Edit: I don't mean this should be an alternative to traditional protection. It just adds another layer of certainty.
Already up to 1/2 of new HIV infections are from people who would test negative in this test; early stage infections. This is because people who have been newly infected are about 4,000% more likely to transmit infection than those who are in late stage infection.
If condom usage dropped even a small amount as a result of this test, it could considerably worsen the epidemic.
From a public health perspective this could be a terrible, terrible disaster.
...1/2 of new HIV infections are from people who would test
negative in this test...
http://www.nature.com/nm/journal/vaop/ncurrent/full/nm.2408....
ELISA is an antibody test.
http://en.wikipedia.org/wiki/ELISA
The 100% detection refers to the detection of the antibodies, not the general detection of HIV infection.
If you're already practicing to be safe, you still worry about the possibility of something going wrong, and you contracting the infection anyway. With this, you can be more certain that nothing will go wrong. You would still use a condom just in case.
Your argument is like saying people engaging in random sexual activity should close their eyes because not seeing warts will lead them to believe the partner doesn't have warts - which may lower then chance they use a condom. This would offer more information, and if it turns out that person is HIV positive by the test, you'd be eliminating your chances of contraction altogether.
The problem is that there is a very real possibility that someone who would go to a bar and test their partner there would then proceed to have unprotected sex instead of using a condom. A test could give them a false sense of security.
While you personally might still use a condom, judging by the reaction to this in the comments on engadget, many would not, not realizing that they actually are putting themselves at greater risk.
When/if this makes this to the FDA, they're going to look at the overall public health risk. If they assess that such a test would lower condom usage, they'd be unlikely to approve it. If you want to market this as such, you'd have to prove that people using it are just as likely to use a condom, and I think you'll have difficulty with that.
The reality is that ELISA tests in the US are cheap and fast enough already; anyone who wants to test themselves faces little barrier. The cheapness of this test is important for countries where that is not the case.
The problem is one of information interpretation. If the test results were given as either "Positive" or "Unknown", this would solve the issue, yes?
For instance, there's evidence that slowing the speed of an epidemic can result in a higher number of total infected.
I'm not at all saying this is bad. Cheap tests are good. However, we already know that test and treat- no matter how cheap it is- will not stop the current epidemic in the U.S. This is an advance in the cheapness of technology but it can't stop an epidemic, only (possibly) slow it. And even that could ultimately result in more people being ultimately infected, but that's not known for sure.
The only technology that can stop the epidemic currently are condoms. The only behaviors that can stop the epidemic are monogamy and using condoms. And it's possible technology such as this could reduce condom usage, and that's the disaster.
From a public health standpoint we need to watch out for anything that can alter behavior on a positive or negative scale. From the comments on engadget I would predict it would impact human behavior in a negative way, and that's what frightens me.
// It's also possible that it could prevent promiscuous sexual activity between people that wouldn't have used condoms and are infected.
I wonder if parking sensors increased the number of parking crashes because people stopped looking out of their windows when parking??? Anyone got stats on that?
At any rate, the analogy is weak. Testing partners for HIV only makes sense if you're planning to be in a monogamous relationship with them, and ideally should be done 6 months after the start of a monogamous relationship.
You should use a condom with a girl you meet at a bar no matter what. An HIV test doesn't help you at all.
Interestingly when I first got a cycle helmet was the first time I banged my head whilst cycling, though it was a direct factor (didn't account for the helmet when ducking under a tree). Seatbelts apparently cause some to take more risks.
http://www.cdc.gov/hiv/topics/msm/index.htm
"A recent CDC study found that in 2008 one in five (19%) MSM in 21 major US cities were infected with HIV, and nearly half (44%) were unaware of their infection." -- eep
Heterosexual college-town hookups? Likely to give you all sorts of things, but probably not AIDS. But expect to see these quick AIDS tests in West Hollywood and the Castro real soon now.
And for straight men who don't want to have sex with other men, it should still be a concern when over a quarter of new infections are suspected to be due to transmission during heterosexual sex.
I'd like it because it's a bit more convenient than going in every three months, but for testing a date? Bad idea.
Get real people.
It's counter-intuitive, but it's not a better idea.
Especially when drunk, people have unfocused attention. Signals of trust are amplified. "He's safe, and we don't have a condom, so just this once..." If you go into a hookup thinking every single person is HIV-positive with an entire host of other STDs, you are much less likely to get one.
You don't want to know how many people I've talked to who got HIV from someone they trusted, and "knew" was negative. On the other hand, by law of averages I've slept with at least 20 poz people. I don't know who they are, but I was smart enough to be careful.
But it's like lots of things in life: sometimes we can't have nice things because other people, who are much less mature and sensible than you, will misuse them, so nobody is allowed them.
Also, "paternalism" is an irritating dog whistle. We are talking about "public health policy", which also means such sensible things as that you can't have plastic surgery done in a car garage or buy cola sweetened with lead acetate or Cyclamate.
Condoms don't substitute for something equivalent that is safer (some people try to make out that they substitute for abstinence, but that is obviously not true since abstinence is obviously not equivalent).
This device could equivalently substitute for condoms (actually, it's probably cheaper and more fun than condoms as long as you don't mind a small pinprick), but it's less safe. Thus my opposition.
