ABUSED WOMEN and “HIV”

“HIV” is the worst evil in the world, according to HIV/AIDS believers:
— They want to give drug addicts fresh needles, because cocaine and heroin are so much better, so much more healthy than “HIV”; see COCAINE AND HEROIN AREN’T GOOD FOR YOU! [a Golden Fleece Award, 13 June 2008];
— They will treat Africans for worm infestation only if that makes antiretroviral treatment more efficient; see PARASITIC WORMS are *NOT* GOOD for you!, 24 July 2008; ARE INTESTINAL WORMS GOOD FOR US? ARE THEY GOOD FOR AFRICANS? FOR AFRICAN CHILDREN?, 30 December 2007;
— They will provide food to malnourished Africans only if that helps with antiretroviral treatment ; see DRUGS OR FOOD?, 25 December 2007; FOOD IS GOOD FOR CHILDREN, 8 January 2008;
— “HIV” does ALL SORTS of dreadful things, like instigating bone fractures; see TALKING OF HIV’S MAGICAL POWERS…, 29 DECEMBER 2007.

And so on. No doubt about it, “HIV” — or, of course, “HIV/AIDS” — is the worst evil in the world.

Therefore it makes sense to study — and to acquire research grants to study — whether abused women are at greater risk of “HIV” than non-abused women are. If one finds that they are at greater risk, that would provide a compelling reason to regard the abusing and battering of women as a bad thing and perhaps even to look for ways of helping abused women and of trying to prevent such abuse.

A corollary that seems to me obvious, though apparently not to HIV/AIDS believers, is that if abused women are NOT at greater risk of “HIV”, then there’s no need to give further thought to the plight of abused women?

My e-mail friend Andy D. found this as absurd as I did, and drew my attention to the several news items in which the HIV status of abused women is treated as a matter of the highest newsworthiness:

“AIDS infection risk higher in abused Indian women, study says” (John Lauerman, Aug. 12, Bloomberg)
“Indian women who are physically and sexually abused by their husbands are four times more likely to have HIV than other wives . . . . AIDS prevention should focus more on mistreatment of women . . . .
India’s AIDS epidemic is the third largest of any country in the world, and infections among women are rising . . . . Health officials should target wives who are forced to have unsafe sex, along with their husbands, for preventive measures, said study author Jay Silverman, an associate professor of society, human development and health at the Harvard School of Public Health in Boston.
’Sexual abuse of adolescent girls and women is driving the HIV epidemic in India and around the world . . . . We need to make it a major priority for prevention.’
The findings echo a 2004 study of women in South Africa, . . . [where] abused women were 50 percent more likely to be HIV-infected than non-abused women, regardless of their own behavior.
’In many settings, women’s risk of HIV is largely driven by the behavior of their male partners,’ said Kristin Dunkle, an assistant professor of behavioral sciences and health education at the Emory Center for AIDS Research in Atlanta . . . .
About 0.73 percent of women who had been physically and sexually abused were infected, compared with 0.19 percent among non-abused women . . . . Almost all the women, 95 percent, reported that they had no extramarital sexual relations themselves . . . . That points to known patterns in the behavior of abusive husbands that puts their wives and children at higher risk of HIV infection . . . . Sexually abusive husbands may force their wives to have intercourse without condoms, or unprotected anal sex, both of which can significantly increase HIV infection risk . . . . The men may also be having risky sex with women outside the marriage, increasing their own chance of infection . . . . ‘We have to get to the men,’ Silverman said. ‘And we have to provide women with reasonable alternatives if they’re being abused, so they can maintain their children and not become destitute.’
. . . . ‘To be truly successful in addressing the spread of HIV in India, we must think of ways to address the all-too-widespread mistreatment of wives,’ said Donta Balaiah of the Indian Council of Medical Research, who helped write the study. The study was supported by the U.S. National Institute of Child Health and Human Development in Bethesda, Maryland, and the Indian Council of Medical Research in New Delhi, which funds and promotes research in the country.”

Another version was in CBC News: “Prevent abuse of women to stem rise of HIV: researchers” (August 12) :
“ . . . . despite a lower prevalence of infection among India’s general population, women account for a rising percentage of HIV cases. . . . ‘married Indian women who experienced both physical and sexual intimate partner violence demonstrated an HIV infection prevalence approximately four times greater than that of non-abused women,’ . . . . The risky sexual behaviour of husbands was the major source of women’s infection . . . . They suggested that doctors and public health officials focus on preventing intimate partner violence to help reduce the spread of HIV/AIDS.”

The scientific publication on which these stories are based is Silverman et al, JAMA 300 [2008] 703-710.

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As I said at the outset: The prime reason for trying to do something about abuse of women is apparently to prevent the spread of HIV.

That’s a heartless HIV/AIDS cart-before-horse stupidities. To my mind, any abuse of human beings is a thoroughly despicable and detestable thing, and we should do everything we can think of to prevent it. Naturally enough, the more it can be prevented, the more beneficial COROLLARIES there will be — for the women’s emotional and mental as well as physical health, and that of their family members; and much more. How on earth does “HIV/AIDS” come to take priority over everything else? Perhaps because any mention of it brings the money flooding in?

