9 ms·

Is the end of AIDS in sight?

79 points by Anon84 3y ago

amanj41 3y ago
A little off topic, but may be beneficial to uppercase all of "Aids" to "AIDS" to avoid ambiguity
- adrianmonk 3y ago
  To an American audience, yeah, it's definitely better in all caps. However, The Economist is British, and sometimes in British English they capitalize acronyms that way. Only "true" (pronounceable) acronyms, though, so they'll write Nato ("nay toh") and BBC ("bee bee see").
  - deleted 3y ago
    [deleted]
  - pathartl 3y ago
    Clarifying what you mean, all acronyms are pronounceable, otherwise they're just a sparkling initialism.
  - edflsafoiewq 3y ago
    The article uses "AIDS". It's just the HN title mangler at work.
    - adrianmonk 3y ago
      Hah, my explanation fits the facts perfectly... except for one tiny little detail. I often forget that the title mangler exists.
- cglong 3y ago
  This was likely the HN title autoformatter at work. I knew what the title was trying to say, but I couldn't help but think of that South Park episode :)
- dang 3y ago
  Fixed now.
- irreticent 3y ago
  It also might be more accurate to not refer to AIDS as a virus. It is a syndrome caused by HIV. HIV is the virus.
teeray 3y ago
https://archive.ph/vNEMG https://archive.ph/vNEMG
ftyers 3y ago
https://archive.ph/vNEMG https://archive.ph/vNEMG
giantg2 3y ago
"Is the End of Aids in Sight?" Short answer - no. Even if they achieve their ambitious plan, 5% is still a large number. Look at how hard it has been to eradicate the last of polio, and that has a lifelong vaccine.
- deaddodo 3y ago
  At this point, even if a genuine vaccine/cure for AIDS were developed; most people wouldn't even know until a loved one directly affected or afflicted told them. The "breakthrough in AIDS research" or "cure in sight" headlines are so recurrent at this point that people are just numb to a real breakthrough.
- londons_explore 3y ago
  It's also a self-balancing system. As HIV becomes rarer, fewer people will be concerned about it, and therefore fewer will bother taking Prep daily. In turn, HIV becomes more infectious, and more people contract it. It will probably stabilize with about 0.4% of humans being infected. Lots of things affect about 0.4% of people, because that's rare enough that most people don't have any friend or colleague affected, and therefore don't take precautions.
  - binarymax 3y ago
    Where did you get that 0.4% number? Is this a well-established statistic?
    - deleted 3y ago
      [deleted]
    - buescher 3y ago
      I'm curious too. My guess - 99.7% covers three standard deviations assuming a normal distribution - so just within three sigma?
    - giantg2 3y ago
      I'm curious too. I have actually heard that .04% number before when dealing with disease prevalence, but I don't remember where from.
bugglebeetle 3y ago
As an older millennial, it’s interesting to me observe the difference with which HIV/AIDS and COVID has been treated. While untreated HIV infection is more lethal than COVID, COVID has killed more people in the past 4 years than HIV/AIDS did in the past 40+. My childhood was filled with warnings and media depicting the tragedy of HIV/AIDS, the surrounding bigotry, and the history of this pandemic still has some cache. COVID, conversely, has all but disappeared from the national stage, despite still actively killing large numbers of people. Pointing this out even now is likely to draw accusals of one being a terrified nut or obsessive. It’s such a drastic change, that it’s hard to reconcile a past where public health and the moral dimensions around our practice of it played such a prominent part in our culture with the disregard and denial of the present. EDIT: To clarify, I’m speaking about my experience of both pandemics in the US. Worldwide, AIDS has of course killed more people than COVID.
- tristor 3y ago
  I've noticed the same thing, and I'm pretty sure it's because COVID no longer features as part of identity politics. It's the identity politics that drove the AIDS discussion, and it's been the identify politics that drove the COVID discussion. Now that has passed, COVID is no longer a topic people care to discuss regularly, while AIDS is still a forefront topic.
  - bugglebeetle 3y ago
    While this may be true to an extent, it doesn’t address why fighting AIDS outside the context of its impact on the LGBTQ community, e.g. in the developing world, still figures so prominently in American culture and public policy. I expect that the real reason is actually something more sinister, where the politics of the US have devolved to a point where almost everyone will accept the “they deserved it” narrative that was used to vilify those with HIV/AIDS, whether it be of the “they’re were old/fat/weak” or “unvaccinated” variety.
    - DelaneyM 3y ago
      Or possibly it’s like the hole in the ozone layer, which has also faded from public discourse, because thanks to that huge amount of press and action it’s been largely addressed. You’re basically saying “why is this thing we’re all working so hard to prevent not happening enough to justify prevention?”.
hn_throwaway_99 3y ago
