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New HIV vaccine shows unprecedented success in preclinical study

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Re: New HIV vaccine shows unprecedented success in preclinical study

#201

Post by dahinds »

shadowtree wrote: post #171
tempfile wrote: post #86

Earlier quoted context omitted.

Right, but we know that HIV/AIDS essentially is a solved problem in rich countries, that the mentioned interventions are readily available in rich countries, and the only reason HIV transmission is high in poor countries is because, well, they're poor. We (humanity as a whole) have plenty of money, we could fund these things, we simply choose not to. I would caution against making an allusion to self control. It woul…

"the only reason HIV transmission is high in poor countries is because, well, they're poor." This is factually untrue. Being poor does not equal a HIV transmission rate. There is no 1:1 correlation. A single protected (condom) sexual act between a male and female averages somewhere around 0.1-0.5% chance of pregnancy, and during the fertile window it could still be around 1% or more even with a condom. Chance of HIV…

I don't think the original assertion is "punching down" on poor people. While you're correct that poverty isn't the "only reason" for high HIV transmission, poverty certainly contributes to it, via lack of access to health care and lack of access to education. How is it less "punching down" to attribute it to social behavior and culture? Isn't needle sharing associated with poverty, or would you also call that "culture"?

Re: New HIV vaccine shows unprecedented success in preclinical study

#202

Post by Jalad »

wavemode wrote: post #91
mohamedkoubaa wrote: post #70

Earlier quoted context omitted.

It doesn't need to be 100% effective in humans, it just needs to slow transmission enough such that the rate of incidence declines in the direction of eradication.

It will have the opposite effect, if people who get the vaccine start behaving as though they are 100% protected (which, many people will).

This is called moral hazard, and people love to worry about it. Usually though (the relevant example here is PrEP, or birth control) it's fine and enables people to live their lives with fewer risks to their, and others, wellbeing

Re: New HIV vaccine shows unprecedented success in preclinical study

#203

Post by jonathanlydall »

saghm wrote: post #180
jonathanlydall wrote: post #44

Earlier quoted context omitted.

You could say the same about teen pregnancy being a practically solved problem, except there is still the problem of teen pregnancy. Or even something more mundane as driving consistently safely all the time to solve the problem of accidents. If everyone was disciplined all the time in regard to everything, many problems in the world would simply not exist. But we live in reality where for whatever reason, people don…

> You could say the same about teen pregnancy being a practically solved problem, except there is still the problem of teen pregnancy. Or even something more mundane as driving consistently safely all the time to solve the problem of accidents. At the risk of derailing this conversation from the original topic, those two things are not remotely equivalent. There's no organized political movement trying to tell people…

Where I am from, organised political movements are not a factor of teen pregnancy and were not the least bit in my mind when I made my statement.

And my two examples are completely arbitrary because my point applies to pretty much any problem which would be solved by people being “more careful”.

So, political/religious elements aside, teen pregnancy and road safety are the same in terms of “if people were just more disciplined, there would not be these problems” (i.e. if teens who have easy access to contraceptives planned ahead before giving into impulsiveness; if drivers were more attentive to their behaviour), which I then pointed out is naive because the reality is that people aren’t perfect, they aren’t always disciplined, we’re all only human.

Hence, we need other solutions to help with problems which don’t require ignoring that people are only human and lack perfect discipline.

I agree that some organised movements can be a problem in that they can make other problems worse.

Re: New HIV vaccine shows unprecedented success in preclinical study

#205

Post by mattjhall »

Telemakhos wrote: post #54
nerdjon wrote: post #36

Earlier quoted context omitted.

> If you are not doing risky sex it isn't for you. That blanket statement I very much disagree with. Sure there are side effects but that is part of why you also get tested every 3 months for liver issues (not that it is the only side effect, but still). Instead of it being a blanket statement it should be a conversation with your doctor about the pros and cons. You can still get HIV even if not engaging in risky beh…

You are extremely unlikely to get HIV from anything other than risky sex. That's what "risk" means: it's another word for "probability," just a probability of negative outcomes. These probabilities are known: https://www.aidsmap.com/about-hiv/estimated-hiv-risk-exposur... Some of that table is already mitigated: we test blood for HIV, so transmission by blood transfusion is unlikely. Transmission by pregnancy is less…

> Is someone irresponsible enough to pursue causal, unprotected sex with random partners also likely to be responsible enough to visit a doctor proactively and comply with a prep regimen?

Yes, it's the exact reason that it is widely available on the NHS. 20,000 people took it, adherence was high, HIV rates dropped significantly.

> Sure, it's a "really good idea," but a simpler and better idea is not to have random sex in the first place

Shaming people has been tried for centuries, maybe millennia and famously _does not work_. We have ample evidence that PrEP does.

Re: New HIV vaccine shows unprecedented success in preclinical study

#206

Post by saghm »

jonathanlydall wrote: post #203
saghm wrote: post #180

Earlier quoted context omitted.

