The global fight against HIV is at risk
science.org
science.org
Imagine if you could test for this right before you "got down." I imagine that'd change the game.
Although, a terrible part of me wonders if the condom debate will become the same as masks.
Yeah there are fringe groups advocating for no birth control and all, but what's really their market share? Doesn't sound similar to the big divide we had a few years ago over masks.
It is why from my perspective the gay community at large has an intimate relationship with the phrase "new normal" because it seems like gay men's cultural understanding of what a healthy sex life looks like truly changed more or less permanently since the AIDS epidemic.
I'd happily raise any kid that came of it so I've never been worried.
Lol? Hormonal birth control has been around since the 1960s. Women old enough to remember a time before the pill are postmenopausal and probably not worried about conceiving. Women in their 30s today grew up in a time of omnipresent birth control.
Good luck!
Unfortunately, HIV tests can't detect early infection, which is when it's most transmissible. The Oraquick FAQ says their test is accurate 3 months after exposure. So there isn't much benefit to testing right before sex vs every few months.
It is at risk. 20 years of investment have gone into it. Now, many renowned HIV researchers seem to be pivoting to help covid / long covid efforts, an epidemic within the pandemic. And they are finding it is similar to HIV - the only reason we cannot cure HIV is because the virus hides where the HIV drugs can’t go in. Leading to high inflammation.
Many researchers believe that if we go all in on one of these, it is possible we can make breakthroughs in HIV, ME/CFS, and post-acute infection syndromes (PAIS) in general. I remain hopeful.
We need a real moonshot here for many things. i.e. similar to what long covid is trying right now https://www.nature.com/articles/d41586-023-03225-w
https://academic.oup.com/cid/article/75/Supplement_4/S557/68...
> "Critical to the therapeutics market has been the role of generic drug manufacturers’ ability to supply low- and middle-income (LMIC) markets with off-patent and licensed products at a high volume and relatively low cost."
HIV patients in wealthy countries are a cash cow for the pharmaceutical industry, at least for as long as a permanent one-shot cure is not discovered, but there's no profit in making drugs for people who can't afford to pay for them. As Goldman Sachs noted, discovery of a cure would destroy the market. Isn't capitalism great?
https://www.cnbc.com/2018/04/11/goldman-asks-is-curing-patie...
That price was half the cost of existing treatment and very high chance of success.
If capitalism actually worked, they would sell their cheaper and better pill. No shocker there, it didn’t happen (generics in India and so in).
If I was CEO of a drug company, I would certainly incorporate that (I won’t reap benefits) in research budget allocations.
meanwhile, some of the obnoxiously, obscenely wealthy individuals in the USA are running small pharm brands, either supplements or critical medicines. This wealth-crowbar was exposed to the public by the "pharma-bro" guy not long ago
If Wikipedia is correct, that drug was long ago out of patent doghouse. I don’t know why USA (government, nonprofit, bill gates I don’t care who) doesn’t just make generics. Ditto insulin, that is another glaring example of that insanity.
You could argue (very reasonably) that one of key requirements for free market is a freedom not to buy. That is a potential choice, but few billion of years of evolution says a very bad choice. Thus rather special status of healthcare in pretty much every country.
Back to the issue of capitalist drug research: maybe it’s just me, but most of the new drugs seem to come from USA. Other countries with less insane healthcare (not even sure if care is the correct word in USA context) system (e.g. NHS in UK) don’t seem to produce new drugs.
Ergo, this bad system seems less bad than others, at least as producing new stuff goes.
It's just you.
What we see from the US is re-patenting. Citalopram gets a minor change and becomes escitalopram, it gets a new patent and some bullshit sales pitch to make doctors switch from a cheap generic to a more expensive branded med. Or ketamine infusion becomes eskatamine nasal spray - moved from a generic and tricky to administer med to a branded and easy to administer med (and, it turns out, much less effective).
The other thing the US does is "Me too" drugs - someone develops an SSRI and the US is then able to spin up 8 different versions of SSRIs that are different enough to get their own names and patents.
Most of the funding in the US doesn't come from big pharmaceutical companies, but is government funding.
For the new meds that are developed in the US the funding normally comes from Government (NIHR) funding, and not direct from pharmaceutical companies.
It's also difficult to work out what to measure: do we look at GERD (gross expenditure on research and development) or do we look at GDP too? DO we look at the quantity of new meds, or the impact on quality of life or years of life lost to disability? Do we focus on meds aimed at diseases that affect wealthy countries (diabetes, breast cancer, etc) or on disease that mostly affects poorer countries? Because three meds that have moderate impact for a small population are "less" than one med that has a good strong impact on a large population.
Who screamed to give it away when who invented it? Who wanted to pay / set a $100k price?
Who made the existing treatment?
