17 ms·

Prevention of HIV

667 points by etiam 2y ago

exztazyyy 2y ago
[flagged]
sillysaurusx 2y ago
In terms of protecting oneself, what are the actual steps? (E.g. if you're HIV- but are participating in activities either directly with someone who is HIV+ or whose partner is HIV+.) Do you schedule a doctor appointment and ask for something specific? And is there anything else to do, such as something over-the-counter? There's a dizzying array of terms to learn in this space. PrEP is apparently different from PEP, which I think is also unrelated to what this article is talking about. It'd be nice if someone put together a 2024 guide for what the latest preventative / protection mechanisms are.
- toomuchtodo 2y ago
  Assuming you do not currently have a viral load of HIV, you can meet with your provider, indicate that you are at risk, and request a prescription for PrEP [1] (Planned Parenthood can assist with sourcing if you don't have a PCP or other stable medical providers). Longer term, it is likely there will be a shift to a twice yearly injectable (Gilead’s Lenacapavir) [2]. State of the art is an undetectable viral load due to antiviral treatment means you cannot transmit to others [3] [4] [5]. Not medical advice, educational purposes only. Seek a medical professional's guidance for your personal circumstances. [1] https://www.hiv.gov/hiv-basics/hiv-prevention/using-hiv-medication-to-reduce-risk/pre-exposure-prophylaxis https://www.hiv.gov/hiv-basics/hiv-prevention/using-hiv-medi... [2] https://news.ycombinator.com/item?id=40742163 https://news.ycombinator.com/item?id=40742163 [3] https://www.hiv.gov/hiv-basics/staying-in-hiv-care/hiv-treatment/viral-suppression https://www.hiv.gov/hiv-basics/staying-in-hiv-care/hiv-treat... [4] https://www.niaid.nih.gov/diseases-conditions/treatment-prevention https://www.niaid.nih.gov/diseases-conditions/treatment-prev... [5] https://www.hiv.gov/blog/science-validates-undetectable-untransmittable-hiv-prevention-message https://www.hiv.gov/blog/science-validates-undetectable-untr...
  - ClarityJones 2y ago
    From [5] https://www.hiv.gov/blog/science-validates-undetectable-untransmittable-hiv-prevention-message https://www.hiv.gov/blog/science-validates-undetectable-untr...: > Even when viral load is undetectable, ... may have detectable HIV genetic material in ... semen, but there is no scientific evidence that such material is associated with HIV transmission. What? Isn't that the primary transmission vector?
    - toomuchtodo 2y ago
      From that same link you cite: > Findings from the breakthrough NIH-funded HPTN 052 clinical trial, a decade-long study involving more than 1,600 heterosexual couples, offered clear-cut evidence that ART that consistently suppresses HIV also prevents sexual transmission of the virus. In 2011, the HPTN 052 investigators reported that starting ART when the immune system is relatively healthy, as opposed to delaying therapy until the immune system has been weakened by the virus, dramatically reduces the risk of sexually transmitting HIV. The protective effect of starting ART early was sustained over four additional years of follow-up. Importantly, when viral loads were measured, no HIV transmissions were observed when ART consistently, durably suppressed the virus in the partner living with HIV. Wild speculation is that the genetic material you mention is inactivated and therefore unable to transmit the virus, but is still detectable. I am just an internet rando surfing the knowledge graph, but the science appears sound. https://www.nih.gov/news-events/news-releases/hiv-control-through-treatment-durably-prevents-heterosexual-transmission-virus https://www.nih.gov/news-events/news-releases/hiv-control-th... https://web.archive.org/web/20150106032855/http://www.niaid.nih.gov/news/newsreleases/Archive/2011/Pages/HPTN052Breakthrough.aspx https://web.archive.org/web/20150106032855/http://www.niaid.... https://www.clinicaltrials.gov/study/NCT00074581 https://www.clinicaltrials.gov/study/NCT00074581
      - pstrateman 2y ago
        >1,600 heterosexual couples Is there a similar study of gay men who are not in a monogamous relationship? Studying the group with the lowest transmission rate who could still transmit seems kind of dishonest.
- nerdjon 2y ago
  What I have noticed is that in most situations saying "PrEP" is enough. For my doctor that meant discussing Truvada, Descovy, and what is just kinda dubbed "Injectable Prep". This aligns with most apps also just saying "on prep" with no distinguishing between what prep. I would imagine that if/when this comes to market it would likely similarly fall under "Prep" for the general community and then you discuss the specifics with your doctor. Edit: There is also Doxypep (I just say Doxy), which while related to STD's is not related to HIV.
  - felixg3 2y ago
    There are people announcing their PrEP status on dating apps so they can raw dog with strangers? Have people forgotten that there are plenty of STD besides HIV? I think this is highly problematic and lifestyle PrEP seems to be counterproductive as a public health measure. But I am open to arguments that I’m wrong. It’s possible that I am biased as a monogamous heterosexual who has grown up in a culture where sex without condom, especially outside committed relationships, is generally frowned upon and 1980-1990s HIV scares are still in the consciousness of people.
    - iknowstuff 2y ago
      Nobody’s giving or getting head with a condom. People who stay on top of preventative measures tend to not bother with condoms since PrEP became prevalent, because the rest of them you can get with or without a condom due to oral. Preventative: 1. Gardasil 9 (vaccine against 9 strains of HPV, prevents genital warts and cancers caused by HPV) 2. Monkeypox vaccine 3. Meningitis ACYW vax 4. Meningitis B vax (35% effective against gonorrhea) 5. doxyPEP (two pills of doxycycline taken after sex, 90% effective against syphilis, 80% chlamydia, 50% gonorrhea) 6. PrEP (prevents HIV infections) 7. and the usual suite of vaccines against the rest like hepatitis A/B, mumps etc You’ll notice all of these give you far more protection than a condom would. Again, especially since oral is a thing. Treatment of the bacterial ones (which transmit through oral too): 1. syphilis - butt shot of penicillin 2. chlamydia - 1/2 pills of an antibiotic 3. gonorrhea - a week of doxycycline pills or one butt shot of ceftriaxone Remaining unpreventable/untreatable one is HSV. Half of the population has it. Condoms dont prevent it either. Hepatitis requires blood contact and as such is not necessarily considered an STI, but hepatitis c is curable these days thanks to DAAs taken over the course of 8-12 weeks, and a/b variants have vaccines.
- preventionexprt 2y ago
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  - nerdjon 2y ago
    That assumes that everyone you are engaging with knows their status. If someone knows they are HIV+ and are undetectable than you are more informed about the risk than you are in many other situations. Also, if your partner is positive are you really not going to want to be with someone just for that reason? Really need to get past the stigma around this and focus on education instead. Edit: You changed your comment to no longer mention just not engaging with people who are HIV+...
    - deleted 2y ago
      [deleted]
    - Vecr 2y ago
      Yeah, or just not "engage" with anyone. Manage risk, assume unknown or not completely trustworthy = positive.
    - hyperliner 2y ago
      [dead]
  - sillysaurusx 2y ago
    One doesn’t always know. And besides, if in modern times the risk is essentially zero, then it’s worth considering.
- 4fterd4rk 2y ago
