that you are actually interested in our opinions on this matter. For what it's worth, in my opinion, WhatamIdoing and Bigtimepeace are correct. The table in the article is appropriately referenced and accurate to the best of the information available. Axl ¤ [Talk] 19:31, 25 March 2010 (UTC)

Bigtimepeace hasnt even commented in this section. He hasnt commented anywhere with respect to rates. So your response makes me think you havent even read what you are responding to. That is out of line. Phoenix of9 19:48, 25 March 2010 (UTC)

"So your response makes me think you havent even read what you are responding to. That is out of line."

— Phoenix of9

You are wrong. Bigtimepeace commented upon your inappropriate discussion at Jimbo's talk page, not HIV info. I know that and I didn't state otherwise. Axl ¤ [Talk] 20:07, 25 March 2010 (UTC)

Yes, he hasnt commented on rates in the table. So your comment "in my opinion, WhatamIdoing and Bigtimepeace are correct. The table in the article is appropriately referenced and accurate to the best of the information available." was non-sensical. Phoenix of9 20:09, 25 March 2010 (UTC)

No, you misunderstood it. Axl ¤ [Talk] 20:17, 25 March 2010 (UTC)

This study [9] is newer than 1992 CDC source. CDC article [10] is not even a meta review. It uses only 2 sources for receptive anal sex rates. One of those sources is based on the other. So your insistence on keeping a 1992 study rates is non-sensical. Phoenix of9 13:37, 27 March 2010 (UTC)

This table should not be deleted, but it should be upgraded to express a global view of the subject. There is substantial difference in heterosexual infection rates between America and Africa; factors such as circumcision and (especially) presence of other venereal diseases affect the rate of transmission. Consider for example the English-speaking South African audience when updating this. Wnt (talk) 21:16, 27 March 2010 (UTC)

Try again

Phoenix, We're actually reasonable people here. If you think that the table can be improved or updated, then we really are willing to consider that -- especially if we can figure out what you actually think is wrong or outdated, rather than needing to have philosophical discussions about medical advice and public health benefits. Try picking a single item in the table and proposing a change. Your message should look something like this:

"The table currently says ___ per 10,000 exposures for (type of exposure). It is supported by (fill in the complete citation here).

"I think this number should be ___ per 10,000 exposures, which is from (fill in the complete citation for your preferred source). This study is better than the other one because it (pick a reason: is a newer study, has a bigger sample size, whatever)."

If you've found an obviously better study, then we'll almost certainly update it. Are you willing to give it a try? WhatamIdoing (talk) 06:45, 30 March 2010 (UTC)

I've already did that [11] which was reverted. Phoenix of9 09:40, 30 March 2010 (UTC)

Thanks for your suggestion Whatamidoing, and your response Phoenix. Can I give an outside perspective here? There are a few issues with the table. The first is: what do we want a table to include in the article? Then there is the second step of determining what actual research results to select. However, the situation in respect of up-to-date figures is a complex one for editors to assess. I'll try and give my account of why. The table is not actually a table assembled by Wikipedia editors: it is a table, with sources carefully reproduced, taken from Recommendations from the U.S. Department of Health and Human Services, as published by the US Centre for Disease Control's publication MMWR. This isn't my field, but this appears to be a highly credible source. It is published in 2005. For Wikipedia editors, this presents the following issue. The table includes results of research dating back to 1992, and Phoenix has understandably raised questions about whether some of these figures should be replaced with those from more recent peer-reviewed articles. However, the publication of these figures in a 2005 article suggests that, at least at 2005, this substantial group of eminent scientists, and the journal's peer reviewers, thought these were the best figures available at that time. I would be reluctant for us to include figures from other publications that are pre-2005, because that involves us in accepting other peer review judgements ahead of the CDC one. To do that, i think we would need to have some specific reasons. For research published post-2005, the situation is simpler on the surface: we can use those figures if they come from reliable sources (such as a journal article identified recently by Phoenix), since they unambiguously represent more recent research than that in the CDC / MMWR paper. HOWEVER: at present the table actually has a footnote to its title which states that it comes from the CDC report. Once we start modifying figures in the table, we need to make sure we remove that claim. Alternatively, we might be better developing a table that presents the range of results from credible peer-reviewed sources. Otherwise, as I think both Phoenix and their critics have said at different points, we as editors end up picking 'favourites' without a sound basis in the external literature. The development of acquisition risk figures is (as I understand the research) extremely challenging research and probably quite vulnerable to the details of the methodology. I would suggest that the overall goal would be to develop a table that gives a range of figures, with all sources individually cited (as in the current approach in that table), with any particularly contentious or interesting results discussed briefly in the body text. Regards, hamiltonstone (talk) 10:36, 30 March 2010 (UTC)

Deleting the table strikes me as a non-solution. Such data will never be perfect (nor is newer data automatically better), but we should include something. I didn't delve closely enough to analyze in detail this edit, but picking and choosing individual studies is a dubious proposition, for the reasons described at WP:PRIMARY. Now, perhaps there aren't really secondary sources which are good enough to treat as the final word, but our preference should be to find such a secondary source(s) if it is out there. Kingdon (talk) 20:54, 30 March 2010 (UTC)

This 2009 meta-analysis ("43 publications comprising 25 different study populations were identified") [12] also gives different numbers and notes:

“ Pooled female-to-male (0·04% per act [95% CI 0·01–0·14]) and male-to-female (0·08% per act [95% CI 0·06–0·11]) transmission estimates in high-income countries indicated a low risk of infection in the absence of antiretrovirals. Low-income country female-to-male (0·38% per act [95% CI 0·13–1·10]) and male-to-female (0·30% per act [95% CI 0·14–0·63]) estimates in the absence of commercial sex exposure (CSE) were higher. Estimates for the early and late phases of HIV infection were 9·2 (95% CI 4·5–18·8) and 7·3 (95% CI 4·5–11·9) times larger, respectively, than for the asymptomatic phase. After adjusting for CSE, presence or history of genital ulcers in either couple member increased per-act infectivity 5·3 (95% CI 1·4–19·5) times versus no sexually transmitted infection. Study estimates among non-circumcised men were at least twice those among circumcised men. Low-income country estimates were more heterogeneous than high-income country estimates, which indicates poorer study quality, greater heterogeneity of risk factors, or under-reporting of high-risk behaviour. ”

So the current table is TOO SIMPLISTIC. It doesnt differentiate between low income and high income countries. It doesnt take into account of early and late phases of HIV infection OR presence or history of genital ulcers, etc. Thats why it needs to be DELETED until we REPLACE it with something more intelligent, which includes several figures from several sources, with intervals, and taking into account of different factors. Phoenix of9 22:36, 30 March 2010 (UTC)

Phoenix, i don't feel you are listening to other editors enough here. All evidence presented in any encyclopedia article is to varying degrees a simplification / summary of original research and the secondary sources reporting it. However, the evidence in the current table is credible - it comes from peer-reviewed research, and its value has effectively been peer reviewed again in 2005 when the paper was released. I agree with others that deleting the table is not an appropriate way forward. Preparing an improved table that makes use of the existing data and new studies, such as the one you have just cited, is a perfectly acceptable approach. But we also need to ensure that whatever table we create, it is not too complex for a reader to understand, and that it is sufficiently general to be suited to a top-level article like "HIV". If I have understood the research correctly, then there are important differences between the type of information being presented in the current table and in the paper you've just quoted. The current table has figures that relate to particular transmission pathways. The data you've quoted includes figures from many different categories, only some of which relate to transmission pathways. So to include all such data in one table may compare apples with oranges. It may be better to have a separate table that contrasts studies that are not transmission-pathway related. For example a table that compares rates in rich and poor coutrnies, and rates with and without commercial sex exposure. (Note also the last two sentences of the abstract you've quoted: "Low-income country estimates were more heterogeneous than high-income country estimates, which indicates poorer study quality, greater heterogeneity of risk factors, or under-reporting of high-risk behaviour. Efforts are needed to better understand these differences and to quantify infectivity in low-income countries". This highlights the challenge for us as editors including results that appear to other researchers to have variable quality. But that is a side-note to the main issues.) Let me conclude though by saying I'm supportive of Phoenix's efforts to find appropriate ways to include the results of some of these other studies, particularly where published in high quality journals (like hte Lancet) and where published post-2005. hamiltonstone (talk) 23:09, 30 March 2010 (UTC)

For what it's worth, I don't like the table at all. I agree with Phoenix that it may grossly misrepresent risk. This is especially true for those without statistics savvy...including most scientists and probably me in with the lot. Annoyingly I must also agree with Hamiltonstone on reliability, which after all is what we strive for, not "truth". Let's leave it for now but try to explicate better. Keepcalmandcarryon (talk) 23:02, 30 March 2010 (UTC)

No, hamiltonstone, the data I quoted is "transmission-pathway related". The thing is transmission risks studies arent done in labs. They dont watch people having sex with HIV positive people while eliminating all confounding factors. So, low-income country estimates are "transmission-pathway related". And these rates: "Low-income country female-to-male (0·38% per act [95% CI 0·13–1·10]) and male-to-female (0·30% per act [95% CI 0·14–0·63])" are quite higher than the ones in table.

Keepcalmandcarryon, we also strive for WP:NPOV. So a 2006 CDC study does not "trump" 2009 meta-analysis review. Phoenix of9 00:35, 31 March 2010 (UTC)

This is part of what I'm talking about [13]. As you can see, its not as simple as the current table makes out it to be. Plus, current table underestimates the risks. Phoenix of9 01:15, 31 March 2010 (UTC)

I expanded the table. Phoenix of9 21:46, 11 April 2010 (UTC)

GA Reassessment

This reassessment was terminated by me because it is not consistent with the intention of WP:GAR and did not follow appropriate procedures. This discussion is preserved only as a record of the actions that were taken. hamiltonstone (talk) 02:54, 30 March 2010 (UTC)

This discussion is transcluded from Talk:HIV/GA2. The edit link for this section can be used to add comments to the reassessment.

Please see Talk:HIV#HIV_Risk_Table which, I think, is a major issue. Phoenix of9 06:01, 25 March 2010 (UTC)

Also looking at HIV#Sexual, there seems to be strong heterosexism. Eg: Parts about circumcision ignore information such as this: [14] Phoenix of9 06:23, 25 March 2010 (UTC)

No problems with the table. Correctly cited with numbers that may be old, but are still best estimates. Heterosexism is your POV. That section is also written and cited correctly. --Bob (talk) 21:45, 25 March 2010 (UTC)

I've waited a few days but noone addressed my concerns. Bob, not only the numbers are old, but they are also contradicted by newer research. Phoenix of9 00:22, 30 March 2010 (UTC)

Phoenix, as an uninvolved editor, but with a lot of experience at GA, this does not look like an appropriate course of action. Please see Wikipedia:Good article reassessment - it does not look like you have acted consistent with this process. Do not delist. This should either be a community GAR or a talk page issue (where I see the issues are being discussed). If you delist, I will immediately commence a process to reverse that action. hamiltonstone (talk) 01:31, 30 March 2010 (UTC)

I now see Phoenix has attempted to close this as a delist. These actions will be reverted. Phoenix, if you have an issue, discuss it at WP:GAR or on the project's talk page, where I have left a notice. hamiltonstone (talk) 01:36, 30 March 2010 (UTC)

FAQ Q3

For those of you who do not have the FAQ on your watchlist, there has today been some discussion by edit summary of the wording of Q3. As I see it, the purpose of this question is to address the problem of people coming here to advocate the view that this article should represent that HIV/AIDS is a "just punishment" or sufferers somehow "deserve" to get sick for engaging in behaviours some see as immoral. A calm, rational discussion of appropriate wording and need for this question would be appreciated. - 2/0 (cont.) 18:15, 25 March 2010 (UTC)

I think the wording is fine now. Actually, I thought it was fine before, since the answer to the question didn't link to truth but to HIV and AIDS misconceptions. It basically told anyone who was asking that question that they were wrong. AniMate 21:32, 25 March 2010 (UTC)

Current version is fine, we can revert to the pre-edit warring version if the question starts appearing again, but the question as it was worded was in the same vein, if not the same wording as the questions being asked. If someone wants to go digging through diffs and talk archives to pages I'm guessing some links would back this up. We write the questions as they are usually worded, not as we wish they would be to avoid having to go through them repeatedly. Writing it as "Why doesn't this article emphasize risk among MSM and IDU?" would be asking the same general question, but wouldn't would be missed and we'd be stuck answering the same general question which would defeat the purpose of a FAQ. -Optigan13 (talk) 22:59, 25 March 2010 (UTC)

Despite being reluctant to suggest any imperfection in such an unimportant page while people are so worked up... What you've got now isn't actually logical. Homosexuality and bisexuality aren't "behaviors". The relevant "behaviors" would be sexual promiscuity and anal sex (regardless of the gender of any participant). WhatamIdoing (talk) 23:17, 25 March 2010 (UTC)

I agree, but the FAQ isn't for people who know that. AniMate 23:27, 25 March 2010 (UTC)

Different people might variously define homosexuality as "a state of mind", "a lifestyle choice", or indeed "a behaviour". I don't regard this as inherently wrong. Axl ¤ [Talk] 23:49, 25 March 2010 (UTC)

I do not like the current wording as it implies that "AIDS epidemic is a result of behaviours such as homosexuality, bisexuality, and drug use". So it asks, why doesnt the article emphasize that? Problems with this:

1) Its an incorrect a priori assumption.

2) It compares homosexuality and bisexuality with drug use.

3) It reduces something as complex as sexual orientation to just behaviour. Phoenix of9 00:53, 26 March 2010 (UTC)

I've taken a shot. Please revert or edit my edit mercilessly - I do not consider a revert of my edit coupled with any discussion here to be edit warring, as I will self revert on request but I'm going to bed. Hipocrite (talk) 06:50, 26 March 2010 (UTC)

I agree with all three of Phoenix of9's points. However there are readers who do indeed believe that "AIDS epidemic is a result of behaviours such as homosexuality, bisexuality, and drug use". [There are also trolls who comment on this.] In my opinion, the former text is better, because it more clearly addresses the misconceptions of the questioner. Axl ¤ [Talk] 08:13, 26 March 2010 (UTC)

There are also people who thinks jewish people should be annihilated. Should we add that to Jews FAQ? This discussion is getting stupid. Phoenix of9 13:13, 27 March 2010 (UTC)

"Jews" already has links to "Antisemitism", "History of antisemitism", & "New antisemitism". Axl ¤ [Talk] 14:43, 27 March 2010 (UTC)

HIV Final Rule by HHS/CDC

Any suggestions on where this should go in the article? It would seem to be pretty significant. I suggest an entry in the See Also section, either immediately before or after the "HIV Prevention Act of 1997" listing. BruceSwanson (talk) 05:47, 27 April 2010 (UTC)

Hi Bruce. I'm pretty sure the short answer is nowehere in this article, and i'd suggest the link to the US Act also should not be there - i'll remove it. This is the top-level article about a medical condition, and should not in general be linking to materials that are country specific. The right place probably is HIV/AIDS in the United States, and rather than include it as an external link, it might be better to discuss its significance briefly in the text of the article, with the item itself as a reference. Cheers, hamiltonstone (talk) 06:02, 27 April 2010 (UTC)

That's exactly what I did, but another editor removed it anyway because it "implies that HIV is not communicable." And this an official U.S. government announcement! If you want to try, feel free. BruceSwanson (talk) 23:04, 29 April 2010 (UTC)

That information is suitable for HIV in the US, not on this page, and should be discussed there. It does appear to me that the information would be appropriate for the HIV in the US page, but you'd have to ask KCCO why he removed it and whether he would be amenable to replacing it. WLU (t) (c) Wikipedia's rules:^simple/_complex 23:12, 29 April 2010 (UTC)

I've put a notice on the Talk page. Let majority decide. BruceSwanson (talk) 23:16, 29 April 2010 (UTC)

Please see WP:CONSENSUS and WP:VOTE. Wikipedia is not a democracy. Base your arguments on policies and guidelines. WLU (t) (c) Wikipedia's rules:^simple/_complex 00:49, 30 April 2010 (UTC)

Sure. I think Swanson was right to add the material at HIV/AIDS_in_the_United_States, and I've suggested an alternative wording at the thread that the editor started there. hamiltonstone (talk) 00:54, 30 April 2010 (UTC)

HIV/AIDS Infection level figures are higher in the developing world

HIV/AIDS Infection level figures are higher in the developing world and particularly so in Africa & Southern Africa tops the list. If what is happening is the West's ponography industry is true as depicted on the websites and videos, why is it so and yet in Africa there is relatively little of that. Is it not there true that while its scientifically proven that AIDS is a result of HIV infection it can not be divorced from poverty? I am not an expert in the subject but work with PLWA every day and so need to be enlightened. —Preceding unsigned comment added by Darota (talk • contribs) 16:26, 16 May 2010 (UTC)

I'm having trouble following you, and I want to emphasize that this is a WP:Talk page, where improvements to the article are discussed (and our entries are signed by adding "~~~~"). So, what would you like to change to improve about the article? Please note that any proposed causal association between the availability of pornography and HIV/AIDS prevalence would need a reliable source (I'm not aware of such evidence). Certainly, there is some correlation between HIV infection and poverty (and all that goes with it - poor education, other STIs, etc), but that link is indirect with many exceptions. -- Scray (talk) 18:20, 16 May 2010 (UTC)

Typical Western pornography does not reflect the sexual practices or even the desires of most Western men and women. See [15] for one scholarly analysis. Adrian J. Hunter^{(talk•contribs)} 10:35, 17 May 2010 (UTC)

Again, this comment fails to address the content of the article to which this Talk page pertains. Please stay on-topic! -- Scray (talk) 23:56, 17 May 2010 (UTC)

Peter Duesberg's Inventing the Aids Virus

Being new to Wikipedia, I'm soliciting comment on a proposed stub for Duesberg's book. It's currently a blacklisted title and so resides on my talk page. Appreciate any constructive comment, as well as a cover-pix. Bruce Swanson 14:40, 7 April 2010 (UTC)

Looks to me like a well-written, thorough and neutral article. I've made some small changes that I've explained in the edit summaries that you can read in the page history, and I intend to make a couple more; feel free to use my talk page if you disagree with or don't understand anything. This can be moved to the mainspace whenever you want, which can be arranged by following the directions at Wikipedia:Requested_moves#Requesting_a_single_page_move. Adrian J. Hunter^{(talk•contribs)} 16:33, 7 April 2010 (UTC)

Actually I agree with Scientizzle's comment at User_talk:BruceSwanson/Inventing_the_Aids_Virus about the lack of information on the authorship dispute. It might be nice to resolve this before moving to the mainspace. Adrian J. Hunter^{(talk•contribs)} 17:37, 7 April 2010 (UTC)

I've copy/pasted the legal dispute into my proposed article. The Duesberg article would then link to it.

I've submitted the page-move request. Bruce Swanson 00:06, 8 April 2010 (UTC)

Please see my comment here. hamiltonstone (talk) 01:14, 8 April 2010 (UTC)

Please, let's be complete. There are no projected transmission rates for female to female nor male to male acts. Those provided are of little use. Let us provide honest, useful, real-world data.

Duesberg's ideas are pseudoscience and AIDS denialism, it shouldn't be portrayed sympathetically or as having any merit. WLU (t) (c) Wikipedia's rules:^simple/_complex 22:41, 29 April 2010 (UTC)

Bruce Swanson's description of his view that Wikipedia's HIV/AIDS articles are "propaganda" because they do not promote AIDS denialism can be found here: http://forums.questioningaids.com/showthread.php?t=6451 He writes: "there is no better place to begin to change public perception of HIV/AIDS than Wikipedia, the de facto headquarters of popular culture. The key is to make the kind of edits that are important enough to make a difference, and that enough dissidents can agree on to keep enforced. I don’t think it would take more than a handful of editors to do this. If successful, it would be a revolution."NM1702 (talk) 21:58, 16 June 2010 (UTC)

In general we like to restrict our comments to sources rather than editors. This may be an exception, Swanson's advocacy and POV-pushing has been not so egregious to require judgment by the community but it's certainly a possibility. In any case, though this is certainly interesting and informative, it's still borderline problematic. A note of caution. WLU (t) (c) Wikipedia's rules:^simple/_complex 01:07, 17 June 2010 (UTC)

I also wrote There are two issues that could successfully unify dissidents. On my Wikipedia talk page [I meant User page] I discuss the need for real user-names instead of pseudonyms; and how primary sources are currently being misused by orthodoxist editors, and what to do about it. I'd appreciate any feedback.

