Heterosexual HIV diagnoses overtake those in gay men for first time in a decade | Hacker News Reader

Heterosexual HIV diagnoses overtake those in gay men for first time in a decade

tht.org.uk

87 pointsmudro_zboris120 comments

Let's do some back-of-the-envelope calculations.

According to the article, "Half of all new HIV diagnoses were in heterosexuals (49%) in England in 2020, compared to 45% in gay and bisexual men."

Based on the official UK statistics, gay men are about 0.85% of the adult general population. [1] Based on the same source, 93.2% identify as being straight.

Then, if the incident rates were the same, you'd expect the straight HIV diagnoses to be about 110 times [2] the gay ones. However, the real number is ~1.09 times [3].

That means the incident rates are not the same, and gay men are about 101 times [4] more likely to be diagnosed with HIV in England. (This is of course just a ballpark number, but the point stands even if the numbers are a bit off)

[1]: https://www.ons.gov.uk/peoplepopulationandcommunity/cultural... ("Around 1.7% of males identified themselves as gay or lesbian in 2017", this might be a slight underestimate because of people being closeted etc.)

[2]: 0.932/0.0085 ~= 110

[3]: 49%/45% ~= 1.09

[4]: https://www.wolframalpha.com/input?i=%280.932%2F0.0085%29%2F...

Even if the estimates are off by a lot, your point is still pretty clear. This is that bias talked about with covid, right? What’s the name again? Where “more vaccinated people have covid” doesn’t mean what some suggest when most people are vaccinated.

Base rate neglect

Those covid stats[0] are age standardized and per 100k people. There are still other differences between the populations that could explain it (for example the vaccinated are probably getting tested more often), but it's not as clear as this.

0 - https://publichealthscotland.scot/publications/covid-19-stat... page 33 of the full report

Simpson’s Paradox?

This is an interesting point about sampling, but I think it's also somewhat moderated by the fact that gay men also get tested much more frequently for HIV and other STIs.

Put another way: half of all new HIV diagnoses are in heterosexuals, who as a population are significantly less likely to be tested for HIV to begin with.

I'm the US and not the UK, but I think the last time I was tested for HIV was when I was in college. When I told doctors that I was straight, they ordered tests for other STIs, but never HIV.

But at most there would be a delay of a few years in diagnosis if they are more prompt about it. No one goes too long with an untreated HIV infection before symptoms become noticeable

> No one goes too long with an untreated HIV infection before symptoms become noticeable

It's not that simple: The chronic phase of HIV is frequently asymptomatic, and frequently lasts over a decade[1]. Even the AIDS phase can last for years before an opportunistic infection causes severe enough illness.

The initial (acute) phase has flu-like symptoms that people typically ignore.

[1]: https://hivinfo.nih.gov/understanding-hiv/fact-sheets/stages...

Granting a decade long delay in diagnosis of all heterosexual HIV+ cases vs instantaneous diagnosis of homosexual men, the disparity still doesn't explain much - unless there is orders of magnitude shifts in the infection rates among heterosexual people over that time period.

> unless there is orders of magnitude shifts in the infection rates among heterosexual people over that time period.

There are two forces at play: decreasing infection rates among gay men, and increasing infection rates among straight men. Both aspects of the curve are "doing work" to change the statistics.

But yes, there are significant shifts that explain these changes: increases in IV drug use, a decline in condom use among straight sex partners due to readily available alternative prophylactics, and an overall increased emphasis on testing the entire population for HIV/AIDS.

> There are two forces at play: decreasing infection rates among gay men, and increasing infection rates among straight men. Both aspects of the curve are "doing work" to change the statistics.

You may have missed the point — only one of those is modulated by (relative) delay in heterosexual diagnoses post-infection.

It's so disproportional that a small number "wrongly" associated with the larger cohort would mean in reality it's far more skewed.

I think you main point stands, but way more men have gay sex than are willing to self-report as gay or bi in a government survey

The bigger question is whether they're reporting it as they join infection statistics.

101 times?

That just increases the incidence relative to straight men.

Is that actually true? The last data I saw on this indicated that there are a huge number of people falsely claiming to be bisexual. That is, relationships amongst the population claiming to be bi are overwhelmingly hetero. The young especially think there are (real or perceived) social benefits from claiming to be gay or bisexual even when they're not.

Do you have the data for this? My experiences have been precisely the opposite. I have spoke to many bisexual men married to women on Grindr who were looking to cheat on their wives (or fantasised about doing it).