  PrEP - An HIV negative person taking Truvada or Descovy once a day to prevent HIV infection. PEP - An HIV negative person taking a course of antiretrovirals within 72 hours after exposure to HIV to prevent HIV infection. This article is referring to injectable PrEP. This is already available via an injection every two months and is typically used in populations that can't be expected to take a pill every day (drug addicts, etc.). The article is referring to a new form of injectable PrEP that extends this to once every six months.
  - chimeracoder 2y ago
    > This is already available via an injection every two months and is typically used in populations that can't be expected to take a pill every day (drug addicts, etc.). That is a pretty bold parenthetical statement. Not only is it not true that "drug addicts" can't be expected to take a pill every day, but neither cabotegravir nor lenacapavir are tested or approved for HIV acquired through non-sexual means, which makes them a poor choice for PrEP for "drug addicts" compared to oral forms, which are effective against all forms of HIV transmission. Source: former counselor and educator for HIV and substance use
    - fragmede 2y ago
      > Not only is it not true that "drug addicts" can't be expected to take a pill every day, The general population can't be expected to take a pill every day, what would make anyone believe people with SUD are able to? Source: person who's expected to take a pill every day, and knows other people who are supposed to taste a pill every day.
      - chimeracoder 2y ago
        > The general population can't be expected to take a pill every day, what would make anyone believe people with SUD are able to? The general population does take PrEP regularly enough to be protected. You seem think that people with substance use disorders are excluded from that, and that belief is grounded in stereotype and bias, not science. Source: clinical data and professional experience
- masspro 2y ago
  PEP means "post-exposure prophylaxis"; PrEP means "pre-exposure prophylaxis". You take PrEP regularly (if you know you're at risk due to sexual habits etc whatever), but only take PEP in response to a specific possible-exposure event (and not already on PrEP). You want pre-exposure instead of post-exposure because post-exposure is very hard on your body and makes you feel sick.
  - dyauspitr 2y ago
    Why is post exposure so hard on the body. Isn’t it still just a 2 drug cocktail (truvada+another one)?
- Eumenes 2y ago
  Don't have sex with strangers you don't trust.
- barfingclouds 2y ago
  Clinics are pretty good. But in general, if you’re a woman in a first world nation your odds of getting it are really low, unless you do significant amounts of anal sex with bisexual men or inject drugs. Same thing with men. Straight men aren’t at much risk. Bi and gay men are at high risk. If you have a hiv+ partner, prep is good enough to keep you safe. Just take it always as prescribed. Pep in for when you may have been exposed, and you need to get it as soon as possible. It’s like a morning after pill. Within 72 hours of exposure but sooner is better. Then for anyone who does unprotected casual sex, there’s doxypep which reduces likelihood of bacterial stds by a lot, so gonorrhea, chlamydia, and syphilis. If you want a person to explain this to you in real life, there’s different clinics in every American city that would love to take the time to teach you about all of this. Part of their funding is to educate
pfdietz 2y ago
It's a wonderful (if rare) event when a medical trial is stopped for efficacy.
- breck 2y ago
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hodder 2y ago
Please forgive my lack of understanding. This appears to be a great achievement. Is there any risk that a Lenacapavir resistant strain would rise up in many years as a result of treating a large portion of the global at risk population (estimated to be 60m people receiving the injection to materially lower global HIV rates)? Sort of like how antibiotic resistant bacteria rates seems to evolve out of the use of antibiotics? Or is that not a thing and Im just clueless?
- deleted 2y ago
  [deleted]
- 4fterd4rk 2y ago
  From another source: "The medication works in two ways: First, it interrupts viral replication by preventing HIV from reaching the nucleus of an infected cell, which then blocks reproduction. The second mechanism is for cases in which integration of the HIV genome has already occurred. In this instance, lenacapavir interferes with production of viral progeny, “making them defective so that they are not able to infect other cells.” Therefore, it works in both early and late stages of the HIV life cycle to disrupt replication." Since the drug works in two ways, it would be difficult for the virus to adapt. Similarly to how the current commonly prescribed PrEP regimen (Descovy or Truvada) is two different drugs in one pill and has not lead to any significant rise in resistance.
  - gibolt 2y ago
    Difficult doesn't mean impossible. Trillions and trillions of chances for mutations to happen may lead to resistance over some period of time. Hopefully not, but evolution is a powerful beast.
    - Vecr 2y ago
      Yes that is correct, it's pretty easy to create escape variants in the lab. I don't think people should be doing it with virus like HIV and SARS, but they do.
thisrod 2y ago
I wonder how much this will cost? A drug you take 2 times a year could be much cheaper than one you take 365 times a year, and that's a big deal. The existing daily pill is really expensive. Australia knew that PrEP would practically eliminate HIV transmission. Even so, the decision to pay for it took years and was fiercely contested. That was before COVID, and people are more willing to pay for public health today. But cheap PReP would make a big difference in the poor countries where HIV prevention really matters.
- argonaut 2y ago
  The shot will likely be exorbitant in the USA. Gilead charged almost $2k/month for Truvada (list price, of course) and Descovy is the same. Generic Truvada is like $30/month now, so the price was never about the cost to manufacture. Obviously Gilead is developing these new drugs/shots for when Descovy's patent expires. They rely on the government mandating that health insurance companies cover the shots. This drives up the price.
  - ortusdux 2y ago
    The price is rarely ever about the manufacturing cost. "A new study in 2020 estimated that the median cost of getting a new drug into the market was $985 million, and the average cost was $1.3 billion, which was much lower compared to previous studies, which have placed the average cost of drug development as $2.8 billion.[4]" https://en.wikipedia.org/wiki/Cost_of_drug_development https://en.wikipedia.org/wiki/Cost_of_drug_development
    - chimeracoder 2y ago
      > "A new study in 2020 estimated that the median cost of getting a new drug into the market was $985 million, and the average cost was $1.3 billion, which was much lower compared to previous studies, which have placed the average cost of drug development as $2.8 billion.[4]" PrEP repurposed Truvada, an existing blockbuster drug that had already reaped immense profit for Gilead for use in HIV treatment by the time the trials for PrEP began. The trials for PrEP were funded by the government, not Gilead. Gilead, however, got to retain all profits earned from PrEP.
w10-1 2y ago
This is an historic achievement with huge benefits, particularly for Africa. AFAIK, Gilead hasn't detailed any commitment to making it available to all who need it. There's been talk of $4K -$42K yearly price. Gilead just this month is promising regulatory submissions for approvals soon. The drugs sounds quite complicated and hence difficult to manufacture, perhaps making it an enduring franchise. The original post is raising a most interesting question: in a world where preventing infection is possible, what's the standard or incentive for a vaccine? It's rare to get 100% prevention from a vaccine. The incentive would seem to depend only on cost, and any vaccine developer would know that Gilead can likely lower cost at will, making it impossible to recoup vaccine development costs.