With that in mind, I thank NM1702 -- whoever and wherever you are or were -- for giving my posting additional exposure here. Not that anyone will read it here, respond to it here, or remember it here. BruceSwanson (talk) 05:56, 17 June 2010 (UTC)

Thus indicating that you don't understand wikipedia. Real names are irrelevant. Sources matter. And that's why AIDS denialism on wikipedia will never win out - because it doesn't matter who advocates for it. Peter Duesberg, in all his misguided glory, could show up here and argue for AIDS being a myth and it wouldn't matter because the sources are against him.

Bruce, you don't get it. Your opinion is worthless because it is based on poor quality, conspiracy mongering sources. The fact that your name is attached to it gives it no credibility. No-one cares. What we do care about is that you are advocating for a lunatic fringe theory that every scientist who actually works with AIDS has given up on. NM1702 has done little but demonstrate you are unlikely to ever adhere to wikipedia's core policies, or even understand them. Something your "editors should reveal their real names!" complaint already amply demonstrated. "Orthodoxy" is a strength here, people who have to invoke conspiracies to support their edits are actually specifically pointed out as losing the argument before it starts.

HIV causes AIDS. Wikipedia will proclaim that until the scientific community changes its mind. Anyone who advocates otherwise gets the same tinfoil hat stamp as creationists, birthers, 9/11 controlled demolition nuts, flat earthers and faked moon landing believers. If "AIDS dissidents" can't prove their theories sufficient to change the scientific communities' mind, they lose.

The use of real names has nothing to do with quality of edits or the ability to find sources to substantiate a point. WLU (t) (c) Wikipedia's rules:^simple/_complex 10:32, 17 June 2010 (UTC)

I agree completely. Tim Vickers (talk) 16:30, 17 June 2010 (UTC)

Likewise. hamiltonstone (talk) 23:42, 17 June 2010 (UTC)

"Real names are irrelevant. Sources matter." What a funny contradiction, WLU. Of course the entire argument that I make on my user page is about sources -- and how they are being misused in Wikipedia's HIV/AIDS articles. My user-page call to action is simply that Wikipedia's primary rule regarding primary sources be enforced. That's it. And it's because such an action would be controversial in and of itself in certain articles -- like HIV/AIDS -- that the real names of editors taking such action would add credibility in comparison with pseudonyms used by active orthodoxist editors enforcing the status quo.

But now to business. We have a new real-name participant to the discussion, Tim Vickers, a bona-fide published scientist. I'm going to assume that he is a supporter, generally speaking, of the HIV=AIDS hypothesis. Editor WLU mentioned how "sources matter". And my user page argument is that active supporters of the standard hypothesis must hide behind pseudonyms because to do otherwise would damage their personal and professional reputations. And that's because -- according to my theory -- the HIV=AIDS hypothesis is unsustainable in detail except through deception.

So, with a qualified real-namer on board, I have a chance to test my hypothesis. [Drum roll]. Tim Vickers, as the whole world watches, please go to my user page and read the sentence I have specified there, taken from the AZT article, and for convenience repeated here as follows: However, AZT has a 100-fold greater affinity for the HIV reverse transcriptase than for the human DNA polymerase alpha, accounting for its selective antiviral activity.[two footnotes]

Then click on its two footnotes and look them over. My question to you, Tim Vickers, is: Do the footnotes to that statement satisfy Wikipedia's following rule:

Our policy: Primary sources that have been reliably published may be used in Wikipedia, but only with care, because it is easy to misuse them. Any interpretation of primary source material requires a reliable secondary source for that interpretation. A primary source may only be used to make descriptive statements that can be verified by any educated person without specialist knowledge.

That rule is formally stated here. I note in passing that the AZT-statement in question implies an in vivo affinity, yet the two experiments described are strictly in vitro, and ask whether any reputable scientist would publicly state that such an affinity should be assumed or implied.

According to my theory, Tim Vickers must side with my argument. Any other response would tend to discredit him, which he no doubt would prefer not to happen because everybody reading this will know who he is. That includes co-workers, academic colleagues, friends, and family. BruceSwanson (talk) 02:26, 18 June 2010 (UTC)

This discussion page is for discussing specific suggestions on how to improve the article on HIV, not for me to educate you about the lack of effect on macromolecular crowding on small molecule/protein interactions. If you wish to debate the role of HIV in AIDS I suggest you find a forum that can cater to your needs. Tim Vickers (talk) 02:49, 18 June 2010 (UTC)

A discussion of AZT on the HIV talk page isn't off-topic -- the two go together, alas. As for educating me (or any other reader) regarding the lack of effect on macromolecular crowding on small molecule/protein interactions -- you've got one too many on's in there, one should be an of -- that's why Wikipedia requires secondary sources: so you won't have to educate anybody. Right? BruceSwanson (talk) 07:35, 18 June 2010 (UTC)

Bruce, does the reference verify this basic statement? MEDRS is a guideline, WP:V is a policy. Unless the statement is inaccurate in its summary of the two sources, there's no reason to bitch and moan. You don't have a general complaint about wikipedia here - you've possibly found an inappropriate use of two sources, which if correct, should be replaced with an explicit source, or removed outright. Based on my reading of the two sources, Furman et al, 1986 sources the statement ("Azidothymidine triphosphate competed about 100-fold better for the HIV reverse transcriptase than for the cellular DNA polymerase [alpha].") and Mitsuya does not. Congratulations, you appear to have improved wikipedia a tiny bit by complaining to other people rather than fixing the problem. Your absurd point still falls though - you still don't know who I am, and I still managed to somehow edit wikipedia in line with the mainstream scientific consensus and in compliance with our policies. WLU (t) (c) Wikipedia's rules:^simple/_complex 14:28, 18 June 2010 (UTC)

You are wrong Bruce - flat out wrong. Furman et al 1986 is 100% explicit in supporting the point you allege it doesn't - the wikipedia page matched nearly word-for-word that line in the study's abstract. Reviewing Mitsuya, 1985, it also clearly substantiates the point in the results section. None of this requires interpretation. I've replaced both citations and reworded that section of the page. I'm not a specialist, and after ten minutes of reading I could see easily and clearly that the text was totally justified by the references in question - without interpretation. You're simply, flatly, completely wrong, both in your interpretation of the studies' results, and in your application of the policy. WLU (t) (c) Wikipedia's rules:^simple/_complex 15:27, 18 June 2010 (UTC)

Well, although Bruce seems to know nothing about biochemistry, he seems to have a reasonable grasp of simple copy-editing. This is a very valuable skill, so he might find a useful role on Wikipedia if he restricts himself to basic clean-up tasks. Tim Vickers (talk) 18:17, 18 June 2010 (UTC)

OK, let's let this go. The sourcing issue seems to have been adequately addressed, and it is beyond the scope of this talk page to argue with people who think HIV is harmless. If there is an issue with Bruce using Wikipedia as a soapbox for AIDS-denialist nonsense, then that should be addressed as a separate user-conduct issue. We've dealt with those sorts of user-conduct issues before - rarely a month goes by without someone stopping by from an AIDS-denialist discussion forum on a mission to spread The Truth - and it goes like this: AIDS denialist makes erroneous assertion. Another editor corrects said assertion. Assertion is then repeated or the goalposts are moved. Repeat until the discussion is allowed to die out. MastCell ^Talk 18:55, 18 June 2010 (UTC)

More Treatments in development are missing

Like Seth Berkley's hiv vaccine strategy and siRNA (http://en.wikipedia.org/wiki/SiRNA#Possible_therapeutic_applications_and_challenges). —Preceding unsigned comment added by 132.69.227.97 (talk) 18:22, 24 June 2010 (UTC)

That section appeared to contain mostly news stories. For something like that we'd need medically reliable sources (ie peer reviewed journals) that discuss it at length; ideally, secondary sources like a review article or perhaps an endorsement from the CDC, NIH or equally august body. WLU (t) (c) Wikipedia's rules:^simple/_complex 22:22, 24 June 2010 (UTC)

Agreed. There are actually dozens of HIV treatments in development (at least), and they are not all of equal significance to the subject. Someguy1221 (talk) 06:37, 25 June 2010 (UTC)

Freely-available HIV book

In this edit Martin Waldhausen (talk · contribs) added a link to a free HIV book. I can understand concerns about COI expressed by TechBear in the edit summary, but I've never been involved in any way with this book, which is truly free - one can download the PDF at no cost, with no requirement for registration, and there are no ads. My understanding is that the German version is very widely used, and I anticipate that the English version could be. I support inclusion of this WP:EL as a resource, in addition to any appropriate links that could be embedded in the article text. Because I cannot prove that I'm not involved, I thought discussion here might be appropriate. -- Scray (talk) 14:56, 11 July 2010 (UTC)

I have been watchful of the additions of 'see alsos' and external links to this article, but like Scray thought this particular one looked like it might be informative, NPOV and worth retaining - i left a message saying as much on Waldhausen's talk page. I noted TechBear's edit summary but am not sure if there is any definite evidence of a COI (Unless i missed it, Waldhausen didn't apepar to be a chapter author or anything, though the account did seem to be a bit of an SPA). Perhaps it could be reinstated. Other views? hamiltonstone (talk) 23:02, 11 July 2010 (UTC)

I removed the link in question -- and the same link from related articles such as protease inhibitor (pharmacology) and HIV test -- for several reasons. First, the book credits itself to Bernd Sebastian Kamps, whose notability is suspect. There are no independent references to him, to the International Amedeo Literature Service which he founded, or to any of the books put out by him and his institute including "HIV Book 2009": all references point back to themselves. That, right there, brings into question the link's reliability and verifiability.

Second, the website for the publisher makes it clear that anyone with information they wish to contribute may do so, and that the book is a compilation of this information. In other words, the book is compiled from a blog, which by definition does not meet the standards of reliability and verifiability. This format also means that this book's content -- in fact, the content of every book edited by this organization -- have not undergone peer review, which reinforces the lack of reliability and verifiability.

Third, the fact that the links were all put in by the same person in within a short period of time, and the fact that the editor who added the links has done nothing before or since, makes me suspicious of conflict of interest, specifically: using the Wikipedia as a means of self-promotion. For brevity, this was the issue I raised in my edit summaries.

Lastly is the policy on external links itself, specifically guideline 2 under Links normally to be avoided: Any site that misleads the reader by use of factually inaccurate material or unverifiable research, except to a limited extent in articles about the viewpoints which such sites are presenting. Because the factual accuracy of the linked material cannot be ascertained, it seems reasonable to err (if my reasoning is in error) on the side of caution. The articles where this link was placed have been repeatedly subjected to edit wars by promoters of pseudo-science. Until the questions raised above have been resolved, I believe it best that the link not be allowed to stand.

TechBear | Talk | Contributions 04:15, 12 July 2010 (UTC)

Thank you TechBear, i'm happy with that. hamiltonstone (talk) 04:49, 12 July 2010 (UTC)

(ec) TechBear, you raise excellent points (especially the editor's flood of links), and I find myself unsettled simply because I'd assumed the HIV Book was as notable as many others on the topic. Thus, I'm grateful for your willingness to tell me the emperor has no clothes - and you may be right - here are some observations from my perspective. I've held Dr. Kamps in high regard for many years, thoroughly enjoying the emailed links to scientific summaries, books, and other information that Amedeo provides, free of charge. Amedeo has generated some very useful books through its Amedeo Challenges. In the case of the HIV Book (which, I think, predates the Challenges), at least one of the two editors is a well-regarded and prolific authority on HIV and viral hepatitis (Rockstroh; it's harder to search for a common name like Hoffmann, but I gather he's the junior member of the pair). I don't see where the book is described as a blog (please point me if I missed it), nor any evidence that it isn't edited by an expert. I admit I've always held books in pretty low esteem relative to peer-reviewed review articles (books receive far less peer review in general); nonetheless, WP articles often cite books and they are generally viewed as reliable - I don't see much reason that this should be a specific exception. The epiphany for me is realizing that Amedeo really looks pretty flimsy unless you're aware of how widely its resources are used - I just have this impression, no hard numbers, so you are right to want more evidence. I hope others who are better-equipped to provide hard numbers can weigh in. Your application of WP:EL #2 applies only if we conclude that the HIV Book truly is misleading, inaccurate, or unverifiable (I'm not convinced this is true). -- Scray (talk) 05:03, 12 July 2010 (UTC)

Just to centralize the discussion, the edits in question: HIV, HIV test, HIV vaccine, Antiretroviral drug, Protease inhibitor (pharmacology). -- Scray (talk) 05:29, 12 July 2010 (UTC)

I have not heard of Dr. Kamps, which is why I tried a web search. As I said, all references to him, his institute and the books put out by that institute circle back to one another; I was unable to find any mention in anything I recognized as a reliable third-party source. I do not mean to imply that the information is incorrect, only that it cannot be verified as reliable according to the standards of the Wikipedia. As for the blog charge, the parent publishing house, Flying Publisher, solicits unedited and unreviewed content. The FAQ on the Amedeo website imply that these contributions provide the content for their weekly newsletters and other publications. There is no mention anywhere of a peer-review process, only the promise that "If you are a passionate clinician or researcher, you have an extraordinary opportunity to speak directly to your audience." Remember that Peter Duesberg, David Rasnick and other clinicians and researchers are passionate; that does not change the fact that their beliefs have been proven to be in error time and again. With regards to guideline 2 from the external link policy, my issue is with the unverifiability of the research: there simply is not enough to determine whether or not the material is factually sound. TechBear | Talk | Contributions 05:24, 12 July 2010 (UTC)

As this stands (in the absence of stronger support for the book), I agree with you (and have not reverted any of your edits). I just wanted to air this out. Let's see if anyone (including the editor who added these links, whom I've notified) steps forward to provide some evidence of verifiability that complies with our standards. I think it's important to say that I don't think that editor did anything wrong - I think they edited in good faith, but did not recognize the issues raised here. -- Scray (talk) 05:34, 12 July 2010 (UTC)

Estimated per-act risk for acquisition of HIV by exposure route

The data shows that circumcision increases the risk from anal intercourse:

- Insertive anal intercourse for uncircumcised men (2010 study) 62 a - Insertive anal intercourse for circumcised men (2010 study) 11 a

Yet the note for this says:

"a Other studies found insufficient evidence that male circumcision protects against HIV infection among men who have sex with men"

The wording implies that this statement negates something, but it supports the given data. —Preceding unsigned comment added by 81.152.246.43 (talk • contribs) 09:04, 25 August 2010

I think you're misunderstanding the data that you quoted here. The per-act rates of HIV acquisition after insertive anal intercourse are (uncircumcised vs circumcised): 62 vs 11 (per 10,000 exposures to an infected source). Thus, the rate is lower in the circumcised men (11) than in the uncircumcised men (62), though as the footnote indicates some other studies did not find this effect (that would not refute - it could be an issue of statistical power). -- Scray (talk) 18:38, 25 August 2010 (UTC)

HIV virion production per day estimate

In this edit the per-day estimate of HIV virion production was revised from 10⁹-10¹⁰ to 10¹⁰-10¹², to match the cited ref. Of the two refs cited there one (Robertson PMID 7723052) does not address this at all; the other (Rambaut PMID 14708016) specifically states "HIV has remarkable replicatory dynamics: it has a viral generation time of ~2.5 days and produces ~10¹⁰–10¹² new VIRIONS each day³¹." Reference 31 there is Perelson et al. PMID 8599114, which specifically states "The estimated average total HIV-1 production was 10.3 x 10(9) virions per day" (i.e. 10¹⁰). In a recent review PMID 17960579, Perelson states that by estimating viral clearance for each HIV-infected patient, "with the amount of extracellular fluid estimated based on the patient’s weight, allowed us to estimate that on average about 10¹⁰ virions are produced each day in a typical chronically infected patient [3]." Ref 3 there is PMID 8599114. I think this makes it clear that Perelson regards the proper interpretation as 10¹⁰, and that the Rambaut cited this number incorrectly in the cited ref (and only tangentially - it was not the main point of that paper). I've changed the number in our article to 10¹⁰ and added a citation to the more recent review. -- Scray (talk) 14:33, 4 September 2010 (UTC)

Treatments in development

http://www.haaretz.com/print-edition/news/hebrew-u-researchers-develop-treatment-to-kill-hiv-cells-1.311823 http://www.google.com/hostednews/afp/article/ALeqM5jIsETGLQloz0bNMUSBJCp1Eg88Ow http://sify.com/news/israeli-scientists-develop-aids-cure-says-journal-news-international-kjfvadbdhhj.html 94.159.250.36 (talk) 07:13, 7 September 2010 (UTC)

Current research

I would like to see an overview on current research themes on HIV. Also, a link to bits that the community can do, say donate to research foundations or support their efforts with their idle compute time (http://www.worldcommunitygrid.org/research/faah/overview.do) would be of interest to the reader. Smoe (talk) 09:52, 17 September 2010 (UTC)

Treatments in development

I think it's important to note researchers at a university published this study to indicate that this was a serious academic study. For example, the U of Michigan is noted in the preceding paragraph regrding BanLec. i also think it is noteworthy that it was an interdisciplinary team of chemists and biologists. Chefallen (talk) 16:13, 12 October 2010 (UTC)

The publication in a refereed medical journal demonstrates that something is a serious academic study. My preference would be to remove the reference to U of Michigan for the same reason. The interdisciplinarity is not relevant in the context of this article, which is also already very long (so we should look for every opportunity to trim the prose). Regards, hamiltonstone (talk) 23:13, 12 October 2010 (UTC)

AIDS denialism vs dissidence

The word dissident is a broad term for people whose views fall outside the mainstream HIV/AIDS. And it does include some people who outright deny it but it appears the wikipedia article is referring to more than those who deny AIDS existence and therefore the term Denialism is misleading. There are many people who are considered dissident who do not deny the existence of AIDS or that HIV is a factor in AIDS progression. Some simply believe it is not the only factor, some still believe conspiracy theories regarding AIDs being a creation of governments to wipeout black and homosexual populations, and there are many more dissident beliefs. I suggest changing the title of the section to Dissidents and expanding it. —Preceding unsigned comment added by 24.22.68.127 (talk) 08:32, 7 September 2010 (UTC)

The Wikipedia article is clearly referring to only those people who have been described in reliable sources as denialists. Watering down a term because you don't like what a reliable source said would be a violation of the neutral point of view. Someguy1221 (talk) 09:02, 7 September 2010 (UTC)

Microbial translocation causes to an IL-10-dependent inhibition of CD4 T-cell expansion and function by up-regulating PD-1 levels on monocytes which leads to IL-10 production by monocytes after binding of PD-1 by PD-L1. —Preceding unsigned comment added by Scien801 (talk • contribs) 21:25, 20 October 2010 (UTC)

Treatment denialism

The claim that antiretroviral therapy is not indicated when CD4 counts are above 500 is not supported by empirical evidence. Hence it belongs in the denialism subsection. KBlott (talk) 19:40, 10 October 2010 (UTC)

I don't think so. First, this section is about the well-known issue of AIDS denialism. Linking anything else to that term in this context is confusing to the lay reader. Second, the information you have added may belong in the article, but it belongs in the treatment section, not down at the end. It may also be worth adding in the main article AIDS (rather than HIV). Third, you talk about a "claim that antiretroviral therapy is not indicated..." etc, but there are no citations making that claim, so there is no evidence of any "denialism". I propose to revert your edits in the denialism section. Then I think we need to look at the Treatment section: it currently states "One study suggests the average life expectancy of an HIV infected individual is 32 years from the time of infection if treatment is started when the CD4 count is 350/µL.[123] Life expectancy is further enhanced if antiretroviral therapy is initiated before the CD4 count falls below 500/µL." Do you believe there is any information in the two citations you have used for your edits that contradict (and post-date) the above quote? If so, the treatment section may need editing. Regards, hamiltonstone (talk) 22:42, 10 October 2010 (UTC)

Agree with hamiltonstone, as reflected in my prior edit summary when I deleted this passage the first time. It is an important point, already made in the Treatment section, and I also agree that it more properly belongs in the AIDS article. Treatment denialism has far more to do with whether to treat HIV rather than when. The NA-ACCORD result is not a revealed truth, and remains controversial; the accompanying editorial in NEJM highlighted many limitations, including:

The strengths of the study notwithstanding, the results of the NA-ACCORD study cannot be considered definitive evidence that everyone with HIV should start receiving antiretroviral therapy. This was not a randomized trial, and the patients who chose to begin therapy early might have differed in other important ways from those who chose to defer therapy — ways that improved survival but were not measured. Although NA-ACCORD investigators tried to account for this potential bias by controlling for known associations with an increased risk of death in patients with HIV infection (e.g., increased rates of coinfection with hepatitis C virus and of injection-drug use), some unmeasured factors inevitably remain. For example, in many ways, patients who were offered and began potent combination antiretroviral therapy with a high CD4+ count in the late 1990s were the ideal patients: highly adherent, committed to doing whatever they could to prevent AIDS, and willing to push through the sometimes punishing side effects and drug-regimen burdens of the early therapies. This sort of “health-seeking” behavior cannot be measured in the NA-ACCORD study yet could still substantially influence outcomes; its effects can be accounted for only in a randomized, prospective study. In addition to differences in baseline factors, such as HCV infection and injection-drug use, the rates of virologic suppression after 12 months of therapy differed between the two groups among patients with a CD4+ count of more than 500 cells per cubic millimeter (81% in the early-therapy group vs. 71% in the deferred-therapy group), which suggests different levels of adherence to therapy.

