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"until the next scarier virus comes along..." is the part I call "spreading fear". If you want to worry about Ebola, and use condoms because of a possible risk

"until the next scarier virus comes along..." is the part I call "spreading fear". If you want to worry about Ebola, and use condoms because of a possible risk of contracting Ebola, I would say you have set your risk threshold at a place more conservative / risk-averse than pretty much every sexual adult, at least in my part of the world. Every interaction with another organism, whether it's a handshake or sharing the same air, carries the risk of transmitting something terrible and scary. And there are people who think about that, and probably have different standards for sharing drinks, or double dipping, or handshaking strangers, or whatever. Other people do not care. They will hug someone who has the flu. It's a personal call. When someone has sex without a condom and takes PrEP, I argue they are not thinking "Oh good, there's no possible way I'm going to die." They are not even thinking "I will not get any STIs". They are thinking "Oh, good, I don't have to think about dying from HIV". That's not foolish. Your characterization is unrealistic and equivocates risk-taking with foolishness. You imply (say) that people are ignorant of the risks, as opposed to taking a deliberate risk. And I would be more careful before saying something so offensive and disrespectful. That's where I set _my_ risk threshold, at least.

azinman2 7y ago
Spreading fear? How about having an honest debate? Let's see.. so far in this thread I've been accused of being prejudice against gays (ad hominem), had goal posts moved repeatedly from my original post, accused of having no data and when presented it's rejected without sufficient reason provided, had my own personal experiences negated as if they don't happen and when acknowledged they're minimized, and now apparently I'm a fear monger. Amazing what happens when you point out vulnerabilities in public health with PReP! That's great for you that you're educated enough to perform rational risk analysis (assuming so given you're on HN) -- and you're willing to take the non-trivial semi-known long-term side effect trade offs. Plus you're honest with yourself about exactly what PReP is. However, that doesn't mean everyone follows. A diversity of education and logic-oriented thinking exists out there, yet sex is universal. I've personally heard individuals express that now that they're on PReP there's nothing to worry about so they can have condom-less sex worry-free, so I know this is non-zero. This is foolish. I think it's dishonest to not acknowledge the risks and vulnerabilities of a large population on PReP. Please look at a short history of epidemics [1] and tell me we're somehow magically done. Ebola was an example of something that once was contained now spreading again. Drug-resistant Neisseria gonorrhoeae is classified as an urgent threat by the CDC [2], and isn't shared by a handshake (to my knowledge). And that classification is from 2013. What will 2025 look like? 2045? Nothing about what I've said is saying we shouldn't have PReP. My original comment said it's made a big dent in the spread of HIV... hardly fear mongering. But it DOES make some portion of users feel safe to have condomless sex, and that creates new vectors that condoms were protecting against. Why is this so hard to acknowledge? [1] https://en.wikipedia.org/wiki/List_of_epidemics https://en.wikipedia.org/wiki/List_of_epidemics [2] https://www.cdc.gov/drugresistance/biggest-threats.html https://www.cdc.gov/drugresistance/biggest-threats.html
- gugagore 7y ago
  First off, you keep writing PReP, it's PrEP. No big deal, but it's hard to keep ignoring! Yes, PrEP _allows_ (makes) many people to feel safe having sex without a condom. Yes, this shift can have consequences for the transmission of other diseases. It's not hard to acknowledge that. It follows completely that if there's a new outbreak, its transmission will be accelerated because people are having sex without condoms. I am not following your other postings on here, so I can't say if you think I haven't acknowledged those things, or what. I think you're talking about other people on this thread, in which case, why? Maybe something in how your expressing your thoughts feels really radical to you, but to be you've been expressing pretty obvious ideas. I can't tell if you got to this point after a previous disagreement, or if this is your baseline feeling about PrEP, but I will say if you just focus on the negative aspects of things that are already stigmatized, you're perpetuating stigma! And my push back on that doesn't mean the negative aspects aren't true (though we should always be dubious). It means I don't like your framing of the situation. Disease is the cost of doing business. Getting down to business? You didn't like the handshake analogy, but think about all the different things we can do to mitigate the spread of disease. We do a lot of them! But we also share buses, go to big events, and we also have sex with each other. It's not wrong to do those things without worry. And it doesn't mean the risk isn't there, it just means you don't worry about it. It rubs me the wrong way that you decide what's foolish to worry about and not.
  - azinman2 7y ago
    Yes you’re right re: spelling. I don’t think I’m being radical at all, and I’m glad you agree with my points. If you read my original post, then you should agree with it. But there are quite a lot of replies against, and many disagreed that it would lead to less condom usage. I don’t, however, believe I’m perpetuating stigma. I’m pointing out that new (to the world) strains of HIV are a perfect example of what worries me about a generation that feels a false sense of security. I’ve already watched previous generations die off, and I don’t want to see lessons lost. If you want to call my concern stigmatizing, we’ll then I wear that with pride. We learned in the 80s/90s that safe sex meant condom use, and that did have a tangible impact. For those particularly at risk PrEP is great because condoms break. Abstinence is the only thing that’s 100% and it’s unrealistic. But removing condom usage because we think there’s no more diseases to worry about beyond HIV to me is foolish, and the evidence of the history of epidemics validates that.

