On the MSM Blood Ban

CGFb3c7W0AAW9b7.jpg:largeOpposition to the UK’s (and others’…) ban on blood donations from (rather awkwardly termed) “men who have sex with men” comes to our collective attention now and then – for instance when Michael Fabricant put forward a parliamentary motion calling for its end last year.

This morning it popped back to my personal attention when a leaflet popped through the door. “If you could give up just 1 hour of your time to save or improve up to 3 lives, would you do it?” it asked. Well, yes – I would. I can’t though. Last week, it popped back to my attention when I saw the blood donation vans parked on campus – “Give Blood” they say. Well, yes – I would. I can’t though. The privilege of the majority is not being constantly aware that you’re in a minority and seeing that demonstrated through opportunities – however altruistic – denied to you. Especially when that denial is rooted in homophobia.

“NO” – you’re thinking – “it’s not homophobia, MSM have an objectively higher likelihood of being HIV positive, and we need to keep that out of the blood supply.” It’s all true. MSM are more likely to be HIV positive, there’s no denying that fact. Nor can you deny that there is slight risk that the window between infection and seroconversion means screening is not 100% effective in keeping an HIV positive person’s blood out of the blood supply. The real question, and my real objection to this ban, is why on earth we have chosen to stratify the population into MSM and non-MSM. I’ll explain, shortly, why I think this distinction is homophobic, but I think it’s worth restating the challenge faced by the Blood Service to give a common basis for understanding.

The goal of the blood service should be – and, despite what I think is misguided reliance on dubious science, is – to keep HIV positive blood out of the blood supply, so that all of us, should we ever need it, can feel confident in receiving a transfusion. In an ideal world, people who are HIV positive (or who carry other diseases like Hepatitis, or vCJD) would be excluded on safety grounds and everyone else would be encouraged to give blood. Keep that simple goal in mind.

The problem, then, is that we don’t have a completely reliable – or even “good enough” – test for HIV. It’s possible to be infected for months or even years prior to the virus becoming detectable through an antibody test (although the average is about 6 weeks) and only about half of people will develop symptoms during seroconversion. So now the challenge is a little more complex, how do we segregate the population into those considered low risk and those considered too high-a-risk to donate blood?

Those people who know they are HIV+ can be screened simply by asking them “Are you HIV+?” – This gets rid of the 80% or so (HIV Aware, 2012) of people who are diagnosed. Of the remaining 20%, many will be picked up by screening, having been infected long enough to develop HIV-specific antibodies that will be detected by the antibody test used by the UK Blood Service. The other HIV test, a nucleic acid test (NAT) is 95% effective in detecting HIV infection in individuals infected for 17 days or more. That leaves a small group of people, who have been recently infected, that cannot be removed from the donor pool either by asking them about their status or by screening their donations – the undiagnosed and undiagnosable-at-point-of-donation HIV+ population – UUHIV+.

In mathematical terms, we’re starting with a single population (of all of us, excluding known HIV+ people), with some known proportion of UUHIV+ people remaining. This is a prior probability distribution – It’s the distribution of risk that we know about, in the absence of any more information about the population.

The challenge that we have in practice, then, is to identify some set of criteria that we can use to improve our probability distribution – to learn more about the likelihood that a given person is UUHIV+.

Excluding every man who has had sex with another man in the last 12 months does do that. But so does excluding all black people, everyone below 60, or, (for a massive reduction in risk, at the expense of supply) everyone who isn’t a gold-star lesbian.

Quite reasonably (and probably in part because most of institutions are now clued-up enough about racism to spot it in their own policies) the UK Blood Service does not exclude all black people from donating blood. They do have restrictions on people who have visited certain countries in the last 6 months, though. The point is that we need to select screening criteria that are reliable and specific.

While it’s undeniable that more MSM people are HIV+, and therefore probable that, proportionally, more MSM people are UUHIV+ than the general population, it’s equally undeniable that a) the vast majority (96% for most of the UK, 92% for London *) MSM are not (and never will be) HIV+ and that b) large numbers of non-MSM people are HIV+.

