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tempfile 4 hours ago

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 would be very cruel to act as if people who get a disease through no fault of their own could have avoided it, and most people who contract HIV could not. You may not have intended to make that allusion, but you did.

> So I would say that it's very evidently not a practically solved problem, because if it were we wouldn't be looking to solve it still.

This is obviously not what is meant by "practically solved problem". Everybody knows it is not actually solved.

jcul 3 hours ago | parent | next [-]

I recently read "Everything is Tuberculosis". It describes a similar issue with the rich / poor country divide.

It's quite sad and difficult to read at times.

everforward 2 hours ago | parent [-]

Tuberculosis is different, in a very dark, utilitarian way. 4% of new TB cases are multi-drug resistant (19% of recurrences).

Once it’s multi-drug resistant, if you’re poor then you get an incredibly depressing choice. Rich countries pay for expensive drug resistance testing.

Poor countries have to answer an impossible question. You either do nothing and see if they live, or you try to guess what drugs will work and give them those. However, if you’re wrong and the treatment doesn’t work then the risk that you’ve just made the strain immune to one or more of the drugs in that cocktail skyrockets.

They get asked to either do nothing, or do the best they can today knowing it will make tomorrow worse.

TB is also shockingly infectious, which is sad. You can at least take steps to dramatically reduce HIV risk, it’s much much harder to avoid TB.

shadowtree 2 hours ago | parent | prev [-]

"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 from one act of unprotected vaginal sex with an HIV-positive partner: ~0.08% male-to-female.

The high HIV transmission rates are NOT correlated with wealth, but social behavior. Unprotected anal sex with many partners? High risk. Now, Africa - the practice of dry sex contributes a ton to HIV transmission. Cultural belief that a dry vagina increases pleasure, hence woman use sand, chalk or bleach to dry out their vaginas, massively increasing HIV risk. Needle sharing of drug users? High HIV risk.

Not a class issue, no reason to punch down on poor people. Poor people have agency and many do not infect themselves with HIV in the first place.

dahinds 15 minutes ago | parent | next [-]

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"?

xenospn an hour ago | parent | prev [-]

I’ve never heard that before. That explains a lot.