As a gay man well into middle age, whenever I get somewhat depressed about the state of human affairs, I think about the incredible improvements in AIDS treatment and prevention and I feel a little better. It's hard for people who didn't live through it to really understand what a terrifying time the 80s and 90s were. First off, the general message of sexual education was pretty much "If you have sex, it's probably going to kill you." There's some hyperbole there, but not much. There was really no such thing as "sex-positive messaging", and even many years later it took me time to realize how much I had internalized "sex is a bad, dangerous thing". More importantly, though, is that an HIV diagnosis really was seen as a death sentence. If you're in your 20s, imagine a situation where tons of your friends had died, and there was an ever-present fear that you might be next. I honestly believe everyone who lived through that time in that situation has some level of PTSD. So yes, there is still a lot to do as this article points out, but it is really amazing to see how far we've come. Even a lot of the issues pointed out in the article had less to do with technology and (honestly to my surprise) economic access than with shitty cultural practices (e.g. overall misogyny and men refusing to get tested). It's important to not lose vigilance, but I think it's also important to indulge in a moment of gratitude every now and then to all the warriors (both in the medical and research fields, and the many patients who lost their lives) who have accomplished so much for all of humanity.
- at_a_remove 3y ago
  I often mention the whole Gen X trauma thing. Part of it is literally seeing the ladder being pulled up just as we reached for it. Not just for jobs or college tuition, but also sexually -- the previous generation had a pretty good time and the worst that was on offer was herpes. Puberty starts rumbling around and we're wondering what the future looks like and suddenly "GRID." And we were flailing around, is it viral? (There was, most people do not know, a period wherein it was thought that this was some kind of weird immune reaction to getting semen, any semen, into the bloodstream, which seemed unlikely to me even as a tween) How transmissible is it? Okay so maybe kissing doesn't do anything. And by the time that we figured out that it isn't exactly Ebola in terms of transmissibility, some damage was done. So, Sex = Death, rain is acid, the bees are coming, the nukes will eradicate us all. Gen X has been waiting for the other shoe to drop for decades and AIDS was just one facet of it.
deleted 3y ago
[deleted]
bdcravens 3y ago
I have a friend who does work (mostly manual labor, handyman stuff, etc) for me in our house. In his early 60s, strong as an ox, and he's been HIV-positive since the 80s. That deserves an asterisk, as his levels are below detectability (and I believe transmissibility), and have been for a long time.
- mathewsanders 3y ago
  That's fantastic! I was recently doing some research and learnt that with ART people who are HIV+ can actually expect to live a little longer than people who are HIV-. I think it's because they have more regular check ups to make sure that treatment is being maintained.
mathewsanders 3y ago
> They can take pre-exposure prophylaxis (prep), a kind of drug that reduces their chance of contracting it by 99% or so. This comes as a daily pill, and is popular among gay men in rich countries. The article takes a global focus (which makes sense since most new HIV diagnoses happen outside of the United States), but even the United States has over 30,000 new HIV infections per year. In 2021 feds mandated that insurance companies must include PrEP as free preventative care, but that doesn't help the most at risk who are young and may not be insured (30-day supply of generic PrEP costs ~$2,500, and every 3 months people must have doctor visit and bloodwork to check HIV and STIs, and for potential liver and kidney damage). In 2022 a federal judge ruled that they can not require Christian companies to cover PrEP as this violates their religious rights under federal law[1]. This will likely make it's way up to the Supreme Court, and there's a high risk that as a result people in the United States will then need to pay out of pocket for PrEP. [1] https://www.axios.com/2022/09/07/court-hiv-prep-requirement-aca-truvada https://www.axios.com/2022/09/07/court-hiv-prep-requirement-...
- cltby 3y ago
  Rather depressing that we're subsidizing wanton sexual indulgence to the tune of $30k/year/person.
  - elil17 3y ago
    Just to dispel some myths here: 1. Many people who use PrEP have only one partner. They're using PrEP because their partner has HIV. 2. The alternative is letting people get AIDs. This is more expensive than PrEP. 3. Insurance doesn't pay the full list price of drugs, they pay a lower, negotiated rate. CostPlus Drug Company charges about $20/month for PrEP. This is probably closer to what insurance companies actually pay.
    - cltby 3y ago
      Good comment. I concede if it's really ~$20/month it's a rounding error and an obvious policy win.
  - 3y ago
bitwize 3y ago
When AIDS and MS are manageable diseases, you know you live in a miraculous society.
- local_crmdgeon 3y ago
  MS has become manageable? Is that true???
  - bitwize 3y ago
    It's a lot more manageable now than when Annette Funicello was diagnosed. People who stay on their treatment regimen can live decades of productive life with the disease.
deleted 3y ago
[deleted]
cdlopi 3y ago
[flagged]
mock-possum 3y ago
Is there any doubt? I mean I get a bottle of pills mailed to me every quarter, i don’t have insurance at the moment and Costco only charges me like $100 for that supply - and all I have to do is pop one Truvada a day, and I’m practically immune to AIDS. How could AIDS hope to persist with that kind of treatment so readily available? (Other than in poverty and mental illness, where all kinds of things stick around because people don’t have the wherewithal to undertake treatment obviously)

