A new Chicago Dept of Public Health (CDPH) study finds sobering results about HIV prevalence among men who have sex with men (MSM): of those sampled, 30% of black men, 12% Latino, and 11% of white tested positive.
There's a statistical twist: the reports of the study only give the sample size 570 which is almost irrelevant compared with how they chose these men. Since the detail wasn't given I would guess that they went to stereotypical places, so results would be more accurately reported as being in terms of MSM who go to the stereotypical hangouts where CDPH knew where to find them. I would expect these men to have more sexual partners, more high risk behavior, and so more likelihood of HIV and other STDs. Such high prevalence among any group is of course shocking, but if some omniscient being did a random sample of all MSM, they could pull the partnered, boring, reclusive, etc., and find lower prevalence.
Further, I wonder if their sampling method is differentially selective for higher risk in some groups than others. Gay black men don't have a neighborhood in Chicago comparable to Lakeview, the predominantly white gay neighborhood in Chicago (my former neighborhood), so the more easily sampled may be the very highest risk. In Lakeview they could have found ice cream shops, laundromats, dog supply stores, and yoga classes where upwards of 30% of the clientele are gay; I doubt there's anywhere else in the city with such a high concentration in non-gay-themed gathering spaces. Even if they limited themselves to bars, it might still be that gay bars in Lakeview attract a much broader cross-section of the Lakeview community than African-American gay bars on the South/West side of the city.
Also there is the phenomenon of small numbers: the smaller the group you are drawing from, the more extreme the numbers get. Just two days ago I was estimating chlamydia prevalence among different subgroups of Evangelical Christians and I found a higher prevalence among a specific evangelical denomination of the more frequent church attenders than among evangelical frequent church attenders in general. Are people who have chlamydia attracted to this denomination? Does this denomination discourage condom use more than others? It's possible that was a real effect, and perhaps it will get its own paper, but it's also possible that the higher prevalence was because I was basing my estimate on only 73 individuals, versus 700 for the highly religiously involved.
Youth Pride Services, an agency that serves the African=American gay community in Chicago writes a letter to the editor of the Windy City Times (gay newspaper) saying that they have little visibility. Sadly, notification of this high prevalence may not bring them visibility either.
Wednesday, June 10, 2009
Parody of the day: STD E-cards
A parody of the CDC's STD ecards.
Kids holding a large piece of paper.
"Giving bad news is sometimes really hard.
So I'm saying I gave you crabs with the help of this card."
A couple holds hands in the sunset on a beach.
"Thanks for the blow job.
Sorry about the herpes!"
Man covering his genitals.
"I've been experiencing some genital burn.
So I got tested and now it's your turn."
Not a bad message since some STDs are more likely to be symptomatic in men than in women.
Kids holding a large piece of paper.
"Giving bad news is sometimes really hard.
So I'm saying I gave you crabs with the help of this card."
A couple holds hands in the sunset on a beach.
"Thanks for the blow job.
Sorry about the herpes!"
Man covering his genitals.
"I've been experiencing some genital burn.
So I got tested and now it's your turn."
Not a bad message since some STDs are more likely to be symptomatic in men than in women.
Monday, June 8, 2009
Abstinence on prime time
Abstinence has made prime time a few times lately:
1. ABC's the Goode Family. Pilot episode: Daughter of liberal vegans thinks of taking a purity pledge. Even though everyone in the family agrees with the sentiment, they are completely wigged out by the trappings, such as the purity ball, purity ring given by father, etc., the fact that it's held in a church and done by primarily religious people. The father is an academic administrator and says he can't be seen in a church or he risks credibility at work.