I think some of the edits are tending to overplay the notion that this is a settled issue even among treatment advocates. -- Scray (talk) 23:41, 10 October 2010 (UTC)

You are correct. The paragraph requires evidence that treatment guidelines call for withholding therapy. Your citation proves this fact and should be included in the paragraph. Discussion of the controversy does not belong in the section on AIDS. AIDS typically occurs in people with HIV who have CD4 counts less than 200. This controversy affects people with HIV who have CD4 counts above 500. (The lay confusion between HIV and AIDS is an example of denialism. No AIDS carrier who has been denied antiretroviral therapy is confused about the distinction.) KBlott (talk) 00:35, 11 October 2010 (UTC)

Not sure I've understood what this is responding to; I just want to reiterate that this may warrant inclusion, but under "treatment", not "denialism". hamiltonstone (talk) 01:15, 11 October 2010 (UTC)

I think KBlott is responding to hamiltonstone (agree it's a little confusing due to premature outdenting). I do agree with KBlott that HIV (rather than the AIDS article) is the right place to discuss treatment timing; the confusion evident in my previous comment reflects the problem (just in my head, perhaps) with the non-existence of an HIV infection article (HIV is, after all, specifically a virus). But, I digress; treatment timing doesn't belong under denialism. -- Scray (talk) 01:26, 11 October 2010 (UTC)

If I understand you correctly, you are denying the validity of the cited study and are demanding the results be replicated with a randomized trial. Have you considered the ethical implications of such a demand? We know that smoking causes cancer. Yet, we have no randomized trial to "prove" this fact. This is because the evidence that smoking causes cancer is coherent and so we know that such research would place the study subjects at a health risk.

The evidence supporting the use of antiretroviral therapy in viremic individuals is equally coherent. There is simply no empirical evidence to support the practice of withholding therapy. We know, for a fact, that those who are denied therapy do get sicker and will die sooner. The citation you provided did not give evidence to support its position. It merely denied the fact that AIDS carriers who initiate therapy sooner outlive those who do not.

This debate is political, not scientific. Are AIDS carriers entitled to the same rights as HIV-negative smokers? Or are we entitled only to the same rights as laboratory mice? KBlott (talk) 02:24, 11 October 2010 (UTC)

I think we are talking somewhat at cross-purposes. I am not concerned to withhold reliably sourced information about treatment from the WP article and have no issue with the cited academic article from NEJM. However I am not seeing any reliable sources being cited to indicate that treatment is being withheld for non-medical reasons from a class of people eligible for that treatment. Even if i was, it would not belong in a section on "denialism" unless that term was itself being used in reliable sources. These conditions are met for the concept AIDS denialism. They are not met for this material. I have no issue with these research results being included in the WP material on treatment as long as they are currently-valid research and don't give undue weight to particular POVs (I have no reason to believe these are concerns, I only add those qualifiers because I have not examined those possibilities). hamiltonstone (talk) 02:37, 11 October 2010 (UTC)

Scray has already provided evidence that therapy is being withheld. Citing additional evidence would not be a problem. Citing evidence that this practice is for the benefit of patients, on the other, would be very difficult, since it does not exist.

The definition of denialism is cited at the opening of the section. The definition is taken from Wikipedia itself. This practice satisfies that definition. Scray himself has already denied the validity of the cited research. You, on the other hand, deny that the practice is even occurring. KBlott (talk) 03:13, 11 October 2010 (UTC)

I have not denied that NA-ACCORD is valid, and from what I read here hamiltonstone has not denied that the practice is occurring. In both cases, we're asking for sources for stated claims. As WP editors we're not engaged in research, and our opinions really don't matter. What I've stated (factually) is that NA-ACCORD was observational and not a randomized trial, and that even the NEJM's editorial raised issues (as quoted above) giving pause to dogmatism about the benefits of early initiation. Whether or not I believe that initiation at all CD4 counts is likely to be beneficial (and I do), we must live up to the requirement for reliable sourcing. A reliable secondary source stating unequivocally that initiation above 500 is beneficial, in the absence of a similarly-reliable opposing source, would suffice. I'll look when I get a chance, but if you find one first then continue being bold! I really don't think we're in disagreement about anything except sourcing. -- Scray (talk) 03:29, 11 October 2010 (UTC)

In every reasonably well designed study comparing early therapy to deferred therapy, early always trumps deferred. Here is one example. However, it would be a bit difficult to provide unequivocal proof as randomized trials of this nature are grossly unethical. As I recall, that hasn't stopped researchers from conducting them, though unethical research and the denialism which is used to rationalize it are two different things. KBlott (talk) 04:21, 11 October 2010 (UTC)

This meta-analysis of 18 different cohort studies also confirmed that early treatment trumps differed treatment. KBlott (talk) 04:33, 11 October 2010 (UTC)

I'm not so sure we are as close to agreement as Scray suggests. First, we cannot quote Wikipedia - it is not a reliable source. This material must be moved out of denialism into the treatment section unless there are reliable third party sources that are saying it is "denialism": per Scray, "as WP editors we're not engaged in research, and our opinions really don't matter". I'm not seeing anything that even comes close. Second, separately to that issue, while this is not my field, the conclusions in the NEJM paper were cautious. See in particular the para beginning "The benefits of initiating antiretroviral therapy earlier after HIV infection must be weighed against potential adverse effects of treatment." The strongest statement appears in the final sentence: "Significant advances in our understanding of the role of HIV infection in inflammation and immune activation resulting in potentially irreversible immune-system and end-organ damage have renewed the impetus for earlier treatment of HIV." But this stops short of the authors even calling for it themselves, let alone suggesting revision of treatment guidelines. The paper just doesn't seem to go that far. The current WP article text goes way further. Third, on a minor note, there is no citation for the claim "...most national guidelines say to start treatment once the CD4 count falls below 350". I'll have a go at a revision. hamiltonstone (talk) 05:29, 11 October 2010 (UTC)

I have posted a copy of the NIH treatment guidelines as requested. Notice the strange wording of the guidelines which reflects the current controversy. You can check the link provided to verify that my wording accurately reflects the current guidelines. The NIH really is as crazy as these guidelines make it seem. Since this debate is political, rather than scientific, its chronicling certainly has no business in the treatment subsection. However, since the two of you deny that this debate is based in denialism, I propose splitting off the chronicle into a separate article. KBlott (talk) 08:44, 11 October 2010 (UTC)

Here is a web page which claims that 'At that point, a large number of experts were already recommending the aggressive "hit early and hard" strategy, and a large number of activists were offering strong reasons for the more conservative "wait and see" approach. ' This supports my claim that opposition to proper therapy is coming (at least in part) from "AIDS activists" (ie denialists). However, this is an incomplete description of what is really going on behind the seens here. To answer the question raised by Lisa Keen. Complete suppression of viral replication now occurs routinely in clinical practice. However, this does not result in a cure. Denialists claim that this is the rationally for withholding therapy. Obviously this is nonsense. Insulin does not cure diabetes. However, no endocrinologist would think of denying a diabetic insulin. Some other factor is preventing consensus among "experts". KBlott (talk) 10:06, 11 October 2010 (UTC)

If the agenda here is to expose a conspiracy to deny treatment, that's not what WP is about - this is not a soapbox (for "exposing" self-identified "AIDS activists" as "denialists", or identifying the "Some other factor" that is preventing consensus among "experts"). Reliable sources seem to indicate that experts are split on the topic of early treatment; there's enough doubt (discussed in the NEJM references) to explain why they might be split, so I don't even see a reason to suspect a conspiracy. -- Scray (talk) 14:08, 11 October 2010 (UTC)

Those 'other factors' that affect treatment guidelines are (1) cost, (2) public health, and (3) the needs of researchers vs the needs of their study subjects. As for “conspiracy theories” I will leave those to you. Evidence speaks for itself. I have already provided you with proof that there is no evidence to support the practice of withholding therapy (provided you are ready to commit to taking at least one pill, containing at least three antiretroviral compounds, at least once a day, for the rest of your life). You and your friend both deleted that proof. If you stop reading things into the literature that are not there, you will see that this is what the current treatment guidelines trying to tell you. 50% of legitimate AIDS experts will tell you to start taking antiretroviral therapy now. The other 50% will tell you to wait until you are ready to face reality. This is because denialists are not merely self-destructive. They are also a threat to anyone they have sex with (factor #2). The disruptive behaviour of denialists has generated enormous costs to the system (and more deaths than the Nazi holocaust). It is much cheaper just to let some people die (factor #1). As for factor #3, (the needs of researchers vs the needs of study subjects) that is still very much a work in progress. Conflicts of interest do exist. For background material read the Tuskegee syphilis experiment. You are the only one here that refers to those conflicts of interest as 'conspiracies'. Additional evidence of conflicts of interest is posted here. I would be happy to provide you with additional evidence if you would kindly stop deleting it. KBlott (talk) 11:23, 13 October 2010 (UTC)

WP is not a forum for your views and the WP:Talk page is not here for you to convince others about the motivations of researchers. This page is here for us to discuss verifiable improvements to the article. Clearly, you have strong views on this subject - this is a place for neutrality. -- Scray (talk) 12:21, 13 October 2010 (UTC)

Misunderstanding of "denial" in this context?

With this edit I am prompted to wonder whether you (KBlott) are confusing (i) the specific term AIDS Denialism as it's used in the biomedical context (refusal to accept HIV and the cause of AIDS, therefore also denying the basic principles underlying HIV treatment) with (ii) Denial as it is used more generally, which could be used juxtaposed with "HIV" in the case of a person who refuses to believe they are infected (as a defense mechanism) rather. The two concepts are related but distinct, and confusion of them might be contributing to the current kerfuffle. Just a thought. I do think it's pretty clear that you're attempting to create a new term, which could be called "antiretroviral denial", to refer specifically to the non-prescription (of antiretroviral drugs) by health care providers for reasons (e.g. nihilism or treatment guidelines) other than a refusal to accept the scientific consensus that HIV causes AIDS and antiretrovirals are relevant to HIV/AIDS treatment. There are words other than "denialism" that could be used to describe these behaviors that would avoid this confusion. -- Scray (talk) 21:43, 13 October 2010 (UTC)

Rather than speculating about what I am “attempting” to do. Let’s focus on what I did do. I placed the definition of the word “denial” in its proper context. (Denialism = denial + ism). I provided verifiable evidence from a reliable source to support my claim. So, why are you objecting? KBlott (talk) 22:21, 13 October 2010 (UTC)

To your first point, word combinations take on meaning with usage as I am sure you're aware. AIDS Denialism has a specific meaning (see our article) in this context, and it does not involve the form of denial you're suggesting. Combining the words "heart" + "burn" to mean something other than the conventional usage of "heartburn" would be similarly erroneous and confusing. To your second point, I'm not sure to which citation you're referring. I recall that you cited a letter to the editor from 1996 (not a reliable source) and a review article from 1991 (predating HAART) - but you might be referring to one of your other edits; please clarify. -- Scray (talk) 23:15, 13 October 2010 (UTC)

AIDS denialism again

There is a disagerement about the title of the article's final section. Here is a copy of my post to editor KBlott:

Before we get into an edit war over a heading, I thought i would explain the issue here. There are two prevailing terms used in the literature for the issue covered by the HIV article: "AIDS denialism" and "HIV denialism". Those are the prevailing terms, and that is why one of those two headings was used in the article; it is also why that is the title of the main article on the subject, AIDS denialism. I have no particular issue with which of those two terms is used to head this section, but it is a title based on the literature, not my preferences. Omitting both HIV and AIDS from the title implies something broader that is not what the WP article is doing. Would you prefer "HIV denialism"? If so, please propose at the article talk page - my initial reaction is that "AIDS denialism" is preferred, just because that is the title of the main WP article, but I'd be happy to change to HIV denialism, if that is what you and other editors supported. Will also post to article talk page. Regards, hamiltonstone (talk) 23:55, 19 October 2010 (UTC)

I will change it back to the original title until an alternative consensus is reached here. hamiltonstone (talk) 23:56, 19 October 2010 (UTC)

and again...

Another day, and the same editor now attempts to introduce this:

Considerable debate still exists within the HIV community surrounding the question of when to initiate antiviral therapy. This debate has no empirical basis. Legitimate scientific questions regarding the timing of antiretroviral therapy were addressed by 1990. They were quickly resolved. However, considerable political opposition to the widespread use of antiretroviral drugs persisted.

There was never any serious opposition to the widespread use of antiretrovirals by virologists. However, all scientists require funding in order to conduct their research. This can potentially place scientists in a conflict of interest. Anthony Fauci is the head of the National Institute of Allergy and Infectious Diseases (NIAID). The National Institute of Allergy and Infectious Diseases is a component of the National Institutes of Health (NIH), which is an agency of the United States Department of Health and Human Services. NIAID conducts a considerable amount of HIV/AIDS research. Fauci is a vocal opponent of the widespread use of antiretroviral drugs.

I feel KBlott is perhaps not hearing what others are saying, but i will continue to try and explain a few of the issues.

• The text pushes a particular POV - it is not neutral to say that there is considerable debate within what is essentially an expert community ("the HIV community") and then say that it has "no empirical basis". It may be that the particular citation may claim that, but given that the text itself concedes that this is still debated, that wording, and its sole cite, implies a critical POV.
• The referencing does not meet an acceptable referencing style. In itself minor, the problem is more significant because of the four externally linked PMID refs, only one even has the abstract available to be read. When I read that abstract, it did not provide apparent support for the point in the proposed text for which it is being used as a cite.
• The comments about Fauci are a violation of WP:BLP as they imply conflict of interest without supplying high quality reliable sources that both make that claim and set out the evidence for it.
• Even if one were to set aside all of the above, there is still a process problem: KBlott knows there is disagreement on these issues, and they should be discussed at the talk page, not through significant changes to the article, some of which have been previously reverted. hamiltonstone (talk) 01:18, 21 October 2010 (UTC)

There is no disagreement among virologists about when to initiate antiretroviral therapy. KBlott (talk) 01:42, 21 October 2010 (UTC)

KBlott, the added cite definitively undermines your case: it includes these points:

"This is a very good study that at least suggests strongly that there is a benefit to starting treatment early," says Dr. Anthony Fauci,... None of these guidelines have been supported by the gold standard of medical evidence, the randomized controlled trial. And as convincing and as large as the current study is, Fauci notes that it too lacks this scientific imprimatur.... Still, Fauci acknowledges that the sheer size of Kitahata's study gives its findings some weight... "The real critical issue that everyone is struggling with is, What about the potential long-term deleterious effects of ART that might override the beneficial effects?" says Fauci.

Yet you have added this reference to a para that violates WP:BLP and have not in any way changed that slur against Fauci. The Time article indicates that the WP text you have added that refers to Fauci is demonstrably false. What the additional cite shows is that there is a major study supporting early intervention, but that there is also a "lively" debate in the professional community about how to proceed - and this is happening in 2009, when you also elsewhere added text that claimed "Legitimate scientific questions regarding the timing of antiretroviral therapy were addressed by 1990", which appears obviously untrue. I remind you that the "treatment" section of the article already contains fairly strong text on this subject:

There is no empirical evidence for withholding treatment at any stage of HIV infection, and death rates are almost twice as high when therapy is deferred (until the CD4 count falls below 500) compared to starting therapy when the CD4 count is above 500. However, the timing for starting HIV treatment is still subject to debate.

The United States Panel on Antiretroviral Guidelines for Adults and Adolescents in 2009 recommended that antiretroviral therapy should be initiated in all patients with a CD4 count less than 350, with treatment also recommended for patients with CD4 counts between 350 and 500. However for patients with CD4 counts over 500, the expert Panel was evenly divided, with 50% in favor of starting antiretroviral therapy at this stage of HIV disease, and 50% viewing initiating therapy at this stage as optional. They noted that "Patients initiating antiretroviral therapy should be willing and able to commit to lifelong treatment and should understand the benefits and risks of therapy and the importance of adherence".

Given you are not only avoiding the talk page and failing to address the objections of other editors, but are also including unfounded and potentially libelous claims against a living scientist, I will revert immediately. If this is reverted, this will go straight to WP:ANI or similar forum. hamiltonstone (talk) 04:07, 21 October 2010 (UTC)

The timing for starting HIV treatment is not a subject of debate among virologists. The treatment guidelines are clear on this point. KBlott (talk) 15:26, 21 October 2010 (UTC)

I don't think this is true. You provide a specific example: Anthony Fauci is a virologist. Do the treatment guidelines clearly state that "the timing for starting HIV treatment is not a subject of debate among virologists"? If they did, what evidence do they cite?

