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Is the end of AIDS in sight?

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Re: Is the end of AIDS in sight?

#81

Post by mathewsanders »

chimeracoder wrote: post #74
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…

> 30-day supply of generic PrEP costs ~$2,500 Er, no, generic Truvada costs $30-$60/month, although it was not available as a generic in 2019, which is when the mandate for free PrEP without cost-sharing was first issued. (The mandate was issued in 2019, but it did not fully go into effect until 2021). That said, the drug costs aren't the only (or even biggest) costs associated with PrEP - the doctors' vists and labw…

I guess I don't fully understand U.S. healthcare system (I'm an immigrant from a country with universal healthcare, and this is the first time in my life that I've had a medication prescribed other than short-term antibiotics).

I pay a $10 co-pay for generic with my insurance, but when I pick up from pharmacy the receipt says "you insurance saved you $1888" (you're right it's not ~$2500/month - I just checked and that's a different prescription I have that I get filled at the same time).

Re: Is the end of AIDS in sight?

#82

Post by mathewsanders »

bdcravens wrote: post #40

I have a friend who does work (mostly manual labor, handyman stuff, etc) for me in our house. In his early 60s, strong as an ox, and he's been HIV-positive since the 80s. That deserves an asterisk, as his levels are below detectability (and I believe transmissibility), and have been for a long time.

That's fantastic! I was recently doing some research and learnt that with ART people who are HIV+ can actually expect to live a little longer than people who are HIV-. I think it's because they have more regular check ups to make sure that treatment is being maintained.

Re: Is the end of AIDS in sight?

#83

Post by graeme »

DelaneyM wrote: post #21
bugglebeetle wrote: post #14

As an older millennial, it’s interesting to me observe the difference with which HIV/AIDS and COVID has been treated. While untreated HIV infection is more lethal than COVID, COVID has killed more people in the past 4 years than HIV/AIDS did in the past 40+. 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…

> …COVID has killed more people in the past 4 years than HIV/AIDS did in the past 40+. Ok, so that’s wrong by an order of magnitude. AIDS has killed ~85.6 million [64.8 million–113.0 million] people, and it’s plausible that could be a huge undercount. COVID has killed ~7M people, which is also bad but nowhere near “more”. There are also a lot of reasons these aren’t really comparable pandemics, and the responses to t…

As abeppu points out, this is their death estimate: 40.4 million [32.9 million–51.3 million] is their estimate on deaths.

Further, covid deaths are severely undercounted. Our world in data reports 26 million excess deaths to date, about 5 million in the past year. That's with three years of data, vs. three decades for HIV.

There's surely some HIV undercount too, but it's a reasonable bet that covid will exceed HIV in terms of deaths long run.

Re: Is the end of AIDS in sight?

#84

Post by FuriouslyAdrift »

irrational wrote: post #58
anaisbetts wrote: post #53

Earlier quoted context omitted.

Both of those are on the same order as "a bad cold" in terms of health - they are straightforward to treat and are not at all a big deal.

That's not true. Both can cause infertility in women. One of my friends is an ob/gyn and they say that one of the saddest parts of their jobs is telling a couple that the wife is infertile because of an STI she contracted (almost always Chlamydia or Gonorrhea) at some time in the past. Both of these STIs can go undetected in females for years. They just don't have any outward symptoms. By the time they find out, it i…

Gonorrhea has become drug resistant due to the overuse of anibiotics (both for people and animals).

Prior to fairly recently, it was easily cured if detected.

https://www.who.int/news-room/fact-sheets/detail/multi-drug-...

Re: Is the end of AIDS in sight?

#85

Post by chimeracoder »

mathewsanders wrote: post #81
chimeracoder wrote: post #74

Earlier quoted context omitted.

> 30-day supply of generic PrEP costs ~$2,500 Er, no, generic Truvada costs $30-$60/month, although it was not available as a generic in 2019, which is when the mandate for free PrEP without cost-sharing was first issued. (The mandate was issued in 2019, but it did not fully go into effect until 2021). That said, the drug costs aren't the only (or even biggest) costs associated with PrEP - the doctors' vists and labw…

I guess I don't fully understand U.S. healthcare system (I'm an immigrant from a country with universal healthcare, and this is the first time in my life that I've had a medication prescribed other than short-term antibiotics). I pay a $10 co-pay for generic with my insurance, but when I pick up from pharmacy the receipt says "you insurance saved you $1888" (you're right it's not ~$2500/month - I just checked and tha…

> I guess I don't fully understand U.S. healthcare system

Yes, it's confusing.

> I pay a $10 co-pay for generic with my insurance, but when I pick up from pharmacy the receipt says "you insurance saved you $1888" (you're right it's not ~$2500/month - I just checked and that's a different prescription I have that I get filled at the same time).

As a rule, the "your insurance saved you $X" is a meaningless statement.

It's actually worse than meaningless - it's effectively an advertisement for health insurance, not an actual statement of fact. It's calculated based on the difference between what you paid and the list price for a drug, which almost nobody is paying (and your insurer is definitely not paying).

Your insurance pays some other negotiated rate for drugs - they will basically never pay list price. Even if you were getting it without insurance, you still would likely not be paying list price. If you were paying out of pocket, you'd probably be using a discount coupon (which usually works as a third party functioning as a pseudo-PBM, a ridiculous concept which I will not bother to try to explain in this post). Or your doctor would explicitly prescribe the branded version ("dispense as written") and you'd be using the Gilead copay assistance coupon to pay for it.

Since there's no situation in which the list price is what you'd be paying, it's completely meaningless to say "you saved $X off the list price". I'm half of the mind that these statements should be banned by the FTC as a deceptive trade practice - that's how misleading they are.

Re: Is the end of AIDS in sight?

#86

Post by Darthy »

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.

That's revolting. Which radio show was this?

Re: Is the end of AIDS in sight?

#87

Post by rafaelero »

0xbadcafebee wrote: post #46
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…

Promiscuity does not propagate sexually transmitted diseases. You are working off of a false stereotype which has limited the capacity of your rational thought, and as a result, you imagine a world which does not exist, and propose solutions which will not work. This is a common problem with HN people. They come up with this one idea that kind-of makes sense, and then stop thinking, and shape their whole thought proc…

> Promiscuity does not propagate sexually transmitted diseases.

Of course not, they are propagated by poneis and unicorns. Nothing to do with having sex with multiple partners.

> Gay people do not have more sex partners than straight people.

You are deluded. Not only gay people have higher median number of sexual partners, but our sexual network is tighter, since fewer people are gay compared to straight. That's a perfect environment for sexual diseases to spread, which was the case with AIDS and more recently MPox.

Re: Is the end of AIDS in sight?

#88

Post by [deleted] »

TZubiri wrote: post #31
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…

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…

[deleted]

Re: Is the end of AIDS in sight?

#89

Post by _jal »

Darthy wrote: post #86
EatingWithForks wrote: post #38

Earlier quoted context omitted.

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.

That's revolting. Which radio show was this?

Rush Limbaugh.

Re: Is the end of AIDS in sight?

#90

Post by [deleted] »

TZubiri wrote: post #32
at_a_remove wrote: post #25

Earlier quoted context omitted.

I often mention the whole Gen X trauma thing. Part of it is literally seeing the ladder being pulled up just as we reached for it. Not just for jobs or college tuition, but also sexually -- the previous generation had a pretty good time and the worst that was on offer was herpes. Puberty starts rumbling around and we're wondering what the future looks like and suddenly "GRID." And we were flailing around, is it viral…

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

[deleted]
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