Perhaps the most insightful message I've seen on abstinence in entertainment: everyone agrees on abstinence, but disagrees on style and how to talk about it: abstinence-only or abstinence-plus. Ultimately I wouldn't be surprised if the inclination to favor "abstinence only" or "plus" were one of the hard-wired political issues that the neuro- political science folks are picking up on brain scans. Teaching birth control feels wrong. So you end up with political stances like Sarah Palin's as governor being in favor of "Abstinence only" that of course teaches birth control. Just can't say the words "comprehensive" or even "abstinence plus" because those evoke the extremes. (Not to pick on conservatives. The opposite also holds: some start to think about the Taliban and "she was asking for it" rape when the issue of modest dress comes up, even if it's minimal standards that everyone adheres to in professional settings without thinking about. As soon as it's called "modesty" instead of "professionalism," the hard-wired instinct kicks in.)
The show is terrific otherwise as well. My favorite non-abstinence part was a fictional animal rights group called "Animals or Else!"
2. Little Mosque on the Prairie had an episode where the fiance of a woman who wears a hijab (headscarf) asks to see his fiancee's hair, but they decide to wait until marriage for him to see her hair. Very little tension throughout this non-touching relationship, but it's a sitcom with only 22 minutes to an episode, and that's not their focus so they don't have to be realistic. Still neat to see the prism of abstinence from a slightly different perspective. I wonder how many viewers without a cultural background that involves hair-covering have an intuitive feeling about this issue. How many think that it's no big deal to show her hair, versus how many feel shocked at the thought.
3. The Jonas Brothers on South Park: "Purity rings are how we sell sex to little girls."
An outrageous thought, and yet the qualitative research finds that until adolescents can conceive of physical intimacy, they have no conception of abstinence, so both abstinence and sex are foreign thoughts to their mind. Telling pre-sexual teens about abstinence is as much of a foreign idea as telling them about sex. Presumably the same holds for telling them about abstaining from drugs or alcohol before they are in a social world in which people take drugs or alcohol.
My neighbor taped it for me , but I haven't gotten down to watch it with him and only saw the 2 minute clip on youtube, so I don't know what else it has.
1. ABC's the Goode Family. Pilot episode: Daughter of liberal vegans thinks of taking a purity pledge. Even though everyone in the family agrees with the sentiment, they are completely wigged out by the trappings, such as the purity ball, purity ring given by father, etc., the fact that it's held in a church and done by primarily religious people. The father is an academic administrator and says he can't be seen in a church or he risks credibility at work.
Perhaps the most insightful message I've seen on abstinence in entertainment: everyone agrees on abstinence, but disagrees on style and how to talk about it: abstinence-only or abstinence-plus. Ultimately I wouldn't be surprised if the inclination to favor "abstinence only" or "plus" were one of the hard-wired political issues that the neuro- political science folks are picking up on brain scans. Teaching birth control feels wrong. So you end up with political stances like Sarah Palin's as governor being in favor of "Abstinence only" that of course teaches birth control. Just can't say the words "comprehensive" or even "abstinence plus" because those evoke the extremes. (Not to pick on conservatives. The opposite also holds: some start to think about the Taliban and "she was asking for it" rape when the issue of modest dress comes up, even if it's minimal standards that everyone adheres to in professional settings without thinking about. As soon as it's called "modesty" instead of "professionalism," the hard-wired instinct kicks in.)
The show is terrific otherwise as well. My favorite non-abstinence part was a fictional animal rights group called "Animals or Else!"
2. Little Mosque on the Prairie had an episode where the fiance of a woman who wears a hijab (headscarf) asks to see his fiancee's hair, but they decide to wait until marriage for him to see her hair. Very little tension throughout this non-touching relationship, but it's a sitcom with only 22 minutes to an episode, and that's not their focus so they don't have to be realistic. Still neat to see the prism of abstinence from a slightly different perspective. I wonder how many viewers without a cultural background that involves hair-covering have an intuitive feeling about this issue. How many think that it's no big deal to show her hair, versus how many feel shocked at the thought.
3. The Jonas Brothers on South Park: "Purity rings are how we sell sex to little girls."
An outrageous thought, and yet the qualitative research finds that until adolescents can conceive of physical intimacy, they have no conception of abstinence, so both abstinence and sex are foreign thoughts to their mind. Telling pre-sexual teens about abstinence is as much of a foreign idea as telling them about sex. Presumably the same holds for telling them about abstaining from drugs or alcohol before they are in a social world in which people take drugs or alcohol.