> You could say the same about teen pregnancy being a practically solved problem, except there is still the problem of teen pregnancy. Or even something more mundane as driving consistently safely all the time to solve the problem of accidents. At the risk of derailing this conversation from the original topic, those two things are not remotely equivalent. There's no organized political movement trying to tell people…

Where I am from, organised political movements are not a factor of teen pregnancy and were not the least bit in my mind when I made my statement. And my two examples are completely arbitrary because my point applies to pretty much any problem which would be solved by people being “more careful”. So, political/religious elements aside, teen pregnancy and road safety are the same in terms of “if people were just more d…

My point is that teen pregnancy very much does have a solution that has empirically worked quite well at preventing it when it's actually practiced (i.e. high quality sex education and ample access to contraceptives), and pushing abstinence as a solution has demonstrably caused teen pregnancy rates in increase whenever it's used as a replacement for that; the only actual impetus for abstinence as a "solution" is ideological. I think teen pregnancy literally would be a solved problem (with instances being essentially a rounding error) in a society embracing what we actually have proven works well at preventing it; I've never seen any similarly successful mechanism at preventing injuries or deaths in automobile accidents be rejected by a society for ideological reasons.

Trying to handwave away the things we know work to prevent teen pregnancy as "just be careful" feels overly reductive, because it's way easier to do correctly than managing to drive without ever having an accident.

Re: New HIV vaccine shows unprecedented success in preclinical study

#207

Post by shadowtree »

dahinds wrote: post #201
shadowtree wrote: post #171

Earlier quoted context omitted.

"the only reason HIV transmission is high in poor countries is because, well, they're poor." This is factually untrue. Being poor does not equal a HIV transmission rate. There is no 1:1 correlation. A single protected (condom) sexual act between a male and female averages somewhere around 0.1-0.5% chance of pregnancy, and during the fertile window it could still be around 1% or more even with a condom. Chance of HIV…

I don't think the original assertion is "punching down" on poor people. While you're correct that poverty isn't the "only reason" for high HIV transmission, poverty certainly contributes to it, via lack of access to health care and lack of access to education. How is it less "punching down" to attribute it to social behavior and culture? Isn't needle sharing associated with poverty, or would you also call that "cultu…

I was poor, grew up in social housing.

I did not use drugs.

"I share needles because I can't afford my own" is an INSANE take. Don't shoot drugs in the first place! Poor people are normal humans, they have willpower, agency. It is a rich people myth that poor people are cattle, devoid of any chance of doing the right thing.

It is culture, behavior, social norms. Being poor does not force you to abandon the nuclear family, does not force you to engage in criminal acts. (there is reverse causality though)

In the early 1960s South Korea had a per capita income lower than those of Haiti, Ethiopia, and Yemen, and about 40% below India's. Did all South Koreans become heroin addicts with HIV?

Re: New HIV vaccine shows unprecedented success in preclinical study

#208

Post by garciasn »

shadowtree wrote: post #171
tempfile wrote: post #86

Earlier quoted context omitted.

Right, but we know that HIV/AIDS essentially is a solved problem in rich countries, that the mentioned interventions are readily available in rich countries, and the only reason HIV transmission is high in poor countries is because, well, they're poor. We (humanity as a whole) have plenty of money, we could fund these things, we simply choose not to. I would caution against making an allusion to self control. It woul…

"the only reason HIV transmission is high in poor countries is because, well, they're poor." This is factually untrue. Being poor does not equal a HIV transmission rate. There is no 1:1 correlation. A single protected (condom) sexual act between a male and female averages somewhere around 0.1-0.5% chance of pregnancy, and during the fertile window it could still be around 1% or more even with a condom. Chance of HIV…

Dry sex in SSA may be one of the contributing factors, but it’s never been truly proven out as a key contributor in any study I have read; they always address it but say more needs to be done to be certain.

Your comment makes it seem like a key factor when it’s not.

Re: New HIV vaccine shows unprecedented success in preclinical study

#209

Post by kstrauser »

freeone3000 wrote: post #191
kstrauser wrote: post #168

Earlier quoted context omitted.

That all makes sense. A couple things I’m still not clear on: * If someone has a negative test after treatment, but that’s not counted as “cured”, does that imply it could (or maybe will ) come back if treatment is stopped? * What’s the importance of the distinction between HIV+ vs AIDS, from a public health or human perspective? We don’t talk about influenza+ vs “has the flu”, at least as far as I know. Does HIV+ ca…

* If someone has a negative test after treatment, but that’s not counted as “cured”, does that imply it could (or maybe will) come back if treatment is stopped? Yes. HIV+ patients require antiretroviral treatment for the remainder of their lives. Most are able to manage with a pill regimen. This is not to say it is cheap or side effect free, but most HIV+ people are able to live normal lives with outpatient support.…

1. What a freaking miracle. Growing up in the 80's, the notion was terrifying. I was straight and it was something my friends and I discussed. I can't imagine how awful it must've been for gay communities. Again, what a miracle.

2. OK, fair point.

Thanks for the info! I know HIV isn't exactly "no big deal" today, but seeing it go from "you're certain to die" to "it's annoying to have to take medicine forever" is still a wonder of modern science.

Re: New HIV vaccine shows unprecedented success in preclinical study

#210

Post by fortran77 »

RGS1811 wrote: post #3

While HIV vaccine research is an exciting field, it's worth pointing out that halting HIV transmission is, practically speaking, a solved problem with oral and injectable reverse transcriptase inhibitors. The ongoing loss of life and health due to HIV could be stopped if we cared enough to invest resources in wide-scale PrEP availability and public health education. Waiting for an HIV vaccine is the domain equivalent…

It's a solved problem for people in stable environments, who can follow instructions, take medication, etc.
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