Why are Primark promoting "Found Family"

[WandaWomblesaurus]

www.primark.com/en-us/a/inspiration/special-occasions/celebrating-found-families

"A Found Family Is About Finally Feeling Whole, Something That Might Be Absent In Your Biological Family, Like A Full Set Of Acrylic Nails Or A Good Pair Of Fake Lashes. It’s A Community You Choose, Whose Values And Honesty Speak To Your Own."
- Jude & Michael, Germany

What???

Can you post the wording of the "absolute zero" statement by the PARTNER study research team please @TeaKlaxon?

Insult me as much as you want @TeaKlaxon, I don't care

Why do you think they need to insert the word "effectively"?

Are you also lacking a dictionary?

Effectively: used when you describe what the real result of a situation is

So my guess is they used effectively convey that the real result of the situation was zero transmission risk.

Please understand that I am not trying to restigmatise. God forbid. The important message is to get tested and adhere to the medication regime and HIV+ people can lead long and healthy lives. This is incredible.

It is understandable that NGO’s and govts want that message widely disseminated. However, the conversation started about consent and informed consent. I’m not getting into the legalities because as TeaKlaxon points out, it’s not legally mandated.

However, ethically it is important to provide information about one’s HIV+ status because it can never be proven beyond a shadow of a doubt that an undetectable VL will 100% forever guarantee no transmission. Surely @TeaKlaxon you understand this point from purely a scientific perspective? They are talking statistically, not in absolutes. It is a great finding, but one taken within the parameters of those studies over those set time frames.

During eligible couple-years of follow-up, couples reported condomless anal sex a total of 76 088 times. 288 (37%) of 777 HIV-negative men reported condomless sex with other partners. 15 new HIV infections occurred during eligible couple-years of follow-up, but none were phylogenetically linked within-couple transmissions, resulting in an HIV transmission rate of zero (upper 95% CI 0·23 per 100 couple-years of follow-up).

This is the Partners study…
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19%2930418-0/fulltext

So my guess is they used effectively convey that the real result of the situation was zero transmission risk.

See, I think it's because they don't want to say it's zero without qualification (why would you add this qualification?) because it isn't. And you know that full well. Hence this lame dictionary dive.

The study explicitly says, in the interpretation of its results:

“Our results provide a similar level of evidence on viral suppression and HIV transmission risk for gay men to that previously generated for heterosexual couples…the risk of HIV transmission in gay couples through condomless sex when HIV viral load is suppressed is effectively zero. Our findings support the message of the U=U (undetectable equals untransmittable) campaign”

effectively zero.

What you think ‘effectively zero’ means ‘not actually zero’?

I mean that’s just not what words mean.

I mean, that is exactly what it means.

you understand this point from purely a scientific perspective? They are talking statistically, not in absolutes.

I don't think @TeaKlaxon understands it, no.

How did that 90% catch it?

Collins dictionary:

You use effectively with a statement or opinionn^ to indicate that it is not accuratee^ in every detaill^, but that you feell^ it is a reasonablee^ descriptionn^ or summaryy^ of a particular situation.
"This effectively means that the government does not agree with the proposals."
"The region was effectively independent. "

Hopefully this should explain things a little more clearly in context if you read the British HIV Association consensus statement, the section on terminology and the messaging link.
https://www.bhiva.org/BHIVA-endorses-U-U-consensus-statement

Thanks for that, but it smacks of political lobbying to me, and it makes me mistrust their framing.

Ah ok, so including reading the links mentioned you’re resistant to believing the information provided by the most informed and knowledgable organisations in the world on the basis that it’s political 🤨

As you will notice if you advance search my posts, I read a wide variety of opinions and make my own mind up, and appeals to authority leave me unmoved. It seems to me like the research was carried out with the goal of "proving" the wanted outcome, that sexual partners were not at risk if the viral load was "undetectable". They mention the slogan in the research paper. That's fine and I'm sure it was carried out in the proper scientific manner, but there's a level of bias. Like transgender medicine, it's political.

Our results provide a similar level of evidence on viral suppression and HIV transmission risk for gay men to that previously generated for heterosexual couples and suggest that the risk of HIV transmission in gay couples through condomless sex when HIV viral load is suppressed is effectively zero. Our findings support the message of the U=U (undetectable equals untransmittable) campaign, and the benefits of early testing and treatment for HIV.

Also note the careful scientific language. Science doesn't deal in absolutes. My bolding.

At some point you really have to wonder what someone gains from spending a big chunk of time trying to convince people that there is a HIV transmission risk when there actually isn’t. And spend a lot of time pretending that their opinion is worth more than the universal scientific consensus, shared by the WHO and virtually all leading health institutes.

What possible reason would that person have to artificially inflate stigma around a condition that has disproportionately affected the LGBT+ community?

Totally agree - it had the desired effect at the time in creating fear and many years later those tombstone ads still resonate with those of us who were around then around then. An ad in France used a scorpion. Difficult to let go of in this time of effective far better tolerated and simplified ART. It also took a while to learn how it was transmitted and how it’s not transmitted yet today some people still think it can be caught from toilet seats or sharing drinks - something I personally experienced.

I was working and travelling in the 80s in places like Australia, spending evenings in the gay bars down Oxford St in Sydney and remember my gay flatmate saying he didn’t want to catch AIDS. Also time in South Africa and Botswana. I never really thought at the time that it would ever be so relevant to me. I thought if it more as AIDS in my head when first diagnosed as did a friend I told even though I’d only recently contracted the virus - it can be difficult to change that mindset.