My neighbor taped it for me , but I haven't gotten down to watch it with him and only saw the 2 minute clip on youtube, so I don't know what else it has.
Thursday, May 7, 2009
Good Morning America goes back to the 1950s
Yesterday was the National Day To Prevent Teen Pregnancy, so the issue got some coverage including Bristol Palin on Good Morning America.
The GMA segment on the subject reminds me of something from the 1950s or 60s where contraception and sex were only hinted at and discussed in veiled terms that only adults could understand.
Bristol Palin's last statement on abstinence a few months ago was incoherent and stumbling but included a statement that "abstinence is not realistic." That interview didn't seem to mention birth control either.
This time she has her talking points down and she gives a well-articulated message. "Abstinence is a hard choice, but it's the safest choice and the best choice." The interviewer asks what's the second line of that since teens might "roll their eyes" at abstinence (is that what they're calling it nowadays?) and her line is, "It's the safest choice, and it's something that kids should know about."
That is, the best choice is abstinence. And the second best choice is also abstinence. And the third best choice. And the fourth choice. Is that really what she means to be saying?
They also had a guy from an anti-teen pregnancy foundation started by a teenage shoe company who summed up the foundation's motto as "Just because you're wearing high-heeled sexy shoes, obviously you shouldn't have a baby."
The only discussion about birth control is impossibly muddled:
Host: "Do you think it has to be black and white, abstain versus protection, or do you think there is going to be some middle ground?"
Palin: "Yes I think definitely some middle ground."
Foundation guy: "Abstinence is obviously the best way, but being realistic you gotta talk to teenagers and say anyway, whether it be protection ... having a baby... a kid having a kid is just not right. Any way you can get through, we have to educate."
What exactly is this middle ground between abstinence and protection? Presumably they don't mean as in this joke site dedicated to "abstinence" from acts that can get women pregnant. It's a shockingly bizarre statement.
There is no getting around it: Teaching birth control is the middle ground.
The GMA segment on the subject reminds me of something from the 1950s or 60s where contraception and sex were only hinted at and discussed in veiled terms that only adults could understand.
Bristol Palin's last statement on abstinence a few months ago was incoherent and stumbling but included a statement that "abstinence is not realistic." That interview didn't seem to mention birth control either.
This time she has her talking points down and she gives a well-articulated message. "Abstinence is a hard choice, but it's the safest choice and the best choice." The interviewer asks what's the second line of that since teens might "roll their eyes" at abstinence (is that what they're calling it nowadays?) and her line is, "It's the safest choice, and it's something that kids should know about."
That is, the best choice is abstinence. And the second best choice is also abstinence. And the third best choice. And the fourth choice. Is that really what she means to be saying?
They also had a guy from an anti-teen pregnancy foundation started by a teenage shoe company who summed up the foundation's motto as "Just because you're wearing high-heeled sexy shoes, obviously you shouldn't have a baby."
The only discussion about birth control is impossibly muddled:
Host: "Do you think it has to be black and white, abstain versus protection, or do you think there is going to be some middle ground?"
Palin: "Yes I think definitely some middle ground."
Foundation guy: "Abstinence is obviously the best way, but being realistic you gotta talk to teenagers and say anyway, whether it be protection ... having a baby... a kid having a kid is just not right. Any way you can get through, we have to educate."
What exactly is this middle ground between abstinence and protection? Presumably they don't mean as in this joke site dedicated to "abstinence" from acts that can get women pregnant. It's a shockingly bizarre statement.
There is no getting around it: Teaching birth control is the middle ground.
Tuesday, May 5, 2009
If banishing from the city doesn't work. . . no kissing until marriage
I love the title of this article True Lips Wait. A 22 year old is quoted as saying her first kiss was after the church wedding service in front of 200 people. That's about the age of marriage until which many evangelicals really do wait until marriage.
