One year 40% HIV infection dropoff in London attributed to grey-market generic pre-exposure prophylaxis drugs

boing
21

Nope–if anything, it makes it worse. Herd immunity is when most people can’t get infected, due to vaccines (or prior exposure) so that people that are most susceptible to infection (children, immunocompromised, etc) are protected.

Picture it as a zombie outbreak; 95% of the population needs to be bitten (normal people), while another 5% can get infected just by breathing the air near a zombie (vulnerable population). Looks nasty, right? Now imagine that 75% of the population has taken a vaccine that renders them immune to becoming a zombie, but only those that will turn if they’re bitten can take it. The 5% of vulnerable people can’t take the vaccine. But their chances of becoming a zombie are reduced, because three out of four potential victims won’t turn regardless, meaning that the chain reaction of infection can’t get up to speed. That’s “herd immunity”.

In this case, this isn’t “herd immunity”, this is prophylaxis in action (although the two are related). The people taking the drug are still vulnerable to infection if they stop taking the drug (or are unlucky), and, being people that are, presumably, part of the “at-risk” population for HIV infection, they are keeping the potential vectors (themselves) immunized. To extend the metaphor above, they’re the zombie handlers who specifically dose themselves with the anti-zombie vaccine because they face the greatest risk. But the “herd” at large does not share their immunity and can face a devastating outbreak if a carrier enters the population, because the “herd” is not immune.

See the distinction?

[/ teacher’s hat] :smile:

7 Likes
22

It’s more than just that. Drunk driving is fucking weird. Growing up in the UK it’s just not done (unless you’re an old person and live in the countryside). You’re a terrible person if you drive drunk. Friends will ditch you. You might kill someone. If you get caught you will lose your license on a first offence.

Then I moved to the States where it’s a nudge nudge, naughty naughty type offence for the most part. How’re you going to get to that bar that’s a twenty minute drive otherwise? It’s a cultural thing. “Oh, I got a DUI the other week. That cost me $500” and that’s it. Meanwhile I’ve had to stop riding my motorcycle after eight at night because I can’t be sure the light coming round ahead of me is on the right side of the road

Same sort of thing. If a cohort group doesn’t punish a given shitty behaviour, it’s not considered a real issue. So going out and fucking loads of people without protection even though you know you’re in a high risk group for HIV, but fuck it? Yeah. Sack of cunts.

I come firmly down on the “People average out to sacks of shit and I’ve seen nothing to make me think otherwise”. It’s not that people don’t have their shit together. It’s that on balance people are fucking terrible.

</rant>

3 Likes
23

3 Likes
24

I miss Will Smith not being terrible.

1 Like
25

Yeah, I think the time you remain infectious is a big issue. Think of Herd Immunity like a pro-active quarantine. If enough of the population is immune, then a person who is sick never encounters a person who can be infected. They are “quarantined”. But it’s kind of a randomly governed quarantine. If you are infectious long enough, you eventually meet someone who can be infected.

Measles needs to find a new host in less than 2 weeks or it’s the end of that family line. Some strains of ebola have to infect a new host within like 2 days before they obliterate their own habitat.

HIV can’t live long outside human body, but inside it continues to be infectious for the rest of your life, and life expectancy with HIV just keeps going up.

So if we imagine a disease:

  • that spreads like measles spreads (that is, if you are in a room with someone who is infected for a minute you are probably infected)
  • that stays with your your entire life once you got it
  • that doesn’t drastically limit your ability to interact with other people either by crippling or killing you in short order (so you have years or decades to spread it)

A disease like that, if 99% of people were immune to it, would be present in the other 1% of the population. Herd immunity just wouldn’t work.

But HIV doesn’t spread like measles, you have to have sex. If we imagine the same 99% effective vaccine and each person has sex with 6 other people, if you aren’t immune then to get the disease you’d have to be unlucky enough to have one of your 6 partners be one of the other 1% non-immune who was also unlucky enough to get it.

So herd immunity would work if we had a vaccine as good as the measles vaccine, though as @bibliophile20 explains, this isn’t one.

Yeah, Drunk Driving has been illegal in Canada since the 1920’s but basically it was widespread and nearly never punished until the 80’s when Mothers Against Drunk Driving had a really success campaign to paint it as a shitty thing to do. When the social message that it’s a shitty thing to do caught on there was a real drop off. Turns out that people largely don’t care what the law is, but do care if their friends think something is a lousy way to act.

I brought it up on a purely, “How could you think this was a good idea?” level. Forget the law and the social backlash - what about the whole getting killed / wrecking your car thing?

Yeah, that’s what I was saying, it isn’t that they don’t have their shit together. They are fucking terrible. Unless your Buddha-nature is dialed up that day and then they are amazing.

5 Likes
26

The unstoppable force (Will Smith’s successful movie career) finally met the immovable object (M. Night Shymalan’s awful post-Sixth Sense movies).

Not that Will Smith’s movies were all high quality before that, but it finally made those movies no longer financially successful, so that he could maybe get the clue that he used to be a much better actor.

1 Like
27

Buddha has the advantage of chilling under his Bodhi tree thinking “That’s right, motherfucker. Guess who’s coming back as a tapeworm,” which I imagine is quite cathartic.

3 Likes
28

thanks a lot, that was interesting!

more a cap, but a very nice one

(Teacher Lämpel, one of the characters in Max and Moritz)

2 Likes
29

Do you have some incredibly efficient and effective marketing campaign that can fundamentally change human behavior? Otherwise, I’d be curious what plan you have that’s more effective at saving money than preventing the need for incredibly expensive HIV care.

1 Like
30

This topic was automatically closed after 5 days. New replies are no longer allowed.