Would this be recommended for anybody sexually active? Or just for people in higher risk like someone with a partner that has HIV or if you're homosexual?
If it's 99% effective and has close to zero sideeffects that's very different from 60% effective and significant sideeffects. In both cases there are probably some people you'd recommend it to, but in the first case you may just recommend it to everyone, in the second case probably not.
You could remove it as an endemic disease in the US and Europe. In places like South Africa where a third of the population is infected, nothing less that a blanket vaccination campaign would work.
(And of course it is not easy to find out who the high risk people are when both HIV and sexual promiscuity are stigmatised, so you might need to vaccinate everyone anyway to avoid costly errors...)
This may actually reduce the HIV infection rate to a large degree. Or people don't take the effing vaccine despite the benefits. Then yes, probably anybody sexually active should get it.
Agree - if we can get rid of HIV we should. I looked at the exclusion criteria in the trial and it didn't mention use of a prophylactic. Widely available prophylactics have been a huge success with preventing HIV, I wonder how that will impact the trial.
"Anybody taking the vaccine" (not "everybody") will actually not eradicate the virus, but rather protect those who take the vaccine. Much like now with Covid.
Everything else is just a question of the statistical signal detection. Those Studies are planned and designed to provide such a signal, with all we know about HIV prevalence (which is already quite low, in most industrial countries, speaking statistically and for the overall population) and the effectiveness of prophylactic treatment.
Also what I'm hearing the prophylactic treatment is not much fun either... I rather see the danger of participants getting the placebo, drop the prophylactics and think they are protected...
So the safety profile will be hugely important in determining how widely to use it.
https://www.cdc.gov/hiv/basics/prep.html
I think the idea in long term would, should be to replace PrEP.
Probably not. PrEP has some nasty side effects. Those who take it need to get their organ function checked every few months (I think just kidneys?).
Of course this vaccine is just entering trials. We have no idea how effective it is, or what the side effects might be. As such we can only guess and hope that it is better than PrEP - though that is a somewhat low bar.
"HIV-positive individuals who use Truvada to control their infection are more likely to experience kidney damage and bone density loss than those who take it to prevent HIV infection, as so-called pre-exposure prophylaxis (PrEP)[2]. But “no significant health effects have been seen in people who are HIV-negative and have taken PrEP for up to 5 years,” according to the U.S. Department of Health and Human Services. Numerous studies have shown that the risk of HIV-negative Truvada users developing kidney disease is not statistically significantly different from those taking placebo[3]."
https://healthfeedback.org/claimreview/hiv-drug-truvada-link...
Please don’t spread this FUD. The side effects are rare and reversible by stopping the medicine. The checks are also required to check for other STIs.
The price for PrEP is also very different from country to country. In some countrys it's almost for free, in some others is very, very expensive.
It won't be necessary for most folks to take both, though, that's just not how things work.
My point being, if we have a magic pill that cures them of a given STD, but there are underlying cultural problems that contribute to elevated STD transmission (such as unprotected sex or rape), etc., then the magic pill is only a bandaid that doesn't address the underlying elevated STD transmission problem.
As a sibling comment stated, maybe the problem is that these Africans believe homeopathic cures like special tea leaves will protect them from HIV when in reality they are just all having unprotected sex, so it's both a cultural and educational issue.
But to the point: the major driver of the early explosion of HIV on the continent was almost certainly large-scale vaccination and medical treatment campaigns by colonial governments, which injected staggering numbers of people in rural areas without adequate disinfection of needles.
In the present, the sociological drivers of HIV spread do include rates of nonconsensual sex (particularly between teen girls and older men). More important factors, however, are historical and contemporary patterns of urban/rural migration and long-distance transit networks. The distinctive forms of cyclical migration created by the shape of the mining industry in apartheid South Africa are the largest reason that the pandemic is so much worse in that region than anywhere else on the continent.
Research is pretty clear that Africans understand that condoms work to prevent HIV transmission - there have now been decades of public education campaigns on the subject. That doesn't mean they are always used, of course, but it's not a knowledge problem.
I admit I am not an expert. I formed an opinion after scanning the official wiki on the topic (https://en.wikipedia.org/wiki/HIV/AIDS_in_Africa) which says things like: "High-risk behavioral patterns are largely responsible for the significantly greater spread of HIV/AIDS in Sub-Saharan Africa than in other parts of the world. Chief among these are the traditionally liberal attitudes espoused by many communities inhabiting the subcontinent toward multiple sexual partners and pre-marital and outside marriage sexual activity." and don't mention anything about migration patterns being the more important factors.
So if this is actually your field of study, it would be helpful if the wikipedia article were updated with the latest research.
That said, I really think you should reflect on how much research you did (read a wikipedia page) before stating that Africa's high HIV rates compared to the rest of the world are due to "a culture of rape/unprotected sex" or quack-medicine. (Also, I don't see "rape" anywhere on the wiki article you linked.)
I never stated those things authoritatively. I threw them out as potential example factors because those were things I saw during my brief wikipedia foray.
> (Also, I don't see "rape" anywhere on the wiki article you linked.)
Yeah because it wasn't on that page but a related page:
Colonial governments were mostly out of Africa after the 1960s.
>In the present, the sociological drivers of HIV spread do include rates of nonconsensual sex (particularly between teen girls and older men). More important factors, however, are historical and contemporary patterns of urban/rural migration and long-distance transit networks. The distinctive forms of cyclical migration created by the shape of the mining industry in apartheid South Africa are the largest reason that the pandemic is so much worse in that region than anywhere else on the continent.
That's being very disingenuous. What makes periodic migration by miners in South Africa different from large-scale worker migrations elsewhere in the world? Mexican farm workers to the US, half of China, or for that matter Canadian, Russian, and Australian miners, or oil-rig workers everywhere. It's not so much the migration patterns, but what the migrants do (or don't do) when "back home".
HIV was probably spreading in the Belgian Congo in the 1920s. It likely spread to the US in the 60s. It takes a decade for HIV to turn into AIDS, which is why we think of the pandemic as starting in the 80s.
The median time is a little longer than that, but the range goes down to less than a year. We think about it as starting in the 1980s because that's when the diverse manifestations were recognized as a common syndrome, not because that's when symptoms first appeared in the US (in fact, there is a case retroactively identified as a death from full-blown AIDS in the US in 1969.)
Do you have a citation for that? I’ve never seen it authoritatively claimed and “almost certainly” seems strong for something which isn’t at the standards for inclusion on the Wikipedia page.
There are parallels between the disinformation in the anti-vax Covid community, and the disinformation in regards HIV in Africa.
HIV transmission is related to sexual activity not sexual orientation. Being in an open relationship, cheating on your partner, performing unprotected sex, are all examples of behaviors that put people at "higher risk". Being attracted to your own gender does not.
Which all goes back to teh point: HIV transmission isn't related to sexual orientation, even if some sex acts are traditionally attributed to one specific sort of orientation.
I’m bi, and hiv is a big deal in the gay community. I know people who have it, we have clinics around dedicated to treating people with it. Straight people can do anal, straight people can get it otherwise, but this is hitting gay/bi men way harder. It’s okay to acknowledge that
So yes, being a homosexual man is a huge risk factor and probably more significant than being in an open relationship, cheating on your partner or performing unprotected sex unless you live in Sub-Saharan Africa.