My experiences point to a lot of bisexual men living in the closet and are ashamed of what they are. I think guys in that situation typically want the heterosexual lifestyle of kids and marriage, but the thrill of sex with a guy on the side. There have been very, very few guys I've seen on there who are married to a woman who are able to openly explore sex with men with their wife's consent.

I can't really comment on women who are bisexual however.

Were those men genuinely bisexual, I wonder? Gay men pretending to be straight and ending up in family marriages is a very long standing issue, or was at least, I thought the "lavender marriage" was dying out.

https://slate.com/human-interest/2016/05/over-80-percent-of-...

"The massive 2013 Pew Research LGBT Survey found 84 percent of self-identified bisexuals in committed relationships have a partner of the opposite sex, while only 9 percent are in same-sex relationships"

The concept of ratios/proportionality is like a grade 9 math concept. I haven't seen the article, but if this is the case, the title is grossly misleading.

I didn't see the headline as misleading because it did not mention individual risk.

Would appending a clause mentioning that gay men remain at greater risk improve the headline? Or is it possible that this story should be presented in a very different way or not at all?

It's misleading because the first thing that comes to mind is "wow, the non-gay community is worse than the gay community when it comes to HIV!", which is completely wrong. It would be right if the proportions of both communities were the same, but they are 100x different.

True, the title does feel misleading, but I don't know how they could make it less misleading while conveying the same information. At least they mention in the article that "gay and bisexual men are still more impacted by HIV relative to population size".

I don't understand why you would use .85% if 1.7% is the correct (but possibly underestimate) number. Additionally, gay/bi is included in the same bracket so the real number would probably be 1-.932=0.068 instead of 0.0085

.932/.068= 13.7

Even though this is still pretty higher, it's probably much more realistic

> I don't understand why you would use .85% if 1.7% is the correct (but possibly underestimate) number.

I think 1.7% is out of the males, and males are about half the general population.

> Additionally, gay/bi is included in the same bracket so the real number would probably be 1-.932=0.068 instead of 0.0085

I think the 1.7% number also includes bisexual males, but I'm not completely sure. (The title of Figure 1 of the section in the source is "Lesbian, gay or bisexual")

My overall point isn't about the exact numbers though, and I agree that the government survey number is probably an underestimate.

Sorry, your point about exclusion of bisexuals was actually totally correct. Also, creata found more up-to-date numbers.

Wow, HIV spreads poorly through penile-vaginal intercourse.

…or heterosexuals are a hundred times less likely to engage in risky behaviour.

> "Around 1.7% of males identified themselves as gay or lesbian in 2017"

Another page on the same website says that "Between 2018 and 2019, the number of men identifying as LGB increased from 2.5% to 2.9%", so maybe 0.0145 is a better number than 0.0085?

https://www.ons.gov.uk/peoplepopulationandcommunity/cultural...

I'm confused, why you are both halving that statistic?

Because what we have is:

  # of gays / # of males

but what we want is:

  # of gays / the whole population

Yes, the ones you found are more up-to-date, and the more recent numbers probably suffer less from the closeted people/stigma bias. Also, as cuteboy19 pointed out, my number excludes the bisexuals. Unfortunately, I can't edit my comment.

I still think the overall point remains valid though.

Your comment is quite misleading, I think.

It reads as if you expose the article to make a wrong statement about incident rates. The article however however is purely right in this regard. It does not talk about comparison of incident rates at all. Its first sentence already clearly talks about numbers of HIV diagnoses.

If your comment would be like "Don't read the title in a wrong way. HIV is still much more common among lgb men than among heterosexual men and women. Reason is that lgb men are around 2.3% of all men compared to heterosexual mean and women who are 93.2% of the population" it might be helpful.

> It reads as if you expose the article to make a wrong statement about incident rates.

No? But you could read it as "exposing" the fact that it mentions incident rates only vaguely [1], and that the title is chosen strategically. (The article looks seems to be part of a public health campaign to encourage heterosexuals to test for HIV, and that's probably part of the reason.)

There were a couple of comments which raised valid points about my rough estimate though.

[1]: It only says "Gay and bisexual men are still more impacted by HIV relative to population size", but the question of by how much seems to be left an exercise for the reader.

