Wei_Dai comments on Open Thread, September, 2010-- part 2 - Less Wrong
You are viewing a comment permalink. View the original post to see all comments and the full post content.
You are viewing a comment permalink. View the original post to see all comments and the full post content.
Comments (858)
Have you seen these two recent meta-analysis of HIV transmission rates? Comparing them to your numbers, it seems that Wikipedia/CDC have greatly understated the risk for P/A sex acts (due to using older studies?).
Also, according to this page, the transmission rates for genital herpes are similar to HIV for P/V sex acts, so AIDS is not the only STD to have such low transmission rates.
I think the conventional theory is that HIV established an initial foothold by means such as needle sharing, blood transfusions, and P/A sex acts. That seems quite realistic to me. Why do you think it's unrealistic?
No I haven't seen them until now. I haven't really been looking into or thinking about this until just recently.
I originally quoted the wikipedia data, which several us tracked down and analyzed in another thread (it comes from the CDC and originally from a single medium-ish European study which I think did a fairly good job to control for factors such as condom use and what not given the complexities):
Let's compare to the 1st meta-analysis:
it finds 0.04/0.08% for insertive/receptive P/V sex in the 1st world, very similar but slightly lower to the older CDC study (from europe). They find the rates are around 5 times higher in the 3rd world.
For P/A receptive, they find a pooled per-act rate of 1.7%, about 3.5 times higher than the 1st world CDC study. I suspect this is simply because they pooled 1st and 3rd world data together.
This does not show that Wikipedia/CDC have "greatly understated" the risk for P/A sex acts - this data is in agreement. The variance is between 1st and 3rd world studies. The 1st world data is of paramount concern for the historical origin theory of the disease. The 3rd world data is a side point - not historically important and suspect in general, as in fact mentioned in the abstract.
The abstract:
So this supports the original CDC data for the 1st world.
The second meta-study finds a receptive A per act rate of 1.4%, a little lower than the 1st study, and about 2.8 times the 1st world CDC data. They make no mention of what countries, and I assume it mixes 3rd and 1st world data - it is a large meta-analysis of many studies.
There is also some serious wierdness in the 2nd study:
So something doesn't fit - the per act and per partner numbers don't square up at all. Somewhere else someone posted an abstract with a similar result, how basically your chance of infection levels off quickly in couples and is much lower than you think - you are either going to get it or not irregardless of number of sex acts. This suggests that there are some major unknown immunity factors at work or the entire model is wrong.
I think the needle sharing and blood transfusions is far more credible, but the 0.5% ish per act of receptive A in the 1st world could possibly support a sexual vector in the gay bathouse scene, but it is debatable.
The conventional theory requires that HIV came over as a mutated form of harmless simian SIV and spread here, through a single source vector from what I recall. Blood donation might make more sense, but one would have to look at the epidemiological models for that.