- ReptileMan 2y ago
  >The incentive would seem to depend only on cost, and any vaccine developer would know that Gilead can likely lower cost at will, making it impossible to recoup vaccine development costs. This is a good argument that some drugs should be developed by state grants or bounties and the patent is in the state. Something similar delivered covid vaccines in record time - in the form of massive pre purchase agreements.
- KoolKat23 2y ago
  It will be virtually non-existent in Africa if it is priced like that.
  - dyauspitr 2y ago
    It will be non existent in Africa until India starts making the generics. That’s how it has historically been for most prescription medication there.
- DoreenMichele 2y ago
  A lot of health care problems are undermined by the profit motive angle. I don't know how to solve that because there's no such thing as a free lunch and the people developing solutions deserve to be paid. But Africa is extremely poor and the rest of the world suffers the consequences when we can't be arsed to make their problems solvable at a price point they can afford.
inasio 2y ago
One other very cool thing here is that this new treatment represents a whole new family of drugs (very sophisticated at that, per Derek Lowe's assessment). I thought back in the late 2010s with integrase inhibitors (e.g. dolutegravir), there was a real chance they could achieve the 90-95% reduction targets in new cases, and hopefully this new drug makes that even more feasible. There's always the risk of losing previously effective drugs due to resistance, so the value of redundancy cannot be overstated
- w10-1 2y ago
  Here's a summary including the mechanism of action from a UW professor in 2022: https://www.youtube.com/watch?v=9IbzMbfEMIY https://www.youtube.com/watch?v=9IbzMbfEMIY
  - hilbert42 2y ago
    Not my field so please bear with me. Before watching the video the notion of interfering with the capsid as a mechanism for stopping the virus made sense. However, what I still don't have a handle on is how does lenacapavir act so long that it only needs to be administered every six months? From the explanation lenacapavir works on the capsid directly, it's not acting on the immune system by training the body's defences as with a traditional vaccine. Surely this molecule can't just hang around for six months without being gobbled up by the liver or such. What am I missing here?
    - jaggederest 2y ago
      It's got so many fluorines running around that intuitively as an amateur chemist I would expect it to have an extraordinarily long half life in the human body, especially so if it's administered as a depot injection in something with a large molecular weight. It takes your body a long time to chew through the inactive components in a depot injection.
      - hilbert42 2y ago
        Yeah, I also noted the fluorines (and Lowe's comment), and I know they're used to prolong action such as with, say, fluoxetine with its three fluorines but six months seems extremely long. I'd have thought it'd have been flushed out long before that. Presumably, it must bind to lipids, fats etc. Anyway, whatever, it's clearly a brilliant bit of chem eng.
nothrowaways 2y ago
> The medication interrupts viral replication by preventing HIV from reaching the nucleus of an infected cell. How does it actually do it?
- mrtesthah 2y ago
  by preventing viral capsid assembly, as noted in the article. Once bound to the P24 capsid protein, the drug also interferes with other stages of the virus’ lifecycle[1]: >Lenacapavir is a multistage, selective inhibitor of HIV-1 capsid function that directly binds to the interface between capsid protein (p24) subunits in hexamers. Surface plasmon resonance sensorgrams showed dose-dependent and saturable binding of lenacapavir to cross-linked wild-type capsid hexamer with an equilibrium binding constant (KD) of 1.4 nM. Lenacapavir inhibits HIV-1 replication by interfering with multiple essential steps of the viral lifecycle, including capsid-mediated nuclear uptake of HIV-1 proviral DNA (by blocking nuclear import proteins binding to capsid), virus assembly and release (by interfering with Gag/Gag-Pol functioning, reducing production of capsid protein subunits), and capsid core formation (by disrupting the rate of capsid subunit association, leading to malformed capsids). 1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e5652804-29c4-40d7-aeb2-0142ed2a7b5b#S12.4 https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e56...
  - deleted 2y ago
    [deleted]
- tjohns 2y ago
  From Wikipedia: "Lenacapavir works by binding directly to the interface between HIV-1 viral capsid protein (p24) subunits in capsid hexamers, interfering with essential steps of viral replication, including capsid-mediated nuclear uptake of HIV-1 proviral DNA, virus assembly and release, production of capsid protein subunits, and capsid core formation[1]... It functions by binding to the hydrophobic pocket formed by two neighboring protein subunits in the capsid shell. This bond stabilizes the capsid structure and inhibits the functional disassembly of the capsid in infected cells.[2]" In other words, it prevents the virus' protein shell (capsid) from being built properly, which in turn prevents the virus from properly opening ("uncoating") once it enters a host cell. [1]: https://en.wikipedia.org/wiki/Lenacapavir https://en.wikipedia.org/wiki/Lenacapavir [2]: https://en.wikipedia.org/wiki/HIV_capsid_inhibition https://en.wikipedia.org/wiki/HIV_capsid_inhibition
nothrowaways 2y ago
> Among 5338 participants who were initially HIV-negative, 55 incident HIV infections were observed... Wait what? Those 55 got infected during the trial. What was the incentive to get exposed?
- matthewmacleod 2y ago
  All 55 of those infections were observed in trial participants randomised to the tenofovir/emtracitabine groups. There were no infections in the lenacapavir group.
  - kemitche 2y ago
    The site also indicated that "Adherence to F/TAF and F/TDF was low" which means those that got infected most likely weren't taking their pills on a daily basis, unfortunately.
- cypherpunks01 2y ago
  Yes, it can be confusing if you only read part of a sentence. Recommend continue reading if you're interested in the findings
- HaZeust 2y ago
  So I won't tell you to keep reading like others (which you should), but these studies don't work by some research scientist having an HIV+ blood IV at the ready with some "you might notice a little prick" trope, they offer these medications to people that are already in high-risk groups and are conducting activities that make them the most likely demographic to obtain or transmit HIV. Folks like promiscuous homosexuals, prostitutes, drug addicts (risk of sharing needles), and focus groups like that.
  - barfingclouds 2y ago
    I think this study was just young African women in a high incidence area. They basically picked the most likely place in the world a person would get it
TZubiri 2y ago
[flagged]
jaymee 2y ago
I hope that vaccines can be made affordable, otherwise, it won't solve anything.
mkl 2y ago
Without mention of the number of study participants or risk, I was a bit suspicious, but it's not a tiny sample size, and not a low-risk group. From the paper: > Among 5338 participants who were initially HIV-negative, 55 incident HIV infections were observed: 0 infections among 2134 participants in the lenacapavir group The infections in the control groups were in people taking other preventative medication, not nothing.
happybuy 2y ago
As with all drugs, efficacy is only one part of the equation. What's the potential side effects, both short term and long term, of this treatment? For this treatment, it may be negligible, but without saying so we are only hearing one side of the story.
