5 ms·

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 treatme

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.
- TZubiri 3y ago
  herpes is the worst thing? What about chlamydia, gonorrhea?
  - at_a_remove 3y ago
    Herpes is permanent. While there are some stubborn antibiotic-resistant versions of the other two, they weren't that bad back then. So, yes, herpes is the worst thing.
    - irrational 3y ago
      Except, there is limited evidence that Herpes causes infertility in women while the other two definitely cause female infertility. I'd say the other two are worse since they often go undetected in women until the damage is already done.
  - cortesoft 3y ago
    Those are both treatable and not permanent.
    - irrational 3y ago
      They are treatable if a person knows they have it, but they often go undetected in women. Women often have no outward symptoms and by the time they are diagnosed, the damage is done and they are infertile. This is permanent damage that is devastating news to couples trying to get pregnant.
      - hn_throwaway_99 3y ago
        Which is precisely why people should get regularly tested for STDs.
        irrational 3y ago
        Except, we all know that doesn't happen, mostly because of the state of healthcare in the USA. My brother got colon cancer, so I tried to get a colonoscopy (I'm over 50), they refused unless I saw a primary care doctor first, well the first available appointment was 6 months out. After that I got a colonoscopy appointment, another 6 months out. Ridiculous reality.
TZubiri 3y ago
Aids is definitely the strongest sexually transmitted virus out there. But don't you think that there will always be sexually transmitted diseases associated with promiscuity? Not to say that aids is only transmitted through promiscuity, but superspreading is highly relevant. It is my understanding that gay people have more sex partners than than straight people, so it's likely that these diseases will disproportionately affect gay men. I think that limiting amount of partners is a vital part to combating sexually transmitted diseases, and that some people will have sex until they encounter the physical limitation of STDs. Not sure "sex-positive" messaging is quite helpful in this sense.
- civilitty 3y ago
  It's not the 90s anymore. In the developed world HIV primarily and disproportionately effects IV drug users, not gay men. In the developing world, it has nothing to do with promiscuity but lack of education and access to preventative measures like condoms and PrEP.
  - deleted 3y ago
    [deleted]
  - jl6 3y ago
    This is not true. In 2018 in the US, 66% of new HIV diagnoses were in the transmission category of male-to-male sexual contact: https://www.cdc.gov/hiv/library/reports/hiv-surveillance/vol-31/content/diagnoses.html https://www.cdc.gov/hiv/library/reports/hiv-surveillance/vol...
  - nonce42 3y ago
    No. New HIV diagnoses in the US are 67% male-to-male sexual contact, 22% heterosexual contact, and 7% injection drug use. (BTW, I have no agenda here except accurate statistics.) From https://www.cdc.gov/hiv/basics/statistics.html https://www.cdc.gov/hiv/basics/statistics.html
  - zajio1am 3y ago
    According to [0] in 2020, MSM accounted for 71% of new HIV diagnoses, while people who inject drugs (PWID) accounted for 7% of new HIV infections. AFAIK similar stats are also for western and central Europe. These are population-level stats, not relative risks, but If we disregard PWID and scale to population size, MSM are still one to two orders of magnitude more at risk than non-MSM, non-PWID population, so they are clearly disproportionately affected. [0] https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics https://www.hiv.gov/hiv-basics/overview/data-and-trends/stat...
ChrisMarshallNY 3y ago
I have spent my adult life in a community that experiences higher-than-average HIV/HepC exposure, and well remember the "Great Die-Off" of the early-to-mid 1990s. To anyone that missed out, dying of AIDs is horrible. The West has the luxury of expensive drugs to treat it, but much of the developing world doesn't have that, and they are still dying like flies, with very little of the transmission happening through homosexual contact. Africa has a big problem with that, and misogyny also plays into it, as the article mentions. The thing that disgusted me the most, was the "Good riddance" attitude of many folks. I see echoes of that, in the Fentanylopocalypse, going on, now. As soon as Muffy and Biff start popping their clogs, though, it becomes a "national tragedy."
- logicchains 3y ago
  > but much of the developing world doesn't have that, and they are still dying like flies, Fortunately life expectancies are steadily rising even in the African countries hardest hit by HIV. Eswatini for instance has over 25% of the population HIV positive, but the life expectancy is now up to around 60 years (it was around 40 two decades ago), only 5 years behind Pakistan.
- aaomidi 3y ago
  The good riddance attitude is so, so disturbing to me. And it’s fucked that we still have that attitude today.
- hn_throwaway_99 3y ago
  > The West has the luxury of expensive drugs to treat it, but much of the developing world doesn't have that, and they are still dying like flies That's not really true, as the article points out. PEPFAR has really done amazing work lowering the HIV mortality rate in developing countries. And a reminder of who may keep this program from being reauthorized: https://www.washingtonpost.com/health/2023/07/29/pepfar-aids-hiv-abortion-congress/ https://www.washingtonpost.com/health/2023/07/29/pepfar-aids...
  - ChrisMarshallNY 3y ago
LordDragonfang 3y ago
One of the (younger) queer creators I follow posted about how they'll occasionally stumble upon pictures of the famous "NO OBITS" newspaper headline[1], and feel a surge of hope for our species. https://www.ebar.com/story.php?ch=news&sc=news&id=280418 https://www.ebar.com/story.php?ch=news&sc=news&id=280418
dekhn 3y ago
Thanks for sharing this. One of my major motivations when I was in high school- around the time that AIDS was starting to grow rapidly, was to go into drug discovery to find medicines that could cure HIV infection/reduce the impact of AIDS on patients. At the time (about 5-6 years later) we were working on reverse transcriptase inhibitors, which I think eventually turned out to work pretty well as an early treatment. But boy, was the process slow... decades of basic and applied biology... to get where we are today. It's so painful to watch COVID vax deniers today because it's hard enough to stay motivated over long periods of time... but when people just sort of crap all over the important scientific and medical work to get to where we are, it reminds me of some of the aggressive groups, such as Act Up SF (which actively fought against the establishment, including Fauci, who was a critical ally to HIV-infected patients at the time): https://www.nytimes.com/2022/12/31/opinion/anthony-fauci-hiv-aids-act-up.html https://www.nytimes.com/2022/12/31/opinion/anthony-fauci-hiv...
AlgorithmicTime 3y ago
[dead]
hinkley 3y ago
I suspect you've blotted out some of the worst of the early years, when lots of people didn't understand that it could only transmit through bodily fluids. People were afraid of the idea of being in the same room with someone with HIV. We had education campaigns about this. PSAs. Character arcs in prime time TV shows. Maybe that period was short in California, but it was spread out over years in the midwest. I'm not convinced that the trauma of Covid for some adults wasn't re-experiencing the trauma of the AIDS epidemic. Here's another scary disease and we don't know how it's communicated and it's killing people and ruining their lives. Will it still be killing people in ten years? Ebola and a few others threatened to do the same, but they never actually arrived.