KBlott, I think the POV embedded in your otherwise useful edits is undermining their value considerably. Try to stick to factual statements rather than pressing a specific agenda. -- Scray (talk) 17:22, 21 October 2010 (UTC)

Fauci is an MD, not a virologist. KBlott (talk) 00:53, 22 October 2010 (UTC)

First of all, "virologists" don't typically create clinical treatment guidelines. Those are usually developed by MD's, because they actually prescribe antiretrovirals and treat patients with HIV/AIDS. You can't seriously be arguing that Anthony Fauci is not an authority on HIV/AIDS, right? But why are we talking about this in the first place? MastCell ^Talk 04:01, 22 October 2010 (UTC)

I agree Fauci is NOT a virologist. He is merely a physician. Therefore, his is not an expert. He is a vocal opponent to "Hit early, hit hard" and he is in the minority. However, he controls research funding. So, many virologists are not free to speak their minds. Historically, this had a profound negative impact on the public debate. However, those days are over. Most HIV physicians now recommend triple therapy for every infected individual who is mature enough to use it responsibly. This practice should have started 23 years ago, before 25 million people died. KBlott (talk) 21:21, 22 October 2010 (UTC)

Fauci, as an immunologist who has spent over 25 years studying HIV/AIDS, is not an expert on treating HIV? Wow. Yobol (talk) 21:50, 22 October 2010 (UTC)

Just because Wikipedia claims that Fauci is an immunologist it does not make it true. He is an MD, nothing more. I agree he has spent the last 25 years disrupting AIDS research. KBlott (talk) 22:08, 22 October 2010 (UTC)

O, the humanity. MastCell ^Talk 23:58, 22 October 2010 (UTC)

LOL. KBlott (talk) 01:50, 23 October 2010 (UTC)

Verging on disruption

My attention has been directed here from WP:AN3. It is clear to me that KBlott is being a disruptive influence here, by continually repeating the same points and not paying attention to the responses. I would like to give notice that I am prepared to take administrative action to solve the disruption if the other editors who are involved here request it. I don't want to intervene in discussions that are making progress, but I have the impression that that point has passed. Looie496 (talk) 17:38, 22 October 2010 (UTC)

Hamiltonstone is a denialist. I publicly debated denialist Peter Deusberg before many people here were born. Denialism is not a DSM defined disorder. However, there are claims in the literature that Deusberg is a malignant narcissist. There appears to be some overlap between denialism and narcissism. However, the relationship between the two personality phenotypes remains to be elucidated. Narcissists are attention seekers. According to the literature, the worst thing you can do for a narcissist is feed his delusions by paying attention to him. Healthy discussions are a good thing. However, Wikepedia policies notwithstanding, some public discussions serve only as platforms for narcissistic abuse. There are other forums for this discussion. It does not belong here. KBlott (talk) 21:44, 22 October 2010 (UTC)

Denialism within the HIV community

Hamiltonstone has still not availed himself of the opportunity edit my [proposed changes] to the HIV#Denialism section. This is not surprising. AIDS carriers must take antiretroviral drugs every day for the foreseeable future or face a markedly increase risk of mortality. It is this distressing fact that denialists within the HIV community do not want to face. There is an abundance of denalism related material within the literature that can be cited while avoiding the stigmatizing word "denial". I will rewrite the material—yet again—from scratch and give Hamiltonstone plenty of time to recover from his [distress]. After that, I will present the proposed changes to Hamiltonstone and give him an opportunity to modify it. KBlott (talk) 22:58, 24 October 2010 (UTC)

I suggest you read my reply to you on my talk page (You have posted on my talk page since I wrote that reply - were you deliberately ignoring it?); or the point made by Scray, with which I have concurred, at the edit warring incident report page, before making posts like the above. I will not comment on my talk page, because this isn't about me, it's about content. I will comment - as can all other editors - if and when any proposed revision is posted here at the article talk page, where it belongs. Please bring your proposal here, and I expect editors including myself will provide input to a consensus view based on WP's core policies and guidelines. hamiltonstone (talk) 00:04, 25 October 2010 (UTC)

You're more charitable than me - KBlott passed well into WP:SHUN territory awhile back from my perspective. MastCell ^Talk 00:25, 25 October 2010 (UTC)

Attitudes such as yours remain quite common in the medical community. [16] If I were in your shoes, I can see how I might not want that fact to come to light. KBlott (talk) 01:33, 27 October 2010 (UTC)

An addition to the intro:

"Without antiretroviral therapy, someone who has AIDS typically dies within a year"

From non-HIV infections of course. HIV does not kill you in and of itself; it is the destruction of the immune system, and subsequent overwhelming by opportunistic infections that kills you. This ought to be mentioned. 98.176.12.43 (talk) 23:42, 11 November 2010 (UTC)

This is mentioned in the very first sentence of the article. Yobol (talk) 03:19, 12 November 2010 (UTC)

Pathophysiology

I wonder if the section on "Pathophysiology" could do with some rearranging and some extra information.

The first three subsections, "Sexual", "Blood or Blood Product" and "Mother to Child" would seem to me to belong under a different subheading - say "Transmission", and the subsection on "Genetic Variability" also probably belongs elsewhere.

The subsections "Structure and genome", "Tropism", and "Replication Cycle" are clear and informative and make an excellent start to the topic of the pathophysiology associated with HIV infection, but apart from a single sentence in the third paragraph of the article's introduction, there is nothing to follow about the mechanisms of CD4+ depletion and related phenomena. There is a "Pathophysiology" section in the AIDS article which attempts this, but it is currently marked for cleanup.

Thoughts? On A Leash (talk) 04:18, 18 November 2010 (UTC)

Evidence of cure

I did a Ctrl+F for "stem cell" in both the article and this talk page, and I was surprised to find no matches. If you guys haven't seen it already, it may be worth taking a look at the following recent journal article:

http://bloodjournal.hematologylibrary.org/cgi/content/abstract/blood-2010-09-309591v1

It may be too soon to incorporate into the article, but it's definitely worth keeping an eye on. --Cryptic C62 · Talk 03:52, 15 December 2010 (UTC)

In is now in the research section. Doc James (talk · contribs · email) 07:32, 15 December 2010 (UTC)

Treatment

Long term evidence of viable cure though bone marrow transplants albeit a risky and complicated procedure. In the journal Blood[1}, the doctors from the Charite University Hospital, Berlin say their findings "strongly suggest that cure of HIV has been achieved" in their patient. Fell free to reference source a journal quote and word appropriately

First accounts 2008

http://www.usatoday.com/news/health/2008-11-12-aids-cure_N.htm

http://www.foxnews.com/story/0,2933,451091,00.html

http://www.cbsnews.com/stories/2008/11/12/health/main4597542.shtml

End 2010 accounts

http://www.americanchronicle.com/articles/view/151468

http://uk.health.lifestyle.yahoo.net/Leukaemia-treatment-cures-man-of-HIV.htm

92.233.71.47 (talk) 18:17, 15 December 2010 (UTC)

As a single-subject study with no replication to date (I assume) you can't really say much. If this turns into a standard treatment then it should definitely be integrated. As is I'm not sure this is worth noting - depends in fair part on the reaction of the community. WLU (t) (c) Wikipedia's rules:^simple/_complex 12:10, 17 December 2010 (UTC)

Hold on.. A man is cured from leukaemia and HIV in 2007, and 3,5 years later is still HIV negative without any medication, gets declared as the first person in human history who's ever been cured from HIV and you're not sure if it's worth mentioning? Ooookay........ --95.236.2.236 (talk) 12:51, 17 December 2010 (UTC)

See [17], the journal article was already on the page and actually forms a substantial section. Whether it's a realistic solution and cure (you'd have to wipe out the bone marrow of every HIV patient, it's possible the cure is worse than the disease) will have to be answered after more research. WLU (t) (c) Wikipedia's rules:^simple/_complex 17:44, 17 December 2010 (UTC)

Agree with WLU, though i might go further. Single cases don't make for good medical evidence about a virus / diease in general, let alone encyclopedia entries. hamiltonstone (talk) 09:50, 18 December 2010 (UTC)

We do not know if this is a cure until we determine that it works in a number of people. We mention it in the section on research where it should be mentioned. Doc James (talk · contribs · email) 10:11, 18 December 2010 (UTC)

The way it's worded its an old paraphrasing of the source "in 2007 as part of a treatment for leukemia it appears that a persons HIV infection may have been cured." Can we deny that was the cure now it's been so long, even if it stays in the same section? 92.233.71.47 (talk) 22:16, 19 December 2010 (UTC)

Given the extrordinary circumstances required for this "cure" to work (must develop leukemia; must survive chemotherapy's 30% kill rate; must find a compatible bone marrow donor; donor must lack a specific CD4 surface antigen for the specific type of HIV the patient is infected with; bone marrow can't be rejected; patient can't die of leukemia) it's not something we can do much more than note in a brief article. In fact, I've updated the text to eliminate the perception that the procedure has been performed twice, based on the authors I'm guessing it's only happened once. I don't have access to the full texts of the articles used, so I can't give a full and detailed listing of the limitations of the potential treatment. If someone with full access would be willing to do so, that'd be great (or, you could e-mail me and I might get around to doing it). WLU (t) (c) Wikipedia's rules:^simple/_complex 20:43, 20 December 2010 (UTC)

Edit request from Pkuzel, 9 January 2011

{{edit semi-protected}} Could you please add the following link to the list of external links at the bottom of the HIV page?

 http://www.mediviews.com/dr-ameeta-singh-hivaids-2/

This is a link to a filmed interview with Dr. Ameeta Singh, on the topic of HIV/AIDS. She is an infectious disease specialist at the University of Alberta in Edmonton, Alberta, Canada, and mediviews.com is a medical website run by medical students from this institution. Only completely unbiased, factual, evidence-based information is presented in this and all other videos on the mediviews website. Thank you!

Pkuzel (talk) 07:42, 9 January 2011 (UTC)

Comment. I would decline this request, though it is made in good faith and I have no reason to doubt both Dr Singh and the quality of the material. Please read WP:EL. We try to keep external links to a minimum: those that are added are usually only reference materials of the highest quality, have the most general coverage in relation to hte subject of the article, and represent material that for some reason cannot or should not be added as references to the text of the article itself. Thanks for your input though. hamiltonstone (talk) 09:37, 9 January 2011 (UTC)

Not done: I agree with Hamiltonstone. I'm sure that there are many reliable doctors or other experts who have made online resources available about HIV, which probably even contain good, quality info. However, per WP:NOT and WP:EL, our goal is not to provide an exhaustive list of all good links available. Qwyrxian (talk) 11:16, 9 January 2011 (UTC)

Latency paragraph to move?

I think that the latency paragraph in the treatment section needs to be moved. It seems out of place. One option would be to move it to the viral replication cycle. Another would to have an independent subtitle separate from the treatment. How do other editors feel about this suggestion? Aqua112233 (talk) 12:05, 18 January 2011 (UTC)

Transmission probability

While I realize that 1/10000 may be an accepted unit in medical research, percent numbers would me more useful for the average person. Please consider adding a separate column indicating percent numbers. Or what's 38/10000 again? 0.38% ist just so more intuitive and obvious. Also 2500/10000 is not as obvious as 1/4. See [[18]] for collective astonishment. -- (unnamed user) 13:47, 18 January 2011 (UTC)

Infection rate chart

This article used to have an excellent chart showing infection rates per act for different types of act with an HIV-positive partner (childbirth, blood transfusion, receptive/insertive oral/anal/vaginal sex) It was deleted on September 20, 2010 in the revision http://en.wikipedia.org/w/index.php?title=HIV&diff=385922353&oldid=385604169 with apparently no discussion. There was a pretty detailed discussion back in March, after which the table was kept (http://en.wikipedia.org/wiki/Talk:HIV/Archive_6#HIV_Risk_Table). Can we have the table restored, or at the very least discuss the possibility? The table was useful, and the edit summary for its deletion smacks of ignorance and politics ("Got rid of infection rate chart with a vengeance. You can't just stick random numbers from different studies. Or have more than 10,000 infections per 10,000 exposures."). 208.118.42.158 (talk) 08:01, 31 December 2010 (UTC)

Yes, I had concerns about the disappearance of this table, but didn't get around to looking at it again. My suggestion is to reinstate it and hunt through it for an error that is implied by the last comment in the edit summary. Agree that of course, provided sources are given, the very point of the table is to aggregate "numbers from different studies". I don't think there was anything random about it. Other views? hamiltonstone (talk) 03:37, 1 January 2011 (UTC)

I'm pretty sure the guy just misinterpreted the table, thinking that the table was supposed to be the fraction of every 10,000 infections that came from each infection vector. That's the only way I was able to make sense of it. 208.118.42.158 (talk) 10:18, 1 January 2011 (UTC)

I concur that User:Erc most likely misinterpreted the table, but will message him/her to confirm. Adrian J. Hunter^{(talk•contribs)} 10:36, 2 January 2011 (UTC)

I haven't followed wiki in a while, especially the bureaucratic side of things for ages. Or article making/writing/editing. Having said that, I remember (and follow) WP:BOLD and WP:IAR and construe them pretty liberally. To give some background for my actions, it appeared to me that the chart was severely malformed. Not having the time, interest, or expertise, I thought that not having bad information was superior to having badly formed/misleading information. Having looked over the chart again, it does make sense to me now, even though it was (apparently) profoundly unclear when I deleted it over three months ago. While I do think I should have probably took a little longer to reflect on the chart before deletion, I think that the fact that it went unnoticed/unactioned for over 3 months is a good indicator that there was no caretaker for the article, and I prefer a proactive stance to these things, so I don't have much regret for my actions, as much consternation as it seems to have caused. Finally, two more notes: I resent the statement that I edited out of "ignorance and politics". Perhaps ignorance in the true, neutral sense of the word, but not the colloquial implication. Secondly, I do hope the graph is better formatted, per the comments below erc ^{talk/contribs} 09:59, 6 January 2011 (UTC)

I remember that table. I thought it was interesting and extremely useful and informative. I say reinstate it. —Stephen (talk) 13:54, 1 January 2011 (UTC)

I was the one that posted a couple of days ago about the chart. I never meant for it to be taken down however as it is very informative and useful. I did suggest that it be altered so that it be more clear that the oral sex figures are only for those performed on men. As there are two figures for oral sex, unless you very carefully look at the table you will assume one is for when performed on a woman and the other a man but the two figures were both on a man and one was insertive the other receptive. My suggestion was simply that the box be extended to show stats of transmission rates when performed on a women and that, if those stats are unavailable, the box still be there reading 'N/A' or '--'. I did think the table is more helpful than not but just easily misinterpretable hence my suggestion for an alteration, not a deletion. — Preceding unsigned comment added by SomeUser5050 (talk • contribs) 17:14, 1 January 2011 (UTC)

(The post SomeUser5050 is referring to is here at Talk:AIDS.) Adrian J. Hunter^{(talk•contribs)} 12:15, 5 January 2011 (UTC)

I also remember the deletion of the table and was surprised no-one challenged it... I guess I should have been bold and done so myself. Originally the table was not at all random but based entirely on this table from a high-quality 2005 source. Over time additional sources and statistics were added, which I think is worthwhile but needs to be done with care to choose excellent sources. I've reproduced the table below, and indicated a suggested change which I think addresses SomeUser5050's concerns. Adrian J. Hunter^{(talk•contribs)} 10:36, 2 January 2011 (UTC)

If perfect clarity is the goal, the terms in question should be: [1] risk to a man receiving a blow-job and [2] risk of giving a blow-job to a man. If a compromise between clarity and "sounding scientific" is desired, the terms would be [1] risk to a man being fellated and [2] risk of fellating a man. A term like "penile-oral intercourse" has to be avoided because it includes the word "intercourse" which will suggest something else to most people and cause at least momentary confusion. No normal human being would use the term "penile-oral intercourse" unless (as in a clinical paper) they are deathly afraid of speaking plainly. - Nunh-huh 20:53, 2 January 2011 (UTC)

Yes, I take your point; I was following the pattern of the lines above, but a Google search shows that you are right. Also, I think it's better to avoid the terms "receptive" or "receive" with regard to oral sex, as typical medical use (receive sexual fluid) clashes with common use (receive pleasure). I've edited the table below per your suggestion. Adrian J. Hunter^{(talk•contribs)} 12:15, 5 January 2011 (UTC)

Estimated per-act risk for acquisition of HIV by exposure route

Exposure Route	Estimated infections per 10,000 exposures to an infected source
Blood transfusion	9,000
Childbirth	2,500
Needle-sharing injection drug use	67
Percutaneous needle stick	30
Receptive anal intercourse (2009 and 2010 studies)	170‡ [30-890] / 143 [48-285]
Receptive anal intercourse (based on data of a 1992 study)	50
Insertive anal intercourse for uncircumcised men (2010 study)	62a [7-168]
Insertive anal intercourse for circumcised men (2010 study)	11a [2-24]
Insertive anal intercourse (based on data of a 1992 study)	6.5
Low-income country female-to-male	38‡ [13-110]
Low-income country male-to-female	30‡ [14-63]
Receptive penile-vaginal intercourse	10
Insertive penile-vaginal intercourse	5
Receptive oral intercourse (performed on a man) Receptive penile-oral intercourse Fellating a man	1†b
Insertive oral intercourse (by a man) Insertive penile-oral intercourse Man being fellated	0.5†b
The data shown represents the rate of transmission when condoms were not used. Note that risk rates may change due to other factors such as commercial sex exposure, phase of HIV infection, presence or history of genital ulcers, and national income levels.
Bracketed values represent 95% confidence interval † "best-guess estimate" ‡ Pooled transmission probability estimate
a Other studies found insufficient evidence that male circumcision protects against HIV infection among men who have sex with men
b Oral trauma, sores, inflammation, concomitant sexually transmitted infections, ejaculation in the mouth, and systemic immune suppression may increase HIV transmission rate.

References

I think this table needs to be better formatted. I think a tree-like structure would help it immensely - the main rows would be along the lines of "vaginal intercourse", "anal intercourse", "oral ", etc., and each would be divided up like "receptive"/"insertive" for the first two and "receptive (female)", "insertive (male)", etc. for oral sex. "Oral sex" could instead be "fellatio" and "cunnilingus", if that's better. It wouldn't increase the width of the table unduly, but I think it would help immensely - the table is very dense to read as it is, and I can understand if some confusion has occurred. Dividing the data by sexual act and subdividing by partner should be intuitive and reduce clutter, and we can include numbers from different studies in the right column if we want to present multiple studies. 208.118.42.158 (talk) 21:03, 2 January 2011 (UTC)

Sounds sensible to me. For now I'll restore the table per current consensus and with the oral sex descriptions re-worded, without prejudice to restructuring as 208.118.42.158 suggests. If no-one here knows advanced table formatting, perhaps someone could be found through the helpdesk? Adrian J. Hunter^{(talk•contribs)} 12:15, 5 January 2011 (UTC)

I'll read up on table formatting and post a reformatted table here as soon as I can, but in the meantime, do you mind changing the table back to float:right and putting 100px/130px width limits on the two columns? The table should be a sidebar, not this page-wide monstrosity that it was changed into right before it was deleted. —Preceding unsigned comment added by 208.118.42.158 (talk) 21:35, 5 January 2011 (UTC)

Sorry, I missed this comment at the time you made it. Apparently the old format wasn't good on some browsers; see this edit summary. Adrian J. Hunter^{(talk•contribs)} 14:12, 18 January 2011 (UTC)

I have to raise another point with this table: The reference cited for most of the values (the "study" from 2002: http://www.ncbi.nlm.nih.gov/pubmed/11773877) is not a classical study, it's just a calculation. And as a biologist myself, I can't really deduce from the paper where they got most of the values they use in their calculation. In the cases where they explicitly state how they arrive at an estimation, they insert "random" values like "10-fold lower" without explaining why it is ten. I know, this is wikipedia, and the "study" somehow got published in a journal, but I just wanted to document that this is not "good science", it's rather bad. For example, the values given for oral sex are in my opinion without any substance, because they were not taken out of the literature, but "guessed". Perhaps another scientist/wikipedian can have a look at the "study" and confirm my view. I'm hesitating to simply remove the values from the table, because they are sourced and the table obviously seems important to some editors. Opinions? --TheMaster17 (talk) 15:31, 19 January 2011 (UTC)

I appear not to have access to the full text, so cannot help with detailed examination. No, please don't remove the values without discussion here. I am not sure what you mean in saying it "is not a classical study, it's just a calculation", but the table itself is titled "Estimated...", so estimates, properly arrived at, are acceptable. The question is whether they were properly arrived at. The fact of the article's publication in a reliable source should be our main assurance that they are valid. If however there are other high quality reliable sources that appear to have superior methodologies, or are based on a more detailed analysis, then their estimates should be considered for inclusion. I would agree that it would be preferable, where possible, to cite the source studies for the data used by the article's authors, over the synthesising article itself, provided that the data was in fact data describing estimated per act risk of acquisition. Going to those original sources would also has the advantage of giving us a date for the source studies (see below).

We have had some debate here previously about what to include in the table, particularly in the event of different estimates being available. I think the principles should be:

• Remember what this table is about: estimated per act risk of acquisition. It is not intended exclusively to report retrospective analysis of acquisition, though such data usually forms the basis of the estimates in the table.
• Be extremely careful in evaluating what is being estimated or reported - different figures usually result from differing methodologies or populations. That doesn't make them invalid, just different - this is one of the reasons the table has ended up with so many lines and footnotes (it ised to be even more complicated IIRC).
• Prefer those published in medical journals to those published in other sources
• Prefer the more recent of two publications
• Prefer global or wide-sample studies to local, national or small-sample studies
• Report more than one result in one line of the table, if there are two differing figures that use broadly the same methodologies, are of a similar age, in similar-status publications, and where there is no analysis published in a reliable source that explicitly explanis why one is to be preferred over the other.