It’s also undeniable that the MSM group covers a massive spectrum of risk: from monogamous long-term couples to [what’s a nice term for megasluts?], from the regularly-tested condom-obsessive to the GUM-avoiding bareback fanatic. The use of a criterion as blunt as “MSM” knowingly excludes those with negligible risk of being UUHIV+ – those who are demonstrably lower risk than many non-MSM people who ARE allowed to give blood.

Meanwhile, straight [nice-term-for-megasluts] are not excluded on the grounds of sexual behaviour – unless they think they might have had sex with an MSM.

Fundamentally: HIV is not created when two men have sex – HIV is transmitted from an HIV+ person to someone else, usually sexually. HIV transmission is not so much a function of the gender or sexuality of the people you’re having sex with, but the prevalence of HIV within the network of people you’re having sex with. A homogeneous network of two – the monogamous HIV-negative diad – isn’t at risk. In fact, the pre-1980s homogeneous network of millions wasn’t at risk until HIV was introduced into that network. It was the individual behaviours within that network – promiscuity and little use of condoms – that facilitated the rapid spread of HIV among members. Two MSM in a monogamous sexual relationship are at infinitely less risk than a non-MSM with many casual partners – the fact that MSMs, as a result of social factors (such as homophily, historic ghettoisation and culture), are at statistically higher risk is a rough correlation only.

Why, then, is being MSM in itself, rather than sexual participation in a broader “at-risk” network, used to screen blood donors? The UK ban was introduced during the early days of the AIDS epidemic – When we knew far less about HIV/AIDS but did know that it affected the gay community most. A ban at that point – in the absence of a clear understanding about what caused AIDS and no time to do the science necessary to establish specific screening criteria – was justifiable.

“Gay” is largely a term of self-identification and so, to your typically positivistic natural scientist, rather too wooly. Men who have sex with men, is, in terms of who it includes, far more objective. With very few edge cases (and only a little uncertainty about what constitutes “sex”) we all know whether we fit into that category.

Despite our knowledge that merely having sex with other men does not lead to HIV infection, and the fact that MSM covers such a wide range of behaviours with such varying degrees of HIV risk, it is still used as an objective and scientifically useful way to categorise people. What debates about objectivity (MSM) vs subjectivity (“gay”, “queer”, “on the D/L”) miss is the extent to which this division is arbitrary – and a distinction between two broad groups, MSM and everyone else, is increasingly arbitrary given documented social changes towards “post-gay” identities, social networks and hence behaviours. If MSMs ever were a homogenous group, they surely aren’t today.

Using MSM as a medical distinction blurs a whole range of complex factors, some of which correlate with HIV risk and some of which are co-incidental. MSM is a distinction that arises, in large part, because of how sexuality has come to define identity and social connections. Only a society in which a continuous spectrum (the Kinsey scale) was awkwardly divided into two discrete groups would even have stumbled into such a categorisation for epidemiological purposes.

Fundamentally, that is why the MSM blood ban is homophobic. It is a ban that denies our individual autonomy, our own understanding of (and appetite for) risk and instead reduces us to a sexuality because that’s how history has defined and marginalised us for centuries. It is a ban justified by a distinction based on two apparently objective groups, but which in reality is a distinction that results from the historic ghettoisation of MSMs, and which today is more and more arbitrary.

Yes, excluding MSMs from donating blood reduces the risk of UUHIV+ individuals donating blood, but it reduces the risk LESS than screening based on individual risk profiles and at the expense of a great deal of supply for a blood service which, it constantly tells us, is often under-supplied.

I want to see a comparison of the effectiveness of screening based on “Have you (a male) had sex with another male in the last 12 months?” and “Have you (a person) had sex with a new partner in the last six months?”, or “Have you (a person) had sex with more than three people in the last twelve months?”. These questions are justified by our increasingly detailed model of HIV transmission, and are not grounded in the arbitrary social divisions of our great grandparents. These questions send the message that your behaviour is what matters, and not your sexuality – If that’s not a helpful public health message then I don’t know what is.

If it turns out that asking “Are you an MSM?” is more effective at screening out UUHIV+ individuals from donating blood, then we should stick with it. Somehow, though, I doubt it would be.