- hyrix 2y ago
  They stopped the study because of the incredible efficacy and lack of side effects. This was a phase 3 clinical trial so they have already cleared substantial hurdles in safety requirements (clinical trials are about both efficacy and side effects). But for argument’s sake, there are even more sides than efficacy and safety: there are substantially different risk profiles for different potential patients, and a long acting treatment with no daily pill is more valuable for some people. One of the reasons that long acting injectables could have a big impact on transmission in Africa is because there’s stigma around PrEP usage, especially for women. Obviously, there is now a big conversation about the cost and who pays, but the potential here is indisputable. https://www.niaid.nih.gov/news-events/nih-statement-preliminary-efficacy-results-twice-yearly-lenacapavir-hiv-prevention https://www.niaid.nih.gov/news-events/nih-statement-prelimin... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10879468/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10879468/
  - breck 2y ago
    > They stopped the study because of the incredible efficacy and lack of side effects. Are you aware that historically when this has happened, it almost always turns out to have negative side effects and marginal efficacy? Don't you think an easy con is to flip a coin 3 times, and if you get heads all 3 times, tell everyone it always comes up heads, and there's no need to continue to measure it, but just to trust them?
    - hyrix 2y ago
      Usually when a study is halted early it’s because of obvious harm to the experimental group from the treatment which means there would be no possible benefit and it would make continuation unethical. A meta analysis of early stopping in randomized clinical trials has found no evidence that early stopping hides side effects or inflates benefit—and I challenge you to produce any examples of a phase 3 trial of an infectious disease treatment that was stopped early which later showed unduly harmful side effects for marginal benefit. This trial showed 100% efficacy. A major consideration of RCTs is also the benefit denied to the public by withholding a viable treatment. HIV remains a global epidemic with no existing good solutions for poor countries. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5133138/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5133138/
_zagj 2y ago
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- seattle_spring 2y ago
  This is a very US-centric view. Further, it could be applied all the way down the rabbit-hole. "My brother has MS, and my sister is a few years from a diagnosis. It's nice to know money is being spent on dementia treatments, a disease that almost exclusively affects the elderly already near end-of-life, when that money could be going toward researching cures for diseases affecting people with much more of their lives to live." Effective altruism sounds nice and fuzzy, but it's pretty silly in practice. It's also not like we can just point all scientists and scientific organizations toward a few of the most highly problematic diseases. At best, there'd be an enormous amount of resources wasted on duplication of efforts.
  - HKH2 2y ago
    > "My brother has MS, and my sister is a few years from a diagnosis. It's nice to know money is being spent on dementia treatments, a disease that almost exclusively affects the elderly already near end-of-life, when that money could be going toward researching cures for diseases affecting people with much more of their lives to live." Sounds reasonable. > At best, there'd be an enormous amount of resources wasted on duplication of efforts. Isn't science about reproducibility?
  - _zagj 2y ago
    >My brother has MS It's telling that the best example you could come up with is yet another neurodegenerative disease, albeit one with some not-so-effective treatments.
    - Varriount 2y ago
      What the significance of using a neurodegenerative disease as an example?
- Varriount 2y ago
  My sympathies for your situation - it's difficult to have to see such terrible diseases take away those we love. That being said, are all individuals in a position to take preventative measures against HIV? And does research of a disease (and ways to treat it) only benefit development of drugs that treat that disease?
peterweyand38 2y ago
[flagged]
iEchoic 2y ago
Derek Lowe is a great writer. Worth reading his "Things I Won't Work With" articles if you want to read more of his writing. https://www.science.org/content/blog-post/things-i-won-t-work-dioxygen-difluoride https://www.science.org/content/blog-post/things-i-won-t-wor...
wsc981 2y ago
With regards to HIV and Aids, Nobel price winner Kary Mullis (inventor of PCR test), made many interesting remarks. I thought that was an interesting interview. https://www.youtube.com/watch?v=W1FXbxDrDrY https://www.youtube.com/watch?v=W1FXbxDrDrY It's a quite old interview (1996), wonder in what ways knowledge has changed regarding the disease.
- mercutio2 2y ago
  Kary Mullis’s AIDS denial has been very, very thoroughly debunked. I would not recommend listening to him about AIDS.
  - wsc981 2y ago
    Your response makes me wonder ... In the interview Kary Mullis mentions that no scientist ever has been able to proof that HIV causes Aids. He also mentions that test monkeys have been injected with HIV and these monkeys didn't develop Aids. Actually, these monkeys got rid of the HIV after some time. I guess many years have passed since this interview (from 1996). My question to you: is there a scientist now that has been able to proof that HIV is the cause of Aids? Because he also mentions a scientist who'd do such a discovery would be famous, maybe Nobel prize winner, etcetera. P.S.: From the interview it doesn't seem Kary Mullis denies Aids. Kary mentions Aids is likely caused by anal sex in some way.
gd1 2y ago
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devonsolomon 2y ago
30 years ago in South Africa there was fear about contracting HIV (and so inevitably dying) through the ear via public telephones (which is ridiculous and impossible). Doctors in trauma wards were terrified of contracting the disease. Huge amounts of stigma and misinformation, and little hope. It’s amazing that since then: - A treated HIV diagnosis no longer necessarily changes your life expectancy. - Your HIV negative partner or unborn child will not necessarily contract the disease, if treated. - Treatment adherence requires just two visits a year. - Doctors have a ready solution in the case of accidental potential transmission. - I can’t remember the last time I saw a public telephone.
slimjimgrin 2y ago
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cchi_co 2y ago
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n0b1m 2y ago
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- talldayo 2y ago
  I've spent plenty of time around the majority of devs, and I can assure you they don't kiss, lick, suck or fuck anything besides the empty Pringles can.
hacker_88 2y ago
Hell yeah..give it to me.. no not really
alex-moon 2y ago
Relevant from 2022: https://www.tht.org.uk/news/heterosexual-hiv-diagnoses-overtake-those-gay-men-first-time-decade https://www.tht.org.uk/news/heterosexual-hiv-diagnoses-overt... I was mind-blown when I learned we were at a point where we could realistically talk about eradicating HIV. Am not a Tory by any stretch of the imagination but props where it's due to them for saying it out loud: no new HIV infections in UK by 2030. As far as I understand the current government are committed to this plan also. Of course, no new infections in UK != eradication, which is the next step. I had not heard of Lenacapavir - this is amazing news from Munich.
Slava_Propanei 2y ago
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667 points by etiam 2y ago