Note also the HIV/AIDS-typical abuse of statistics and data in this:

“India’s AIDS epidemic is the third largest of any country in the world”
— only because India has so large a population. The HIV-positive rate in India is among the lowest in the world. Moreover, the HIV/AIDS guru at the World Health Organization admitted that there had not been and would not be a heterosexually spread epidemic there, see WHO SAYS that WE’VE BEEN VERY WRONG about HIV and AIDS? (Clue: WHO = World Health Organization), 10 June 2008. A year ago, it was conceded that there were about 2.5 million “HIV/AIDS” people in India rather than the 5.7 million estimated earlier (for example, REDIFF: India Abroad — “India’s HIV/AIDS affected reduced to half in revised figures” July 06, 2007; acknowledged in the Silverman et al. article). The earlier number had corresponded to a rate of 0.9%, so the newly estimated rate is 0.4% — as I said, among the very lowest in the world.

However:
“and infections among women are rising”

This illustrates a common way in which statistics are abused for the purpose of misleading. If something starts at zero and then “increases” to barely noticeable, that’s an enormous increase if you express it in percentages!

This device is used pervasively in marketing medicines. “Take XXXXX”, we are assured, and “cut in half” our risk of YYYYY; where YYYYY might be heart attack, stroke, just about anything undesirable. If you are inclined to take this sort of thing at face value, then you should read Malignant Medical Myths by Joel Kauffman (read this for an excellent summary). If the risk of YYYYY is, say, 1%, does it make sense to try to reduce this to 0.5% when the “side” effects of prolonged dosing with XXXXX brings its own tangible risks? The only clinical trials worth attending to are those for which the important data are rarely published: namely, changes (if any) in ALL-CAUSE MORTALITY. If XXXX is good for you, then it should lower ALL-CAUSE mortality, not just the risk of YYYYY.

Silverman et al. further illustrate misleading via numbers with “Despite recent reductions in HIV prevalence among both the general population and many high-risk groups, the percentage of all infections occurring among Indian women (currently estimated at 39%) has continued to rise relative to that among men” [emphasis added].
How impressive that “39%” appears! An enormous “increase”!
But in India the overall rate for women is 0.22% and for men 0.36%, both extraordinarily low by any standards. Yet these trivially low rates allegedly cause India to be “recognized as the source of increasing HIV prevalence among its South Asian neighbors”!
I suppose a prevalence of even 0.4% poses a threat to neighbors like China, Laos, and Pakistan where the prevalence is estimated at 0.1%; let alone to those where it’s estimated at LESS than 0.1% (Afghanistan, Bhutan, Bangladesh, Sri Lanka); but surely the threat is the other way around from Myanmar (1.3%) or even Nepal (0.5%). This is worse than ludicrous.

Silverman et al. reported that “7.68%” (2161) of 28,139 women had been both physically and sexually abused; and “0.73%” (205) tested HIV-positive. A statistical test marked the difference between that 0.73% and the 0.19% among non-abused women as “statistically significant”. Maybe, although we lay people wonder why fewer than 1 in 10 of those “at risk” abused women were actually HIV-positive; but bear in mind that “statistically significant” is not the same as PROVEN. More important, what’s statistically significant is NOT that physical and sexual abuse are CAUSATIVE of testing HIV-positive, only that the two things are CORRELATED; and

CORRELATION NEVER PROVES CAUSATION

Note, too, the usual abundance of assertions about matters that are not known:
“women’s risk of HIV is largely driven by the behavior of their male partners”
— Were all the male partners investigated to arrive at that “largely”?
— And who established “known patterns in the behavior of abusive husbands”?

Where I would thoroughly agree — at least for the purpose of the published study — is that “’We have to get to the men,’ Silverman said”.

I wish the authors had done that, and had tested all the husbands of those abused women of whom 95% had not had extramarital relations, because an essential — but missing — part of the study is to discover, how many of those husbands are themselves HIV-positive. If they aren’t, then they didn’t infect their wives, after all.

My prediction is that very few of those husbands are HIV-positive, certainly many fewer than 95% of them.

Think about it. 0.73% of Indian women are physically and sexually abused and HIV-positive. Each has a husband, so those husbands represent about 0.73% of Indian men (only “about” because the ratio of males to females is not 1 and varies with age). In the overall population of India, however, only 0.36% of men are HIV-positive. Therefore physically and sexually abusive husbands must be twice as likely as other men to be HIV-positive AND ALL OF THOSE MUST HAVE INFECTED THEIR WIVES — a truly remarkable set of circumstances, especially given that the claimed average rate of sexual transmission of “HIV-positive” without use of condoms is about 1 per 1000. It gets only more remarkable when one takes into account that about ¾ of all “HIV transmission” in India is NOT owing to marital sex, if India is at all comparable to Asia as a whole, see HIV/AIDS ILLUSTRATES COGNITIVE DISSONANCE, 29 April 2008. Then the husbands of those poor HIV-positive abused women must themselves be not twice as likely but 8 times as likely as other Indian heterosexual men to be HIV-positive?

The fact of the matter is that testing HIV-positive does not mark infection by a sexually transmitted agent, it is a sign of physiological stress. That physically and sexually abused women are 4 times as likely as untroubled women to be seriously stressed should be no surprise to anyone, not even to researchers who conjure up imaginative grant proposals.