 

* Although, even if you knew how MSM people had HIV (which is possible), since nobody can agree how many MSM there are (estimates of the “gay” population ranges from 2% to 10% of the UK population, with much of government going for something around 6%), stating what proportion are HIV+ is more akin to divination than actual statistics.

(HIV Aware, 2012) http://www.hivaware.org.uk/facts-myths/hiv-statistics

Raymond Charles Gomer

I struggled to pick any particular memories of Grandad. There are no individual moments that stand out from the others, no single memory that sums him up. On reflection, though, that is befitting of a man who has been a sort of persistent calm in our lives. A friendly face, a warm smile, and a heartfelt pat on the back.

My memories are of him sat in his chair, feeding his fish; Of arriving at his house and rushing to find him in his greenhouse or knelt in the garden in his string vest.

William Wordsworth wrote that “the best portion of a good man’s life [is] his little, nameless, unremembered acts of kindness and of love”. Little nameless acts like bringing in carrots with the tops on (because one of us liked to eat them), or keeping birds eggs in the shed to show us next time we visited (even though they kept exploding); sharing his stories and eating the holes from doughnuts.

Other acts – building model snowmen, or growing the pineapple – were achievements in themselves, but the ease with which we accepted them is testament in itself. I still feel an intuitive sense of childish bemusement at the suggestion that either of these things might be unusual. “Of course he’s grown a pineapple, of course he’s built a big model snowman, he’s grandad.”

In truth, then, memories of Grandad are not hard to find. Memories of grandad are memories of Christmas, of Birthdays, of the everyday activities that we did together and the memory of a childhood spent with grandparents that loved and cared for us.

Grandad leaves behind a family that, as we have seen these past weeks, continues to care. A family with little drama but defined by the same calm, patient affection that characterised him. We all know how proud he was of each of us, and I hope he was proud of himself for being such a part of an environment in which we could flourish.

Raymond Charles Gomer leaves us each with his calm kindness, his understated affection. These are virtues for us to remember and to emulate. We may no longer find grandad in his garden, or in his shed; but still, as we go on with our own lives we can remember, when we are sad, when we feel stressed, when we need to remember a calm or a safe place, to keep finding grandad.

Quick Thought on Brendan Eich’s Resignation

(Based on a comment I posted on FB)

The response to the criticism of Mozilla’s appointment of Brendan Eich as CEO was, from some, “it is intolerant to want Eich gone because of his political beliefs”.  I think that’s too naive an interpretation of what really happened.

This is, to me, not about Eich. It’s about the employees, contributors and supports of mozilla who have the right not to work with him. The issue was not “Eich is a dick, so he must be sacked” it was “parts of the community are leaving because they have a right not to work with this dude”. You cannot be a leader if the people you are leading feel like you have a personal issue with them – and lots of people clearly felt that.

The ill-will following Eich’s appointment seems to have been at a mostly individual level. There was no co-ordinated campaign trying to get him sacked, or make him resign, it was largely just many individuals expressing their disappointment. Those individuals obviously have that right. Those individuals also have the right (seeing as how they are not subject to some kind of open source bonded labour) to choose which organisations they contribute to. When  contributors feel like an organisation doesn’t align well with their values it is inevitable that some will leave. After all, the pay off for working for an organisation like mozilla is that you feel you’re contributing to something worthwhile – something that aligns with your values, often in more ways than just a shallow “I believe in making a good web browser”.

Eich has a right to say what he likes and support the causes he believes in, but he does not have the right to expect other people still to be happy to work with his organisation in spite of that. Fundamentally, this was an issue of whether the community felt like it shared the same values as the leadership. It looks like Eich has, quite rightly, recognised that although he has the RIGHT to be CEO of mozilla it was not in the interests of the organisation for him to do so.

Remote access to Linux display

VNC server on Linux normally just lets you log in with a new session, but it is also possible to connect to an existing display and use it remotely.

