The gay rights community is wrong about blood donations (again)

[Magic Man]

Well, how exactly would you differentiate between the two types of anal sex? If your argument is that only those who receive anal are significantly more at risk, how would you go about excluding only them from donating blood? I mean, that would have to be one very detailed questionnaire.

No, it wouldn't. Instead of asking "Have you ever had sex with a man?", you ask "Have you ever received anal intercourse from a man?", for instance.

And I was not aware that there is so much specialization among homosexuals. Are you saying there is a significant portion of gays who only practice the one...ahem...position?

No, I'm not, but that misses the point. The point is that asking a more specific question directed at the root cause, you get a better idea of who is and who isn't infected.

 

[SoyLeche]

Maybe, but not by enough to make a distinction.

Depends on how much higher than 1.54x the likelihood is. If your partner is actually 3x more likely to have HIV then the likelihood of having it transmitted is ~2x as high. If he is 15.4x more likely then you are 10x more likely to get the disease.

 

[Commoner]

No, it wouldn't. Instead of asking "Have you ever had sex with a man?", you ask "Have you ever received anal intercourse from a man?", for instance.

Well, with all due respect, that seems like a really poor question. I would certainly misinterpret it.

No, I'm not, but that misses the point. The point is that asking a more specific question directed at the root cause, you get a better idea of who is and who isn't infected.

Ok...but when you first argue that the reason not all MSM should be excluded, since the rates of infections differ significantly depending on the manner of intercourse and then cannot show that there is a significant portion (or even one statistically different than zero) of individuals practicing MSM that only "pitch", aren't you contradicting yourself?

Either there is a need for more specific questions, or there isn't. Both premises - that one form of anal sex carries with it a significantly higher risk of infection while the other does not, and that there is a significant portion of individuals who do not practice both types (or just the high-risk type) of anal sex - must be true in order to justify it.

Plus, you would have to make sure that the questions you pose are clear and unambiguous, so that a true differentiation can be made. And with each level of detail that becomes more and more difficult. So, even if I accept both premises to be true, it might not be possible to implement in practice. But, if both premises are true and a practical implementation is possible, then I agree it should be done.

But from what I can tell, that's not at all the argument the gay community is making and is, while worty of consideration, really not the crux of the issue.

 

[Magic Man]

Ok...but when you first argue that the reason not all MSM should be excluded, since the rates of infections differ significantly depending on the manner of intercourse and then cannot show that there is a significant portion (or even one statistically different than zero) of individuals practicing MSM that only "pitch", aren't you contradicting yourself?

No, all I want is for the questions to be as relevant as possible. Asking someone whether they've ever had sex with a man is not the best question to use. There are many other more specific questions that would do a much better job.

 

[SoyLeche]

Either there is a need for more specific questions, or there isn't. Both premises - that one form of anal sex carries with it a significantly higher risk of infection while the other does not, and that there is a significant portion of individuals who do not practice both types (or just the high-risk type) of anal sex - must be true in order to justify it.

Also - I know I'm harping on this, so I'll stop after this unless it needs to be harped on again - the form that has less risk of infection requires having sex with someone who is of higher risk of being infected. Low probability times high exposure can still end up being high* probability.

*higher than the general population at least, and in all liklihood significantly higher.

 

[SoyLeche]

No, all I want is for the questions to be as relevant as possible. Asking someone whether they've ever had sex with a man is not the best question to use. There are many other more specific questions that would do a much better job.

And the FDA disagrees with you - and they are working with empirical evidence rather than merely assuming.

 

[Commoner]

No, all I want is for the questions to be as relevant as possible. Asking someone whether they've ever had sex with a man is not the best question to use. There are many other more specific questions that would do a much better job.

Well, that actually has to be demonstrated, I'm sure they didn't just pick a guy off the street to come up with the questions.

I'll say it again - there must be a significant enough portion of individuals practicing MSM that only practice the safer type of sex for that to even be applicable. If you want to ask more detailed questions, not only more personal, but ones more likely to be misunderstood, you must balance that negative effect with the positive effect of having fewer people excluded - there must be a significant amount of people that would benefit from it. I don't believe there is a significant amount of such individuals - but...I've already conceeded that, if there are (and assuming, for the sake of argument, that the risk is indeed low), then I'm for it.

Otherwise, why not get more specific - there are ways to have anal sex that carries with in absolutely no risk of an infection, if you know what I mean. So maybe your question isn't specific enough?

 

[Magic Man]

And the FDA disagrees with you - and they are working with empirical evidence rather than merely assuming.

Who's assuming? I'm working with empirical evidence, too. The empirical evidence says that receiving anal sex is much riskier than giving it. Logic and empirical evidence suggest that "Have you ever had sex with a man?" is not the best question to ask, unless you just don't care about how many good donors you exclude.

 

[Magic Man]

So maybe your question isn't specific enough?

It's not. It was an example. I wouldn't advocate that particular question, just questions that get to the heart of the matter, rather than superficial ones like "Have you ever had sex with a man?".

Edit: It's like trying to find out which potential mate will die young on you, and asking them whether or not the drive a car. Anyone who drives a car is at risk of being killed in a crash. The relevant questions would be about how you drive the car. If you drive a normal speed, don't smoke, eat or do anything else out of the ordinary while driving, and you obey all traffic laws, you're at significantly less risk than just someone who drives a car.