If capitalism worked who would sell the new pill for less? If it’s better, couldn’t you charge more?
https://en.m.wikipedia.org/wiki/Sofosbuvir#Society_and_cultu...
> In April 2014, U.S. House Democrats Henry Waxman, Frank Pallone Jr., and Diana DeGette wrote Gilead Sciences Inc. questioning the $84,000 price for sofosbuvir. They specifically asked Gilead CEO John Martin to "explain how the drug was priced, what discounts are being made available to low-income patients and government health programs, and the potential impact to public health by insurers blocking or delaying access to the medicine because of its cost."
People definitely caterwauled about a $100,000 drug regimen, nevermind that it is often a cure and a lot better than an organ transplant.
A breakthrough happens because the research community, available technology and it's economics are pointing in that direction anyway, even if the exact moment can't be known: i.e. Newton and Leibniz both inventing calculus around the same time.
If you're a pharma company and you find the cure for AIDS, then the race is on: someone else is very likely to find it within the same time frame (you know, if none of your thousands of employees decides to just leak it in its entirety).
There will be no market for for product if you don't get to market first: because anyone else will conclude the same.
"Suppressing the cure" doesn't happen. There are too many people involved, and no one goes into bioscience to not help people - the actual scientists don't get paid enough for that.
> Yet, current reauthorization is at an impasse because of misperceptions and inaccurate assertions that have no bearing whatsoever on PEPFAR’s purpose and work. Some conservative voices contend that PEPFAR funds support access to abortions, assertions that PEPFAR staff and public health leaders repeatedly affirm are groundless. Other concerns point to PEPFAR language regarding groups that scientific data have shown to be at-risk for HIV and whose members need HIV prevention and treatment services, including transgender people and sex workers.
Yes, but that's sort of irrelevant for PEPFAR, which is a foreign aid program.
it sounds like this is mostly about the US?
https://en.m.wikipedia.org/wiki/President's_Emergency_Plan_f...
Like what?
PrEP offers 100% protection against HIV.
It’s heavily subsidized through public health channels, manufacturer rebate programs to help with high deductibles for insured people, and grant organizations like the PAN Foundation. Truvada has a generic now. Plus, in 2019 the federal government designated it as a preventative therapy that ~all insurance plans must cover without copay or deductible [0].
Now, it’s true that not everybody is insured (though people who are economically vulnerable tend to qualify for heavily subsidized insurance under the ACA or Medicaid). Still, the costs of Prep specifically in the US, while very high, don’t tend to be borne by the patients directly.
[0] [PDF] https://nastad.org/sites/default/files/2021-12/PDF-PrEP-Cove...
The connection between marriage and abortion isn't what you think it is.
77% of abortions done by people who are not married and 46% done by women who are not married and not even cohabiting.
Abortion is a symptom of a problem which is the lack of marriage and the highly promiscuous lifestyle that is sold to us. Married people when there is a child on the way (planned or unplanned), there is little to no reason to get an abortion. Sleeping around lifestyle, of course the first thing that happens when pregnant, abortion...
And you realize that people of every age group are having less sex than any time in the last 30 years, right? It's almost like this "promiscuous lifestyle" you're so terrified of doesn't exist.
To make more women married, we would have to roll back the clock on all those hard won freedoms. Let's not do that, let's maybe just make birth control more accessible, effective and affordable. Boom! Abortion problem solved.
The person I was responding to initially clearly does not want to solve abortion this way.
Virtually every cultural subgroup in history had their birthrates plummet once they reached a certain amount of wealth. Evidence indicates that if anything, poverty is good for population growth.
They believe they are the only sane men and women in a world of shadows and madness because that's the only way they can continue to function. There is no reasoning with someone who's gone that far. The veneer of egalitarianism that politics in the U.S. has prevents anyone from actually doing anything to stop this increasingly volatile group lest the intervening mediators be seen by their peers both within the volatile group and without as aggressive savages who would subvert well established conventions. The potential mediators must let themselves be stabbed and reply with "That is quite impolite" or else they lose all trust from said peers.
I never see poor people collectively failing to have children.
I only ever see wealthy people complain they aren't wealthy enough to have children and once they have more money that's when they'll have children.
It doesn't actually take very much money at all to have a child if you have no standards.
Are you really trying to imply that a "prudish lifestyle" where people actually have long-term relationships and marry is bad for birthrates, and more casual sex is good?
And so are birthrates, as a result.
Not sure if I'd recommend doing that, but people will find a way to screw if they can.
1: Getting off prep, in which case kidney/bones should return to normal.
2: Switching to a newer version of prep called Descovy (in the US), which is has less of the aforementioned side effects, but is more expensive because there is no generic for it yet, and may not be covered by some insurances.
Although technically not sanctioned in the US (IIRC), the 2-1-1 method can also be an option for planned encounters: 2 pills 24hrs before the encounter, and 1/day for 2 days after the encounter.