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7 years ago  ::  Jan 18, 2008 - 5:30PM #41
JoeRoyce
Posts: 75
"I recall you mentioning your opinion that gay men (implying as a whole or at least for the most part) are not monogamous"
There is plenty of research to point that out. Suprisingly many of the studies and surveys were done by Gay organizations.


So, you can produce proof that, on average, unmarried gay men have sex with a greater number of different partners than unmarried straight men?  Or, more to the point of your claim, that a larger percentage of unmarried gay men are non-monogamous than unmarried straight men?
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7 years ago  ::  Jan 18, 2008 - 8:52PM #42
REteach
Posts: 14,551
Larc, did  you notice this from the abstract of your article?

[QUOTE]Limitations: The study was retrospective, and sexual risk behavior was not assessed[/QUOTE].

And we have this:
[QUOTE]We calculated the incidence of multidrug-resistant USA300 infection in each city ZIP code based on the 532 cases and used 2000 U.S. Census data (33) to test the association between disease incidence estimates and the proportion of male same-sex couples living in those ZIP codes.[/QUOTE]

They were not asking if these guys were sexually active with other men--they were guessing based on census data. 

This statement referred to an HIV clinic in which the participants were actually asked about their sexual activity:
[QUOTE]Eight patients had missing sexual behavior data and no history of anal Pap smears; we classified them as men who do not have sex with men. Seven of these men had nonmultidrug-resistant USA300 infection, and 1 had a non-USA300 infection. Our estimates of risk for multidrug-resistant USA300 with male–male sex did not change meaningfully when these 7 patients with nonmultidrug-resistant USA300 infection were reclassified as occurring in men who have sex with men or when they were excluded from analyses (data not shown).
[/QUOTE]  This doesn't exactly support your thesis. 

I'm also not sure one can generalize from an HIV clinic to the general population. 


I would also note that this study is particularly looking at the health status of gay men.  The take home message to me is that if I am looking at a sore on the butt of a gay man in Boston or SF, I ought to consider that it might belong to this strain of MRSA and get a culture and treat appropriately. 

The message that is already understood in health care is that sex involves close physical contact and that infections can be passed sexually.    BTW, Fournier gangrene is a medical emergency.  No man, gay or straight, wants that one missed or wants it to be treated with an ineffective antibiotic.  Unless you don't really want your genitalia any more. 

Another quote:
[QUOTE]The high incidence of multidrug-resistant USA300 among men who have sex with men has major implications for empirical treatment of skin infections among these patients.[/QUOTE]

Here we go.  The point is not that gay men should be placed in quarantine, but that we need to consider a multiresistant strain when ordering antibiotics.

[QUOTE]Specific sexual behaviors were not assessed or documented in clinic charts; we therefore cannot comment on the association between multidrug-resistant USA300 infection and specific male–male sexual practices. Finally, because the number of multidrug-resistant USA300 infection within risk-factor subgroups was small, some of our higher estimates of risk are statistically compatible with more modest risk increases (that is, many of the CIs are wide and their lower bounds approach 1.0).[/QUOTE]

By the way, the lower bound approaching 1 means the results may not be statistically significant.
I know you believe you understand what you think I said, but I am not sure you realize what you heard was not what I meant...
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7 years ago  ::  Jan 18, 2008 - 8:54PM #43
REteach
Posts: 14,551
So now we can all take a deeeep breath and relax. 


And if you know any young adults of any sexual orientation who are still feeling the joys of sex and the invulnerability of youth, get them a condom.  They tend to think nothing bad will ever happen to them.  It's an age and immaturity thing.
I know you believe you understand what you think I said, but I am not sure you realize what you heard was not what I meant...
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7 years ago  ::  Jan 19, 2008 - 11:48AM #44
REteach
Posts: 14,551
I just pulled up a presentation from the state department of public health.  They are talking about USA300--in the burn unit. 
Of the 4 patients, one was a middle aged male, one was a 70+ year old male, the other two were a middle aged and an young adult female. They went back and looked for more cases of USA 300 on the burn unit.  They found a female healthcare worker who was positive.  They also identified 10 more patients. 2/15 were prisoners, 2/15 were morbidly obese, 9/15 were female.   Their best guess is that 9/15 cases were community rather than hospital acquired.

Here is some data from that presentation:
[QUOTE]8/1/01-7/31/04USA300:
2000 ~50 of CA-MRSA 2003 > 90% of CA-MRSA
Kaplan, et al. CID 2005;40:1785-91[/QUOTE]


Another was from a department of public health grand rounds in 2006.  Here is a slide from that presentation:
[QUOTE]CA-MRSA: Risk Factors for Infection
• Young age
• Contact sports
• Sharing towels or athletic equipment
• Weakened immune system
• Living in crowded or unsanitary conditions
–military, prison inmates, day cares• Recent antimicrobial use
Strategies for Clinical Management of MRSA in the Community, CDC March 2006[/QUOTE]