The article makes this point and the headline which several have objected to does not mention rates of infection in the two populations. New infection volumes are also affected by the population infection rate in the respective groups and the time to diagnose and treat. If you wanted to be a bore, you could model the number of expected encounters with the virus in each population and figure out the relative transmission rates too.

The take away from the article is that your risk as a man who does not have sex with men is nonzero and that regular testing is important to personal health outcomes and to keeping infection rates low, and that cheap and effective preventative measures are available, including PReP and PEP. After thirty-odd years of dealing with it, MSM be aware.

Wow, this is really fascinating to me. The article touches on this, but PrEP has to be having a huge impact. PrEP is now the default basically for young gay men, at least in urban settings. Plus, since gay men are more likely to know their status, they're more likely to be on treatment allowing "U=U" to be a thing: undetectable equals untransmittable.

Also, generally being on PrEP involves a full run of STI testing including HIV quarterly. I would imagine that most straight people do not get tested for STIs as regularly.

Heck, most people don't see their doctor for any reason quarterly in the US.

Agree heterosexuals don’t get tested as often for STIs (humans are terrible at quantifying risk). Really needs to be a part of an annual metabolic panel you’d have performed alongside a physical. You’re already doing the blood draw, just order the tests and grab an additional vial. If you’re sexually active with multiple partners, quarterly, regardless of orientation/preferences.

Right.

For PrEP they require a blood draw anyways to check creatinine levels since it can indicate side effects involving the kidneys, so you may as well draw blood for everything else too.

You also need to continue testing for HIV because it is easy to take prep wrong and miss tablets.

Who sees a doctor quarterly? Much less gets quarterly panels? My super premium insurance wouldn’t even cover annual pannels (only one every 2 years) when I was under 30

Haven't seen a doctor in at least 10 years (not counting dental and eye care).

Bit of a tangent, but I encourage you to at least check your blood-pressure occasionally. Hypertension is called "the silent killer" for a reason.

You don't need to see a doctor, in many places you can get STI tests at a clinic or blood lab.

I think a test ("proscribed" online) was over $200 for a basic panel and Qwest or Labcorp almost didn't want to accept it because it wasn't from a local doctor. I just had my yearly physical (after not going for a few years) and the basic blood panel not including stds was $500 total and only 300 was covered by a fortune 500 company insurance. The cost is prohibitive. Though I have a feeling women get the test for free possibly?

Definitely not my experience. Decent US insurance, my annual physical, metabolic panel, and STI screen is free.

For those in your situation, Planned Parenthood might be an option for reduced or no cost STI screening.

Slightly misleading implication in the headline.

Heterosexuals did not "overtake" gay men (HIV diagnoses amongst heterosexuals dropped too), so much as gay men have been so effective at reducing transmission over the last 5 years that they've "fallen behind".

https://www.gov.uk/government/statistics/hiv-annual-data-tab...

Important to note that once you adjust for the base rate (gay men being well under 10% of the population), the risk among gay men is still much much higher.

Inclined to agree, but I feel it's potentially dangerous to think these are actually distinct populations.

Plenty of HIV+ "hetero" folks are hiding their homosexual activities, for myriad obvious reasons, i.e. the stats probably aren't accurate.

Don't assume you're particularly well insulated because you think you're playing bareback in the non-gay pool. Plenty of folks are pissing in all the pools, there are no boundaries.

It's not just about pools of people. Anal sex is inherently more dangerous regarding STDs.

> It's not just about pools of people. Anal sex is inherently more dangerous regarding STDs.

As if heterosexuals don't have anal sex. Back in my teens it was a running joke that the catholic girls would only do anal before marriage, give me a break dude.

So even assuming that this very old meme was ever true to any significant degree (why would you think it is?), do you really think straight people are anywhere near as likely to engage in anal sex with massive numbers of partners like gays are? Do you know how gay bath houses used to work? A guy could go to one of those and have anal sex with a dozen men in a day. And then go back the next day or next week for a different dozen men. It was so bad that San Francisco only allowed them to reopen like two years ago, having originally forced them shut in the 80s. San Francisco!

I assume a lot of gay men are informed of the risks and opt for alternatives like oral and/or hand jobs on the regular.

Attended a catholic private school growing up in an extremely conservative+religious part of the midwest, not really interested in divulging anything more personal than that on the subject. But I can confirm it's not a pure myth.

I'm firmly against woke culture, where you'd be attacked personally for writing up some homophobic vitriol. I don't want to live in a place like that, and I won't go anywhere near San Francisco.

