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Is the end of AIDS in sight?

economist.com

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Re: Is the end of AIDS in sight?

#61

Post by abeppu »

bugglebeetle wrote: post #43
abeppu wrote: post #33

Earlier quoted context omitted.

> My childhood was filled with warnings and media depicting the tragedy of HIV/AIDS, the surrounding bigotry, and the history of this pandemic still has some cache ... but for years, the HIV/AIDS crisis _was_ ignored, or even laughed at by critical people in government. When you say your childhood was filled with warnings about the tragedy of HIV/AIDS, I think you must be talking about the early 90s, a decade after t…

While this is correct, my point was that the experience of the HIV/AIDS seemingly had no impact on our handling of COVID. But Reagan/AIDS, Trump/COVID, is a pretty bleak manifestation of “first as tragedy, then as a farce.”

I guess, how did you want the HIV/AIDS experience to inform the COVID response? I don't want to defend Trump and his bleach-injection suggestions etc, but we did:

- develop vaccines at a really rapid pace (it's too bad they aren't more effective)

- learn a lot about how to treat COVID

- shut down broad categories of activity which would have contributed to spread

- gave everyone free vaccines and tests (I think this is the only 'free for everyone' health care I've seen in my life)

Trump _wasn't_ able to ignore the crisis the way Reagan did for years.

But we landed at a place where the vaccines help but don't offer good immunity from infection, and where many people are more comfortable getting infected repeatedly than they are cutting out shared space and public events. It's not clear to me what lessons we're supposed to draw from the HIV/AIDS experience now. Do you think that a generation of people should have fastidious habits around mask use?

By contrast, with HIV/AIDS, 'taking it seriously' in the 90s meant doing research, and messaging about being paranoid about sex and drugs. Most people did not need to disrupt their lives. And frankly, they could watch a TV special about the crisis, victim-blame quietly, and cheaply virtue-signal by talking about how important it all was. But if slowing down HIV/AIDS transmission had required that most people inconvenience themselves, or behave differently for even a week, I think the story would have been very different.

Re: Is the end of AIDS in sight?

#62

Post by irrational »

at_a_remove wrote: post #35
TZubiri wrote: post #32

Earlier quoted context omitted.

herpes is the worst thing? What about chlamydia, gonorrhea?

Herpes is permanent. While there are some stubborn antibiotic-resistant versions of the other two, they weren't that bad back then. So, yes, herpes is the worst thing.

Except, there is limited evidence that Herpes causes infertility in women while the other two definitely cause female infertility. I'd say the other two are worse since they often go undetected in women until the damage is already done.

Re: Is the end of AIDS in sight?

#63

Post by elil17 »

cltby wrote: post #57
mathewsanders wrote: post #52

> They can take pre-exposure prophylaxis (prep), a kind of drug that reduces their chance of contracting it by 99% or so. This comes as a daily pill, and is popular among gay men in rich countries. The article takes a global focus (which makes sense since most new HIV diagnoses happen outside of the United States), but even the United States has over 30,000 new HIV infections per year. In 2021 feds mandated that insu…

Rather depressing that we're subsidizing wanton sexual indulgence to the tune of $30k/year/person.

Just to dispel some myths here:

1. Many people who use PrEP have only one partner. They're using PrEP because their partner has HIV.

2. The alternative is letting people get AIDs. This is more expensive than PrEP.

3. Insurance doesn't pay the full list price of drugs, they pay a lower, negotiated rate. CostPlus Drug Company charges about $20/month for PrEP. This is probably closer to what insurance companies actually pay.

Re: Is the end of AIDS in sight?

#64

Post by burkaman »

Simulacra wrote: post #50
londons_explore wrote: post #10

Earlier quoted context omitted.

It's also a self-balancing system. As HIV becomes rarer, fewer people will be concerned about it, and therefore fewer will bother taking Prep daily. In turn, HIV becomes more infectious, and more people contract it. It will probably stabilize with about 0.4% of humans being infected. Lots of things affect about 0.4% of people, because that's rare enough that most people don't have any friend or colleague affected, an…

IMO Prep has raised the risk of HIV by giving people a false sense of security.

What is false about it? It is apparently close to 100% effective if you take it every day, that seems like a very real sense of security.

Re: Is the end of AIDS in sight?

#65

Post by 535188B17C93743 »

cltby wrote: post #57
mathewsanders wrote: post #52

> They can take pre-exposure prophylaxis (prep), a kind of drug that reduces their chance of contracting it by 99% or so. This comes as a daily pill, and is popular among gay men in rich countries. The article takes a global focus (which makes sense since most new HIV diagnoses happen outside of the United States), but even the United States has over 30,000 new HIV infections per year. In 2021 feds mandated that insu…

Rather depressing that we're subsidizing wanton sexual indulgence to the tune of $30k/year/person.

So queer people should remain celibate?

Other methods of protection fail. People lie about the status. People don't know their status.

Know what's ridiculous is that these drugs cost so much money and companies like Gilead can engage in "revenue maximization" schemes at the cost of the health of US citizens... and then apparently win lawsuits with their Big Pharma war chests.

Re: Is the end of AIDS in sight?