I hope this helps. hamiltonstone (talk) 00:23, 20 January 2011 (UTC)

I know those rules, and I agree that they are reasonable. And don't worry, I wont't delete anything without consensus, this is why I posted my comment on the talk page. I think the problem in this case is that I don't understand how the authors could publish a "study" like this. The referees must have been blind. Just as an example, that really blew my mind, the authors state that the risk of infection during oral sex is generally considered much lower than during vaginal intercourse (a true and traceable statement), and from this they deduce the introduction of a factor of 10 in their estimation formula, basically setting the risk 10fold lower than the risk of vaginal sex. Is this an accepted technique of estimating a value in the respective literature? I'm not really working in epidemiology, but I would think a scientific approach would at least need to name reasons for the number 10, because much lower could also mean 100fold, or 1000thousand fold. And then, in their results (and our table), they/we just put all these numbers next to each other, although some include "magic numbers", and others are really derived from a calculation with sourced values (from observations)... In my opinion, a table with estimates here on wikipedia should not be composed of guessed values! But I know I'm probably fighting a lost battle here, because published means published, and if we start to differentiate according to our opinion, constructive discussions are impossible... How about at least marking the dubious values as such? --TheMaster17 (talk) 10:09, 20 January 2011 (UTC)

Do you mean dubious in *our* opinion, or dubious based on a reliable source's analysis? -- Scray (talk) 13:35, 20 January 2011 (UTC)

You both have a point. Scray is right, that the key to these judgements lies in the published literature rather than our own opinions. But we can exercise discretion provided we have a foundation for it. For example, if there is a published paper on the transmission risk from oral sex, and it is based on empirical research, we should generally favour that result over one that is an estimate based on other data. These sorts of judgements are ones we do need to make: "published means published" yes, but once there are two or more published accounts, we can and do have discussions about how to weigh these up. Any chance of you having a hunt for other published results on these transmission paths? Regards, hamiltonstone (talk) 22:41, 20 January 2011 (UTC)

Other treatment

 Stem cell transplantation
 In 2007, a 40-year-old HIV-positive patient was given a stem cell transplant as part of his treatment for acute myelogenous leukemia    
 (AML).[153] The bone marrow used was chosen for being homozygous for a CCR5-Δ32 mutation that confers resistance to HIV infection.[154][155] 
 After 600 days without antiretroviral drug treatment, HIV levels in the person's blood, bone marrow, and bowel were below the limit of 
 detection, though it was suspected that the virus was still present in other tissues. The treatment is not considered a a possible cure 
 because of its anecdotal nature, the mortality risk associated with bone marrow transplants, and other concerns.[156]

Some new info is out about this guy, he's actually completely cured: http://www.sw-gm.com/index.php?t=6716#82961 Can I add that and his name, etc to the article? --Synethos (talk) 17:17, 21 February 2011 (UTC)

Two things: 1) that website does not meet our standards for reliable sources for medical claims, and 2) we would need significant new information, probably in the form of a review article before we give any more weight to this one method of "treatment" that is unlikely to be repeated any time soon. Yobol (talk) 17:27, 21 February 2011 (UTC)

There's enough articles here (Googled his name): http://www.google.com/#sclient=psy&hl=en&safe=off&site=&source=hp&q=Timothy+Ray+Brown&aq=f&aqi=g10&aql=&oq=&pbx=1&bav=on.1,or.&fp=b5fc6a07c812d0bf

Example: http://gizmodo.com/#!5713498/man-officially-cured-of-hiv?comment=34103725 http://www.queerty.com/is-timothy-ray-brown-the-first-man-to-be-cured-of-hiv-by-stem-cells-20101214/

Plus, they guy is mentioned in those treatments already, so some more info about it won't hurt? --Synethos (talk) 17:54, 21 February 2011 (UTC)

More info would actually probably be inappropriate, per WP:UNDUE. This is one person, with a dangerous "cure" that is unlikely to be repeated. Any more information would have to come from a top notch WP:MEDRS (such as peer reviewed journal review articles) rather than random website Google hits. Yobol (talk) 17:58, 21 February 2011 (UTC)

Ah ok, I get it. Sorry. --Synethos (talk) 18:45, 21 February 2011 (UTC)

No need to apologize, understanding the multitude of policies and guidelines when first starting out can be difficult. Yobol (talk) 18:52, 21 February 2011 (UTC)

This is a very important development, but as Yobol notes, this is one case and it would be unacceptably risky to perform a bone marrow transplant that wasn't medically necessary. Furthermore, it will be impossible to confirm a complete cure until potential reservoir tissues can be examined, and that couldn't occur until the end of what I hope is a long and healthy life for this man. The term "functional cure" has been tossed about, though, and if insights from this case lead to new therapies that don't require transplants, the article eventually will be expanded. Keepcalmandcarryon (talk) 19:52, 21 February 2011 (UTC)

• Here is the scientific reference you should site if you are going to include this case study.

Allers K, Hütter G, Hofmann J; et al. (2010). "Evidence for the cure of HIV infection by CCR5{Delta}32/{Delta}32 stem cell transplantation". Blood. doi:10.1182/blood-2010-09-309591. PMID 21148083. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link) Aqua112233 (talk) 09:32, 24 February 2011 (UTC)

Can human work job and if he is HIV infected?

Does human can work at job if he is HIV infected and if he have AIDS? —Preceding unsigned comment added by 84.240.9.58 (talk) 12:17, 3 December 2010 (UTC)

Yes. Given modern treatment options, many HIV+ people are able to continue working for years. Also, since HIV is not communicable through air or skin contact, there is no health risk to having an HIV+ person in a workspace. This isn't, generally, the proper forum for such questions, however. Mr. G. Williams (talk) 11:11, 15 December 2010 (UTC)

It would be interesting to note that in some professions there are restrictions, like working as a dental doctor in UK —Preceding unsigned comment added by 85.219.24.75 (talk) 17:51, 26 February 2011 (UTC)

SERIOUS PROBLEMS IN THE STUDIES

Most of the studies were made with people already in treatment (of course, its hard to find people before they begin treatment, when most don't even they have HIV)! When someone is doing the treatment the virus drop to LESS THAN 50 COPIES PER MILILITER. But when someone didn't begin the treatment often they have MORE THAN 100.000 COPIES PER MILILITER (and it can go beyond a million)! So the studies investigate mostly people who have MORE THAN 1000% LESS CHANCE to infect with HIV than the average transmissor!!! This chart needs to make this clear! Or be removed, with I prefer. EternamenteAprendiz (talk) 11:52, 6 March 2011 (UTC)

That's simply not true - this (obvious) potential pitfall was addressed. Many of the studies were done at a time/place when/where effective treatment was not yet available. Also, the essay on shouting may help you understand why over-user of capitalization will not help you make a point. -- Scray (talk) 16:54, 6 March 2011 (UTC)

Experimental treatments and research

The addition of experimental or speculative treatments etc goes on and on. The article will be hopelessly unwieldy, and layered with detail that obscures important points, if every medical researcher / onlooker with some exciting results gets to add them in here, on the strength that they've been published in a peer-reviewed journal. My impulse is to be ruthless and cut all such material unless it involves drugs in actual use, or extensive coverage by other sources beyond the publication of the original medical research as well as publication in one or more of the top journals. Do other editors have a view on whether there should be some threshold(s) that must be met before material gets a spot in this vital article? hamiltonstone (talk) 11:07, 18 January 2011 (UTC)

Yes, this could be problematic. One possible solution is to move new ART agents that are not used in the clinic to treat patients, however are interesting research into the Antiretroviral drug

article, maybe we could insert a new subtitle under classes of drugs. On the HIV page a brief mention of the new drugs being developed eg. xyz is an entry inhibitor. My other concern with the treatment section is the location of latency subtitle. I'm going to suggest moving this. Aqua112233 (talk) 11:59, 18 January 2011 (UTC)

I agree with Hamiltonstone. The article should not be a catch-all for proposed treatments, and any such additions should be removed unless and until they are widely reviewed. Keepcalmandcarryon (talk) 16:49, 10 March 2011 (UTC)

I removed some of these, such as Banlec. Let's follow Hamiltonstone's suggestions for future additions. Keepcalmandcarryon (talk) 17:41, 10 March 2011 (UTC)

Transmission, safe sex and treatment

This edit was an interesting change, but I'm not sure the sources support the assertion that refusal to practice safe sex or take ART is responsible for significant HIV transmission. It would seem that lack of knowledge about one's HIV status, lack of awareness and education and availability of treatment are more influential factors than personal decisions. In addition, the relationship of viral load and transmission risk is more complicated than it may at first appear, remaining somewhat controversial even in the literature. Let's discuss these proposed changes and agree on how and if to change the current language. Keepcalmandcarryon (talk) 22:25, 9 March 2011 (UTC)

I will reword the portion of text you object to. --I am 51% Vulcan, 49% Klingon. Don’t push it. 100px 22:39, 9 March 2011 (UTC) — Preceding unsigned comment added by MuzeMarc (talk • contribs)

Let's discuss your proposed changes and agree on sources and wording first. Thanks. Keepcalmandcarryon (talk) 01:57, 10 March 2011 (UTC)

• The last three sentances in the treatment section are worded as:

"Research to improve current treatments includes decreasing side effects of current drugs, further simplifying drug regimens to improve adherence, and determining the best sequence of regimens to manage drug resistance. Unfortunately, only a vaccine is thought to be able to halt the pandemic. This is because a vaccine would cost less, thus being affordable for developing countries, and would not require daily treatment. However, after over 20 years of research, HIV-1 remains a difficult target for a vaccine."

since this material is research related, it should be moved to the research section. It is also out of date. --I am 51% Vulcan, 49% Klingon. Don’t push it. 100px 02:14, 10 March 2011 (UTC) — Preceding unsigned comment added by MuzeMarc (talk • contribs)

• Two studies [19] have confirmed predictions that the life expectancy of gay men who begin treatment early in the course of infection (and attain and undetectible viral load)have normal life expectancies. These results have not been replicated for women (probably because of poor resolving power of the research)or IV drug abusers (probably because they do not have normal life expectancies). This matirial belongs at the end of the sixth paragraph of the treatment section. --100px I am 51% Vulcan, 49% Klingon. Don’t push it. (talk) 02:35, 10 March 2011 (UTC)
• The claim "However, HAART sometimes achieves far less than optimal results, in some circumstances being effective in less than fifty percent of patients" was true 20 years ago. This is 2011, not 1991. --100px I am 51% Vulcan, 49% Klingon. Don’t push it. (talk) 02:56, 10 March 2011 (UTC)
• The claim "The complexity of these HAART regimens, whether due to pill number, dosing frequency, meal restrictions or other issues along with side effects that create intentional non-adherence also contribute to this problem" is "supported" by three citations, the most reasent of which is nine years old. Modern combination therapy is a once a day regumen which can be taken with or without food and has few side affects. (Tenofovir, the back-bone of the current state-of-the-art regumen still should not be taken with a number of other drugs including: ddI, d4T, and AZT. --100px I am 51% Vulcan, 49% Klingon. Don’t push it. (talk) 03:15, 10 March 2011 (UTC))
• Lipodystrophy is caused by drugs which inhibit adipose mitochondrial DNA synthesis (d4T > ddI > AZT). These drugs are not components of modern therapies. --100px I am 51% Vulcan, 49% Klingon. Don’t push it. (talk) 03:22, 10 March 2011 (UTC)
• Some commonly used drug combinations cause kidney diesease. --100px I am 51% Vulcan, 49% Klingon. Don’t push it. (talk) 03:27, 10 March 2011 (UTC)

Muze, you're making some good points, and others that seem to reflect misunderstandings of the literature. For example, AZT, ddI and d4T are components of several combination therapies. I completely agree with you that there are many updates to be made, but confrontational remarks ("this is 2011, not 1991") and inaccurate statements are unlikely to facilitate this goal. Keepcalmandcarryon (talk) 03:35, 10 March 2011 (UTC)

The Antiretroviral drug page lists several state-of-the-art fixed dose combinations, none of which contain AZT, ddI or d4T. All of these combinations contain tenofovir. Tenofovir should not be used in combination with AZT, ddI or d4T due to enhanced nephrotoxicity. Once a day dosing is the current fashion though I admit to still using a TID regumen (if it ain't broke, I don't believe in fixing it.) This is 2011. What year do you think it is? --100px I am 51% Vulcan, 49% Klingon. Don’t push it. (talk) 04:00, 10 March 2011 (UTC)

• In San Fransisco, treatment for HIV infection is now initiated imediately regardless of CD4 count. [20] --100px I am 51% Vulcan, 49% Klingon. Don’t push it. (talk) 04:10, 10 March 2011 (UTC)

AZT, ddI and d4T are used in several available combination meds, and many combinations are available that do not contain PMPA. Keepcalmandcarryon (talk) 05:25, 10 March 2011 (UTC)

Update request

In the section above, MuzeMarc comments on the current state of the article. Although the reliable sources don't support all of the editor's statements, MuzeMarc is certainly correct that the article could use a good updating. There's nothing that's necessarily wrong with a primary article from, say, 1997, but most likely much progress has been made and many secondary sources written in the interim. If not, it's probably time to reconsider our inclusion of that 1997 publication. Is anyone willing to join me in a line-by-line review of the article and sources in the near future? Keepcalmandcarryon (talk) 16:46, 10 March 2011 (UTC)

Would have liked to have helped, but I'm basically not active at present. Maybe some time in the distant future... hamiltonstone (talk) 04:30, 25 March 2011 (UTC)

Probably unnecessary statement.

"But critics warn of psychological harm for thirteen-year-olds from positive test results."

Yes, it has a source, but it does not appear to matter to the subject. The article is about the virus, not the psychological effects. Plus, it appears that both sides have the same validity, that possible psychological effects might outweigh knowing if you have the deadliest disease on Earth.68.60.16.174 (talk) 03:12, 20 March 2011 (UTC)

Tests for HIV

Giraldo(sp?) has run a test showing that everyone appears to have HIV. (IE it is common but at varying strenghts depending on your health or the tests used for HIV are garbage) The section on tests for HIV is almost nonexistent - 159.105.80.220 (talk) 13:28, 24 March 2011 (UTC)

If you are referring to Roberto Giraldo's claim that a large fraction of the population is HIV positive, this claim is demonstrably false. It is covered by our FAQ at the top of this page (questions 1 and 2), and is discussed in more detail elsewhere. You can see more about this in our AIDS Denialism article. HIV tests are very accurate. -- Scray (talk) 15:40, 24 March 2011 (UTC)

Transmission through oral sex

I know that Wikipedia is not a forum but I've got a question that is relevant to this article because there is no information about this issue and I think there should be. In oral sex the person who stimulates (A) his/her partner (B) might catch HIV --given that B is infected with the virus-- due to oral contact with seminal/vaginal fluids. Conversely, supposing that A is infected, might she/he transmit the virus to B (the stimulated person)? In this case there is no transference of body fluids, except for saliva which is harmless at least in relation to HIV transmission; then is it different from the first case or is the risk still high? It would be good if someone clarifies this matter in the article as well.

There is some accessible information on this question here. Keepcalmandcarryon (talk) 20:22, 7 April 2011 (UTC)

You shouldn't make decisions that could affect your health based on Wikipedia. Please see the Medical disclaimer. Adrian J. Hunter^{(talk•contribs)} 08:55, 8 April 2011 (UTC)

Good reminder. Keepcalmandcarryon (talk) 13:54, 8 April 2011 (UTC)

Edit request from 205.215.242.171, 7 April 2011

Please fix section about HIV Testing. ELISA testing does not test for antibodies to HIV in the sample, it REQUIRES specific antibodies to select for and be able to detect HIV-1 protein within a sample, specifically p24 capsid protein. Experimentally it is not correct as written.

205.215.242.171 (talk) 23:22, 7 April 2011 (UTC)

As suggested in our article on HIV tests, the HIV ELISA tests for antibodies to HIV antigens. There are a variety of ELISA kits from different manufacturers, but a common format is made by depositing whole virus protein extract on the plate (in the factory). In the testing laboratory, the plate is exposed to the patient's serum or plasma, washed, and bound antibodies are detected. Thus, it is a test for the presence, in the sample being tested, for antibodies to HIV. Do you have an evidence-based suggestion for an improvement to the article? -- Scray (talk) 02:39, 8 April 2011 (UTC)

I just realized that you might be referring to the p24 antigen capture assay, described here. Indeed, that is a sandwich ELISA test, but when people generally refer to "HIV ELISA" they're referring to the test for antibodies, not antigens. Similarly, there are many ways to construct an HIV Western blot (including the detection of proteins in a sample), but in general usage that term ("HIV Western blot") refers to the commercial kits that use Western blot to detect antibodies to HIV proteins. -- Scray (talk) 02:48, 8 April 2011 (UTC)

Hans Rosling on HIV

See — Preceding unsigned comment added by 91.182.86.177 (talk) 12:38, 6 July 2011 (UTC)

why

why is it so hard to tell poeple what you have i been with it for 10 years now and the only one that know is my famliy — Preceding unsigned comment added by 216.49.215.6 (talk) 00:15, 6 July 2011 (UTC)

This page is just for discussing improvements to Wikipedia's article on HIV. You might try entering HIV forum support into a search engine to find a site for people with HIV. Adrian J. Hunter^{(talk•contribs)} 13:16, 6 July 2011 (UTC)

"No publicly available cure"

To me this statement at the start of the "Treatment" section implies that there is, or may be, a cure that has been developed but isn't publicly available. If so I've never heard of it, and given the huge global importance of any such development I feel sure it would quickly become widely known, even if it were too expensive or impractical to become "publicly available". I think "publicly available" should be deleted. Pharmagiles (talk) 13:52, 17 July 2011 (UTC)

Agree. I've deleted those words. hamiltonstone (talk) 23:34, 18 July 2011 (UTC)

Ayurveda

Ayurveda compounds that contain Arecatannin B1 from seeds of Areca catechu have been reported to inhibit HIV-1 protease in vitro. Advantages that Ayurveda has over conventional HIV replication inhibitors is that it is (I presume) cheap and natural, making the compound potentially desirable to people who refuse to take, or cannot afford to take, conventional antiretroviral drugs. It has yet to be demonstrated that Ayurveda inhibits HIV replication in vivo. MorkMike (talk) 22:17, 4 August 2011 (UTC)

Edit request from 193.232.122.114, 5 August 2011

Please, change " Both SIVcpz and HIV-1 appear to have been transmitted relatively recently to chimpanzee and human populations, so their hosts have not yet adapted to the virus. Both viruses have also lost a function of the Nef gene that is present in most SIVs; without this function, T cell depletion is more likely, leading to immunodeficiency.[121] "

to

"SIVcpz appear to have been transmitted relatively recently to chimpanzee and human populations, so their hosts have not yet adapted to the virus. This virus have also lost a function of the Nef gene that is present in most SIVs; without this function, T cell depletion is more likely, leading to immunodeficiency.[121] "

because:

1)The article cited [121] refers to SIVcpz but not HIV-1.

2) Persons infected with HIV-1 strains that have deletions of the Nef gene actually develop AIDS symptoms much more slowly than those infected with standard HIV strains [Learmont JC, Geczy AF, Mills J, Ashton LJ, Raynes-Greenow CH, Garsia RJ, Dyer WB, McIntyre L, Oelrichs RB, Rhodes DI, Deacon NJ, Sullivan JS' (June 1999)]

Thank you!