Instead, here's a reminder that being prejudiced is quite normal. It's easier to associate gay people with promiscuity, to connect those dots, than to think of people differently along so many axioms of different traits.

I'm reminding myself as well. Can't judge another with one finger without the remaining fingers pointed at myself (well except for the thumb).

No prejudice here. Some gay people are promiscuous. Some straight people are promiscuous. Some straight people have anal sex. Some gay people have anal sex.

But what's also true is that gay people on average are much more promiscuous and much more likely to have anal sex. This is obvious to anyone who knows any significant number of gay people. And it is also reflected in countless surveys.

As a bisexual, I've met more promiscuous women than men.

This isn't just a joke among students at BYU, either.

I replied with this in a thread further up, but I'll put it here as well: gay men get tested for HIV much more frequently than heterosexual men do.

HIV diagnosis rates are subject to both a latent rate bias and a skewed sampling bias: if the average gay man gets tested 10 times (factor chosen at random) as often as the average straight man, then we would expect higher positive diagnoses in a smaller population without as much (if any) underlying difference in true positive rates.

The problem with your whole little theory is that when previously undiagnosed HIV kills you (and it does), it doesn't do it without the doctors figuring out you have HIV. Do you really believe that HIV rates for straight and gay people are comparable?

It's not a theory. You can look at the raw testing data from the UK yourself[1]: the gay male population takes HIV tests at 10 times the rate of the straight male population.

I'm not saying that the infection rates are comparable, because I don't have any hard data to support that. But the story is much more nuanced than "gay people are significantly more likely to give each other HIV," and will continue to gain nuance over time.

[1]: https://assets.publishing.service.gov.uk/government/uploads/...

You just ignored my whole point that HIV doesn't secretly kill people in Western countries. By the time someone dies, the medical system knows whether they had HIV. Either we catch it early enough to successfully or somewhat successfully manage it, or we catch it once it starts killing you.

> You just ignored my whole point that HIV doesn't secretly kill people in Western countries.

HIV is positively correlated with overall morbidity: straight men who are in risk categories for HIV (in the US) are also in risk categories for overdose, violent death, and exposure (homelessness). We don't test people who die from these things for HIV, and we don't have a unified federal (or even state) tracking system for correlating those deaths with HIV diagnoses.

Even if these cases were a minority, you're still misunderstanding the basic statistical shape here: fewer than 35,000 people receive positive HIV diagnoses each year, and diagnoses frequently don't happen (especially in non-gay/MSM population) for years after initial exposure. In other words: our sampling for the straight population trails our sampling for the gay/MSM population by at least a decade. This is especially important to factor when you consider that PrEP only really became universally available in the last decade, and that the last decade has also seen an unprecedented rise in IV drug use.

So the problem with this explanation is the straight infection rate is steady while the gay one is what’s changing recently. There’s no reason to suspect a yet undetected spike in straight infections.

> So the problem with this explanation is the straight infection rate is steady while the gay one is what’s changing recently.

No, the sampled rates for each are what they are. I've extensively described the sampling bias with each.

> There’s no reason to suspect a yet undetected spike in straight infections.

There doesn't need to be a spike for what I'm saying to be true. But even still, demographic trends support the (unverified!) hypothesis that straight men will continue to grow as a proportion of diagnosed HIV cases: increased IV drug use, increased availability of non-barrier prophylactics, etc. But again, I've said all of this before.

"On 14th June 2021, the UK implemented a new blood donation policy allowing gay, bisexual and other men who have sex with men to donate blood without any waiting periods [...]" https://en.wikipedia.org/wiki/Men_who_have_sex_with_men_bloo...

This is unfortunately still very common. Trans people do not even need to have sex to be excluded (merely existing suffices, we're all prostitutes don't you know) from donating blood here in Germany.

Funnily enough one of the sources used in the risk assessment report made in the 2000s was literally a porn site.

The medical field in general has room for improvement when it comes to behaving sensitively and respectfully towards trans patients. If you're trans then you don't even need to be donating blood to feel disrespected. You could just be going for a routine checkup. It's sad and things definitely need to change. Anyway, here's numbers relating to the subject at hand: https://www.chrisstucchio.com/blog/2016/why_gays_cant_donate... Ultimately it boils down to the tests aren't very accurate, so many policymakers decided to use bias against groups as a stop-gap.

Unironically: The way to find a doctor as a trans person is to ask on Twitter.