1. SSH with port forwarding

$ ssh my.hostname -L 5900:127.0.0.1:5900

2. Find xauthority file

$ ps wwwaux | grep auth
root      3360  0.0  0.3 309556 50380 tty7     Ssl+ Mar20   6:33 /usr/bin/Xorg :0 -background none -verbose -auth /run/gdm/auth-for-gdm-lXSVZp/database -seat seat0 -nolisten tcp vt7

The -auth part is what matters (in the case above, /run/gdm/auth-for-gdm-lXSVZp/database)

3. Start x11vnc

I have to use sudo because my user doesn’t have permission to read the auth file – YMMV.

$ sudo x11vnc -auth /path/to/auth/file -display unix/:0

4. Connect using a VNC client
The address will be 127.0.0.1:5900, which is being forwarded to the remote host by SSH.  If x11vnc picks a port other than 5900 you’ll need to disconnect and modify the SSH port forwarding

Using CalDAV with Kolab & Evolution

I wanted to sync my Kolab calendar with Evolution – Kolab now supports this via their iRony component and setup was relatively simple.  It is still largely undocumented in their own docs, though, so here’s what you need to do:

1. Go to http://your.kolab.install/iRony/ to check that iRony is working.

1a. If you get an error like Requested uri (/iRony/) is out of base uri (ony/public_html/) then edit  /etc/iRony/dav.inc.php and set $rcmail_config[‘base_uri’] = ‘/iRony/‘;

2. In evolution, add a new Calendar.  Select “CalDAV” as the type and give it a name.  Enter http://your.kolab.install/iRony/ as the URL, enter your username and then click “Find Calendars” to get a list of your Kolab calendars.  Select the one you want and off you go 🙂

Oliver Hotham: The sordid tale of how I was censored by Straight Pride UK

[Judith Flanders has re-posted Oliver’s original blog post (the one that the post below refers to) – Check it out at http://www.judithflanders.co.uk/2013/08/my-turn-straight-pride-uk/]

[Reprinted from Oliver Hotham’s blog after threats from the Straight Pride UK group. I would suggest that other bloggers do the same, as a direct counter to this attempt at censorship and intimidation. – via Soupy]

Oliver Hotham writes:

“A few weeks ago, when thinking of interesting things I could write for this blog, I remembered a weird organisation that gathered some attention on the internet a month or two ago.

The organisation is called Straight Pride UK. It’s a strange group which believes that the tide of Gay rights has gone too far, and that now heterosexuals have become the oppressed minority. Essentially their philosophy is spun from the same reactionary cloth as “Men’s Rights activists” – the notion that, having essentially run Western society for most its existence, progressive demands that Christian white straight males share some of their total grasp on power is somehow a removal of their rights.

Anyway, I wrote to Straight Pride asking that they answer some questions. Stipulating that I was “a freelance journalist”, I sent them some questions, about what they do and what they believe.

About a week later they responded with an attached document with the title “press release”. I went through the questions, corrected the horrendous grammar, and organised it so it coherently answered the questions I’d posed. I also noted that two rather pointed questions I’d asked, regarding the problem of the bullying of LGBTI youth and the nature of other “pride” movements, had not been answered. I sent them an email about this, saying that I’d give them the opportunity to respond but, if they didn’t, I’d “make it clear in the article” that they avoided the questions. They didn’t get back to me for 2 days, which I thought ample time to write two sentences.

Fully satisfied that my journalism had made them look like the arses they are, I hit the publish button, and sat back, feeling all together really pleased with myself. I called the article “It’s great to be straight… yeah”, too, which I thought acutely summed up their philosophy and referenced a mid-90s dance album I rather like.

The article gained a lot of traction, too. A friend and I put it on Reddit, and I got thousands of hits. In my short career of attempting to become a respectable journalist, it was one of the most successful things I’d done.

Then came the email from Straight Pride UK’s press officer, Nick Steiner:

“It has been brought to my attention that you have published the email that I sent you to, you did not state this in your email request, nor you did have consent to do this.

I therefore request that you take down the article that you have placed on your blog.

You have 7 days in which to do this, failing this I shall submit a DMCA to WordPress to have it removed.”

I laughed this off, and responded to the email arguing their case was absurd:

1) There was no indication on the “press release” they sent me that it was copyrighted material. (I’m no expert on copyright law, but I do know you have to make clear on the material that it is protected). Nor did they make any mention of the fact that anything they gave me was copyrighted.