193.232.122.114 (talk) 14:35, 5 August 2011 (UTC)

Done Topher385 (talk) 04:25, 7 August 2011 (UTC)

HIV-2

"HIV-2 is much less pathogenic than HIV-1 and is restricted in its worldwide distribution. The adoption of "accessory genes" by HIV-2 and its more promiscuous pattern of coreceptor usage (including CD4-independence) may assist the virus in its adaptation to avoid innate restriction factors present in host cells. Adaptation to use normal cellular machinery to enable transmission and productive infection has also aided the establishment of HIV-2 replication in humans. A survival strategy for any infectious agent is not to kill its host but ultimately become a commensal organism. Having achieved a low pathogenicity, over time, variants more successful at transmission will be selected.[103]"

I'm pretty sure that the previous statement is not quite correct, or at the very least confusingly worded. HIV-1 is rapidly overtaking HIV-2, even in the areas where HIV-2 is endemic. On average, HIV-1 patients also have a higher viral load, which would seemingly correlate with an enhanced ability to transmit the infection. — Preceding unsigned comment added by 96.247.33.98 (talk) 16:41, 22 August 2011 (UTC)

Via urethera

is it saliva can trnsmit hiv? I ever hear that 2 gallons of saliva can transmit hiv is it true? And can it transmitted via urethera (The saliva get in to the body via saliva) — Preceding unsigned comment added by 125.162.44.177 (talk) 18:55, 2 September 2011 (UTC)

New review on PEP

[21] --Doc James (talk · contribs · email) 22:34, 21 September 2011 (UTC)

Edit request from , 6 October 2011

Typo: "20h" should be "20th"

67.180.210.149 (talk) 03:22, 6 October 2011 (UTC)

Done - nice catch. Cheers! -- Scray (talk) 03:33, 6 October 2011 (UTC)

Experimental treatment options, future treatment options.

Suggestion: Experimental treatment options, future treatment options. This could help shine light on the possibility of future treatment options and why there isn't a cure available.

Found some interesting information that came out a few days ago about the possibility of an HIV vaccine:

http://www.sciencedaily.com/releases/2011/10/111013141816.htm — Preceding unsigned comment added by 75.178.18.22 (talk) 05:59, 20 October 2011 (UTC)

HIV

"Human immunodeficiency virus (HIV) is a lentivirus (a member of the retrovirus family) that causes acquired immunodeficiency syndrome (AIDS),[1][2]" This is an over simplification of what these two papers contain and only takes the first question of the abstract. The paper it's self questions that the two may not be mutually exclusive. HIV can lead to AIDS but is not the cause of AIDS, HIV is a virus, AIDS is a syndrome. A disease can be part of a syndrome but not required to meet the criteria. AIDS is not a disease.(Center for Disease Control(CDC), US National Library of Medicine, World Health Organization(WHO),Pan American Health Organization(PAHO), United Nations) HIV does not cause AIDS. HIV can be a contributing factor to the development of AIDS but is not a cause in and of it's self. (CDC, US National Library of Medicine, World Health Organization,Pan American Health Organization, United Nations) There are several markers the CDC use to classify AIDS- CD4, CD8, Platelet counts, are but a few. When the numbers or percentages of these markers drop below a certain level someone is said to have AIDS.(from the CDC markers and flags in communicable diseases 1981) Graves Disease, Lupis, Crones Disease, Microscopic Polyiiangitis, Agammaglobulinemia, Hypogammaglobulinemia, the list goes on. As of 2004 there were 100 disease exclusive of HIV infection known to suppress the immune system that could lead to AIDS. (US National Library of Medicine 2004, Internal Medicine Journal Volume 34, Issue 6, pages 348–354, June 2004- opened for public use, CDC,WHO)Bilingram (talk) 09:48, 26 October 2011 (UTC)

You're arguing that there are other things that can cause AIDS, therefore HIV does not cause AIDS? Surely you can see the logical error there. You have not provided a link to the Internal Medicine Journal article you're talking about, and I can't find it; so far as I can see, the articles in that journal require payment for access. Please read AIDS denialism, as well as the FAQ near the top of Talk:AIDS denialism. Adrian J. Hunter^{(talk•contribs)} 11:23, 26 October 2011 (UTC)

Transmission Table

I happened to go into the source cited for "Insertive anal intercourse for uncircumcised men (2010 study)." I noticed that the risk was actually "1.43% (95% CI 0.48%-2.85%) if ejaculation occurred inside the rectum occurred, and it was 0.65% (95% CI 0.15%-1.53%) if withdrawal prior to ejaculation was involved." So, the statistic is misquoted. This needs to be corrected, and given the evidence of biased editing, I would say the whole table needs to be checked.71.233.149.246 (talk) 18:11, 8 November 2011 (UTC)

What bias are you concerned about? hamiltonstone (talk) 00:48, 10 November 2011 (UTC)

Edit request 11/13

I edited this out, but it was reverted as "vandalism". The following statement as it is found on the HIV page is completely wrong. The figures are *clearly* incorrect (they contradict all the other numbers on the Wikipedia page, and they can't be found in the cited paper either).

"In 2005, it was estimated that HIV would infect 90 million people in Africa, resulting in a minimum estimate of 18 million orphans.[8]" — Preceding unsigned comment added by Americanuck (talk • contribs) 04:09, 14 November 2011 (UTC)

I too am puzzled by the label "vandalism" on the revert of your earlier edit; in any case, I've updated and refactored the sentence using numbers from the 2010 report. I hope you'll agree that it is improved. -- Scray (talk) 00:34, 15 November 2011 (UTC)

Diagram of HIV

The "picture" of the virus titled "Diagram of HIV" should in fact be titled "Theoretical Diagram of HIV" since the virus has never been seen. To the best of my knowledge there are no "experts" in this field who claim to have isolated the virus and generated an image of it. There *are* images being circulated which carry labels that *claim* that the image is of the virus but such images never site their source. A good example of this kind of propaganda can be found on the NIAID website (http://www.niaid.nih.gov/topics/HIVAIDS/Understanding/Biology/Pages/biology.aspx). If indeed there is a consensus among "experts" that the "Diagram of HIV" accurately reflects scientific observations then sources must be sited. I propose that the title of the image should be changed to reflect the true consensus that the diagram is theoretical at best. Better yet - remove the diagram altogether and replace it with an image of Santa Claus. — Preceding unsigned comment added by 124.180.220.215 (talk) 05:48, 16 November 2011 (UTC)

Santa wants you to go have a nice long look at The Big Picture Book of Viruses]. I'm sure you'll see something you like. - Nunh-huh 06:01, 16 November 2011 (UTC)

Well Santa, I checked out your website The Big Picture Book of Viruses. There aren't many pictures posted there claiming to be of HIV. None of the pictures are referenced to an authoritative source. Many of the source links are dead (conveniently). The only source to which the active links point turns out to be a website for clip art [CMSP.com]. Do you seriously hope to convince people in the scientific community with *clip art*? DavoDavoDavo (talk) 07:57, 16 November 2011 (UTC)

Of course not, I neither said nor implied any such thing: you're the one setting up that straw-man. Do you seriously hope to convince people with such illogic? Do you seriously think that stating that authoritative sources aren't authoritative makes it so? - Nunh-huh 14:22, 16 November 2011 (UTC)

And do you seriously think that simply stating that the sources *are* authoritative will make them authoritative? Don't try to finish with logic unless you start with it. If you know of an image from an authoritative source then publish that information here, otherwise you don't have an argument, accept for an illogical one. As I have already said, to the best of my knowledge there are no images of the virus which can be linked to an authoritative source and as such the "Diagram of HIV" is only a theoretical diagram. If I'm wrong, fine, but demonstrate it. Give us one clear image of the virus which has come from a study published in a reputable, relevant peer reviewed journal. Unless and until this can be done the image is a theoretical diagram and its title should reflect this fact.DavoDavoDavo (talk) 07:40, 17 November 2011 (UTC)

Wikipedia sets the rules for which sources are considered authoritative. Please see WP:RS for the criteria used here. - Nunh-huh 05:17, 19 November 2011 (UTC)

At no point does WP:RS assert that clip-art is acceptable as an authoritative source. It *is* stated there that sources should come from scholarly secondary publications - a criteria that your suggested source (The Big Picture Book of Viruses) does not meet.

I guess we're fortunate, then, that we aren't trying to use clip-art as an authoritative source. - Nunh-huh 04:38, 20 November 2011 (UTC)

As I have already said, the only active link connected to "images" of the virus directs the viewer to Custom Medical Stock Photo Inc. who publish "Royalty Free - Rights Ready - Rights Managed -Images for Cell Phones". None of the images are referenced to anything even remotely resembling a reliable source.

The diagram actually is cited; you just need to click it to see. The image is redrawn from this page in the NIAID. Adrian J. Hunter^{(talk•contribs)} 06:12, 16 November 2011 (UTC)

Thanks for the tip on how to use my mouse to navigate on the internet Adrian. I had already checked out the NIAID website. I am not saying that there are no pictures on the internet claiming to be of HIV. There are plenty of those. If you take another look at the site you referenced you will notice that the diagram is not referenced to academic sources. There is no set of photographs from which the diagram is derived. The "Diagram of HIV" is only theoretical and as such it needs to be renamed "Theoretical Diagram of HIV".DavoDavoDavo (talk) 07:57, 16 November 2011 (UTC)

The source of the "picture" of the virus titled "Diagram of HIV" is given as - http://www.niaid.nih.gov/factsheets/howhiv.htm & http://www.niaid.nih.gov/factsheets/graphics/howhiv.jpg but neither of these webpages contains an image that even resembles the "picture". The reliable source must be correctly sited or the "picture" must be deleted.DavoDavoDavo (talk) 11:48, 17 November 2011 (UTC)

It was a simple linkrot problem and easily fixed. See WP:LINKROT. Adrian J. Hunter^{(talk•contribs)} 12:15, 17 November 2011 (UTC)

It was indeed a linkrot problem, however, since you repaired the link it has now become an unreliable source problem for two reasons: 1) Wayback Machine is not a "respectable publisher". The NIAID is not the current publisher of this image, even though they may have been 5 or 6 years ago, so your source is a publisher who is not respected in the field of virology. 2) The information in the image does not appear to "reflect current medical knowledge" since it is at least 5 years old and you haven't sited sources that are currently publishing this information. If you can reliably source this image then it may be suitable for this article, otherwise it will have to be deleted. — Preceding unsigned comment added by DavoDavoDavo (talk • contribs) 08:34, 18 November 2011 (UTC)

As I've already pointed out to you, an equivalent diagram remains live on the NIAID website here. Equivalent diagrams are also readily available in many reputable biology or virology textbooks (see below). Adrian J. Hunter^{(talk•contribs)} 11:00, 18 November 2011 (UTC)

If you have found and "equivalent diagram" from a reliable source then why do you insist upon using a diagram from an unreliable source? As I see it you have three options at this stage: 1) Exchange the current image from the unreliable source for the image that you claim to have found from a reliable source; 2) If the image is sufficiently similar, reference the current image to the newly found reliable source; 3) Change the title of the image from "Diagram of HIV" to "Theoretical Diagram of HIV". Unless you undertake one of these three options the image will have to be deleted. — Preceding unsigned comment added by DavoDavoDavo (talk • contribs) 03:54, 19 November 2011 (UTC)

(1) I can't use any of the other images as I do not own their copyrights; (2) I can't change the reference in the image because I can't re-write history – that's the reference the author of the image actually used; (3) You have not demonstrated there's anything unreliable about the current image source, not to mention the other equivalent images (WP:MEDRS). Adrian J. Hunter^{(talk•contribs)} 05:23, 19 November 2011 (UTC)

(1) That's too bad. (2) You have said below that the other images are sufficiently similar to warrant the use of the current image. By definition this means that they would be suitable sources to site for the current image. If indeed the other images do contain the same information and if they are actual pictures of the virus and not theoretical diagrams then they would be suitably reliable sources and you could use them. If your excuse for not using those references is that the originator of the image used the current reference and you can not change that then you have no choice but to delete the image since it is published by an unreliable source. (3) As to proving that the current image comes from an unreliable source let me simply ask you - Is Wayback Machine a reputable publisher in the medical sciences? As for the "other equivalent images" they are of no help to you here unless you are prepared to cite them as your references for the current image. Again, you must either site reliable sources for the current image; change the title from "Diagram of HIV" to "Theoretical Diagram of HIV"; or delete the image. I encourage you to review WP:Verifiability before you reply.DavoDavoDavo (talk) 20:23, 19 November 2011 (UTC)

The Wayback Machine is not a publisher. It is an archiving service that preserves web pages published by others. Its use on Wikipedia is described at WP:DEADREF and in pages linked therein. It is used widely and uncontroversially in Wikipedia, as most contributors recognize that the reliability of a web page does not change just because it is accessed through an archive. Adrian J. Hunter^{(talk•contribs)} 03:25, 20 November 2011 (UTC)

You have just admitted that your reference for the current image is not from a currently published source. WP:NOR states that "all material challenged or likely to be challenged, including quotations, needs a reliable source." One of the criteria for identifying reliable sources states that "Articles should be based on reliable, third-party, published sources with a reputation for fact-checking and accuracy"WP:IRS. By your own admission your source does not meet this criteria. According to Verifiability "The burden of evidence lies with the editor who adds or restores material. You may remove any material lacking a reliable source that directly supports it." It is time for you to either remove the image or reference it to a reliable source.

You seem to be confusing sources with live links. There's no requirement that the source utilized be on the Internet, or still be if it once was, only that it is cited. And I believe the diagram you are on about is cited to the US National Institute of Health. - Nunh-huh 04:38, 20 November 2011 (UTC)

As stated above, the reference utilised for the current image "Diagram of HIV" does not meet the criteria for reliable sources. If you had read WP:NOR, WP:IRS and Verifiability you would know that. But the fact that you haven't shouldn't matter because I spelled it out in black and white in my last statement above. If you think my reasoning as to why it does not meet the criteria for reliable sources is wrong please state your case.DavoDavoDavo (talk) 07:52, 20 November 2011 (UTC)

I'm doing my best to understand your concern, but I'm afraid you've lost me. Precisely which criterion from WP:NOR / WP:IRS / WP:V do you believe this source does not fulfil? Adrian J. Hunter^{(talk•contribs)} 08:02, 20 November 2011 (UTC)

As I have already clearly stated above - One of the criteria for identifying reliable sources states that "Articles should be based on reliable, third-party, published sources with a reputation for fact-checking and accuracy"WP:IRS. Wayback Machine is not the publisher of the image and is therefore not a satisfactory source for your image. The original publisher still has a current website from which you can still source the same information IF the information is still espoused by the publisher. Your image has to be from a "published" source WP:IRS but you have admitted that your image is not from a publisher at all but instead from a web archive. The use of a web archive may be useful if the original publisher's website no longer existed but that is not the case here. You have no excuse for not referencing your image to the publisher since the publisher has a current website. By choosing to source from a web archive when the original publisher has a current publication from which you could source suggests that the information contained in the image is no longer current and that you were forced to dig up old/outdated information to support your assertion summarized in the image's title. Why would you use a reference to Wayback Machine instead of citing the publisher's current information? Why would you cite six year old references when the same publisher has a contemporary view? You are clearly in violation of reliable source policy. Either cite the publisher's current view or the image will have to be deleted.DavoDavoDavo (talk) 09:16, 20 November 2011 (UTC)

Well, it's clear that nothing I can say will dissuade you from nominating the image for deletion. The instructions are at Wikipedia:Guide to image deletion. I won't oppose. Adrian J. Hunter^{(talk•contribs)} 09:51, 20 November 2011 (UTC)

Do you accept that the NIAID/NIH is the publisher of the image, or are you still insisting the Wayback Machine is somehow the new publisher? If the latter, just look around Wikipedia. {{Cite web}}, {{Cite news}} etc would not have archivelink parameters if archiving services were not widely accepted, nor would {{Wayback}} exist, nor would we have the bots listed at Wikipedia:Linkrot#Bots uncontroversially replacing dead links with links to archives. Adrian J. Hunter^{(talk•contribs)} 08:09, 20 November 2011 (UTC)

File:HIV Virion-en.png Nominated for Deletion

An image used in this article, File:HIV Virion-en.png, has been nominated for deletion at Wikimedia Commons in the following category: Deletion requests November 2011 What should I do? Don't panic; a discussion will now take place over on Commons about whether to remove the file. This gives you an opportunity to contest the deletion, although please review Commons guidelines before doing so. If the image is non-free then you may need to upload it to Wikipedia (Commons does not allow fair use) If the image isn't freely licensed and there is no fair use rationale then it cannot be uploaded or used. This notification is provided by a Bot --CommonsNotificationBot (talk) 12:13, 21 November 2011 (UTC)

There seems to be some procedural problem with the nomination, but the discussion is currently here. Adrian J. Hunter^{(talk•contribs)} 01:15, 22 November 2011 (UTC)

would like to have students add to HIV article

Hi, I teach a course at Boston University, Neuropsychology, and this year am allowing students to submit or edit a Wikipedia article as an extra project. This is being done with the encouragement of the APS (Association for Psychological Science) Wikipedia Initiative. It's all new to me as well as to the students, so please forgive our ignorance of procedures. I have 2 students who know about cognition in HIV and noticed that there is little about this in the current article. They don't want to edit what's already there, but just add a section on cognition and HIV. At present they can't do this because it's semi-protected. Would they be able to do this, and if so, what is the procedure? Thanks very much. Alice C-G Alicecg (talk)

They can create accounts by clicking on the Log-in/Create account button at the top right corner of the wiki. You can go to the Tutorial for beginning info. After being auto-confirmed or being white-listed by a sysop, they can edit/add to the article. You can find highly active sysops here. After creating an account, users should create his or her user page by clicking on his/her username at the top of the wiki. Then they can create a draft in a sub-page by creating an page that is titled: Username/(subpage name). Example: en.wikipedia.org/User:Exampleuser/HIV draft. For more information and help you can go to Help:Contents. - M0rphzone (talk) 03:42, 4 December 2011 (UTC)

When they are ready to put the information in the article, if they are still unable to edit the article, they can put the information here (or if they put it in a sub-page, link to it) along with "{{editsemiprotected}}" to ask that an editor make the change on their behalf. --Philosopher ^{Let us reason together.} 08:46, 4 December 2011 (UTC)

Also, while we welcome users to edit on their own, you may be interested in checking out the Wikipedia Education Program. --Philosopher ^{Let us reason together.} 08:46, 4 December 2011 (UTC)

Edit request on 1 December 2011

Please add major new research 100% protection to HIV in mice with vectored immunoprophylaxis

Antibody-based protection against HIV infection by vectored immunoprophylaxis Alejandro B. Balazs,1 Joyce Chen,1 Christin M. Hong,1 Dinesh S. Rao,2 Lili Yang1 & David Baltimore1 Nature(2011) doi:10.1038/nature10660 Published online 30 November 2011

94.171.168.132 (talk) 21:00, 1 December 2011 (UTC)

Wikipedia tries to be an encyclopedia, and tries to avoid primary research and avoid recentism. This research is "interesting" but do you know how many studies in mouse models end up being nothing? I bet it's most. I just read where a couple of HIV vaccine trials were ended midway because of lack of promising data. I think this doesn't belong here, though maybe in future research directions. OrangeMarlin ^{Talk• Contributions} 21:16, 1 December 2011 (UTC)

hiv1st n hiv 2nd

what is defferent between hiv 1st and hiv 2nd if person has no hiv in the test of hiv 1st then person has saved in test of 2nd hiv please tell now because i have gone through hiv test i got saved in hiv 1st — Preceding unsigned comment added by 116.202.65.227 (talk) 18:31, 3 December 2011 (UTC)

If you want to know more about the results of your tests, you really should ask your doctor about them....we don't have the information needed to tell you about them, and he does. It's also not entirely clear which tests you are talking about. If you are discussing tests for specific strains of HIV (HIV-1 or HIV-2) then they are tests for sub-types of HIV. But your doctor should be able to tell you specifically what tests you have taken. -Nunh-huh 22:24, 3 December 2011 (UTC)

HIV, the Brain, and Cognition

HIV enters the brain early on in the infection. It is thought that HIV uses a “Trojan horse” mechanism to enter the brain. Normally, the blood brain barrier (BBB) serves as a protective mechanism by preventing entry of foreign substances; disruption of the BBB by HIV contributes to the progression of infection . The virus is able to enter the brain through infected cells that pass through the BBB to replace the immune cells surrounding the blood supply in the brain. When infected, immune cells are able to better migrate into tissues compared to uninfected cells. Infected microglia add to the production of the virus. This activation of the microglia may contribute to the process of neuropathogenesis that spreads the infection to nearby cells . Other cells that can get infected include the astrocytes, which can trigger bystander cellular dysfunction and apoptosis, further compromising the blood brain barrier. The toxicity spreads through a gap junction-dependent mechanism .