Unfortunately doctors here are very sue-happy when you write about how they're bad to trans people, so lists of recommendation and anti-recommendations are often only made and shared in private.

Or move to a metropolitan area with a health clinic that caters to LGBT people like Callen-Lorde in NYC or Mazzoni Center in Philadelphia. That way respectful treatment is a sure thing. The gay aristocracy privately donates a lot of money to take care of the health needs of their own. It makes the world healthier and safer for everyone gay and straight.

Also this now: "Fast-spreading HIV variant doubles rate of immune system decline" https://news.un.org/en/story/2022/02/1111372

What about HIV incidence in gay women? Doesn't it deserve a mention?

It's the US and not the UK, but here's the breakdown for 2019[1].

TL;DR:

* 66% of recorded infections are in the gay/MSM population;

* 23% of recorded infections are in the straight population

The site doesn't provide the actual statistic for gay women/WSW, but those two numbers imply that it's around 11% (+/- 2% for the transgender population, which is also not clearly factored out.)

[1]: https://www.hiv.gov/hiv-basics/overview/data-and-trends/stat...

There was the conspiracy theory that the covid vaccines would give people AIDS or VAIDS as they say.

So this is an interesting development

There was also the counter theory that the corona virus had been mixed with HIV components in a lab and would give AIDS to people that had no vaccine

Interesting to see how this theory pans out

Oct 2020, https://www.science.org/content/article/could-certain-covid-...

> Cold-causing adenovirus used in four experimental COVID-19 vaccines increased risk of HIV infection when used in AIDS vaccine trials ... In today's issue of The Lancet, four veteran researchers raise a warning flag about those COVID-19 vaccine candidates by recounting their experience running a placebo-controlled AIDS vaccine trial dubbed STEP.

Feb 2022, https://www.theguardian.com/uk-news/2022/feb/10/prince-harry...

> Prince Harry: get tested for HIV to protect others in same way as for Covid ... Every single one of us has a duty, or at least an opportunity, to get tested ourselves to make it easier for everybody else to get tested.” Noting there had been a drop in HIV testing during Covid, he added that with people regularly testing for coronavirus, it should be “ingrained in us that that’s what we need to do, to know our status in order to be able to keep other people safe”.

Feb 2022, https://www.healthline.com/health-news/moderna-launches-clin...

> Moderna and International AIDS Vaccine Initiative (IAVI) have launched the clinical trial of an experimental HIV vaccine that utilizes the same mRNA technology used in some COVID-19 vaccines ... The development of an HIV vaccine has taken decades, and the mRNA technology may help speed up the process.

Moderna stock is down 58% in the last six months, https://www.google.com/finance/quote/MRNA:NASDAQ?window=6M

Moderna's Covid vaccine dosage was reduced by 50% in the FDA-approved booster, from 100mcg to 50mcg, https://www.modernatx.com/covid19vaccine-eua/providers/dosin.... Pfizer's Covid vaccine dosage for adults was unchanged at 30mcg in their FDA-approved booster. Pfizer's Covid vaccine dosage for 5-11y children is 10mcg, https://www.cdc.gov/vaccines/covid-19/downloads/Pfizer-Pedia...

Article doesn't offer many reasons why. I wonder if anal sex is on the rise

@spywaregorilla 'Heterosexuals were also far more likely to be diagnosed late, meaning damage to the immune system has already begun. More than half (51%) of women, 55% of heterosexual men and 66% of those aged 65 and over diagnosed with HIV in 2020 were diagnosed at a late stage. This compares to just 29% of gay and bisexual men. This is likely driven by a belief that they are not at risk of HIV, which is often reinforced by healthcare professionals.'

seems a possibility

> it’s primarily the result of a sharp, sustained drop in diagnoses among gay and bisexual men with a 71% fall since 2014.

https://www.theguardian.com/commentisfree/2022/feb/09/hiv-in...

People that identify as heterosexual have extremely poor STD testing routines.

People that identify as gay or bisexual have better STD testing routines.

All groups have better STD testing routines and preemptive measures than before.

Gay and bisexual groups have better results by being more proactive.

No new risker behavior is being seen as more prevalent from this data, in the UK.

