CDC - Estimates of new HIV infections in the United States | Hacker News Reader

CDC - Estimates of new HIV infections in the United States

cdc.gov

14 pointsyapcguy16 comments

I was surprised to see black heterosexual women ahead of any group other than homosexual men--and by a large margin. I wondered why this would be. Some ideas:

1) Black heterosexual women are more likely to have sex with black heterosexual men, who are in turn more likely to have HIV (according to the same data). The black male population has fewer cases than the females, but this might be reconciled by noting that male-to-female transmission is more likely than the reverse.

2) Perhaps the bigger risk factor for heterosexual women is not being black, but being poor. TFA does not include a breakdown by socioeconomics. Or perhaps, the risk factor for women is being part of a community with a high rate of male imprisonment.

Related to the above, it seems that male-to-female transmission during sex is more likely then the reverse in high-income countries like the US, but this does not hold in low-income countries. So that raises another question of why. See http://www.aidsmap.com/Estimated-risk-per-exposure/page/1324...

There are a whole bunch of possibilities, and I don't claim to know which are most true, but presenting a simple graph that says black women get HIV a lot seems a little...not helpful?

Edited to add: I dug up a study from three years ago by the very same CDC which specifically says it's poverty more than race that matters. So why are they publishing charts that highlight race and ignore poverty? See here: http://www.cdc.gov/nchhstp/newsroom/povertyandhivpressreleas...

>>Perhaps the bigger risk factor for heterosexual women is not being black, but being poor.

I'm confident you're correct; this has everything to do with being poor/middle-class/rich than race. But you can't see people's net-worth as easily as physical features so we continue to publish studies grouping people by race. I mean really, as if HIV is just waiting to get me because of my brown skin...

What would be the drivers? Lack of education about safe sex habits?

Other than that, I'm not sure why socioeconomic status would be so correlated with new infections.

HIV is just waiting to get you because of your low bank balance.

Well played. I laughed, but see my reply to another commentor: https://news.ycombinator.com/item?id=6949440

I admit without my more detailed explanation, you'd be right. low bank balance is just as absurd a cause for increased HIV infections as my brown skin is.

Your explanation of why socio-econimic status might be correlated with HIV makes sense.

However I still think your dismissal of race as having independent explanatory power is wrong.

For example, race has independent explanatory power in predicting crime rates, even after taking into account many other social and economic variable. This doesn't mean that skin color causes crime, e.g. there could be (and almost certainly are) very many social factors that are correlated with race but hard to measure objectively.

Ah, well if you're poor & living in a poor neighborhood then the following are more likely:

  - Low income tends to imply low education, so maybe not
   fully understanding the risks of HIV. 
  In some parts of Africa they think(thought) 
  that sleeping with a virgin would cure men of HIV. 
  That's an education problem in the poorer parts of the continent.

  - Prostitution is probably nearby.

  - Stress of life living paycheck-to-paycheck, can't 
  afford vacations, one of the few things you can enjoy 
  at some random parties & nightclubs is random hook-ups
  with whatever person you can get.

  - Drugs an unclean needles 'n such.

With well off people those above still happens, but in a different way sorta.

- middle-class to wealthy understand how HIV works for the most part and will more often avoid the risky behaviors

- Prostitution is not needed when you can hook-up with the random co-worker or at some university party with smart people who are more likely than not HIV-free. Then there's what I like to call "high class legal prostitution": http://www.prlog.org/12074839-gold-digger-cruise-connects-be... We know what's probably happening on that cruise... Also expensive high class gentlemen's clubs...

Drugs for middle-class/rich? They don't have to buy/share them off the street from random people like poor people have to. They order from reddit's sheepmarketplace or silkroad!!!

Education is a critical one. Lack of stable relationships in poor communities (money issues being a key factor in many divorces). Injection drug use without sterile supplies (which cost money in most places). Substance abuse is higher in some poor communities in the US, which even aside from injection drugs might be an accelerant for HIV transmission, e.g. drunk people may not practice safe sex even though they normally would, or they may have sex with people they normally would avoid.

There are three times as many white people as black people in the US living below the poverty line (absolute numbers, not percent). So if it was just a poverty issue, you'd expect to see more HIV cases amongst white heterosexuals than black heterosexuals.

in 2010: 31 million white 10 million black 13 million hispanic

http://www.infoplease.com/ipa/A0104525.html

Because of the fact that it uses MSM (male having sex with male as means of transmission) rather than "homosexual orientation) it is entirely possible that a male in this chart that contracted HIV from prison rape or opportunistic homosexual sex could then upon leaving prison, infect a woman who on the chart would be listed in the heterosexual category. So that is a possible connection to prison, and the high incidence of imprisoned black males specifically. Complete speculation on my part though.

I am guessing the reason that the categories are across race and (very roughly) sexual orientation is because those are the groupings you would have to address prevention and treatment programs by for the most effectiveness. As a class poor people may get HIV more than the rich, but a program for homosexuals is not going to be the same as for heterosexuals, and there are probably social reasons why there would be different programs for blacks and whites. But again, just speculation.

Interesting...but I don't think hacker news is the right place to share this type of article.

It's not irrelevant. Look through the HN guidelines [1]. Articles like this are definitely acceptable.

Hacker News Guidelines - What to Submit

On-Topic: Anything that good hackers would find interesting. That includes more than hacking and startups. If you had to reduce it to a sentence, the answer might be: anything that gratifies one's intellectual curiosity.

[1] http://ycombinator.com/newsguidelines.html

I actually think this particular article is not very good (see my top-level comment). However, this topic is one of the most important issues facing younger adults today. If the logical thinking, cold rationality, problem solving, and technical skills of this community can be applied to dealing with diseases like HIV, malaria, etc., it seems worth encouraging.

The article doesn't really seem to mention what IDU/MSM mean:

MSM: Men who have Sex with Men IDU: Injection Drug Users

The reasons why these people are at extra risk should be obvious :)

That is some of the most racist, homophobic garbage I have seen. Which shitlord funded this study? Probably the Koch brothers.

Please explain why you felt the study was racist and homophobic. Was it simply because it categorized new infections by race and sexual orientation?

I'm not sure I understand.

Reply on news.ycombinator.com