79 points by Anon84 3y ago

amanj41 3y ago

A little off topic, but may be beneficial to uppercase all of "Aids" to "AIDS" to avoid ambiguity

adrianmonk 3y ago
To an American audience, yeah, it's definitely better in all caps. However, The Economist is British, and sometimes in British English they capitalize acronyms that way. Only "true" (pronounceable) acronyms, though, so they'll write Nato ("nay toh") and BBC ("bee bee see").
- deleted 3y ago
  [deleted]
- pathartl 3y ago
  Clarifying what you mean, all acronyms are pronounceable, otherwise they're just a sparkling initialism.
- edflsafoiewq 3y ago
  The article uses "AIDS". It's just the HN title mangler at work.
  - adrianmonk 3y ago
    Hah, my explanation fits the facts perfectly... except for one tiny little detail. I often forget that the title mangler exists.
cglong 3y ago
This was likely the HN title autoformatter at work. I knew what the title was trying to say, but I couldn't help but think of that South Park episode :)
dang 3y ago
Fixed now.
irreticent 3y ago
It also might be more accurate to not refer to AIDS as a virus. It is a syndrome caused by HIV. HIV is the virus.

teeray 3y ago

https://archive.ph/vNEMG https://archive.ph/vNEMG

ftyers 3y ago

https://archive.ph/vNEMG https://archive.ph/vNEMG

giantg2 3y ago

"Is the End of Aids in Sight?" Short answer - no. Even if they achieve their ambitious plan, 5% is still a large number. Look at how hard it has been to eradicate the last of polio, and that has a lifelong vaccine.