[flagged]

In terms of protecting oneself, what are the actual steps? (E.g. if you're HIV- but are participating in activities either directly with someone who is HIV+ or whose partner is HIV+.) Do you schedule a doctor appointment and ask for something specific? And is there anything else to do, such as something over-the-counter? There's a dizzying array of terms to learn in this space. PrEP is apparently different from PEP, which I think is also unrelated to what this article is talking about. It'd be nice if someone put together a 2024 guide for what the latest preventative / protection mechanisms are.

toomuchtodo 2y ago
Assuming you do not currently have a viral load of HIV, you can meet with your provider, indicate that you are at risk, and request a prescription for PrEP [1] (Planned Parenthood can assist with sourcing if you don't have a PCP or other stable medical providers). Longer term, it is likely there will be a shift to a twice yearly injectable (Gilead’s Lenacapavir) [2]. State of the art is an undetectable viral load due to antiviral treatment means you cannot transmit to others [3] [4] [5]. Not medical advice, educational purposes only. Seek a medical professional's guidance for your personal circumstances. [1] https://www.hiv.gov/hiv-basics/hiv-prevention/using-hiv-medication-to-reduce-risk/pre-exposure-prophylaxis https://www.hiv.gov/hiv-basics/hiv-prevention/using-hiv-medi... [2] https://news.ycombinator.com/item?id=40742163 https://news.ycombinator.com/item?id=40742163 [3] https://www.hiv.gov/hiv-basics/staying-in-hiv-care/hiv-treatment/viral-suppression https://www.hiv.gov/hiv-basics/staying-in-hiv-care/hiv-treat... [4] https://www.niaid.nih.gov/diseases-conditions/treatment-prevention https://www.niaid.nih.gov/diseases-conditions/treatment-prev... [5] https://www.hiv.gov/blog/science-validates-undetectable-untransmittable-hiv-prevention-message https://www.hiv.gov/blog/science-validates-undetectable-untr...
- ClarityJones 2y ago
  From [5] https://www.hiv.gov/blog/science-validates-undetectable-untransmittable-hiv-prevention-message https://www.hiv.gov/blog/science-validates-undetectable-untr...: > Even when viral load is undetectable, ... may have detectable HIV genetic material in ... semen, but there is no scientific evidence that such material is associated with HIV transmission. What? Isn't that the primary transmission vector?
  - toomuchtodo 2y ago
    From that same link you cite: > Findings from the breakthrough NIH-funded HPTN 052 clinical trial, a decade-long study involving more than 1,600 heterosexual couples, offered clear-cut evidence that ART that consistently suppresses HIV also prevents sexual transmission of the virus. In 2011, the HPTN 052 investigators reported that starting ART when the immune system is relatively healthy, as opposed to delaying therapy until the immune system has been weakened by the virus, dramatically reduces the risk of sexually transmitting HIV. The protective effect of starting ART early was sustained over four additional years of follow-up. Importantly, when viral loads were measured, no HIV transmissions were observed when ART consistently, durably suppressed the virus in the partner living with HIV. Wild speculation is that the genetic material you mention is inactivated and therefore unable to transmit the virus, but is still detectable. I am just an internet rando surfing the knowledge graph, but the science appears sound. https://www.nih.gov/news-events/news-releases/hiv-control-through-treatment-durably-prevents-heterosexual-transmission-virus https://www.nih.gov/news-events/news-releases/hiv-control-th... https://web.archive.org/web/20150106032855/http://www.niaid.nih.gov/news/newsreleases/Archive/2011/Pages/HPTN052Breakthrough.aspx https://web.archive.org/web/20150106032855/http://www.niaid.... https://www.clinicaltrials.gov/study/NCT00074581 https://www.clinicaltrials.gov/study/NCT00074581
    - pstrateman 2y ago
      >1,600 heterosexual couples Is there a similar study of gay men who are not in a monogamous relationship? Studying the group with the lowest transmission rate who could still transmit seems kind of dishonest.
nerdjon 2y ago
What I have noticed is that in most situations saying "PrEP" is enough. For my doctor that meant discussing Truvada, Descovy, and what is just kinda dubbed "Injectable Prep". This aligns with most apps also just saying "on prep" with no distinguishing between what prep. I would imagine that if/when this comes to market it would likely similarly fall under "Prep" for the general community and then you discuss the specifics with your doctor. Edit: There is also Doxypep (I just say Doxy), which while related to STD's is not related to HIV.
- felixg3 2y ago
  There are people announcing their PrEP status on dating apps so they can raw dog with strangers? Have people forgotten that there are plenty of STD besides HIV? I think this is highly problematic and lifestyle PrEP seems to be counterproductive as a public health measure. But I am open to arguments that I’m wrong. It’s possible that I am biased as a monogamous heterosexual who has grown up in a culture where sex without condom, especially outside committed relationships, is generally frowned upon and 1980-1990s HIV scares are still in the consciousness of people.
  - iknowstuff 2y ago
    Nobody’s giving or getting head with a condom. People who stay on top of preventative measures tend to not bother with condoms since PrEP became prevalent, because the rest of them you can get with or without a condom due to oral. Preventative: 1. Gardasil 9 (vaccine against 9 strains of HPV, prevents genital warts and cancers caused by HPV) 2. Monkeypox vaccine 3. Meningitis ACYW vax 4. Meningitis B vax (35% effective against gonorrhea) 5. doxyPEP (two pills of doxycycline taken after sex, 90% effective against syphilis, 80% chlamydia, 50% gonorrhea) 6. PrEP (prevents HIV infections) 7. and the usual suite of vaccines against the rest like hepatitis A/B, mumps etc You’ll notice all of these give you far more protection than a condom would. Again, especially since oral is a thing. Treatment of the bacterial ones (which transmit through oral too): 1. syphilis - butt shot of penicillin 2. chlamydia - 1/2 pills of an antibiotic 3. gonorrhea - a week of doxycycline pills or one butt shot of ceftriaxone Remaining unpreventable/untreatable one is HSV. Half of the population has it. Condoms dont prevent it either. Hepatitis requires blood contact and as such is not necessarily considered an STI, but hepatitis c is curable these days thanks to DAAs taken over the course of 8-12 weeks, and a/b variants have vaccines.
preventionexprt 2y ago
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- nerdjon 2y ago
  That assumes that everyone you are engaging with knows their status. If someone knows they are HIV+ and are undetectable than you are more informed about the risk than you are in many other situations. Also, if your partner is positive are you really not going to want to be with someone just for that reason? Really need to get past the stigma around this and focus on education instead. Edit: You changed your comment to no longer mention just not engaging with people who are HIV+...
  - deleted 2y ago
    [deleted]
  - Vecr 2y ago
    Yeah, or just not "engage" with anyone. Manage risk, assume unknown or not completely trustworthy = positive.
  - hyperliner 2y ago
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- sillysaurusx 2y ago
  One doesn’t always know. And besides, if in modern times the risk is essentially zero, then it’s worth considering.
4fterd4rk 2y ago
PrEP - An HIV negative person taking Truvada or Descovy once a day to prevent HIV infection. PEP - An HIV negative person taking a course of antiretrovirals within 72 hours after exposure to HIV to prevent HIV infection. This article is referring to injectable PrEP. This is already available via an injection every two months and is typically used in populations that can't be expected to take a pill every day (drug addicts, etc.). The article is referring to a new form of injectable PrEP that extends this to once every six months.
- chimeracoder 2y ago
  > This is already available via an injection every two months and is typically used in populations that can't be expected to take a pill every day (drug addicts, etc.). That is a pretty bold parenthetical statement. Not only is it not true that "drug addicts" can't be expected to take a pill every day, but neither cabotegravir nor lenacapavir are tested or approved for HIV acquired through non-sexual means, which makes them a poor choice for PrEP for "drug addicts" compared to oral forms, which are effective against all forms of HIV transmission. Source: former counselor and educator for HIV and substance use
  - fragmede 2y ago
    > Not only is it not true that "drug addicts" can't be expected to take a pill every day, The general population can't be expected to take a pill every day, what would make anyone believe people with SUD are able to? Source: person who's expected to take a pill every day, and knows other people who are supposed to taste a pill every day.
    - chimeracoder 2y ago
      > The general population can't be expected to take a pill every day, what would make anyone believe people with SUD are able to? The general population does take PrEP regularly enough to be protected. You seem think that people with substance use disorders are excluded from that, and that belief is grounded in stereotype and bias, not science. Source: clinical data and professional experience
masspro 2y ago
PEP means "post-exposure prophylaxis"; PrEP means "pre-exposure prophylaxis". You take PrEP regularly (if you know you're at risk due to sexual habits etc whatever), but only take PEP in response to a specific possible-exposure event (and not already on PrEP). You want pre-exposure instead of post-exposure because post-exposure is very hard on your body and makes you feel sick.
- dyauspitr 2y ago
  Why is post exposure so hard on the body. Isn’t it still just a 2 drug cocktail (truvada+another one)?
Eumenes 2y ago
Don't have sex with strangers you don't trust.
barfingclouds 2y ago
Clinics are pretty good. But in general, if you’re a woman in a first world nation your odds of getting it are really low, unless you do significant amounts of anal sex with bisexual men or inject drugs. Same thing with men. Straight men aren’t at much risk. Bi and gay men are at high risk. If you have a hiv+ partner, prep is good enough to keep you safe. Just take it always as prescribed. Pep in for when you may have been exposed, and you need to get it as soon as possible. It’s like a morning after pill. Within 72 hours of exposure but sooner is better. Then for anyone who does unprotected casual sex, there’s doxypep which reduces likelihood of bacterial stds by a lot, so gonorrhea, chlamydia, and syphilis. If you want a person to explain this to you in real life, there’s different clinics in every American city that would love to take the time to teach you about all of this. Part of their funding is to educate