Brain Regions Affected

HIV is associated with pathological changes in mainly subcortical and fronto-striatal areas of the brain, including the basal ganglia, deep white matter, and hippocampal regions. Neuroimaging studies of HIV patients indicate that significant volume reductions are apparent in the frontal white matter, whereas subcortically, hypertrophy is apparent in the basal ganglia, especially the putamen . Furthermore, the results of some studies suggest loss of brain volume in cortical and subcortical regions even in asymptomatic HIV patients and patients who were on stable treatment . Cerebral brain volume is associated with factors related to duration of the disease and CD4 nadir; patients with a longer history of chronic HIV and higher CD4 nadir present with greater cerebral atrophy . CD4 lymphocyte counts have also been related to greater rates of brain tissue loss . Current factors, such as plasma HIV RNA, have been found to be associated with brain volumes as well, especially with regards to basal ganglia volume and total white matter .

Changes in the brain may be ongoing but asymptomatic, that is with minimal interference in functioning, making it difficult to diagnose HIV-associated neurocognitive disorders in the early stages .

Behavioral Aspects of Neurocognitive Impairments

Cognitive impairments associated with HIV occur in the domains of attention, memory, verbal fluency, and visuospatial construction. Specifically for memory, the lowered activity of the hippocampus changes the basis for memory encoding and affects mechanisms such as long-term potentiation . Severity of impairment in different domains varies depending on whether or not a patient is being treated with HAART or monotherapy . Studies have shown that patients exhibit cognitive deficits consistent with dysfunction of fronto-striatal circuits including associated parietal areas, the latter of which may account for observed deficits in visuospatial function . In addition to cognitive impairments, psychological dysfunction is also noted. For example, patients with HIV have higher rates of clinical depression and alexithymia, i.e., difficulty processing or recognizing one’s own emotions . Patients also have more difficulty recognizing facial emotions .

Without combination antiretroviral therapy, cognitive impairments increase with successive stages of HIV . HIV patients in early stages show mild difficulties in concentration and attention . In advanced cases of HIV-associated dementia, speech delay, motor dysfunction, and impaired thought and behavior are observed . Specifically, lower motor speeds were found to correlate with hypertrophy of the right putamen .

The diagnosis of HIV-associated neurocognitive impairment is made using clinical criteria after considering and ruling out other possible causes . The severity of neurocognitive impairment is associated with nadir CD4, suggesting that earlier treatment to prevent immunosuppression due to HIV may help prevent HIV-associated neurocognitive disorders .

Neuroimaging Studies Investigating Neurocognitive Impairments

A study by Melrose et al. (2008) examined the integrity of the fronto-striatal circuitry that underlies executive functioning in HIV. Participants in the study were diagnosed with HIV three months to sixteen years before the study. Ten out of eleven patients were on antiretroviral medication and none scored within the demented range on the HIV Dementia Scale. It was found that HIV+ patients showed less activity within the ventral prefrontal cortex (PFC) and left dorsolateral PFC. There was reduced connectivity between the left caudate and ventral PFC and between the left caudate and dorsolateral PFC compared to healthy controls. Additionally, there was hypoactivation of the left caudate in the HIV+ patients. In the control group, there was correlation between caudate activity and executive functioning as shown by performance on neuropsychological testing. Further analysis of the pathways in the HIV+ group involving left caudate showed reduced functional connectivity between the left caudate and globus pallidus (basal ganglia output nucleus). This dysfunction with the basal ganglia and PFC may explain the executive function and semantic event sequencing task impairments noted in HIV+ patients included in this study.

The study by Melrose et al. (2008) also investigated parietal activation. It was found that anterior parietal activation in HIV+ patients was slightly anterior to that in control participants, which follows the idea that HIV causes a reorganization of the attention network leading to cognitive impairments. Additionally, the anterior parietal activity showed a relationship with caudate functioning, which implicates a compensatory mechanism set forth when damage to the fronto-striatal system occurs .

Overall, the study by Melrose et al. (2008) showed that HIV in the brain is associated with cognitive impairments. Damage to the fronto-striatal system may underlie cognitive problems including executive function and sequencing tasks.

Another area of impairment due to fronto-striatal dysfunction is in the area of emotion recognition. In a study of HIV+ patients and control adults by Clark et al. (2010), it was shown that HIV patients demonstrate impairments in the recognition of fearful facial expressions. The authors suggested that fronto-striatal abnormalities related to HIV may underlie these impairments.

In identification tasks, administered by Clark et. al (2010), HIV+ patients and control participants were asked to identify different facial emotions and landscapes, with these picture categories matched for image complexity. HIV+ patients did worse than the control group on the facial recognition task but not on landscape identification. In the facial emotion task, fear recognition was significantly worse in the HIV than in the control group.

Vwwong (talk) 17:24, 13 December 2011 (UTC)

My suggestion — because this is well referenced and interesting material that should be included in Wikipedia, but which is probably too detailed for this article, which is already long — is that this, with a brief introduction, become an article in its own right (say, "Cognitive effects of HIV" or some other title if you'd like), and that a one-paragraph summary be placed in the "HIV" article proper. If that sounds reasonable, let me know, and I can created the article for you and insert your summary here.... - Nunh-huh 19:32, 13 December 2011 (UTC)

Thats sounds like a fine suggestion! I have submitted a new page for review titled "HIV, the Brain, and Cognition." The following is a brief summary.

HIV in the Brain

HIV affects the brain early on in the infection. Many brain areas, including the fronto-striatal regions and subcortical regions, are infected. Brain volume reductions in these areas have implications for cognitive abilities. Neurocognitive impairments include memory deficits, visuospatial problems, psychological dysfunction, and recognizing facial emotions. Neuroimaging studies show how brain regions correlate with the aforementioned deficits.

Vwwong (talk) 12:01, 16 December 2011 (UTC)

requested edit

Under Acute Infection section: "During this period (usually 2–4 weeks post-exposure) most individuals (80 to 90%) develop an influenza or mononucleosis-like illness called acute HIV infection, ..." Would someone be able to provide a citation by the claim of "80-90%"? The citation at the end of the list of symptoms seems more to be about the symptoms than prevalence. I am curious if there were any data that could be extrapolated to the general human population about the likelihood and severity of acute HIV infection/seroconversion. If there is a lack of generalizable data, I think it would be more ethical to remove the specific percentage range, as the way it reads now it may be mistakenly confirming someone's belief of not being infected due to not having experienced any seroconversion symptoms.

Thanks

Pilcher CD, Eron JJ Jr, Galvin S, Gay C, Cohen MS. Acute HIV revisited: new opportunities for treatment and prevention. J Clin Invest. Apr 2004;113(7):937-45 [22] suggests a lower rate of symptomatic acute HIV infection, and a significantly lower rate of about 50% if you only consider the influenza/mono-like syndrome. To avoid the inference that the absence of this syndrome in any way suggests that the person is not infected with HIV, it might be worth referring to the fact that of 60 million individuals worldwide with HIV, fewer than 1,000 were diagnosed during the period of acute infection. We do already state that infected persons may not experience any symptoms. I'll remove the 80-90% since it's directly contradicted by this reference but will await suggestions on any other changes you feel need to be made. - Nunh-huh 00:58, 29 September 2011 (UTC)

Conflicting facts on the page: Based on the statistical data provided (regarding HIV transmission), it is noted that out of 10,000 cases, around 9000 were through blood transfusion, and the rest of the cases were spread among other methods. However, in the following paragraph citing "Sexual", it is mentioned that majority of the transfer is through Sexual Intercourse. Was this added to promot condome or enforce indirect government policy? Or is it a simple mis-sight? — Preceding unsigned comment added by 213.39.33.80 (talk) 11:04, 20 December 2011 (UTC)

Edit request from , 16 November 2011

Please change the title of the image from "Diagram of HIV" to "Theoretical Diagram of HIV". The "picture" of the virus titled "Diagram of HIV" should in fact be titled "Theoretical Diagram of HIV" since the virus has never been seen. To the best of my knowledge there are no "experts" in this field who claim to have isolated the virus and generated an image of it. There *are* images being circulated which carry labels that *claim* that the image is of the virus but such images never site their source. A good example of this kind of propaganda can be found on the NIAID website (http://www.niaid.nih.gov/topics/HIVAIDS/Understanding/Biology/Pages/biology.aspx). If indeed there is a consensus among "experts" that the "Diagram of HIV" accurately reflects scientific observations then sources must be sited. Otherwise the image and the title for the image is Original Research(OR) and should be deleted. I propose that the title of the image should be changed to reflect the true consensus that the diagram is theoretical at best.

DavoDavoDavo (talk) 08:06, 16 November 2011 (UTC)

Not done: As shown above, reliable sources already present diagrams like this with no such disclaimer. If you don't like the NIAID then go pick up any decent biology textbook, eg ISBN 978-1-4425-0221-5, page 391. So the onus would be on you to provide a reliable source to support your criticism.

But more fundamentally, Wikipedia is not a soapbox or a place for you to advocate a discredited and dangerous ideology. You are wasting your time here. Adrian J. Hunter^{(talk•contribs)} 12:42, 16 November 2011 (UTC)

"If indeed there is a consensus among "experts" that the "Diagram of HIV" accurately reflects scientific observations..."

Choose from:

Turner, B. G.; Summers, M. F. (1999). "Structural biology of HIV1". Journal of Molecular Biology. 285 (1): 1–32. doi:10.1006/jmbi.1998.2354. PMID 9878383.

Adamson, C. S.; Jones, I. M. (2004). "The molecular basis of HIV capsid assembly—five years of progress". Reviews in Medical Virology. 14 (2): 107–121. doi:10.1002/rmv.418. PMID 15027003.

Cimarelli, A.; Darlix, J. L. (2002). "Assembling the human immunodeficiency virus type 1". Cellular and molecular life sciences : CMLS. 59 (7): 1166–1184. doi:10.1007/s00018-002-8495-6. PMID 12222963.

The first most closely matches the diagram in the article; the other two highlight areas of uncertainty in the aspects of the assembly of virion, but not in its structure.

Now will you (a) argue that three recent peer-reviewed review articles indexed on pubmed are somehow unreliable; (b) start with a new conspiracy theory; or (c) graciously accept that volunteers have spent time addressing your concerns and move on to something more constructive? Adrian J. Hunter^{(talk•contribs)} 10:44, 17 November 2011 (UTC)

I too am a volunteer representing a significant minority (eg.) so get down off your high horse. As to your question of the reliability of your three new sources I will not be able to comment until I have read them. If you own these sources I request that you share them with me. If you are unable to do this then I will respond after having sourced them myself which will take some time. — Preceding unsigned comment added by DavoDavoDavo (talk • contribs) 04:19, 19 November 2011 (UTC)

If you're here to represent some group, I would again direct you to Wikipedia:What_Wikipedia_is_not#Wikipedia_is_not_a_soapbox_or_means_of_promotion. Adrian J. Hunter^{(talk•contribs)} 05:33, 19 November 2011 (UTC)

I am representing a group in as much as you are representing a group. I suggest you spend your energies learning to source your information reliably. Will you agree to share the articles with me or not? DavoDavoDavo (talk) 19:50, 19 November 2011 (UTC)

As I said above, I don't own their copyrights. Adrian J. Hunter^{(talk•contribs)} 14:33, 19 November 2011 (UTC)

If you can't be bothered to research them yourself, DavoDavoDavo, then don't make any demands unless you have sources/citations to back them up. - M0rphzone 03:13, 4 December 2011 (UTC)

Well Adrian, I do not wish to disclose my out-of-pocket expenses for my recent expedition, but I have made the trip to the nearest medical library and tracked down the articles you have cited. It turns out that there are some pretty micrograph pictures of what the authors claim is the HIV virion but the primary sources from which these images come have not demonstrated that the micrographs contain images of the virion. It turns out that due process has not been utilised by Gallo nor any other scientist who has made the claim that they have managed to isolate the virion. Since the virion has never been isolated we can hardly be sure that any micrograph actually contains an image of HIV. Therefore the image - "diagram of HIV" is only a theoretical diagram and as such the label should be changed to reflect this fact. If you truly believe that you have an image of the HIV then there is $20,000+ reward up for grabs. Scientists havn't been able to claim the prize yet, perhaps you will be the first?DavoDavoDavo (talk) 03:28, 22 December 2011 (UTC)

Please see Righting Great Wrongs. It is abundantly clear that your concerns are not reflected in reliable sources, so they should not be influencing Wikipedia content. Adrian J. Hunter^{(talk•contribs)} 05:52, 22 December 2011 (UTC)

References

Reference #205 has a dead link to a discussion of the connection between HIV and AIDS at NIAID. A current link is: http://www.niaid.nih.gov/topics/HIVAIDS/Understanding/howHIVCausesAIDS/Pages/HIVcausesAIDS.aspx 2cultures (talk) 00:25, 11 January 2012 (UTC)

 Fixed, thanks. Adrian J. Hunter^{(talk•contribs)} 05:55, 11 January 2012 (UTC)

Cognitive effects

Main article: Cognitive effects of HIV

HIV affects the brain early on in the infection. Many brain areas, including the fronto-striatal regions and subcortical regions, are infected. Brain volume reductions in these areas have implications for cognitive abilities. Neurocognitive impairments include memory deficits, visuospatial problems, psychological dysfunction, and recognizing facial emotions. Neuroimaging studies show how brain regions correlate with the aforementioned deficits.

Have you seen the article, HIV dementia? It is on a similar topic to your new article. Perhaps they can be combined. 96.247.33.98 (talk) 06:26, 26 December 2011 (UTC)

WP:MEDRS

All of the sources used are primary research. We need to use either major textbooks or review articles per WP:MEDRS especially since this is a good article. Thanks.Doc James (talk · contribs · email) 17:19, 16 December 2011 (UTC)

I don't think that's right, Doc James. Items 1 and 2 look secondary to me per MEDRS. Do you disagree? hamiltonstone (talk) 11:41, 5 January 2012 (UTC)

PMID 15579291 states "In 25 HIV-infected patients, we found that" and is classified as a non review by pubmed. [23]

PMID 17846265 states "Twenty-two nondemented HIV+ patients" and is also classified as a none review article by pubmed. [24]

We have an article here review article that discusses what is and isn't...Doc James (talk · contribs · email) 18:21, 5 January 2012 (UTC)

Treatment as prevention

User:Alternative account no2012/HIV prevention --Alternative account no2012 (talk) 04:52, 10 February 2012 (UTC)

 Doing...  Done, great edit --andy4789 ★ · (talk? contribs?) 18:29, 10 February 2012 (UTC) and 18:43, 10 February 2012 (UTC)

New section as I am not interested in editing the mess of templates above

I have undone this edit. Sources must be either review articles or major textbooks per WP:MEDRS and many of the above are not. Please improve the references. This sort of stuff "The BC treatment as prevention model has been endorsed by David Ho, [85] Douglas Richman, [86] Hillary Rodham Clinton, [87] and Barack Obama. [88]" is a little too much like trivia. There where also too many "see also's" Doc James (talk · contribs · email) 16:04, 12 February 2012 (UTC)

Dissocial personality disorders among healthcare providers

Regarding this diff. I believe that Jmh649’s concerns have been adequately addressed here.

Psychopathy occurs among individuals who carry the dissocial genotype. [25] Narcissistic personality disorder (NPD) occurs among individuals who carry the dissocial genotype and also carry two copies of the long form of the serotonin transporter promoter. Borderline personality disorder (BPD) occurs among dissocial individuals who carry two copies of the low activity form of the COMT gene. The COMT gene and the serotonin transporter gene assort independently and individuals can inherit both the narcissistic genotype and the borderline genotype simultaneously. Individuals who suffer from factitious by proxy disorder (FbPD) exhibit phenotypic characteristics of BPD and NPD simultaneously. Both of these genotypes confer an aptitude for medicine.

Psychopathy is a rather common personality disorder among healthcare providers [26] and physicians who suffer from FbPD tend to work in subspecialties where the patient is expected to die. Such subspecialties include HIV, oncology, and emergency medicine. Worldwide implementation of Anthony Fauci’s recommendations has lead to 60 million cases of preventable HIV infection and 24 million preventable deaths. These deaths would not have happened if pre-med students were routinely screened for psychopathy and offered help before they got into trouble.

There is considerable stigma associated with psychopathy. Rather than seeking proper therapy, individuals who suffer from this disorder almost inevitably try to conceal it. Jmh649’s user page makes his COI clear. Indeed, Jmh649 has already been admonish by two psychologists for posting confidential information that helps psychopathic individuals evade detection by professionals who are trying to help them.

Please revert Jmh649’s edits.--Alternative account no2012 (talk) 18:19, 13 February 2012 (UTC)

•  Not done: Inadequate rationale. The diff supplied in your first paragraph doesn't support a revert. The rest of your post is a series of incoherent and off-topic ramblings, coupled with outright misrepresentations of the sources you cite. For example, you write: "Psychopathy is a rather common personality disorder among healthcare providers." The source you cite to support this claim states that "the psychopathic physician (is) fortunately, rare" (emphasis mine). That sort of misrepresentation is probably the fastest way to lose credibility around here, so I'd suggest not doing that anymore. MastCell ^Talk 21:58, 13 February 2012 (UTC)

Take a break, MastCell. Your combative behaviour won’t help Fauci’s 60 million victims. It is not necessary for me to rewrite my edits as they do not infringe upon anyone’s copyright and the respective authors would be more than pleased that I cited their work. Please restore the edits which were deleted by Jmh649 and the page that was deleted by MastCell. --Alternative account no2012 (talk) 23:48, 13 February 2012 (UTC)

First of all, it's probably a WP:BLP violation to assert that a single researcher is responsible for 60 million deaths (and it's definitely not a path to being taken seriously). Secondly, you seem to beleive that Jmh649's edit deleted material, but it didn't; it simply moved text. It's not at all clear what your concern is, or why you want it moved back. Finally, if you want the other article undeleted, then you'll need to ask elsewhere. MastCell ^Talk 23:55, 13 February 2012 (UTC)

Take a break, MastCell. The deleted text contains no such assertion. --Alternative account no2012 (talk) 00:00, 14 February 2012 (UTC)

Thanks - I will take a break, since I have no idea what "deleted text" and what "assertion" you're referring to. Which reminds me of a joke: A dangling modifier walks into a bar. After finishing a drink, the bartender asks it to leave. MastCell ^Talk 00:05, 14 February 2012 (UTC)

HIV virus

Somewhere in this artikle, I found the word HIV virus. Please correct it to HIV! I can not edit this page. --BuschBohne (talk) 20:22, 13 March 2012 (UTC)

I have no problem if someone does this, but it's a hypercorrection of well-established usage. HIV virus, PIN number, ATM machine, LCD display, SAT test, etc. are all perfectly acceptable. Redundancy is not an error. - Nunh-huh 22:19, 13 March 2012 (UTC)

File:2007 HIV STATISTICS.jpg Nominated for Deletion

An image used in this article, File:2007 HIV STATISTICS.jpg, has been nominated for deletion at Wikimedia Commons in the following category: Deletion requests March 2012 What should I do? Don't panic; a discussion will now take place over on Commons about whether to remove the file. This gives you an opportunity to contest the deletion, although please review Commons guidelines before doing so. If the image is non-free then you may need to upload it to Wikipedia (Commons does not allow fair use) If the image isn't freely licensed and there is no fair use rationale then it cannot be uploaded or used. To take part in any discussion, or to review a more detailed deletion rationale please visit the relevant image page (File:2007 HIV STATISTICS.jpg) This is Bot placed notification, another user has nominated/tagged the image --CommonsNotificationBot (talk) 20:06, 19 March 2012 (UTC)

New 2011 guidelines

Simplified recommendation regarding treatment [27] Doc James (talk · contribs · email) 17:43, 28 March 2012 (UTC)

Too long?