azinman2 7y ago

Spreading fear? How about having an honest debate? Let's see.. so far in this thread I've been accused of being prejudice against gays (ad hominem), had goal posts moved repeatedly from my original post, accused of having no data and when presented it's rejected without sufficient reason provided, had my own personal experiences negated as if they don't happen and when acknowledged they're minimized, and now apparently I'm a fear monger. Amazing what happens when you point out vulnerabilities in public health with PReP! That's great for you that you're educated enough to perform rational risk analysis (assuming so given you're on HN) -- and you're willing to take the non-trivial semi-known long-term side effect trade offs. Plus you're honest with yourself about exactly what PReP is. However, that doesn't mean everyone follows. A diversity of education and logic-oriented thinking exists out there, yet sex is universal. I've personally heard individuals express that now that they're on PReP there's nothing to worry about so they can have condom-less sex worry-free, so I know this is non-zero. This is foolish. I think it's dishonest to not acknowledge the risks and vulnerabilities of a large population on PReP. Please look at a short history of epidemics [1] and tell me we're somehow magically done. Ebola was an example of something that once was contained now spreading again. Drug-resistant Neisseria gonorrhoeae is classified as an urgent threat by the CDC [2], and isn't shared by a handshake (to my knowledge). And that classification is from 2013. What will 2025 look like? 2045? Nothing about what I've said is saying we shouldn't have PReP. My original comment said it's made a big dent in the spread of HIV... hardly fear mongering. But it DOES make some portion of users feel safe to have condomless sex, and that creates new vectors that condoms were protecting against. Why is this so hard to acknowledge? [1] https://en.wikipedia.org/wiki/List_of_epidemics https://en.wikipedia.org/wiki/List_of_epidemics [2] https://www.cdc.gov/drugresistance/biggest-threats.html https://www.cdc.gov/drugresistance/biggest-threats.html

gugagore 7y ago
First off, you keep writing PReP, it's PrEP. No big deal, but it's hard to keep ignoring! Yes, PrEP _allows_ (makes) many people to feel safe having sex without a condom. Yes, this shift can have consequences for the transmission of other diseases. It's not hard to acknowledge that. It follows completely that if there's a new outbreak, its transmission will be accelerated because people are having sex without condoms. I am not following your other postings on here, so I can't say if you think I haven't acknowledged those things, or what. I think you're talking about other people on this thread, in which case, why? Maybe something in how your expressing your thoughts feels really radical to you, but to be you've been expressing pretty obvious ideas. I can't tell if you got to this point after a previous disagreement, or if this is your baseline feeling about PrEP, but I will say if you just focus on the negative aspects of things that are already stigmatized, you're perpetuating stigma! And my push back on that doesn't mean the negative aspects aren't true (though we should always be dubious). It means I don't like your framing of the situation. Disease is the cost of doing business. Getting down to business? You didn't like the handshake analogy, but think about all the different things we can do to mitigate the spread of disease. We do a lot of them! But we also share buses, go to big events, and we also have sex with each other. It's not wrong to do those things without worry. And it doesn't mean the risk isn't there, it just means you don't worry about it. It rubs me the wrong way that you decide what's foolish to worry about and not.
- azinman2 7y ago
  Yes you’re right re: spelling. I don’t think I’m being radical at all, and I’m glad you agree with my points. If you read my original post, then you should agree with it. But there are quite a lot of replies against, and many disagreed that it would lead to less condom usage. I don’t, however, believe I’m perpetuating stigma. I’m pointing out that new (to the world) strains of HIV are a perfect example of what worries me about a generation that feels a false sense of security. I’ve already watched previous generations die off, and I don’t want to see lessons lost. If you want to call my concern stigmatizing, we’ll then I wear that with pride. We learned in the 80s/90s that safe sex meant condom use, and that did have a tangible impact. For those particularly at risk PrEP is great because condoms break. Abstinence is the only thing that’s 100% and it’s unrealistic. But removing condom usage because we think there’s no more diseases to worry about beyond HIV to me is foolish, and the evidence of the history of epidemics validates that.