letter to the LA Times: increased or reduced risk of transmission?

Here is the gist of a letter I wrote to the Los Angeles Times:


"Your 17 April 2013 article 'HIV concentrations in breast milk higher at earlier, abrupt weaning' states 'HIV-infected mothers who breast-fed exclusively longer than the first four months after birth had less risk of transmitting the virus to their babies through their milk, researchers said.'

"Here's what the Science Translational Medicine paper actually says about the risk of HIV transmission: 'Viewed from an intent-to-treat perspective, the risk of late postnatal transmission was 7.6% in the group randomized to stop breast-feeding at 4 months and 10.2% in the group randomized to continue breast-feeding (RH, 0.67; 95% CI, 0.39 to 1.15).'

"I.e., HIV-infected mothers who breast-fed exclusively longer than the first four months after birth had an increased risk of transmitting the virus to their babies through their milk."


It's true that HIV concentrations were higher in the milk collected at 4.5 months from the mothers who stopped breastfeeding at four months, but that milk was collected after the babies had stopped drinking it.   It's also true that adherence to the regimen was incomplete, which led to the "excess transmission risk" that the authors mentioned, but the fact remains that the risk was still lower in the group randomized to stop breastfeeding.

I think the culprit here is this sentence from the abstract: "This may explain the reduced risk of HIV-1 transmission associated with exclusive breast-feeding and why early weaning does not achieve the magnitude of HIV prevention predicted by models."  I think what the authors meant by "reduced" here is "reduced compared to what you would expect", but I can only come to that conclusion after having read the entire article.  STM is not an open-access journal: other readers of the LA Times (and, indeed, the science journalist that wrote the article) might not have the same opportunity I have.

Letter to The New Yorker

Better late than never?

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Dear New Yorker,

If the FBI is serious about taking on the sexual abuse of minors (The Science of Sex Abuse, January 14th), they should making a higher priority of cracking down on the $33 billion a year industry of prostitution: the average age of entry into prostitution in this country is thirteen, well below the age of consent.  Why are so much of our resources dedicated to catching "John"s while johns, who actually have sex with young girls, are rarely prosecuted, and even when they are, are given only the lightest of sentences, and are never considered pedophiles?  Are we more offended by the aesthetics than the actual deeds?

letter to the Baltimore Sun: human trafficking in Maryland

Here's the text of a letter I sent to the Baltimore Sun, and here's a link to the article I refer to.  (Warning: the Baltimore Sun now has a New York Times-style paywall, so you only get a certain number of free page views per month.)

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Dear Baltimore Sun,

I was very pleased to see your front page story today (Nov.6, "On the streets of Baltimore, a new hustle") on human trafficking in the United States. When most people think of human trafficking, they imagine third-world countries, not Baltimore Street. Thank you for doing your part to raise awareness about this very important, very relevant, and very local issue. I hope that you will continue your coverage on this important topic: for example, what is the status of the Phylicia Barnes murder case, and is anyone investigating whether she was a victim of human trafficking?

Fukushima Daiichi vs. Deepwater Horizon

Here's the text of a letter I submitted to The New Yorker:

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Dear The New Yorker,

Evan Osnos makes useful comparisons between the Fukushima Daiichi meltdown and the meltdowns at Three Mile Island and Chernobyl ("The Fallout", October 17), but an even more useful comparison would be to the Deepwater Horizon disaster.  Both disasters were man-made (although one was catalyzed by a natural disaster of historic proportions, and the other only by human error); both exposed its workers to acute risks (although one killed eleven people, and the other killed no one); both continue to have enormous environmental and economic impact.  The decision to pursue nuclear power is unquestionably not without risks, but neither is the decision not to.  If, in an effort to avoid disasters like Fukushima Daiichi, we increase our reliance on fossil fuels, we can expect in the future more disasters like Deepwater Horizon.


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In particular, Germany decided to shut down all of its nuclear power plants by 2022 (and that probably has more to do with its slow economic growth recently than Euro crisis does, since Germany exports electricity (or, used to)), but no one's talking about quitting drilling for oil, even though it seems clear to me that in any comparison between Fukushima Daiichi and Deepwater Horizon, the latter was a more serious disaster.  And that's not even getting into the long-term impacts of anthropogenic climate change.