It's the clichee movie ending, but still it seems unusual (in my wine glass stomping Jewish perception) to kiss as a de facto part of a religious ceremony at all. But especially for someone who hadn't kissed at all before to have their first kiss in front of so many people, it seems particularly unusual to share such an intimate thing as one's first kiss with 200 people.
(I wonder when kissing at the end developed. Do any other religions kiss right after the ceremony? Which branches of Christianity? Variants of Eastern Orthodox? Are there any types of Protestantism that don't?)
It's the clichee movie ending, but still it seems unusual (in my wine glass stomping Jewish perception) to kiss as a de facto part of a religious ceremony at all. But especially for someone who hadn't kissed at all before to have their first kiss in front of so many people, it seems particularly unusual to share such an intimate thing as one's first kiss with 200 people.
(I wonder when kissing at the end developed. Do any other religions kiss right after the ceremony? Which branches of Christianity? Variants of Eastern Orthodox? Are there any types of Protestantism that don't?)
Virginity pledge alternative
The former Sephardic Chief Rabbi of Israel, Rav (Rabbi) Ovadia Yosef is known both for his great wisdom and his unfortunate moments with the press. Like father like son, perhaps, as his son recently made a decree that all unmarried men over age 20 must leave Jerusalem. It's meant as an incentive to push them to get married, but of course it sounds not so good. Much like Rav Ovadia's statements.
According to the rabbi, who publishes a weekly column on the Eretz Israel Shelanu leaflet, in the past it was customary to banish "older" single men from the capital as punishment for their refusal to marry and provide for a family.
In recent generations, Sephardi rabbis decided to annul this regulation, but according to Rabbi Yosef it should be reinstated. "Only a yeshiva student who studies Torah has an exceptional permission to postpone marriage, if he fears that marriage might distract him from his studies.
"But normally one must not delay marriage till after 20, and those who do had better leave Jerusalem and go study somewhere else," he wrote.
Last week the rabbi discussed in his column the question of what was the right age for marriage, and concluded that men must wed no later than age 19.
"Any man who reaches the age of 20 must hurry without tarrying, or he might find himself looking for many more years," he stated.
Friday, May 1, 2009
Flu risk perception
My understanding about the 1918 flu is that the first wave had few deaths, and those deaths followed standard pattern of seasonal flu: elderly and very young. The second wave came several months later and was a slightly changed form that had higher mortality, mostly in the healthiest age group, ages 20-40. These people didn't get it the first time around, so they were vulnerable in the second wave when it was more dangerous.
My question: is it possible that all these extreme measures such as closing schools --- e.g., Harvard closed down medical, dental, and public health schools today because of a case in the dental school --- will make the flu epidemic worse rather than better by inducing precaution fatigue and decreasing credibility of preventative measures such as vaccines and shutting down institutions so that when the flu is really serious people will assume it will be low mortality as it is now?
If this follows pattern of 1918, by the time the second scary wave of flu comes around, we will have a vaccine, perhaps even in adequate numbers to cover much of the population, but there's no vaccine for human irrationality. Everyone is getting all fired up now --- lots of parents kept their kids home at a local school here in suburban Baltimore due to 1 case in the school.
When the same thing happens next October or November, will people reason it's not important to be careful since last time turned out okay? Will people not bother to get the vaccine?
My question: is it possible that all these extreme measures such as closing schools --- e.g., Harvard closed down medical, dental, and public health schools today because of a case in the dental school --- will make the flu epidemic worse rather than better by inducing precaution fatigue and decreasing credibility of preventative measures such as vaccines and shutting down institutions so that when the flu is really serious people will assume it will be low mortality as it is now?
If this follows pattern of 1918, by the time the second scary wave of flu comes around, we will have a vaccine, perhaps even in adequate numbers to cover much of the population, but there's no vaccine for human irrationality. Everyone is getting all fired up now --- lots of parents kept their kids home at a local school here in suburban Baltimore due to 1 case in the school.
When the same thing happens next October or November, will people reason it's not important to be careful since last time turned out okay? Will people not bother to get the vaccine?
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