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.

TZubiri 3y ago
herpes is the worst thing? What about chlamydia, gonorrhea?
- at_a_remove 3y ago
  Herpes is permanent. While there are some stubborn antibiotic-resistant versions of the other two, they weren't that bad back then. So, yes, herpes is the worst thing.
  - irrational 3y ago
    Except, there is limited evidence that Herpes causes infertility in women while the other two definitely cause female infertility. I'd say the other two are worse since they often go undetected in women until the damage is already done.
- cortesoft 3y ago
  Those are both treatable and not permanent.
  - irrational 3y ago
    They are treatable if a person knows they have it, but they often go undetected in women. Women often have no outward symptoms and by the time they are diagnosed, the damage is done and they are infertile. This is permanent damage that is devastating news to couples trying to get pregnant.
    - hn_throwaway_99 3y ago
      Which is precisely why people should get regularly tested for STDs.
      - irrational 3y ago
        Except, we all know that doesn't happen, mostly because of the state of healthcare in the USA. My brother got colon cancer, so I tried to get a colonoscopy (I'm over 50), they refused unless I saw a primary care doctor first, well the first available appointment was 6 months out. After that I got a colonoscopy appointment, another 6 months out. Ridiculous reality.

TZubiri 3y ago

Aids is definitely the strongest sexually transmitted virus out there. But don't you think that there will always be sexually transmitted diseases associated with promiscuity? Not to say that aids is only transmitted through promiscuity, but superspreading is highly relevant. It is my understanding that gay people have more sex partners than than straight people, so it's likely that these diseases will disproportionately affect gay men. I think that limiting amount of partners is a vital part to combating sexually transmitted diseases, and that some people will have sex until they encounter the physical limitation of STDs. Not sure "sex-positive" messaging is quite helpful in this sense.