#66

Post by ChrisMarshallNY »

hn_throwaway_99 wrote: post #19

As a gay man well into middle age, whenever I get somewhat depressed about the state of human affairs, I think about the incredible improvements in AIDS treatment and prevention and I feel a little better. It's hard for people who didn't live through it to really understand what a terrifying time the 80s and 90s were. First off, the general message of sexual education was pretty much "If you have sex, it's probably g…

I have spent my adult life in a community that experiences higher-than-average HIV/HepC exposure, and well remember the "Great Die-Off" of the early-to-mid 1990s.

To anyone that missed out, dying of AIDs is horrible. The West has the luxury of expensive drugs to treat it, but much of the developing world doesn't have that, and they are still dying like flies, with very little of the transmission happening through homosexual contact.

Africa has a big problem with that, and misogyny also plays into it, as the article mentions.

The thing that disgusted me the most, was the "Good riddance" attitude of many folks. I see echoes of that, in the Fentanylopocalypse, going on, now. As soon as Muffy and Biff start popping their clogs, though, it becomes a "national tragedy."

Re: Is the end of AIDS in sight?

#67

Post by vkou »

bugglebeetle wrote: post #43
abeppu wrote: post #33

Earlier quoted context omitted.

> My childhood was filled with warnings and media depicting the tragedy of HIV/AIDS, the surrounding bigotry, and the history of this pandemic still has some cache ... but for years, the HIV/AIDS crisis _was_ ignored, or even laughed at by critical people in government. When you say your childhood was filled with warnings about the tragedy of HIV/AIDS, I think you must be talking about the early 90s, a decade after t…

While this is correct, my point was that the experience of the HIV/AIDS seemingly had no impact on our handling of COVID. But Reagan/AIDS, Trump/COVID, is a pretty bleak manifestation of “first as tragedy, then as a farce.”

The 'worst' that Trump/COVID did was lose him the election. If he had a lick of sense, he would have won in a landslide.

All he did was what he always does - act like an easily-distracted petulant child on television. It had next to no bearing on vaccine development, distribution, or uptake.

Just about everyone already made up their mind on those three questions, without his input. There's a lot he can be blamed for, but this really isn't one of them.

Re: Is the end of AIDS in sight?

#68

Post by x0x0 »

EatingWithForks wrote: post #38
TZubiri wrote: post #31

Earlier quoted context omitted.

Aids is definitely the strongest sexually transmitted virus out there. But don't you think that there will always be sexually transmitted diseases associated with promiscuity? Not to say that aids is only transmitted through promiscuity, but superspreading is highly relevant. It is my understanding that gay people have more sex partners than than straight people, so it's likely that these diseases will disproportiona…

The difference with AIDS is that AIDS at the time condemned you to a slow, horrible, visible decline, in which your death was celebrated via a radio talk show host that at the time had an entire regular segment to name and mock the people who died. Like, this doesn't apply to people who get cervical cancer from HPV or other similarly tragic outcomes of acquiring an STD. The cruelty on the scale is way above anything.

Don't forget Reagan's press secretary mocking the so-called "gay plague"

https://www.vox.com/2015/12/1/9828348/ronald-reagan-hiv-aids

Re: Is the end of AIDS in sight?

#69

Post by cltby »

535188B17C93743 wrote: post #65
cltby wrote: post #57

Earlier quoted context omitted.

Rather depressing that we're subsidizing wanton sexual indulgence to the tune of $30k/year/person.

So queer people should remain celibate? Other methods of protection fail. People lie about the status. People don't know their status. Know what's ridiculous is that these drugs cost so much money and companies like Gilead can engage in "revenue maximization" schemes at the cost of the health of US citizens... and then apparently win lawsuits with their Big Pharma war chests.

There's wide, wide middle ground between celibacy and the debauched status quo.

Re: Is the end of AIDS in sight?

#70

Post by TZubiri »

hn_throwaway_99 wrote: post #45
TZubiri wrote: post #31

Earlier quoted context omitted.

Aids is definitely the strongest sexually transmitted virus out there. But don't you think that there will always be sexually transmitted diseases associated with promiscuity? Not to say that aids is only transmitted through promiscuity, but superspreading is highly relevant. It is my understanding that gay people have more sex partners than than straight people, so it's likely that these diseases will disproportiona…

The point I try to get across is to separate "promiscuity is inherently bad" from "sex can have serious negative consequences that you should appropriately plan for depending on your risk tolerance." Another way to think of it: it's also highly likely that if you go to a crowded event that there are tons of diseases you can expose yourself to. Pre-COVID, people used to talk about getting "SXSW flu", e.g. with so many…

Regarding concert going, I've certainly met people so risk averse that they don't join a concert mass outdoors, and a lot more that don't do so indoors. This is especially more common before important events like a trip.

That said, the respiratory route is very distinct from the oral, genital and anal route.

On a spectrum of frequency of contact, respiratory is the most frequent, then comes oral/digestive, then genital, and finally anal.

The more frequent and vital a route is, the more natural and artificial resources we can allocate to combat infections.

So infections spread by talking to each other, being vital, gets a vaccine developed in less than a year, and gets diverse natural antibodies.

On the other hand, a disease that spreads among adults who seek pleasure, will be allocated less resources, more so if it spreads preferentially through non reproductive sex.

Aids on the respiratory system would be fucking deadly, but my guess is that it would never spread there because there's more protection mechanisms, respiratory is like a process running unprivileged on an open port 80. Genital is port 22 and anal-genital is rdp or teamviewer with admin privileges on a server.

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