This device is not a substitute, nor will anyone with a conscience and a brain present it that way. It is something to be used in addition to existing technologies and sensibilities. It is about increasing available information so that people are able to make more informed decisions.
Now I think about it, you and me both should be fighting the catholic church and the american right over abstinence-only instead of fighting each other over exactly how HIV testing kits should be distributed.
Unlike this rubber seatbelt strawman, these tests actually work, and actually have a use. What is their use? Allowing people to make more informed decisions regarding their sex life and HIV. What is HIV in layman's terms? A death sentence. These chips will potentially allow people to avoid an untimely and painful DEATH, and you oppose them because you hypothesise that stupid people might ignore condoms as a result and get something instead that is either not deadly, or require nothing more than a few shots of penicillin.
Opposing the spread of such devices is beyond comprehension to me. It's flat out abhorrent.
The real concern here is that this test isn't accurate for as long as THREE MONTHS after initial infection, and that during that early stage you at at lease FOUR HUNDRED TIMES more likely to pass on the infection. It's not to be used to check if you're still healthy so now you can go bang that hottie at the bar, it's to be used to see if you have HIV and need to get treated.
Nice qualification. Guess where the majority of people in the world don't live. Guess what the countries with the highest HIV infection rates are not.
This whole conversation is only serving to make me more and more cynical than I normally like to be. I'm beginning to get the strong impression that there are some members of society that would actually be disappointed if a total cure that could be widely deployed to this plague were found. Like HIV is the enforcer for their idea of proper morals and skin color. I've heard this idea bounced around in LGBT communities before but never really paid it much credence until now.
For Third world countries, it's a different matter, I think this test is great. It helps a real problem by providing a convenient way to test for aids to doctors in remote villages and might help slow this awful epidemic...
Therefore: 1) This is also an argument for banning The Pill and the like in college towns. Clearly an idiotic idea. 2) Knowing their partner does not have HIV will not prevent people most people from using a condom if they were going to otherwise.
I was knocking around the idea of a website where you sign up with just an email and are issued a unique id, potentially with the ability to generate new ones on the fly. When you hook up with someone, you load an app on your phone or a website, and it generates a QR code. Each partner scans each others code and the website logs the encounter.
At some point, someone is going to get an STD/STI. When this happens, the infected parter can go to the website and with just a few clicks, you can send a notification to your recent (for some medical definition of recent), and they'll be notified to get themselves checked.
Now, the whole HIPAA compliance thing (or compliance in general, since the US isn't the only government affected here) would be a bitch and a half, and getting user adoption would be hard ("you use website.com? slut!"), but if it was safe and caught on, I could see it having a real effect on infection rates.
Some really common infections (chlamydia, gonorrhea) show no symptoms in a lot of cases, so just getting that easy notification could really help people identify that they have the disease, and so they could get quicker treatment.
I just wish I had the skill and finances to try it. Maybe some kid that wants to take a run at YC funding could use this as their idea?
How do you manage that risk? Otherwise, yes a wallet STD test would be a fantastic little thing to have available in "hook up spots"
UPDATE: Folks this is indeed one of the oldest jokes ever told. I’m not surprised nobody is laughing, my ability to tell a joke it matched only by my ability to compose rhyming couplets extemporaneously. But I am surprised nobody identified it as such.
http://www.youtube.com/watch?v=hEn0px0uJZQ
DISCLAIMER: despite being both clever and serious, this link is very NSFW.
http://www.lifesitenews.com/news/breaking-vatican-reaffirms-...
Do you have a reference?
I thought it was a hoot, anyway.
This is either a joke or the stupidest thing I've heard all month.
Anyway, the RCC does allow people to use condoms when the primary purpose is disease control and not contraception.
http://www.telegraph.co.uk/news/religion/the-pope/8148899/Po...
Alas, this was a joke AND the stupidest thing you’ve heard all month. I will be more mindful of Poe’s Law (as suggested elsewhere) in the future.
It's certainly possible that, when condoms are made widely available in a region, this will result in more people having sex. Likely, even. The Vatican's position is that this increase in people having sex outweighs the lower average chance of transmission.
This is empirically false. But it needn't be inherently. Suppose you offered people some other form of protection that decreased the chance of transmission of HIV by 90%, and for some reason in response to this people widely abandoned the use of the condom. This would increase the overall prevalence of HIV by a wide margin.
Take a model where this device decreases the chance of transmission of HIV by 0%, while making some decent sized chunk of people more likely to have unprotected sex because of a false sense of security.* In that case, passing this out at night clubs would likely significant increase HIV's prevalence.
I see a definite use for it, but more in the way of buying a 4 pack every year and not having to go to a clinic.
*I think this model is likely correct, given what we know about the epidemiology of HIV.
Generally, the best public safety campaigns work are "defense in depth". You discourage sex in general, discourage unsafe sex, discourage casual sex, discourage polygamy, provide condoms, and encourage tests. It all generally works, as long as you don't treat any of it as a magic bullet.
It's the extremists who either think a) abstinence is the only protection; or b) causal sex is fine as long as you take precautions; who cause problems, as they tend to discourage defense in depth.
So ideally, they would have an ambiguously enthusiastic "Over 90% accurate!" blurb, and be packaged with a condom or two.