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This post was published on 05/05/11 in Condomania, Good sex and bad.

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  1. Comment by Eren Bilgin, 11/05/11, 05:29:

    Your comments in the attached file are great. This information needs be repeated and repeated. I wonder if the people writing the guidelines are unaware of the realities, don’t want to rock the boat or think they can’t.

    It’s refreshing to hear everything you’ve got to say knowing your education and experience in epidemiology. I would like to hear more scientists being vocal about public health guidelines all over the world which give advice that is not ‘likely to be actionable.’

  2. Comment by Juliana, 15/05/11, 06:41:

    Wow, what a depressing article, though very informative. I think that there needs to be a middle ground between both, stressing that constant condom use is the most effective way, and providing advice for those moments when people choose not to use them. Right?

  3. Comment by Merrian Brooks, 19/06/11, 07:56:

    As a physician, I see this as a problem with patient education in general. Its equally frowned upon to advise with nuances in other areas ie hey kid smoking cigs is bad for you and heres why, but if you’re going to do it stop by age 25 and studies show your lungs should heal. I think it is partially related to the way that physicians want patients to just ‘do what I say’ instead of ‘if you won’t take all of your pills take these 3 most important ones’ and the simplified message that public health workers shoot out in order to appeal to the masses like ‘always wear a helmet’ vs ‘if you don’t always wear a helmet at least wear one on the road where more serious injury can occur’ Guess the second one doesn’t fit onto a poster very well… Thanks for your blog in general I enjoy reading your honest perspectives.

  4. Comment by Bryan, 23/06/11, 04:00:

    I don’t disagree with the idea that public health messages need to be realistic, obviously people will incur risks for any number of reasons…least of which, they just want to. But I know many gay men who feel that “topping” sans rubber is safe (ie. they can’t contract HIV doing this). Obviously, it’s not “safe.” Truthfully though, we don’t quite know enough yet to determine how risky it is. There are still many unanswered questions regarding how infectious anal mucous is, what kind of tearing goes on in the anus and the presence of blood in anal sex (gross, but it’s very common!), the role of circumcision, and problems with response bias among gay men (they don’t like to say that their “bottoms” or ever “bareback.”) …

  5. Comment by Daniel Reeders, 21/07/11, 10:51:

    I honestly believe the problem is there are so many BORING PEOPLE writing these strategies and recommendations, people who’ve never taken a risk in their entire lives. This produces what Paul Ward has called “epistemological dissonance”, so even if we give feedback, they won’t understand why we’re saying what we do.

  6. Comment by Andy, 24/01/12, 11:16:

    Bullsh*t. Part of the problem with HIV prevention – at least in the developed world with gay men – is that we’ve shifted the burden of prevention to people that already have the virus. These are the very people who have the least to gain from prevention. Altruism sounds great, but its nit a rational public health expectation. Telling poz guys to “wear a comdom” to protect someone else is so idiotic, so against human nature, and so plainly condescending that it makes me want to vomit. Telling gay men with HIV that they should “always use a condom” when they top makes a nice sentiment when undertaken as a voluntary measure, but doesn’t do anything for the masses who aren’t so nice, the majority of poz gay men who rightfully feel maligned by the focus on prevention or the 50% of poz guys who don’t know their status. How about this: negative? Want to stay that way? Wrap it up.

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