Health care professionals are just not viewing this as some kind of gay plague.
I know you believe you understand what you think I said, but I am not sure you realize what you heard was not what I meant...
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7 years ago  ::  Jan 20, 2008 - 3:26PM #45
JonAtFaithUCC
Posts: 294
Apparently, the researchers aren't happy that this story has been spun into another gay-scare event:

http://www.boxturtlebulletin.com/2008/01/19/1319 (UCSF Apologizes for Misleading Statements on MRSA)

and

http://www.boxturtlebulletin.com/2008/01/20/1320 (Mainstream Media Retreats From MRSA Hysteria).
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7 years ago  ::  Jan 21, 2008 - 10:22AM #46
REteach
Posts: 14,551
[QUOTE=JonAtFaithUCC;227484]Apparently, the researchers aren't happy that this story has been spun into another gay-scare event:

http://www.boxturtlebulletin.com/2008/01/19/1319 (UCSF Apologizes for Misleading Statements on MRSA)

and

http://www.boxturtlebulletin.com/2008/01/20/1320 (Mainstream Media Retreats From MRSA Hysteria).[/QUOTE]

That isn't surprising when you read the article. 

There is actually information about resistance to different antibiotics in different areas.  I might need to prescribe a different antibiotic than someone in Boston to be most likely to adequately treat an infection.  Resistance can vary from hospital and community to community.   

Again, when I read the article, the take home message is to consider a multiply drug resistant strain of MRSA when treating a gay man, particularly in the SF or Boston areas, and especially if the sores are in the buttocks area.  Likewise, because I read other stuff, too, I'd want to consider that athletes are at risk, and prisoners, and individuals caring for someone recently released from the hospital. 

Inadequate or inappropriate treatments can increase resistance, which is a problem for all of us.  We prescribers need to think about what we are doing.

Science writers should be required to take statistics and research classes.  Too often they take a legitimate research article and turn it into something it was never intended to be.
I know you believe you understand what you think I said, but I am not sure you realize what you heard was not what I meant...
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7 years ago  ::  Jan 22, 2008 - 11:46AM #47
larcman
Posts: 63
"Apparently, the researchers aren't happy that this story has been spun into another gay-scare event:"

That wasnt much of an apology if you ask me.  The post I read seemed to be more concerned about the use of the words "general population" than the scare factor.
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7 years ago  ::  Jan 22, 2008 - 3:47PM #48
The_Maven
Posts: 372
[QUOTE=larcman;232246]That wasnt much of an apology if you ask me.  The post I read seemed to be more concerned about the use of the words "general population" than the scare factor.[/QUOTE]

Really?  Let's see what it actually said:

We regret that our recent news report (1-14-08) about an important population-based study on MRSA USA300 with public health implications contained some information that could be interpreted as misleading. We deplore negative targeting of specific populations in association with MRSA infections or other public health concerns, and we will be working to ensure that accurate information about the research is disseminated to the health community and the general public. [emphasis mine]



I wonder if they would view starting a thread on a board about homosexuality (and mentioning that you thought of one gay man in particular) with the title "you all be careful out there" as "negative targeting of specific populations."  What do you think?

I see the use of the word regret as an apology because my dictionary identifies apology as "an admission of error or discourtesy accompanied by an expression of regret." (Courtesy Merriam-Webster)

However, if you aren't convinced, you may want to read further from Wallace Ravven (Manager, Research Communications, UCSF), who issued the above statement, he makes it clear that he was apologizing and that he realizes the infomration was not clear:

First, let me apologize for unintentionally offending many people. I do think there were statements in the news release that were open to misinterpretation, as our official statement below acknowledges. [emphasis mine]
http://mpetrelis.blogspot.com/2008/01/g … staph.html

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7 years ago  ::  Jan 22, 2008 - 3:54PM #49
robinsgarret
Posts: 228
Just an observation... there are only a few popular gyms in the areas that are described in the study.  Pity that the researchers did not look into the possibility that the people they were looking at were both likely to be gym-going, and likely to go to the same gym.

They were more likely to get it from a common steam room (where they were likely to be sitting with their bare butts...) than by having had sex with each other...

Jon-  interesting comments.  I got distracted by the article about Paul Cameron:  http://www.boxturtlebulletin.com/Articles/000,020.htm

More "science" based on what someone wants to believe than anything approaching facts.   Larcman... Cameron refers to homosexuality as something people do on a "lark"... fyi.
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7 years ago  ::  Jan 22, 2008 - 5:33PM #50
BetteTheRedde
Posts: 2,325
I read the article, rob, and the summary of the kind of 'truthiness' it takes to construct and make some sort of sense of "Cameron's world".

You know, Cameron's apparent devotion to his cause always makes me wonder about his orientation. The lady doth protest overmuch.
"Sometimes they are referred to as the 'radical Right.' But the fact is that there is nothing radical about them. They offer no novel solutions to the problems that plague them; indeed, they offer no solutions at all. They are immensely discontented with things as they are and furiously impatient with almost everyone in public office who can in any way be held responsible for their frustrations. But it cannot be said that they hold any clearly stated objectives or have any specific program either in common or individuals. They are fundamentally and temperamentally 'aginners.' And perhaps the commonest characteristic among them is anger. They can fairly be called, if nothing else, the Rampageous Right."

Alan Barth, New York Times, November 26, 1961
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