civilitty 3y ago
It's not the 90s anymore. In the developed world HIV primarily and disproportionately effects IV drug users, not gay men. In the developing world, it has nothing to do with promiscuity but lack of education and access to preventative measures like condoms and PrEP.
- deleted 3y ago
  [deleted]
- jl6 3y ago
  This is not true. In 2018 in the US, 66% of new HIV diagnoses were in the transmission category of male-to-male sexual contact: https://www.cdc.gov/hiv/library/reports/hiv-surveillance/vol-31/content/diagnoses.html https://www.cdc.gov/hiv/library/reports/hiv-surveillance/vol...
- nonce42 3y ago
  No. New HIV diagnoses in the US are 67% male-to-male sexual contact, 22% heterosexual contact, and 7% injection drug use. (BTW, I have no agenda here except accurate statistics.) From https://www.cdc.gov/hiv/basics/statistics.html https://www.cdc.gov/hiv/basics/statistics.html
- zajio1am 3y ago
  According to [0] in 2020, MSM accounted for 71% of new HIV diagnoses, while people who inject drugs (PWID) accounted for 7% of new HIV infections. AFAIK similar stats are also for western and central Europe. These are population-level stats, not relative risks, but If we disregard PWID and scale to population size, MSM are still one to two orders of magnitude more at risk than non-MSM, non-PWID population, so they are clearly disproportionately affected. [0] https://www.hiv.gov/hiv-basics/overview/data-and-trends/statistics https://www.hiv.gov/hiv-basics/overview/data-and-trends/stat...

ChrisMarshallNY 3y ago

I have spent my adult life in a community that experiences higher-than-average HIV/HepC exposure, and well remember the "Great Die-Off" of the early-to-mid 1990s. To anyone that missed out, dying of AIDs is horrible. The West has the luxury of expensive drugs to treat it, but much of the developing world doesn't have that, and they are still dying like flies, with very little of the transmission happening through homosexual contact. Africa has a big problem with that, and misogyny also plays into it, as the article mentions. The thing that disgusted me the most, was the "Good riddance" attitude of many folks. I see echoes of that, in the Fentanylopocalypse, going on, now. As soon as Muffy and Biff start popping their clogs, though, it becomes a "national tragedy."

logicchains 3y ago
> but much of the developing world doesn't have that, and they are still dying like flies, Fortunately life expectancies are steadily rising even in the African countries hardest hit by HIV. Eswatini for instance has over 25% of the population HIV positive, but the life expectancy is now up to around 60 years (it was around 40 two decades ago), only 5 years behind Pakistan.
aaomidi 3y ago
The good riddance attitude is so, so disturbing to me. And it’s fucked that we still have that attitude today.
hn_throwaway_99 3y ago
> The West has the luxury of expensive drugs to treat it, but much of the developing world doesn't have that, and they are still dying like flies That's not really true, as the article points out. PEPFAR has really done amazing work lowering the HIV mortality rate in developing countries. And a reminder of who may keep this program from being reauthorized: https://www.washingtonpost.com/health/2023/07/29/pepfar-aids-hiv-abortion-congress/ https://www.washingtonpost.com/health/2023/07/29/pepfar-aids...
- ChrisMarshallNY 3y ago

LordDragonfang 3y ago

One of the (younger) queer creators I follow posted about how they'll occasionally stumble upon pictures of the famous "NO OBITS" newspaper headline[1], and feel a surge of hope for our species. https://www.ebar.com/story.php?ch=news&sc=news&id=280418 https://www.ebar.com/story.php?ch=news&sc=news&id=280418

dekhn 3y ago

Thanks for sharing this. One of my major motivations when I was in high school- around the time that AIDS was starting to grow rapidly, was to go into drug discovery to find medicines that could cure HIV infection/reduce the impact of AIDS on patients. At the time (about 5-6 years later) we were working on reverse transcriptase inhibitors, which I think eventually turned out to work pretty well as an early treatment. But boy, was the process slow... decades of basic and applied biology... to get where we are today. It's so painful to watch COVID vax deniers today because it's hard enough to stay motivated over long periods of time... but when people just sort of crap all over the important scientific and medical work to get to where we are, it reminds me of some of the aggressive groups, such as Act Up SF (which actively fought against the establishment, including Fauci, who was a critical ally to HIV-infected patients at the time): https://www.nytimes.com/2022/12/31/opinion/anthony-fauci-hiv-aids-act-up.html https://www.nytimes.com/2022/12/31/opinion/anthony-fauci-hiv...

AlgorithmicTime 3y ago

[dead]

hinkley 3y ago

I suspect you've blotted out some of the worst of the early years, when lots of people didn't understand that it could only transmit through bodily fluids. People were afraid of the idea of being in the same room with someone with HIV. We had education campaigns about this. PSAs. Character arcs in prime time TV shows. Maybe that period was short in California, but it was spread out over years in the midwest. I'm not convinced that the trauma of Covid for some adults wasn't re-experiencing the trauma of the AIDS epidemic. Here's another scary disease and we don't know how it's communicated and it's killing people and ruining their lives. Will it still be killing people in ten years? Ebola and a few others threatened to do the same, but they never actually arrived.