 

[SoyLeche]

Who's assuming? I'm working with empirical evidence, too. The empirical evidence says that receiving anal sex is much riskier than giving it. Logic and empirical evidence suggest that "Have you ever had sex with a man?" is not the best question to ask, unless you just don't care about how many good donors you exclude.

The empirical evidence that you have indicates that recieving anal sex is riskier than giving it. It says nothing about whether or not having sex with a man is riskier than not having sex with a man.

You seem to be assuming that since other ways of having sex with a man aren't as risky as receiving anal that means they aren't risky. That's not a foregone conclusion.

 

[Gunfingers]

It's worth noting that also deferred from donation are people who have had sex with MSM. So, for example, a woman who has banged a bi guy cannot give blood. Their deferral is only 12 months, however.

Eligibility Criteria by Topic | American Red Cross

 

[SoyLeche]

Some forms of insurance utilize models called "loss models". These models usually combine two separate models: a "frequency" model and a "severity" model.

Something could not happen very often, but if it is severe enough then the probability of loss may be high enough to be of concern. Likewise, something could happen several times an hour, but if it isn't very severe the probability of loss could be small and not need to be worried about.

You are focusing on the severity part of the equation and ignoring the frequency. You're only getting a part of the entire puzzle.

 

[SoyLeche]

It's not. It was an example. I wouldn't advocate that particular question, just questions that get to the heart of the matter, rather than superficial ones like "Have you ever had sex with a man?".

Edit: It's like trying to find out which potential mate will die young on you, and asking them whether or not the drive a car. Anyone who drives a car is at risk of being killed in a crash. The relevant questions would be about how you drive the car. If you drive a normal speed, don't smoke, eat or do anything else out of the ordinary while driving, and you obey all traffic laws, you're at significantly less risk than just someone who drives a car.

But, are you significantly more risky than someone who doesn't drive a car? That's a question you are ignoring.

In your car example, probably not. In the MSM question we don't have enough data to determine it.

 

[Magic Man]

It's worth noting that also deferred from donation are people who have had sex with MSM. So, for example, a woman who has banged a bi guy cannot give blood. Their deferral is only 12 months, however.

Eligibility Criteria by Topic | American Red Cross

That's actually very worth noting. Why would they be eligible after 12 months? Shouldn't they be rejected for life just like a man who has had sex with another man?

 

[Magic Man]

But, are you significantly more risky than someone who doesn't drive a car? That's a question you are ignoring.

I'm not ignoring the question. The answer is obvious. The point is that asking whether someone drives a car isn't the best way to find out whether they're going to die in a car crash. Someone who rides, but doesn't drive might be just as risky. Someone who rides a bus instead might be just as risky. If you want to know whether the person is at risk of being killed in a crash, the best way to find out would be to ask about their driving habits, not just whether or not they drive.

 

[SoyLeche]

I'm not ignoring the question. The answer is obvious. The point is that asking whether someone drives a car isn't the best way to find out whether they're going to die in a car crash. Someone who rides, but doesn't drive might be just as risky. Someone who rides a bus instead might be just as risky. If you want to know whether the person is at risk of being killed in a crash, the best way to find out would be to ask about their driving habits, not just whether or not they drive.

BUT - if just the act of driving puts you at significantly more risk than not driving - EVEN IF other aspect may put you at EVEN MORE risk - then it's possible that excluding all drivers from your pool may significantly reduce the chance of having your partner die.

The question isn't "what's the riskiest thing you can do". It's "does this action put you at significantly more risk than not doing this action".

Let's assume your risk threshold is 1%, and non-drivers have a 0.5% chance of dying, drivers who don't text have a 1.1% chance of dying, and texting-while-driving-ers have a 5% chance of dying.

Asking "do you drive" gets rid of those above your threshold - including the texters. If I only excluded the texters I'd still have more risk than my threshold.

 

[SoyLeche]

I'm not ignoring the question. The answer is obvious. The point is that asking whether someone drives a car isn't the best way to find out whether they're going to die in a car crash. Someone who rides, but doesn't drive might be just as risky. Someone who rides a bus instead might be just as risky. If you want to know whether the person is at risk of being killed in a crash, the best way to find out would be to ask about their driving habits, not just whether or not they drive.

See all of those "might"s in there. They could just as easily be "might not"s. Deduction isn't going to get you any closer than "might". A statistical analysis would be much better.

 

[Magic Man]

BUT - if just the act of driving puts you at significantly more risk than not driving - EVEN IF other aspect may put you at EVEN MORE risk - then it's possible that excluding all drivers from your pool may significantly reduce the chance of having your partner die.

Yes, it is. However, since 90+% of people in your age group drive, it's not very conducive to finding a mate.

The question isn't "what's the riskiest thing you can do". It's "does this action put you at significantly more risk than not doing this action".

No, the question is "Are you at enough of a risk for me to exclude you without narrowing down my options too much?"

 

[Magic Man]

See all of those "might"s in there. They could just as easily be "might not"s. Deduction isn't going to get you any closer than "might". A statistical analysis would be much better.

That's why it's an analogy. It's supposed to show a point more easily than the example we're talking about. I never said it's perfect, but it shows the point I'm trying to get across, which you still seem to be missing.

 

[SoyLeche]

That's why it's an analogy. It's supposed to show a point more easily than the example we're talking about. I never said it's perfect, but it shows the point I'm trying to get across, which you still seem to be missing.

But it's not, because it has oversimplified the problem. You've gone to an extreme, where your logic makes some sense. The actual problem we are discussing isn't anywhere near the extreme, and other concerns pop up when you get into it.