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Comment by briefcomment | Hacker News Reader

Does this require everyone to get it?

I presume it would only be recommended for those who are sexually active (particularly homosexuals like me) and those who regularly use needles.

Many who are 'sexually active' are also unwillingly so. By that criteria, it would be best to recommended it to all women and all prisoners in the United States, due to how common rape is among those populations here. I'd like to say "we are better as a society" but that's not true yet, and in the meantime, at least I won't have to worry about AIDS when it's my turn to be raped.

I feel confident enough that I don't have to look this up, but I might be wrong. Most women in the US surely aren't raped right? Not even 0.1% of women in the US get raped no? So I don't think you need to forcibly vaccinate people because of any rape risks.

Most people who are sexually active are voluntary so, so let's just assume people are not talking about sexual assault when talking about an active sex life.

> Most women in the US surely aren't raped right? Not even 0.1% of women in the US get raped no?

You’re presumption is so bad it’s not even wrong.

> “Nearly 1 in 5 women (18.3%) and 1 in 71 men (1.4%) in the United States have been raped at some time in their lives, including completed forced penetration, attempted forced penetration, or alcohol/drug facilitated completed penetration. [0]

[0] https://www.nsvrc.org/statistics

> Most women in the US surely aren't raped right? Not even 0.1% of women in the US get raped no?

It's closer to 15%.

https://www.rainn.org/statistics/scope-problem

EDIT: Wow people really hate rape statistics.

If you look up the history of the HPV vaccine and how a subset of the United States decided that it wasn't acceptable to protect women from cervical cancer because 'reasons', you can start to get a sense of the kind of uphill battle an HIV vaccine will face. It's hard enough to explain to parents that it doesn't matter if their kid is sexually active for HPV, imagine how much worse it's going to be when they add "10% of girls will be raped before they turn 18" to the mix.

So rape ends up being epidemiologically-relevant to STD vaccines, but there's a lot of folks who would rather not confront that — even here on HN.

For the purposes of HIV, I would think that “attempted” is not very informative?

Irrelevant. If I successfully defend myself from a rape attempt by biting the attacker, that will be recorded as "attempted", and yet I will still be exposed to the risk of HIV infection.

I guess that’s the question: does “attempted rape” really expose one to risk of HIV infection? What fraction of attempted rape victims go on to contract HIV compared to those who were actually raped? What gets counted as “attempted rape”? If the victim escapes before anyone’s clothes are off, does that get recorded as attempted rape? Presumably in that scenario omens risk of contracting HIV isn’t meaningfully increased?

If the rapist spits on them, maybe. If the person being raped bites them in self-defense, maybe. If the rapist is wounded and bleeds on them (and others!), maybe. The statistic you seek is "unsuccessful rape attempts that did not result in fluid transfer risk to the person being raped, bystanders, or emergency responders". If you are able to find it, feel free to link it here. I suspect you will find that no such data is collected.

Fortunately, this is irrelevant. Given the severity of HIV, the full 18% figure can be safely taken at face value, for society-level disease prevention purposes. HIV is both expensive and deadly and vaccination is cheap.

So basically, if someone gets raped and gets HIV we can just blame them for not fighting back enough?

If that is the question, it's based on some abhorrent moral assumptions.

The “almost 15%” referred to the 14.8% experiencing “completed” rape, not the additional 2.8% experiencing only “attempted” rape.

As with any vaccine the ideal outcome is the general population is vaccinated and we develop a herd immunity. For a deadly disease like HIV spending the effort to eradicate the disease would be for the best, but like HPV vaccination there's a moral judgment tied to it that will prevent some people from accepting everyone should be vaccinated.

As a side note, it was ridiculous that it took so long for boys to start getting the HPV vaccine. If you're a public health person, even if your only concern is cancer in women, you still want to vaccinate boys to improve herd immunity. If you're a heterosexual man, even if you only care about cancer in women, you would like to have been vaccinated if you are a remotely decent person, because you don't want to give women cancer -- especially the women you have sex with, who, generally, are going to be people you care about. And additionally there are male health concerns related to HPV -- for heterosexuals, primarily oral cancer, and for homosexuals, possibly also anal cancer (these being generalizations, of course). These are nasty, lethal diseases. Surely they should be prevented as well? Given the multitude of common-sense reasons to do it, for the benefit of so many people, it was frustrating to watch it happen only with such a long delay.

Much of the opposition seemed to come from a vengeful kind of religious conservative who wants sex to have negative consequences. Those conservatives represent a familiar kind of evil.

Yet I suspect that some opposition also came from women who had a problem with protecting men's sexual health. This is a newer kind of evil, and even less sensible for women who are heterosexual, for the herd-immunity reasons I outlined in my first paragraph.

A more-widely-administered HPV vaccine was literally a win-win for everyone, gay and straight, female and male, and still it came about slowly and faced opposition. This made me despair of my fellow humans.

You do know that anal or oral sex with/by/for males isn't tied to sexuality. Straight heterosexual couples can have anal sex.

You're right, and I've added some defensive language, but please don't get distracted from the main point, which is that we had an opportunity to reduce the spread of a contagious cancer in people of all sexes, genders, and orientations, and yet we got into stupid fights instead of doing it quickly.

How would a man catch sexually transmitted anal cancer from another person, if not through homosexual activity?

Google (if you're not a work) "Anilingus".

Yet another reason to vaccinate.

Don't religious people claim that limiting your sex activity to one single person is the best way to prevent diseases at large scale? [obviously denying the frustration and alienation that goes with it]

What does "religious people" mean? ;-)

But sure, that works when people do it. Just like social distancing.

Relying on other people's good behavior at a large scale is a bad plan though.

Also not sure which number of partners brings the most frustration or alienation. One? Three? Zero? Each situation seems to bring its own problems. Life is suffering.

("One" is the best plan for most people, but it depends a lot on which one...)

[flagged]

HIV is sexually transmitted, so only sexually active people would be required to get a vaccine.

The high risk group is larger than that, though.

The public health community learned a hard lesson from this mentality with the HPV vaccine. Many young girls did not get the vaccine because they (or their parents) insisted they were not and would not be sexually active. The CDC recommendations for who should get the vaccine (which controls whether insurance covers it and whether military members are eligible to receive it) expanded from young girls to all people under 27, then to all people under 45.

Regarding HIV, why not get vaccinated if you have easy access to it? What is the harm in being immune to HIV?

OP asks about what's required, not what makes sense. Everyone needs to be required to get vaccines like measles and Covid because the vaccine doesn't work on everyone so we need herd immunity to ensure safety. HIV does not require herd immunity in the same way as there is no way to get it if you are in a monogamous relationship/not sexually active and don't share needles. Therefore the vaccine isn't required to ensure the safety of everyone that desires it.

> ...there is no way to get it if you are in a monogamous relationship...

People are frequently unfaithful without their partner's knowledge. Healthcare workers/Dentists are at an elevated risk of infection, and by association so are their partners. As are law enforcement, and their partners. If you routinely interact with the homeless professionally or as a volunteer, you're at an elevated risk.

>...monogamous relationship/not sexually active...

This is the same mentality that was so tragically wrong and disproven by the data numerous times, no? Girls grow up and eventually have sex, right? Sex is a very human thing, and proclamations about monogamy or abstinence tend to be more religious/cultural signaling than reflections of people's actual behavior or the real need for people to get vaccinated.

You left out transmission via blood.

Drug users are also high risk, as are any medical professionals that work around needles.

Wtf are you talking about?

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