pfdietz 2y ago

It's a wonderful (if rare) event when a medical trial is stopped for efficacy.

breck 2y ago
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hodder 2y ago

Please forgive my lack of understanding. This appears to be a great achievement. Is there any risk that a Lenacapavir resistant strain would rise up in many years as a result of treating a large portion of the global at risk population (estimated to be 60m people receiving the injection to materially lower global HIV rates)? Sort of like how antibiotic resistant bacteria rates seems to evolve out of the use of antibiotics? Or is that not a thing and Im just clueless?

deleted 2y ago
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4fterd4rk 2y ago
From another source: "The medication works in two ways: First, it interrupts viral replication by preventing HIV from reaching the nucleus of an infected cell, which then blocks reproduction. The second mechanism is for cases in which integration of the HIV genome has already occurred. In this instance, lenacapavir interferes with production of viral progeny, “making them defective so that they are not able to infect other cells.” Therefore, it works in both early and late stages of the HIV life cycle to disrupt replication." Since the drug works in two ways, it would be difficult for the virus to adapt. Similarly to how the current commonly prescribed PrEP regimen (Descovy or Truvada) is two different drugs in one pill and has not lead to any significant rise in resistance.
- gibolt 2y ago
  Difficult doesn't mean impossible. Trillions and trillions of chances for mutations to happen may lead to resistance over some period of time. Hopefully not, but evolution is a powerful beast.
  - Vecr 2y ago
    Yes that is correct, it's pretty easy to create escape variants in the lab. I don't think people should be doing it with virus like HIV and SARS, but they do.

thisrod 2y ago

I wonder how much this will cost? A drug you take 2 times a year could be much cheaper than one you take 365 times a year, and that's a big deal. The existing daily pill is really expensive. Australia knew that PrEP would practically eliminate HIV transmission. Even so, the decision to pay for it took years and was fiercely contested. That was before COVID, and people are more willing to pay for public health today. But cheap PReP would make a big difference in the poor countries where HIV prevention really matters.

argonaut 2y ago
The shot will likely be exorbitant in the USA. Gilead charged almost $2k/month for Truvada (list price, of course) and Descovy is the same. Generic Truvada is like $30/month now, so the price was never about the cost to manufacture. Obviously Gilead is developing these new drugs/shots for when Descovy's patent expires. They rely on the government mandating that health insurance companies cover the shots. This drives up the price.
- ortusdux 2y ago
  The price is rarely ever about the manufacturing cost. "A new study in 2020 estimated that the median cost of getting a new drug into the market was $985 million, and the average cost was $1.3 billion, which was much lower compared to previous studies, which have placed the average cost of drug development as $2.8 billion.[4]" https://en.wikipedia.org/wiki/Cost_of_drug_development https://en.wikipedia.org/wiki/Cost_of_drug_development
  - chimeracoder 2y ago
    > "A new study in 2020 estimated that the median cost of getting a new drug into the market was $985 million, and the average cost was $1.3 billion, which was much lower compared to previous studies, which have placed the average cost of drug development as $2.8 billion.[4]" PrEP repurposed Truvada, an existing blockbuster drug that had already reaped immense profit for Gilead for use in HIV treatment by the time the trials for PrEP began. The trials for PrEP were funded by the government, not Gilead. Gilead, however, got to retain all profits earned from PrEP.

w10-1 2y ago

This is an historic achievement with huge benefits, particularly for Africa. AFAIK, Gilead hasn't detailed any commitment to making it available to all who need it. There's been talk of $4K -$42K yearly price. Gilead just this month is promising regulatory submissions for approvals soon. The drugs sounds quite complicated and hence difficult to manufacture, perhaps making it an enduring franchise. The original post is raising a most interesting question: in a world where preventing infection is possible, what's the standard or incentive for a vaccine? It's rare to get 100% prevention from a vaccine. The incentive would seem to depend only on cost, and any vaccine developer would know that Gilead can likely lower cost at will, making it impossible to recoup vaccine development costs.