A massive campaign would help I agree. It’s a shame the It’s a Sin series didn’t continue to the present day as originally planned - I still live in hope a second series will be commissioned. Increasing knowledge in the general public (and for them to believe it), stigma from others, self stigma and the way people with HIV feel about it themselves often leading to suicidal ideation, isolation, dropping out of care and other challenges facing a lot of people with HIV are all things that need addressing. The meds themselves controlling the virus are only a small part of it really.

And yes to the last bit (my mum wouldn’t have had a clue, bless her, as she only ever had sex with my dad) and something I’ve told my DC although they already know this. Testing is the only way to know (taking the window period into account) however well you know the person, and then as in any relationship it’s about trust. It’s great nowadays that postal tests are easily available.

I am completely ready to accept the findings of these, no doubt, carefully managed research cohort studies. The findings across several studies were replicated and are great news and reassuring. There is no wish to restigmatise anyone. Jesus. I recall so clearly how my dear friend didn’t want to tell friends because of fear of rejection.

If there is a ‘political’ aspect, I believe it would be an understandable and laudable desire to perpetuate the message on the importance of getting tested and adhering to the medication regime. This message is vital to reducing transmission rates and I am not trying to take anything away from that message or that goal.

This issue of zero transmission came up in a discussion on informed consent. So, on the one hand, no research deals in absolutes. That language is deliberate to convey this and to convey the parameters of the findings ie using the phrase ‘effectively zero’. This is why the findings state upper 95% CI 0·23 per 100 couple-years of follow-up ie a confidence interval of 95% 0.23 over several years of follow up.

On the other, the HIV medical community may have felt, on balance, population transmission rates will be lower by encouraging people to get tested and stay on the medication and perpetuating the message that there’s no need to inform if risk of transmission is effectively zero. About the latter, I have no knowledge. Is this something explicitly stated by the medical community? Is current advice explicit on ‘no need to inform’ potential partners?

It’s been many many years since I was involved in HIV care and no doubt discussions will have moved on keeping in mind that the medical community is concerned at a population level whereas morality is individualistic ie personal choices about what’s right and wrong. I’m not saying it isn’t difficult to navigate. But agree with @Boiledbeetle that no unprotected sex until tested (after no risk of seroconversion) is the only way to be sure. However, humans being human and complicated, that is never going to be wholly the case. So thank god for ART.

My sole reason for bringing any of this up is that I believe it's deeply immoral to withhold that you have this sexually transmitted disease from a sex partner. It's a consent issue. I do accept that the risk is very small. I don't accept that it is zero, or that morally it's up to the HIV positive person whether they tell a sex partner.

And you know this @TeaKlaxon which is why you won't discuss the morality of it.

On the other, the HIV medical community may have felt, on balance, population transmission rates will be lower by encouraging people to get tested and stay on the medication and perpetuating the message that there’s no need to inform if risk of transmission is effectively zero. About the latter, I have no knowledge. Is this something explicitly stated by the medical community? Is current advice explicit on ‘no need to inform’ potential partners?

Yes of course it is hugely reassuring to know that once undetectable for over 6 months we can't pass it on through sex. I couldn't wait to start meds and get the shit kicked out of the virus and put it back in its box (so to speak) and take back control over my life.

It's more about choice to inform rather than explicitely stated as no need to and this can be individual in various scenarios. When we see our clinicians whether consultant or HIV nurse we have this explained to us. If in a relationship when diagnosed sharing this information with them is discussed so they can be invited in to get tested, and also partner notification regarding previous partners. In any future relationship, once UD it is more about choice and what we wish to do. We might have conversations with the clinic nurse or peer support for those who access it about ONS (I'm wondering how much people generally bring up risk of any STIs whether wearing condoms or not here and if there have been any studies done?). We also might discuss relationships, starting them and when to share.

Here's a link to BHIVA non tech guidance summary version includes a link to the full guideleines. https://www.bhiva.org/file/6356610071a8d/BHIVA-ART-guidelines-NTS.pdf

So @TeaKlaxon 's repeated conflation of legality with morality is because they clearly think it should work like this: I ask a potential partner if they are HIV+, the other person is but says they're not, the lying party is not in the wrong.

There's another thread on here right now where a woman deceived a partially sighted girl into thinking she was having sex with a boy rather than a woman. People are rightly agreeing this sort of obtaining sex by deception is wrong. But by Klaxon's logic it's not because there's no physical harm called (we'll set aside the fact many here do not agree there's no risk from having sex with a HIV+ person). And because there's stigma attached to being trans / presenting as the opposite sex so the partner has no right to know.

I mean to me, whether someone is HIV+ or not is a much bigger deal than whether someone is male or female - that's how I am. But no doubt Klaxon will attempt to argue that their idea of what should or shouldn't matter is valid and mine is not. To me it's fairly clear though: If you have to lie in order to get someone to have sex with you, then you're being unethical. That doesn't matter if it's marital status, STDs or your sex - you're deceiving someone into doing something they wouldn't otherwise.

If someone says to you: "I want to know you're not HIV+ before I have sex with you" then your ethical options are to give them an honest answer and let them to decide or to say "I wont discuss it" and let them make a pretty damn educated guess as to what the reality is and decide accordingly. Anything else is wrong.