2 ms·

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

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.

woodruffw 5y ago
> 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.
- legalcorrection 5y ago
  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.
  - woodruffw 5y ago
    > 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.

woodruffw 5y ago

> 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.

legalcorrection 5y ago
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.
- woodruffw 5y ago
  > 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.