ReptileMan 2y ago
>The incentive would seem to depend only on cost, and any vaccine developer would know that Gilead can likely lower cost at will, making it impossible to recoup vaccine development costs. This is a good argument that some drugs should be developed by state grants or bounties and the patent is in the state. Something similar delivered covid vaccines in record time - in the form of massive pre purchase agreements.
KoolKat23 2y ago
It will be virtually non-existent in Africa if it is priced like that.
- dyauspitr 2y ago
  It will be non existent in Africa until India starts making the generics. That’s how it has historically been for most prescription medication there.
DoreenMichele 2y ago
A lot of health care problems are undermined by the profit motive angle. I don't know how to solve that because there's no such thing as a free lunch and the people developing solutions deserve to be paid. But Africa is extremely poor and the rest of the world suffers the consequences when we can't be arsed to make their problems solvable at a price point they can afford.

inasio 2y ago

One other very cool thing here is that this new treatment represents a whole new family of drugs (very sophisticated at that, per Derek Lowe's assessment). I thought back in the late 2010s with integrase inhibitors (e.g. dolutegravir), there was a real chance they could achieve the 90-95% reduction targets in new cases, and hopefully this new drug makes that even more feasible. There's always the risk of losing previously effective drugs due to resistance, so the value of redundancy cannot be overstated

w10-1 2y ago
Here's a summary including the mechanism of action from a UW professor in 2022: https://www.youtube.com/watch?v=9IbzMbfEMIY https://www.youtube.com/watch?v=9IbzMbfEMIY
- hilbert42 2y ago
  Not my field so please bear with me. Before watching the video the notion of interfering with the capsid as a mechanism for stopping the virus made sense. However, what I still don't have a handle on is how does lenacapavir act so long that it only needs to be administered every six months? From the explanation lenacapavir works on the capsid directly, it's not acting on the immune system by training the body's defences as with a traditional vaccine. Surely this molecule can't just hang around for six months without being gobbled up by the liver or such. What am I missing here?
  - jaggederest 2y ago
    It's got so many fluorines running around that intuitively as an amateur chemist I would expect it to have an extraordinarily long half life in the human body, especially so if it's administered as a depot injection in something with a large molecular weight. It takes your body a long time to chew through the inactive components in a depot injection.
    - hilbert42 2y ago
      Yeah, I also noted the fluorines (and Lowe's comment), and I know they're used to prolong action such as with, say, fluoxetine with its three fluorines but six months seems extremely long. I'd have thought it'd have been flushed out long before that. Presumably, it must bind to lipids, fats etc. Anyway, whatever, it's clearly a brilliant bit of chem eng.

nothrowaways 2y ago

> The medication interrupts viral replication by preventing HIV from reaching the nucleus of an infected cell. How does it actually do it?

mrtesthah 2y ago
by preventing viral capsid assembly, as noted in the article. Once bound to the P24 capsid protein, the drug also interferes with other stages of the virus’ lifecycle[1]: >Lenacapavir is a multistage, selective inhibitor of HIV-1 capsid function that directly binds to the interface between capsid protein (p24) subunits in hexamers. Surface plasmon resonance sensorgrams showed dose-dependent and saturable binding of lenacapavir to cross-linked wild-type capsid hexamer with an equilibrium binding constant (KD) of 1.4 nM. Lenacapavir inhibits HIV-1 replication by interfering with multiple essential steps of the viral lifecycle, including capsid-mediated nuclear uptake of HIV-1 proviral DNA (by blocking nuclear import proteins binding to capsid), virus assembly and release (by interfering with Gag/Gag-Pol functioning, reducing production of capsid protein subunits), and capsid core formation (by disrupting the rate of capsid subunit association, leading to malformed capsids). 1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e5652804-29c4-40d7-aeb2-0142ed2a7b5b#S12.4 https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e56...
- deleted 2y ago
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tjohns 2y ago
From Wikipedia: "Lenacapavir works by binding directly to the interface between HIV-1 viral capsid protein (p24) subunits in capsid hexamers, interfering with essential steps of viral replication, including capsid-mediated nuclear uptake of HIV-1 proviral DNA, virus assembly and release, production of capsid protein subunits, and capsid core formation[1]... It functions by binding to the hydrophobic pocket formed by two neighboring protein subunits in the capsid shell. This bond stabilizes the capsid structure and inhibits the functional disassembly of the capsid in infected cells.[2]" In other words, it prevents the virus' protein shell (capsid) from being built properly, which in turn prevents the virus from properly opening ("uncoating") once it enters a host cell. [1]: https://en.wikipedia.org/wiki/Lenacapavir https://en.wikipedia.org/wiki/Lenacapavir [2]: https://en.wikipedia.org/wiki/HIV_capsid_inhibition https://en.wikipedia.org/wiki/HIV_capsid_inhibition

nothrowaways 2y ago

> Among 5338 participants who were initially HIV-negative, 55 incident HIV infections were observed... Wait what? Those 55 got infected during the trial. What was the incentive to get exposed?

matthewmacleod 2y ago
All 55 of those infections were observed in trial participants randomised to the tenofovir/emtracitabine groups. There were no infections in the lenacapavir group.
- kemitche 2y ago
  The site also indicated that "Adherence to F/TAF and F/TDF was low" which means those that got infected most likely weren't taking their pills on a daily basis, unfortunately.
cypherpunks01 2y ago
Yes, it can be confusing if you only read part of a sentence. Recommend continue reading if you're interested in the findings
HaZeust 2y ago
So I won't tell you to keep reading like others (which you should), but these studies don't work by some research scientist having an HIV+ blood IV at the ready with some "you might notice a little prick" trope, they offer these medications to people that are already in high-risk groups and are conducting activities that make them the most likely demographic to obtain or transmit HIV. Folks like promiscuous homosexuals, prostitutes, drug addicts (risk of sharing needles), and focus groups like that.
- barfingclouds 2y ago
  I think this study was just young African women in a high incidence area. They basically picked the most likely place in the world a person would get it

TZubiri 2y ago

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jaymee 2y ago

I hope that vaccines can be made affordable, otherwise, it won't solve anything.

mkl 2y ago

Without mention of the number of study participants or risk, I was a bit suspicious, but it's not a tiny sample size, and not a low-risk group. From the paper: > Among 5338 participants who were initially HIV-negative, 55 incident HIV infections were observed: 0 infections among 2134 participants in the lenacapavir group The infections in the control groups were in people taking other preventative medication, not nothing.