2) I wrote “I’m a journalist and I’d like to ask you some questions” in my first email. If you’re a press officer and you don’t know what this means, then you really aren’t qualified to have your job.

3) In my email about the questions they didn’t answer, I made reference to “the article”. If that isn’t an indication that I’m going to publish something then I really don’t what is.

I thought this was a good enough defence, and I assumed this would all be swept under the carpet, and that their rather sad attempts to remove my article because it made them look stupid were all for naught.

I was wrong – within a few days WordPress caved to them without question, removing my article and telling me if I tried to publish it again I’d be suspended, but that I could challenge the takedown of my article. I responded that yes, I very much would like to, and was emailed a form I’d have to fill in. One of the requirements was that I “consent to local federal court jurisdiction, or if overseas, to an appropriate judicial body”.

I’m a student. I don’t have the money, time, or patience to go through with potentially having to go to court over this. All in all, I just could not be bothered to challenge the decision.

So I accepted the takedown, feeling thoroughly shit about myself.

Then I get another email from Straight Pride UK, which pissed me off even more. They demanded I take down the material (which I had) but also that I:

“…remove all references to Straight Pride UK, The Straight Forward Project, along with images, and links, from your Blog.”

Ok.

So not content with forcing me to eat a shit sandwich on dubious grounds and making me take down my work, they now demand that I never write anything about them again. Are these people kidding? Who the hell do they think they are that they can simply demand that I not write about them again, in an email with the pointedly sinister name of their solicitors at the bottom?

This, for me, was the final straw, and why I decided to write this article.

Because I find it absurd that this silly little group can simply demand that remove all my references to them because it makes them look bad. What are they afraid of? Their views make them look stupid enough, why the need to so aggressively bully and harass me? Why do they care so much?

And are they so cowardly that an article criticising them is enough to attempt to pursue a tenuous legal case against the author?

It really boggles the mind.”

Aerial Photos of 1BJ

(SO17 1BJ = The University Postcode – Nobody has trouble remembering that!)

Scraped together “SO17 1BJ through the ages” from Bing and Google. Most focussed on the bits that have changed (Old Mountbatten, Life Sci, the Interchange) and added some self-indulgent annotations.

uni_aerial_years

Unshortening URLs in PHP

I had cause to unshorten a ton of links from twitter today.  There are loads of services that do it for you (and the popular shorteners have APIs) but I couldn’t see any existing PHP libraries to do it.  Below are some fairly straightforward PHP functions to unshorten URLs based on the Location: header that’s used in redirects.  The “isShort” function is a bit of a hack because I was only interested in a few domains, but should be straightforward to modify it for other tasks.

Requires curl support in PHP.


/**
 * Get the value of the Location header obtained when dereferencing the given URL. False if there isn't one
 */
function getLocation($url)
{
$ch = curl_init();
$timeout = 5;
curl_setopt($ch, CURLOPT_URL, $url);
curl_setopt($ch, CURLOPT_RETURNTRANSFER, 1);
curl_setopt($ch, CURLOPT_CONNECTTIMEOUT, $timeout);
curl_setopt($ch, CURLOPT_FOLLOWLOCATION, false);
curl_setopt($ch, CURLOPT_HEADER, true);

$data = curl_exec($ch);
curl_close($ch);

list($headers, $body) = explode("rnrn", $data, 2);

$headers = explode("n", $headers);
foreach($headers as $h)
{
if(preg_match('@Location:(.*)@i', $h, $match))
{
return $match[1];
}
}

return false;
}

function is_short($url)
{
return preg_match('@^https?://(www.)?(bit.ly|t.co|goo.gl|dlvr.it|tl.gd|is.gd)@', $url);
}

/**
 * Unshorten a short URL until it isn't short anymore (copes with URLs that have been 
 * shortened multiple times, up to $limit).
 * 
 * Returns false (by virute of getLocation() ) if the URL isn't short
 */
function unshorten($inurl, $limit = 5)
{
$i = 0;
$url = $inurl;
while(is_short($url) && $i < $limit)
{
$url = getLocation($url);
$i++;
}

return $url;
}