221–230 of 325 posts
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Most things are a solved problem if we give up the things that make life worth living. Obesity is a solved problem if you just eat for health. Road traffic deaths are a solved problem if you never leave your house. Suicides are a solved problem if you just don't kill yourself.
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We haven’t even managed to wipe out polio, and that is a cheap, lifelong vaccine.
If we gave every living human on the planet the polio vaccine as soon as they were able to receive it, it would still exist in the wild somewhere. If new generations are not also given the vaccine, it will eventually return. Probably the same with HIV, although I could see it being somewhat more difficult for that to make a resurgence. If we inoculated the entire human race against it, it could possibly eradicate HIV…
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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 ideo…
In South Africa we have 12,000+ road fatalities a year, by comparison Australia (renowned for strong law enforcement) with about half of our population size has 1,200 or something. (And they apparently happen to have about 4,500 teen pregnancies a year.)
Australia’s (or maybe it was New Zealand’s which I visited on the same trip) road safety campaign is called “Towards Zero”, while South Africa’s is called “Arrive Alive”.
A big part of the difference in fatalities is that Australia has much better general law enforcement (such that a lot of foreigners complain about it), while over here it’s dismal with Arrive Alive’s strategy seemingly being to always do the same thing as last year’s holiday season except with “trying harder”, while largely ignoring day-to-day traffic offences.
Due to the high chance of being caught for transgressions, Australians tend to way more often stick to the rules of the road, while over here there is horrendous amount of (to put it politely) shenanigans happening almost all the time.
And the impact of this difference in discipline shows in the above stats.
Years ago now, but my now wife spent 10 days in intensive care after a minibus taxi driving on the wrong side of the road head on collided into the car she was a passenger in. My wife was fortunately in a car with good safety features and had a medical aid plan allowing her to receive some of the best care possible in the country, but I’m doubtful that the mini bus taxi passengers (who tend to be in the poor class of the population) sent to public hospitals received care anywhere near as good, I think I heard after this article [1] was published that two people died.
Perhaps road accidents, or at least fatalities, can be reduced more than you realize.
[1]: https://www.citizen.co.za/northcliff-melville-times/222787/2...
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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 fa…
you don't have to care about the drug users at all. even if you treat them as pests rather than humans, we frequently vaccinate pests for public health measures. pathogens will spill over to populations you do care about, they'll create a drain on the healthcare system, they'll harbor other opportunistic infections. it's not sanitary.
this is completely leaving aside that some drug addicts can and do turn their life around, and that HIV is a horrible illness nobody should have to deal with, even if it's "their fault."
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The epistemic modality of my statement was implied. I obviously don't know the future.
> I obviously don't know the future Nor the past. Seatbelt requirements did result in riskier driving. It also, on the net, saved lives. Same for every other vaccine, or e.g. birth control in respect of teenage and unwanted pregnancies. Also, PreP exists and works.
Okay? This seems unrelated. A better analogy would be if they had invented airbags and then people stopped wearing seatbelts. (like taking a 44% effective vaccine and then stop using PreP)
> Same for every other vaccine, or e.g. birth control in respect of teenage and unwanted pregnancies.
Also unrelated. Birth control is highly effective, and in fact is statistically more effective than condoms (since condoms can slip and/or break). My issue is the poor effectiveness of this vaccine.
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> but if someone is unwilling to go on PrEP, why would they suddenly be willing to get a vaccine? Because PrEP at even its best and most modern version requires an update every six months for life. If you're well-off and in SF or NYC or London that might be easy, but there's so many externalities such as: - People who misjudge the risk they're at, so don't go on the meds in the first place - People who live in region…
That's absolutely not correct. Truvada has had the same formulation since it was introduced in 2012. Descovy hasn't changed since it was approved in 2019. You may be thinking of STD tests and bloodwork that is done every 3-6 months depending on your risk level to ensure that you're still HIV negative and that your kidneys are functioning normally, as kidney issues is a rare but serious side effect, especially for Tru…
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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
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…
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> You are extremely unlikely to get HIV from anything other than risky sex. Yes because it is such a fantastic idea to just ignore that there is still a risk regardless of what we call "risky" sex just because it doesn't fit in your puritanical views of sex. If someone can get HIV the first time they have sex than your entire argument is moot. Just have the conversation with your doctor and protect yourself and stop…
Are you arguing that all sexually active people should take prep?
Maybe it isn't worth it for you in the end after that conversation, but we should also not assume that the only way you get HIV is through "risky" behavior. That is irresponsible.
At least you would know it's an option and you can make the decision yourself, I know a lot of straight people that do not know prep exists because it just isn't talked about. Or maybe they have heard about it but they don't really understand what it is. That is a problem.
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> 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…
derailing further, it's no organized political movement, and they don't call it immoral but in Caucasus region some men avoid using seat belts as "unmanly", and that's a very social thing. Small plugs into a seatbelt socket to shut up the car audible warning are very common, including taxis.
Also, I’ve found that when asked about the risk of something, most people believe that bad things only happen to other people (who also believed that, until it happened to them).