happybuy 2y ago

As with all drugs, efficacy is only one part of the equation. What's the potential side effects, both short term and long term, of this treatment? For this treatment, it may be negligible, but without saying so we are only hearing one side of the story.

hyrix 2y ago
They stopped the study because of the incredible efficacy and lack of side effects. This was a phase 3 clinical trial so they have already cleared substantial hurdles in safety requirements (clinical trials are about both efficacy and side effects). But for argument’s sake, there are even more sides than efficacy and safety: there are substantially different risk profiles for different potential patients, and a long acting treatment with no daily pill is more valuable for some people. One of the reasons that long acting injectables could have a big impact on transmission in Africa is because there’s stigma around PrEP usage, especially for women. Obviously, there is now a big conversation about the cost and who pays, but the potential here is indisputable. https://www.niaid.nih.gov/news-events/nih-statement-preliminary-efficacy-results-twice-yearly-lenacapavir-hiv-prevention https://www.niaid.nih.gov/news-events/nih-statement-prelimin... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10879468/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10879468/
- breck 2y ago
  > They stopped the study because of the incredible efficacy and lack of side effects. Are you aware that historically when this has happened, it almost always turns out to have negative side effects and marginal efficacy? Don't you think an easy con is to flip a coin 3 times, and if you get heads all 3 times, tell everyone it always comes up heads, and there's no need to continue to measure it, but just to trust them?
  - hyrix 2y ago
    Usually when a study is halted early it’s because of obvious harm to the experimental group from the treatment which means there would be no possible benefit and it would make continuation unethical. A meta analysis of early stopping in randomized clinical trials has found no evidence that early stopping hides side effects or inflates benefit—and I challenge you to produce any examples of a phase 3 trial of an infectious disease treatment that was stopped early which later showed unduly harmful side effects for marginal benefit. This trial showed 100% efficacy. A major consideration of RCTs is also the benefit denied to the public by withholding a viable treatment. HIV remains a global epidemic with no existing good solutions for poor countries. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5133138/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5133138/

_zagj 2y ago

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seattle_spring 2y ago
This is a very US-centric view. Further, it could be applied all the way down the rabbit-hole. "My brother has MS, and my sister is a few years from a diagnosis. It's nice to know money is being spent on dementia treatments, a disease that almost exclusively affects the elderly already near end-of-life, when that money could be going toward researching cures for diseases affecting people with much more of their lives to live." Effective altruism sounds nice and fuzzy, but it's pretty silly in practice. It's also not like we can just point all scientists and scientific organizations toward a few of the most highly problematic diseases. At best, there'd be an enormous amount of resources wasted on duplication of efforts.
- HKH2 2y ago
  > "My brother has MS, and my sister is a few years from a diagnosis. It's nice to know money is being spent on dementia treatments, a disease that almost exclusively affects the elderly already near end-of-life, when that money could be going toward researching cures for diseases affecting people with much more of their lives to live." Sounds reasonable. > At best, there'd be an enormous amount of resources wasted on duplication of efforts. Isn't science about reproducibility?
- _zagj 2y ago
  >My brother has MS It's telling that the best example you could come up with is yet another neurodegenerative disease, albeit one with some not-so-effective treatments.
  - Varriount 2y ago
    What the significance of using a neurodegenerative disease as an example?
Varriount 2y ago
My sympathies for your situation - it's difficult to have to see such terrible diseases take away those we love. That being said, are all individuals in a position to take preventative measures against HIV? And does research of a disease (and ways to treat it) only benefit development of drugs that treat that disease?

peterweyand38 2y ago

[flagged]

iEchoic 2y ago

Derek Lowe is a great writer. Worth reading his "Things I Won't Work With" articles if you want to read more of his writing. https://www.science.org/content/blog-post/things-i-won-t-work-dioxygen-difluoride https://www.science.org/content/blog-post/things-i-won-t-wor...

wsc981 2y ago

With regards to HIV and Aids, Nobel price winner Kary Mullis (inventor of PCR test), made many interesting remarks. I thought that was an interesting interview. https://www.youtube.com/watch?v=W1FXbxDrDrY https://www.youtube.com/watch?v=W1FXbxDrDrY It's a quite old interview (1996), wonder in what ways knowledge has changed regarding the disease.

mercutio2 2y ago
Kary Mullis’s AIDS denial has been very, very thoroughly debunked. I would not recommend listening to him about AIDS.
- wsc981 2y ago
  Your response makes me wonder ... In the interview Kary Mullis mentions that no scientist ever has been able to proof that HIV causes Aids. He also mentions that test monkeys have been injected with HIV and these monkeys didn't develop Aids. Actually, these monkeys got rid of the HIV after some time. I guess many years have passed since this interview (from 1996). My question to you: is there a scientist now that has been able to proof that HIV is the cause of Aids? Because he also mentions a scientist who'd do such a discovery would be famous, maybe Nobel prize winner, etcetera. P.S.: From the interview it doesn't seem Kary Mullis denies Aids. Kary mentions Aids is likely caused by anal sex in some way.

gd1 2y ago

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devonsolomon 2y ago

30 years ago in South Africa there was fear about contracting HIV (and so inevitably dying) through the ear via public telephones (which is ridiculous and impossible). Doctors in trauma wards were terrified of contracting the disease. Huge amounts of stigma and misinformation, and little hope. It’s amazing that since then: - A treated HIV diagnosis no longer necessarily changes your life expectancy. - Your HIV negative partner or unborn child will not necessarily contract the disease, if treated. - Treatment adherence requires just two visits a year. - Doctors have a ready solution in the case of accidental potential transmission. - I can’t remember the last time I saw a public telephone.

slimjimgrin 2y ago

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cchi_co 2y ago

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n0b1m 2y ago

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talldayo 2y ago
I've spent plenty of time around the majority of devs, and I can assure you they don't kiss, lick, suck or fuck anything besides the empty Pringles can.

hacker_88 2y ago

Hell yeah..give it to me.. no not really

alex-moon 2y ago

Relevant from 2022: https://www.tht.org.uk/news/heterosexual-hiv-diagnoses-overtake-those-gay-men-first-time-decade https://www.tht.org.uk/news/heterosexual-hiv-diagnoses-overt... I was mind-blown when I learned we were at a point where we could realistically talk about eradicating HIV. Am not a Tory by any stretch of the imagination but props where it's due to them for saying it out loud: no new HIV infections in UK by 2030. As far as I understand the current government are committed to this plan also. Of course, no new infections in UK != eradication, which is the next step. I had not heard of Lenacapavir - this is amazing news from Munich.

Slava_Propanei 2y ago

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