I wonder if increasing public acceptance of gays is helping as well. Maybe in the past, you were kind of forced into the 'gay club'/promiscuous sex subgroup, even if you were just looking for a longterm monogamous relationship, because there just weren't many places to meet potential partners.

probably helps, the mobile-first dating apps have had a pretty wide and nearly immediate rollout across all orientations over the last decade - which is the time period this report looks at - so people could find each other based more so on the theme of the app (longterm, fling, religion, wealth, extroversion, introversion etc) instead of just the supposed theme if their orientation (but thats an option too)

Actually apps like Grindr (and ofc Tinder for heterosexuals) allowed for more short-term sexual contacts than ever before, thereby massively helped the spread of STIs.

short term sexual encounters will outnumber introverted long term ones, this thread is about the option of choosing where you want to find connection being better, within a comment thread about only HIV spread going down, not all STIs. I think its an ok observation just not really what we’re going over or trying to imagine an optimization for

There’s a bad moon on the rise.

"The fall in diagnoses among gay and bisexual men is a result of the growing availability of HIV prevention pill PrEP and targeted promotion of routine HIV testing followed by the rapid initiation of HIV treatment for those diagnosed, meaning they are more quickly virally suppressed and cannot pass on HIV."

Sexually active gay men generally take PrEP.

At least in many localities in the US, PrEP is free or nearly free and free testing is nearly always available, if you identify as non-heterosexual (or belong to other at-risk groups as identified by your local government, like needle users).

The end result: historically at-risk populations have HIV more-or-less under control, while populations that historically have considered it a non-or-low risk (heterosexuals) don't. It has nothing in particular to do with sex acts.

It's primarily that it's wrong.

Men who have sex with men are a tiny proportion of the population so the effective rate of infection is still (as we've known for four decades) far higher in these people.

They also don't account for other key risk factors: IV drug abuse, increased immigration from high incidence populations such as Africa and heterosexual woman who have sex with bisexual men.

Apparently understanding numbers and statistics is too hard for people trying hard to fit facts to woke narratives.

I think we need to seriously consider mandatory HIV screening with health pass technology at bars and restaurants. We’ve got a good framework from Covid and we can use that technology to force everyone to get an HIV test. The vast majority of new infections are caused by people who don’t know their status so I think it’s a no brainer to require this of anyone who wants to eat at a restaurant or bar or even purchase non essential goods. We owe it to the people who go to restaurants on dates with people who don’t know their status. Maybe also require the HIV test pass to enroll your kids in school.

Sure also it should be a condition of employment for all government workers and osha should mandate testing because it’s a hazard if you get cut and bleed. We need a presidential order to make it happen. I’m with her! Again!

> I think we need to seriously consider mandatory HIV screening with health pass technology at bars and restaurants. We’ve got a good framework from Covid and we can use that technology to force everyone to get an HIV test.

I'm going out for dinner with my wife, and you want me to have to get an HIV test to get into the restaurant? No. Get lost. Not all of us go into restaurants to try to score, and we're tired of people trying to dictate how we should live "for our good".

> I think it’s a no brainer to require this of anyone who wants to eat at a restaurant or bar or even purchase non essential goods.

Doubly get lost. I know HIV tests exist; if I want one, I'll get one. Stop trying to force me to do what you think I should do.

Or was that sarcasm, aimed at the Covid "response"?

Given that obesity related conditions are the biggest health risks out there, perhaps we should mandate blood pressure and body fact caliper checks?

Yes. And carb passes that you need to flash in bar, restaurants, shops to purchase anything edible or imbibible. Plus a mandatory diet check every 4 months, or else you are not allowed to work in a society. Want to eat whatever you want? Go grow it yourself!

There are easier ways to combat obesity. Taxing sugar/fructose are some proposals

You can buy about 1100 calories of candy for $1 at Dollar General. Taxes aren’t gonna do it.

I’m not so sure, personally I usually don’t end up having unprotected sex with everyone who comes within a few metres of me in a bar or restaurant so I’m not sure this would give me much more protection than the status quo.

I’m shocked that you aren’t willing to put up with the mild inconvenience of an HIV test to make sure that people don’t die of HIV.

Then I have good news for you! I have in fact had an HIV test, negative thankfully. So you can rest easy now.

Missing /s ?

HIV isn't an airbone disease.

doesn’t matter if it’s airborne. What matters is that people goes to bars and restaurants to hook up. Seems super dangerous and deadly to not make sure everyone at the club is HIV-! Especially when it would be so easy to expand Covid passes to other diseases and health screens! Almost all HIV is transmitted by people who don’t know their status so this seems super obvious to me. Excuse me now while I inject this 9th Covid booster into my eyeball.

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