Ah, well Jack... If you have developed a sense of saying what you mean rather than what you think you want others to think you mean, we can all play at that game...

Stop reading the fucking thing then. It isn't hard, just hover your mouse away from the thread title before clicking. A bit like thinking before clicking the keyboard.

You really haven't worked out the jet set have you? Ski is soooo last winter! Golly gosh, Johnny Foreigner, no wonder you pass the port the wrong way and struggle with the fish knives! One is orf to Dublin at the weekend to observe the American ritual of Paddy's Day that they imported there a few years ago. Apparently it coincides with a church observance of theirs. Rather jolly fun all the same. They do this drinkypoo called an Irish cocktail. A pint of that black stuff they inflict on the working classes with a potato stuck in the top. Not very sophisticated but goes down well with the Paddy and the Power.

MSM aren't the most effected, but there is evidence to support they have been hitherto over represented in terms of being affected.

Two words there Keith, affected and hitherto. Your use of the word effected was somewhat Freudian but I'll not pick you up on that. You pick me up but reciprocating isn't cricket.

How many times do I have to repeat the information coming from commissioning support units and PHE to providers of sexual health services? The historical position is based on

a) anal sex being an efficient transmission therefore an explosion (dramatic use of the word epidemic for good reason) in the '80s which went through the well worn stages of immediate decline followed by complacent rise followed by steady rise followed by small numbers informing a steady rise trajectory.

b). Due to the success of public health promotion, rise in drop in clinics and awareness, more gay men seek screening than other groups. This, considering the small numbers involved, (a nationwide screening service that even when combined with routine screening as part of other tests in primary and secondary care picks up a few thousand nationwide, out of a population of sixty odd million,) leads to more MSM occurrence on the statistics. If you only counted anonymous drop in clinics, it would be skewed even more towards MSM.

c). They are still a very high risk group, but only in terms of the few who practice unprotected anal sex with new partners. There are far more women do that than men who receive.

d). The age demographic demonstrates older men contracting the condition in larger numbers than expected. Hence the need to remain vigilant with regard to unknown positive condition.

Those are my words, but lifted in context from a paper going to the specialised commissioning board for a region of England shortly. The paper was written by a consultant in public health as part of his attachment to PHE. Once it is in the public domain, May, if you really want, I can forward it to you.

In short, you continually accuse me of complacency and extend that to the sexual health services on the basis that you disagree with me therefore the work I am involved in. I Must be wrong because Keith knows more than a successful sexual health service nationally.

There is an issue for MSM based on prevalence, but an even larger issue for other groups, based on both statistics for other health issues such as colo rectal, and indeed seeing the rise in non gay contraction in other countries, especially Africa. Don't forget that it used to be seen as a gay issue around that continent too.....

Promiscuity in gay men has a higher chance of HIV than promiscuous lifestyle in heterosexual men. No denying that, and the reason is nothing more and nothing less than anus wall tissue being, just like under the tongue, a good transmitter of external chemicals to the rest of the body. This is why suppositories are popular in France, and many quick action tablets are under the tongue type here.

None of this fits with a programme of targeting gay men, whether for good or evil purposes. Stigmatising will make Akenaton's analysis a self fulfilling prophesy.

Now. Here are the rules. I was quoting PHE, and the report it was in cites many published papers, comprising of meta analysis. Cochrane studies, various reports of local directors of public health and background study for clinical trials of medicines allied to the condition. Published in BMJ, Lancet, NEJM and others.

Your task, should you wish to accept, is to put forward evidence that could counter the argument . It isn't hard, and I am already seeing some of it questioned by real people who I would be advised to listen to. If you want to influence debate here, your questioning would have to be as objective and informed as that I have in front of me, (ok, opened in a Word file I pulled) and not in the slightest driven by prejudice or agenda.

Thought not.


Out of interest, I have nothing to do with that proposal, but a proposal for mobile screening units for certain cancers is also on the agenda and that is my interest in the meeting.