deaddodo 3y ago
At this point, even if a genuine vaccine/cure for AIDS were developed; most people wouldn't even know until a loved one directly affected or afflicted told them. The "breakthrough in AIDS research" or "cure in sight" headlines are so recurrent at this point that people are just numb to a real breakthrough.
londons_explore 3y ago
It's also a self-balancing system. As HIV becomes rarer, fewer people will be concerned about it, and therefore fewer will bother taking Prep daily. In turn, HIV becomes more infectious, and more people contract it. It will probably stabilize with about 0.4% of humans being infected. Lots of things affect about 0.4% of people, because that's rare enough that most people don't have any friend or colleague affected, and therefore don't take precautions.
- binarymax 3y ago
  Where did you get that 0.4% number? Is this a well-established statistic?
  - deleted 3y ago
    [deleted]
  - buescher 3y ago
    I'm curious too. My guess - 99.7% covers three standard deviations assuming a normal distribution - so just within three sigma?
  - giantg2 3y ago
    I'm curious too. I have actually heard that .04% number before when dealing with disease prevalence, but I don't remember where from.

bugglebeetle 3y ago

As an older millennial, it’s interesting to me observe the difference with which HIV/AIDS and COVID has been treated. While untreated HIV infection is more lethal than COVID, COVID has killed more people in the past 4 years than HIV/AIDS did in the past 40+. My childhood was filled with warnings and media depicting the tragedy of HIV/AIDS, the surrounding bigotry, and the history of this pandemic still has some cache. COVID, conversely, has all but disappeared from the national stage, despite still actively killing large numbers of people. Pointing this out even now is likely to draw accusals of one being a terrified nut or obsessive. It’s such a drastic change, that it’s hard to reconcile a past where public health and the moral dimensions around our practice of it played such a prominent part in our culture with the disregard and denial of the present. EDIT: To clarify, I’m speaking about my experience of both pandemics in the US. Worldwide, AIDS has of course killed more people than COVID.

tristor 3y ago
I've noticed the same thing, and I'm pretty sure it's because COVID no longer features as part of identity politics. It's the identity politics that drove the AIDS discussion, and it's been the identify politics that drove the COVID discussion. Now that has passed, COVID is no longer a topic people care to discuss regularly, while AIDS is still a forefront topic.
- bugglebeetle 3y ago
  While this may be true to an extent, it doesn’t address why fighting AIDS outside the context of its impact on the LGBTQ community, e.g. in the developing world, still figures so prominently in American culture and public policy. I expect that the real reason is actually something more sinister, where the politics of the US have devolved to a point where almost everyone will accept the “they deserved it” narrative that was used to vilify those with HIV/AIDS, whether it be of the “they’re were old/fat/weak” or “unvaccinated” variety.
  - DelaneyM 3y ago
    Or possibly it’s like the hole in the ozone layer, which has also faded from public discourse, because thanks to that huge amount of press and action it’s been largely addressed. You’re basically saying “why is this thing we’re all working so hard to prevent not happening enough to justify prevention?”.

hn_throwaway_99 3y ago

As a gay man well into middle age, whenever I get somewhat depressed about the state of human affairs, I think about the incredible improvements in AIDS treatment and prevention and I feel a little better. It's hard for people who didn't live through it to really understand what a terrifying time the 80s and 90s were. First off, the general message of sexual education was pretty much "If you have sex, it's probably going to kill you." There's some hyperbole there, but not much. There was really no such thing as "sex-positive messaging", and even many years later it took me time to realize how much I had internalized "sex is a bad, dangerous thing". More importantly, though, is that an HIV diagnosis really was seen as a death sentence. If you're in your 20s, imagine a situation where tons of your friends had died, and there was an ever-present fear that you might be next. I honestly believe everyone who lived through that time in that situation has some level of PTSD. So yes, there is still a lot to do as this article points out, but it is really amazing to see how far we've come. Even a lot of the issues pointed out in the article had less to do with technology and (honestly to my surprise) economic access than with shitty cultural practices (e.g. overall misogyny and men refusing to get tested). It's important to not lose vigilance, but I think it's also important to indulge in a moment of gratitude every now and then to all the warriors (both in the medical and research fields, and the many patients who lost their lives) who have accomplished so much for all of humanity.