Is there an argument to be made to make this article a little more concise? It seems like all the subsections have their own page anyway. This page being so long, it can make it difficult to navigate especially if you don't know exactly what you're looking for. For instance, I'm looking for the virulence factors of the virus and not having much luck. — Preceding unsigned comment added by 137.43.188.170 (talk) 17:31, 26 April 2012 (UTC)

The subject is pretty meaty, and it is common that "Main Article" links be summarized in the principle article; compare, for example, the Epidemiology section with AIDS pandemic. The HIV article would be deficient without something about the virus' epidemiology, but a brief summary is all that is necessary: the user can use the Main Article link to get more information.

As for virulence factor, it is would be useful information to add to the article. If you can find some sources that meet the Wikipedia's standards for Reliable Sources, feel free to add a new section, probably under Virology. The cooperation of interested editors is one of the biggest strengths of the Wikipedia, and people willing to work on improving articles are always welcomed. TechBear | Talk | Contributions 20:53, 26 April 2012 (UTC)

Sexual

Why does the chart say that 90% of infections are acquired by blood transfusions, whereas the sexual section states that that the majority of infections are acquired through sexual relations? Isn't this a contradiction? — Preceding unsigned comment added by Carnival Honey (talk • contribs) 02:36, 16 March 2012 (UTC)

The chart doesn't say that. It says that receiving a blood transfusion from an HIV infected donor will result in the recipient being infected nine out of ten times. Sexual relations with an HIV infected person occur many many times more often than do HIV-contaminated blood transfusions, which is why sexual relations lead to most of the infections even though the transfusion is more dangerous. - Nunh-huh 03:22, 16 March 2012 (UTC)

That's right. That's how AIDS went from being a gay/drug-user disease to a world-wide non drug-using heterosexual pandemic. For at least ten years now almost all AIDS mortality, even in the Western world, has been among formerly healthy non drug-using heterosexuals, with minorities predominating due to lack of safe-sex education. Operative67 (talk) 22:51, 28 March 2012 (UTC)

So, does that mean that if you have sex with an HIV+ person, you get HIV 0-3% of the time? Jackstormson (talk) 14:22, 28 May 2012 (UTC)

Yes if you only have sex with an HIV positive person once that is your average risk. (there are lots of things that change change that including other STIs, open wounds, etc) Doc James (talk · contribs · email) 22:36, 28 May 2012 (UTC)

Searching for hiv: error?

If you enter "hiv" (lower case) in the Search box, it takes the user to a stub of an article about a rural village in Iran. This makes no sense: I expect that the overwhelming majority of cases where someone is searching for "hiv" wants the virus, not a dustspeck in the Middle East. It would make sense to have this article as the primary article, with disambiguation links. How can this be changed? TechBear | Talk | Contributions 13:31, 2 May 2012 (UTC)

I think I fixed it. I created a new page, Hiv (village), then made the old page a redirect. Also added disambig links to this article. SpectraValor (talk) 15:37, 4 May 2012 (UTC)

Excellent, thank you. I wasn't sure what the guidelines were for setting all that up. TechBear | Talk | Contributions 17:00, 4 May 2012 (UTC)

Image wrong?

In the picture, p7 is labeled at the top but p7 is actually the nucleocapsid. — Preceding unsigned comment added by 98.218.229.41 (talk) 21:45, 5 June 2012 (UTC)

Our content published by someone else without appropriate attribution

This book [28] look very much like our articles on HIV and AIDS. And was of course published after we wrote our article. Doc James (talk · contribs · email) 06:36, 3 June 2012 (UTC)

I love that it's copyrighted. SpectraValor (talk) 19:22, 8 June 2012 (UTC)

One article about the disease and one article about the virus

I have been making the HIV/AIDS article about the spectrum of disease cause by the HIV virus (and still have a ways to go). I wish to propose that we make the HIV article about the virus (which will involve removing some of the content). Currently the sections that are exactly the same between these two articles include: sign and symptoms, transmission, prevention, management, prognosis, epidemiology, and research. I wish to removes these from this article and add this tag to the top

This page is about the virus. For the disease, see HIV/AIDS.

. Comments? Doc James (talk · contribs · email) 08:50, 8 June 2012 (UTC)

Whoa, I'm not sure about completely deleting those sections from HIV. Removing some, summarising some, keeping some, maybe. For example, I would certainly agree that "signs and symptoms" should not come first, but two of the three subsections are actually about HIV rather than AIDS. Shouldn't they be kept? Is not transmission also about transmission of the virus rather than transmission of the disease? Not sure. I can see why prevention, management and prognosis should not be in the HIV article. Inclined to agree epidemiology should go. Since research section appears to be about the disease, yes it could probably go. Other views? hamiltonstone (talk) 09:45, 8 June 2012 (UTC)

While we now say right at the top of this article that for information about the disease see HIV/AIDS. My primary concern is keeping two exact sets of the same content up to date. I guess the other thing we could consider doing is having the sections we wish to be in both articles be placed by a template, and the template becomes the single copy we edited (for the sections on history maybe?).Doc James (talk · contribs · email) 10:02, 8 June 2012 (UTC)

I would support having sign and symptoms, transmission, prevention, management, prognosis, epidemiology, and research in the disease article rather than the virus article, and this would bring the pair of articles in line with related pairs, for example Hepatitis B virus / Hepatitis B and Hepatitis C virus / Hepatitis C. I agree with Hamiltonstone that this feels like a large change, but part of the problem is the semantic issue of the term HIV being used to mean the virus itself and sometimes the disease the virus causes. Having two distinct articles called HIV (about the virus) and HIV/AIDS (about the disease) would clarify this. On A Leash (talk) 04:12, 9 June 2012 (UTC)

Sure I think that position is reasonable. Will give others a week to comment and if there are not concerns will make this change.Doc James (talk · contribs · email) 11:05, 9 June 2012 (UTC)

Circumcision

Under prevention, it states that male circumcision definitely reduces AIDS. This is highly disputed. It says that female circumcision definitely increases AIDS. This is also highly disputed. The source is also not a valid reference for claim about female circumcision. One should at least state that there are two opposing views. 66.68.99.162 (talk) 13:09, 8 June 2012 (UTC)

Yes the ref which is a Cochrane review says male circumcisions definitely reduces AIDS. Please read the refs in question. Doc James (talk · contribs · email) 21:22, 8 June 2012 (UTC)

Agree per Doc James. I glanced at both the Cochrane Review and a Scientific American paper based on similar material. The results appear incontrovertible and strong, but should not be taken to extend beyond the scope of their findings. The current paragraphs appear to do a very good job on this: they focus on sub-Saharan Africa, where the trials took place, they flag areas of uncertainty, and they note that changed behaviour could end up offsetting the benefits of circumcision. They also note that female genital cutting has the reverse effect. Looks balanced to me. hamiltonstone (talk) 03:33, 9 June 2012 (UTC)

Merge of HIV and AIDS article into a single article called HIV/AIDS

The following discussion is an archived discussion of a requested merge. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review. No further edits should be made to this section.

The result of the move request was: not merged.

---

Yes I know this has been brought up before however:

1) Many of the section in both article are nearly the same including sections on: treatment, epidemiology, history, and prognosis among others. Many sections would combine easily such as sign and symptoms and diagnosis. We could than create subpages for those sections that have gotten too large as has been done with Epidemiology of HIV/AIDS and similar to what is done on other large topics such as schizophrenia or obesity.

2) WHO refers to them as HIV/AIDS here http://www.who.int/hiv/en/ and does so in many places [29] as does UNAIDS in their 2011 report [30]

3) The red ribbon signifies both.

4) Anyway am working on improving this subject area as part of the translation project.[31] Both articles are going to need updating before there are ready to translate. And IMO it would be nicer to have a single article. Doc James (talk · contribs · email) 12:46, 27 May 2012 (UTC)

I think merging the articles is an excellent idea, but I'm slightly concerned about the proposed title: would the "/" character create any problems, esp in the corresponding talk page? Jakew (talk) 13:03, 27 May 2012 (UTC)

Oppose. "HIV" should be about the virus. "AIDS" should be about the disease. Both articles are already long. Only a small amount of information is actually duplicated. Axl ¤ [Talk] 18:32, 27 May 2012 (UTC)

The thing is HIV does not just mean a virus but also means a disease and is used in the disease sense by both the general public and the majority of the medical community. It deals with the history, prognosis, treatment and signs and symptoms of the diseases known as HIV/AIDS. This Lancet review refers to HIV/AIDS Simon, V (2006 Aug 5). "HIV/AIDS epidemiology, pathogenesis, prevention, and treatment". Lancet. 368 (9534): 489–504. PMID 16890836. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help) Doc James (talk · contribs · email) 23:58, 27 May 2012 (UTC)

Oppose. AIDS is a distinct phase of HIV disease, the phase at which the immune system has been damaged to the point that opportunistic infections begin to manifest. There are historic, cultural, social and even medical reasons to maintain a distinction between the full spectrum of HIV disease and AIDS, and I would say that there are therefore reasons to maintain two different articles. I would rather remove the redundant material out of the AIDS article and replace it with a brief section giving an overview of HIV, headed by a "main article" link to the HIV article. This way, the AIDS article would focus on just those things that make AIDS distinct. TechBear | Talk | Contributions 00:11, 28 May 2012 (UTC)

Both these articles get more than 200,000 page views a month. While there are slight technical differences (such as AIDS being the more severe spectrum of the disease and HIV sometimes being used to means just the virus) these terms are most commonly used interchangeably by the general public and used together by our best medical sources. Emedicine's article is on HIV/AIDS [32] Doc James (talk · contribs · email) 00:39, 28 May 2012 (UTC)

Speaking as someone who is involved in public relations and outreach for an HIV research facility, it is my experience that, among the general public, "AIDS" and "HIV" are NOT used interchangeably. That is why the word "AIDS" has persisted, even though it became obsolete in the mid 90s when HIV was shown to be the causative agent for AIDS. That conceptual distinction is part and parcel to what I described above, in the significance of AIDS as distinct from HIV. TechBear | Talk | Contributions 03:48, 28 May 2012 (UTC)

Sure but this does not preclude discussing them together. Doc James (talk · contribs · email) 03:53, 28 May 2012 (UTC)

Tentative support. First, there is a significant amount of material in common between the two articles - I don't agree with Axl's assessment that the overlap is small. Second, I agree with DocJames that the HIV article is already not solely about the virus. Third, I think fully separating virus from disease articles may be unusual - contrast Smallpox for example. Fourth, I think most general readers are not looking for distinct articles on these two subjects, so it would be better if there was a single 'top-level' article. I think some key subsidiary articles can resolve any issues. Some likely candidates include Virology of HIV/AIDS, History of HIV/AIDS, in addition to the existing hatnoted subarticles mentioned in the existing AIDS article. However, I am interested in any technical issues that might arise from the punctuation of the article title. hamiltonstone (talk) 00:12, 28 May 2012 (UTC)

I could go ahead and create an example of what it would look like in my user space. The proposal would be to redirect both HIV and AIDS to the article called HIV/AIDS. We do have the article called AD/HD which redirects to ADHD.Doc James (talk · contribs · email) 00:44, 28 May 2012 (UTC)

That may be helpful, though you might want to wait a little while yet. I've been doing some more looking around. Although Rabies is the obvious peak article, there is a separate article Rabies virus. We have Kaposi's sarcoma but also Kaposi's sarcoma-associated herpesvirus. This presence (of more than one article in relation to a viral condition) is common. I am not sure I could support there being no article called HIV, so i'd want to hear what you think the article HIV would look like. hamiltonstone (talk) 01:09, 28 May 2012 (UTC)

Yes I know and we have Hepatitis C and Hepatitis C virus. We have redirected AIDS virus to HIV. I would propose the creation of a page called Virology of HIV/AIDS which would be a subpage of the HIV/AIDS section on virology, a recommended section per Wikipedia:MEDMOS#Diseases_or_disorders_or_syndromes. The main HIV/AIDS article will be providing a substantial overview of virology so I do not think this will be too much of an issue. Doc James (talk · contribs · email) 01:30, 28 May 2012 (UTC)

" HIV... is used in the disease sense by by both the general public and the majority of the medical community. "

— Doc James

I am calling you out on that statement. I don't believe it. Can you prove it?

Harrison's Principles of Internal Medicine (18th edition), Part 8, Section 14 is entitled "Infections Due to Human Immunodeficiency Virus and Other Human Retroviruses". Within the section, Chapter 188 is entitled "The Human Retroviruses". Chapter 189 is "Human Immunodeficiency Virus Disease: AIDS and Related Disorders".

The Oxford Textbook of Medicine (4th edition), chapter 7.10.21 is "HIV and AIDS". Axl ¤ [Talk] 08:27, 28 May 2012 (UTC)

I guess the question is what sort of proof would you accept. Here the CDC refers to blood bore infectious diseases and lists HIV/AIDS as one [33]. This page refers to the stages of HIV infections commenting on primary, asymptomatic, symptomatic and AIDS [34]. Of course the popular press is full of references to HIV as a disease "Yes, of course, because in a stigmatised disease like HIV"[35] And we have the Lancet paper above. The majority of both medical community and the lay public use the term HIV to simultaneously mean both a disease caused by a virus and for a virus that causes a disease. It is similar to how Hepatitis C means both a disease and a virus.

My concern is just that these articles overlap so much with each other. Currently our article about HIV discusses the signs and symptoms of an infection and thus the disease caused by the virus.

Would you support moving AIDS to HIV/AIDS and than making the current HIV page more about the virus? Doc James (talk · contribs · email) 09:18, 28 May 2012 (UTC)

In my opinion, use of the term "HIV/AIDS" in the medical press is a shorthand for "HIV and AIDS". It is often convenient to describe the two together. For example, prevention of AIDS is best achieved by prevention of transmission of HIV.

Regarding the overlap, duplicated text should be moved to the more appropriate article (either "HIV" or "AIDS").

I do not support moving "AIDS" to "HIV/AIDS", although that has a better justification than conflating both articles into one. Axl ¤ [Talk] 09:42, 28 May 2012 (UTC)

As you mention above the Oxford Textbook uses "HIV and AIDS". Thus I do not see why we shouldn't. The subsequent article would than deal with the entire spectrum of diseases (which it sort of dose already). With respect to removing duplicate text to the more appropriate article, which article do you think should contain the epidemiology section as both article currently have the exact same content? Doc James (talk · contribs · email) 09:46, 28 May 2012 (UTC)

I recommend that the epidemiology should be in "AIDS". Axl ¤ [Talk] 10:29, 28 May 2012 (UTC)

Okay and not here at all? You did note that we have an "infobox disease" in the right upper hand corner of this article complete with "international classification of diseases" numbers. ICD 9 has 042 for HIV disease [36] And here is the ICD 10 where it is also referred to as HIV disease with the severe form of HIV disease also designated as AIDS [37]Doc James (talk · contribs · email) 10:38, 28 May 2012 (UTC)

There's a fundamental semantic confusion here. "AIDS" is the name of a disease - more specifically it is the name given to the later stages of the disease "HIV/AIDS", which is synonymous with the term "HIV disease". On the other hand, "HIV" is the name of the virus which causes that disease. The problem is that in English the names of diseases and the names of infectious agents which cause those diseases are often the same.

I wouldn't support merging HIV and AIDS - I think it is important to have one article about the infectious agent, and the other about the disease that agent causes. However, "AIDS" is an increasingly outdated term, and I think the article about the disease should be renamed "HIV/AIDS" to better reflect the spectrum of the disease beyond the immunosuppression aspect. The term "AIDS" is also problematic in that it is defined for epidemiological purposes differently in different places, eg the US versus almost everywhere else. In most parts of the developed world where antiretroviral treatment is available AIDS is becoming increasingly rare, although HIV/AIDS is not.

There is some duplication in the two articles, but having one focusing on the infectious agent and the other on the disease would provide a rational framework for minimising this. For example, the epidemiology section belongs with the disease article, while the molecular biology belongs to the virus page. On A Leash (talk) 12:32, 29 May 2012 (UTC)

Yes would support this. One article called HIV/AIDS about the disease and the other called HIV about the virus.Doc James (talk · contribs · email) 12:38, 29 May 2012 (UTC)

On a quick scan of the two articles, more than half of the material in HIV (eg signs and symptoms, transmission, epidemiology, diagnosis, treatment) seems more suited to the AIDS (to be renamed HIV/AIDS?) article, and could be removed from the HIV article or briefly summarised with links to the HIV/AIDS page.On A Leash (talk) 13:08, 29 May 2012 (UTC)

I'm not expressing a view about On A Leash's suggestions, but did want to say that I'm liking how Doc James's version is shaping up so far. Cheers. hamiltonstone (talk) 13:12, 29 May 2012 (UTC)

Thanks for the vote of confidence. As this is a key diseases and of huge global importance we need to make it as good as possible before translating it into other languages.[38] I will be spending the next few weeks / months making sure it reflects the most recent high quality evidence and of course am always happy to have help :-) Doc James (talk · contribs · email) 13:24, 29 May 2012 (UTC)

I saw this merge discussion at the time it was happening, but I was busy with other things at that time. Now, however, I have to state that I'm not convinced that the merge was/is a good thing, per the comments above about why keeping the articles separate is best. As has been stated, people strive to be clear that HIV is only the infection and not the disease known as AIDS. The merge, along with the first sentence of the HIV/AIDS article, makes it seem as though the two things are the same. And now there doesn't seem to be a point in even having this HIV article. I highly doubt that most people are going to link to the HIV article when they can just link to the HIV/AIDS article. Even this edit by an IP shows HIV no longer simply being referred to as the infection. Although, in defense of the first line of the HIV/AIDS article, and that edit by the IP, HIV is commonly referred to as a sexually transmitted disease (James mentioned that semantics aspect as well); "disease" can also refer to things that are only infections (per the big debate at the Sexually transmitted disease article about renaming it to Sexually transmitted infection). Flyer22 (talk) 17:52, 27 June 2012 (UTC)

The articles where not merged. We now have one article about the disease/infection and one article about the virus. Otherwise most of the content would simply have been duplication. The distinction between HIV infection/disease and AIDS is not sharp since the introduction of HAART and thus most people use the term HIV/AIDS including WHO and the UN. Doc James (talk · contribs · email) (please reply on my talk page) 18:09, 27 June 2012 (UTC)

I still don't feel that having the merged title is a good thing, per the distinction between the virus and the disease. From what I have seen, that distinction is demonstrated as important by most of the medical community, despite the more recent medical sources now using the wording "HIV/AIDS." But it's settled now; I just wanted to weigh in anyway. Flyer22 (talk) 18:17, 27 June 2012 (UTC)

HIV does still direct here as does AIDS virus. AIDS just goes to a page called HIV/AIDS now. The majority of the literature has moved in this direction.Doc James (talk · contribs · email) (please reply on my talk page) 18:40, 27 June 2012 (UTC)

I wouldn't state that the majority of medical literature has moved in the direction of titling AIDS as "HIV/AIDS" (they certainly still usually state "AIDS" when referring to the disease instead of "HIV/AIDS"; the latter is used more so for article titles). And even if the majority has moved in the direction of titling AIDS as "HIV/AIDS," it certainly has to do with what Axl explained about it being "shorthand for 'HIV and AIDS'." But like I stated, the matter is settled. I'm not interested in debating it, especially since you have displayed authoritative medical sources using the new phrasing "HIV/AIDS." Flyer22 (talk) 18:51, 27 June 2012 (UTC)

Oppose HIV is the virus, AIDS is the late stage syndrome caused by the virus. They should remain separate. It is up to the editors to keep the articles distinct. This is similar to Varicella zoster virus and the articles Chickenpox and Herpes zoster and similar to Herpes simplex virus in relation to Herpes simplex and Kaposi's sarcoma-associated herpesvirus in relation to Kaposi's sarcoma. --Bob247 (talk) 19:09, 27 June 2012 (UTC)

Closed as no merge. Doc James (talk · contribs · email) (please reply on my talk page) 19:33, 27 June 2012 (UTC)

The above discussion is preserved as an archive of a requested move. Please do not modify it. Subsequent comments should be made in a new section on this talk page. No further edits should be made to this section.