A Day In Photos… And In Propaganda

Hey, dig the latest produce from my rooftop garden.  I’m a farmer!

Here’s a photo of a little known street behind the Central Reference Library in downtown Toronto:

I get it. Sherlock Holmes was a major literary character, and the street is behind a big building full of books. But what an odd choice for a street name in Toronto! Are there any Canadian literary characters worth celebrating? Actually, I can’t think of any.

More concerning is that City Council chose to celebrate Holmes and not his creator, Sir Arthur Conan Doyle.  Makes me wonder how many Torontonians actually realize that Holmes was fictional, and that Conan Doyle was real.  Hmm.

The last photo I will share with you is essentially a follow-up of my 2007 post called “Abuse of Numbers“.  In that post, I railed against a well-meaning ad by a women’s shelter that presented statistics in such a way that, in my opinion, ended up being propagandistic.  Go have a quick look at that post before continuing to read.  Go.  I’ll wait.

Okay, back?  Cool.  Now check out this ad I saw in a Toronto subway station:

It’s put out by the Canadian Foundation for AIDS Research (CANFAR) and says, “Did you know that 86% of HIV Positive Canadians are male, And 2/3 of boys, aged 15 to 19 are sexually active? You think your kids aren’t at risk? Think again.”

All right, epidemiology fans, who sees the problem with this quote? (Other than the questionable grammar, that is.)

Well, the concept of risk is a touchy thing.  It’s not a lie: everyone is at risk for pretty much everything.  And HIV/AIDS is a serious disease worldwide that needs our attention and resources….

…BUT, the data as presented in this ad are propagandistic because they have been selected for their largeness and their emotional appeal moreso than for their accuracy in representing the true scenario.  It is true that about 86% of Canadian HIV Positive people are male.  CANFAR itself states that about 58000 people are living with HIV in Canada.  Using their 86% statistic, that means that 49880 males are living with HIV.

Note that the ad says “male”, not “men”.  According to the same CANFAR page, “youth between the ages of 15 and 19 account for 1.5% of all reports”.  So atuomatically we see some duplicity in the ad, trying to conflate “male” with “men”, when in fact the thrust of the ad is to warn of youth behaviour.  Yes, I know the implication is that male youths grow up to become men, but I think the propagandistic elements here are obvious.

So, of our 49880 males with HIV, about 98.5% are adults, giving us 49132 cases, to be generous.  Each case is a tragedy that should have been avoided, to be sure.   But 49132 cases, divided by a denominator of  16,332,277 total adult males gives us a prevalence estimate of adult men living with HIV of 0.3%.    Obviously, 0.3% is not as impressive a number as 86%.

But let’s consider the thrust of the ad again: it warns of sexual activity among male youths and the risk of HIV.  Okay, but not all of the prevalent HIV cases were the result of unprotected sex.  Some were the result of drug abuse, or transfusions, for example.  So let’s break down the transmission stats.  It is believed that sex of any kind is responsible for the bulk of HIV cases in Canada, with the bulk of those cases due to gay sex (or as we in the business call it, “MSM” or “Men Who have Sex With Men”).  According to Avert.org, sexual contact constitutes about 44% of cumulative HIV cases over the past 15 or so years.

Using the most recent complete data of 2007, it seems that sex was responsible for 37% of male HIV diagnoses in that year alone, and that includes cases of mixing sex with IV drug use.  Among those, heterosexual contact accounted for 18% of all sex-based cases, or 7% of all adult male HIV cases overall.  And heterosexual contact still remains the most prominent form of sex among Canadian males.  (Looking at cumulative stats from 1985 to 2007, heterosexual contact accounted for 6.2% of all Canadian male HIV cases.)

Overall, then, the prevalence of Canadian males currently living with HIV who likely got it from sex (including sex mixed with IV drug use) is about 44% of 0.3%, or 0.13%.  In my opinion, then, 0.13% more accurately represents the risk of of being sexually active, where HIV is concerned in Canada.

To get even more sticky (no pun intended), the risk of being a Canadian man living with HIV, having contracted it through heterosexual contact, is about 6.2% of 0.3%, or 0.02%.  (Another way to look at it is to divide the 3000 cases of known male HIV cases due to heterosexual contact by the 16 million at-risk male population, which also gives 0.02%).

Obviously, neither 0.13% nor 0.02% are as impressive numbers as 86%.

Lastly, the ad makes a sly connection between a problematic allusion to HIV rates (i.e., 86% of HIV positive cases are male) and sexual activity among young people (i.e., 2/3 of males aged 15 to 19 are sexually active).  The slyness is in not spelling out the connection, which is fraught with issues, many of which are outlined above.  I hope it’s obvious that one particular pitfall really throws a wrench into the ad’s wording: sure, maybe 2/3 of youthful males are indeed sexually active; but are they having risky sex?

Risky sex is unprotected sex.  If the ad-makers knew the proportion who are having unprotected sex, or knew that proportion to be substantial, I assume they would have included that bit of information.  Without it, we are left with the following message: “sex is bad, mmkay?”

Sex is not bad.  Unprotected sex is problematic and probably unwise.  That is all.

So, are sexually active male youths not at risk for acquiring HIV?  Of course they are!  But not nearly to the extent that the misleading ad suggests.

Draw your own conclusions, but I call shenanigans on a very sloppy and anti-intellectual ad campaign by CANFAR.