at_a_remove 3y ago
I often mention the whole Gen X trauma thing. Part of it is literally seeing the ladder being pulled up just as we reached for it. Not just for jobs or college tuition, but also sexually -- the previous generation had a pretty good time and the worst that was on offer was herpes. Puberty starts rumbling around and we're wondering what the future looks like and suddenly "GRID." And we were flailing around, is it viral? (There was, most people do not know, a period wherein it was thought that this was some kind of weird immune reaction to getting semen, any semen, into the bloodstream, which seemed unlikely to me even as a tween) How transmissible is it? Okay so maybe kissing doesn't do anything. And by the time that we figured out that it isn't exactly Ebola in terms of transmissibility, some damage was done. So, Sex = Death, rain is acid, the bees are coming, the nukes will eradicate us all. Gen X has been waiting for the other shoe to drop for decades and AIDS was just one facet of it.

deleted 3y ago

[deleted]

bdcravens 3y ago

I have a friend who does work (mostly manual labor, handyman stuff, etc) for me in our house. In his early 60s, strong as an ox, and he's been HIV-positive since the 80s. That deserves an asterisk, as his levels are below detectability (and I believe transmissibility), and have been for a long time.

mathewsanders 3y ago
That's fantastic! I was recently doing some research and learnt that with ART people who are HIV+ can actually expect to live a little longer than people who are HIV-. I think it's because they have more regular check ups to make sure that treatment is being maintained.

mathewsanders 3y ago

> They can take pre-exposure prophylaxis (prep), a kind of drug that reduces their chance of contracting it by 99% or so. This comes as a daily pill, and is popular among gay men in rich countries. The article takes a global focus (which makes sense since most new HIV diagnoses happen outside of the United States), but even the United States has over 30,000 new HIV infections per year. In 2021 feds mandated that insurance companies must include PrEP as free preventative care, but that doesn't help the most at risk who are young and may not be insured (30-day supply of generic PrEP costs ~$2,500, and every 3 months people must have doctor visit and bloodwork to check HIV and STIs, and for potential liver and kidney damage). In 2022 a federal judge ruled that they can not require Christian companies to cover PrEP as this violates their religious rights under federal law[1]. This will likely make it's way up to the Supreme Court, and there's a high risk that as a result people in the United States will then need to pay out of pocket for PrEP. [1] https://www.axios.com/2022/09/07/court-hiv-prep-requirement-aca-truvada https://www.axios.com/2022/09/07/court-hiv-prep-requirement-...

cltby 3y ago
Rather depressing that we're subsidizing wanton sexual indulgence to the tune of $30k/year/person.
- elil17 3y ago
  Just to dispel some myths here: 1. Many people who use PrEP have only one partner. They're using PrEP because their partner has HIV. 2. The alternative is letting people get AIDs. This is more expensive than PrEP. 3. Insurance doesn't pay the full list price of drugs, they pay a lower, negotiated rate. CostPlus Drug Company charges about $20/month for PrEP. This is probably closer to what insurance companies actually pay.
  - cltby 3y ago
    Good comment. I concede if it's really ~$20/month it's a rounding error and an obvious policy win.
- 3y ago

bitwize 3y ago

When AIDS and MS are manageable diseases, you know you live in a miraculous society.

local_crmdgeon 3y ago
MS has become manageable? Is that true???
- bitwize 3y ago
  It's a lot more manageable now than when Annette Funicello was diagnosed. People who stay on their treatment regimen can live decades of productive life with the disease.

deleted 3y ago

[deleted]

cdlopi 3y ago

[flagged]

mock-possum 3y ago

Is there any doubt? I mean I get a bottle of pills mailed to me every quarter, i don’t have insurance at the moment and Costco only charges me like $100 for that supply - and all I have to do is pop one Truvada a day, and I’m practically immune to AIDS. How could AIDS hope to persist with that kind of treatment so readily available? (Other than in poverty and mental illness, where all kinds of things stick around because people don’t have the wherewithal to undertake treatment obviously)