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You could say the same about teen pregnancy being a practically solved problem, except there is still the problem of teen pregnancy. Or even something more mund

• cj 2mo ago
  Taking teen pregnancy as an example: we have the tools to avoid it. We have condoms, we have birth control, we have the morning after pill, we have abortion. We have all the tools -- are more tools really going to help? The fact that teen pregnancy is still an issue is not because we lack the tools to solve it. HIV prevention is similar. We already have the tools. We have condoms. We have PrEP. Sure, a vaccine would be nice, but if someone is unwilling to go on PrEP, why would they suddenly be willing to get a vaccine? Another tool isn't going to hurt, obviously. But it also isn't the #1 highest leverage place to be spending our time if the goal is to reduce HIV transmission. (It is, however, a great use of time to develop a vaccine if you're profit-motivated. HIV prevention is a massive business. 1 year of PrEP in the US costs $20-30k, although luckily ACA mandates $0 copay. I could imagine a $50k HIV vaccine being a blockbuster drug especially if ACA also mandates $0 copay - tons of money to be made! Ugh) Edit: To be clear, I'm excited there's a promising vaccine. However, I am not getting my hopes up that a vaccine will magically cure all of the social/political issues getting in the way of a vaccine actually being widely distributed and administered.
  • egeozcan 2mo ago
    All the tools we have against teen pregnancy need teens making right decisions, or taking corrective actions. If there were a pill that'd block pregnancy for X years, given at the age of Y, then parents could enforce it and teen pregnancy would be solved (also it'd be very cruel but I'm just trying to make a point so bear with me). Going back to our topic: People could also forget PrEP, be drunk and forget to wear a condom and so on. If this vaccine (or vaccine series) creates a somewhat permanent protection, it'd make a huge difference.
    • toomuchtodo 2mo ago
      The US state of Colorado provided young women free IUDs (which are reversible and can last up to eight years) with private funds, and it was wildly successful. I argue teen pregnancy is solved assuming systems remain in place for women to have robust access to contraceptives and reproductive healthcare (which is a systems problem that is never solved completely, but reliant on defending the subject system constantly in perpetuity). The current US administration is rolling back teen pregnancy prevention programs to increase fertility rates in these age cohorts, so there is clearly work ahead to maintain the progress we've made. If you're sure you don't want kids, or more kids, a bisalp, or bilateral salpingectomy (permanent birth control, removal of both fallopian tubes), is covered by Medicaid or ACA compliant private insurance in the US at 100% with no patient cost sharing as part of the Affordable Care Act federal statute. Doesn't apply to teens imho, but provides protection for 20-39 prime reproductive age cohort for those seeking it. It also decreases the risk of ovarian cancer by 42–77% (https://doi.org/10.5468/ogs.2018.61.5.542 https://doi.org/10.5468/ogs.2018.61.5.542). HIV PrEP in the short term is solved with a twice a year injectable (lenacapavir) until improved options become available (rapid deployment and robust availability of a vaccine given to as many at risk people as possible, as soon as possible). It can be provided for as little as $40/person (HN Search: lenacapavir - https://hn.algolia.com/?q=lenacapavir https://hn.algolia.com/?q=lenacapavir). US Government Overhauls Teen Pregnancy Program to Focus on Marriage and Starting Families - https://www.nytimes.com/2026/07/22/us/politics/teen-pregnancy-prevention-trump.html https://www.nytimes.com/2026/07/22/us/politics/teen-pregnanc... | https://archive.today/ https://archive.today/ - July 22nd, 2026 Teen birth rates hit another historical low in 2025, CDC says - https://www.npr.org/2026/04/09/nx-s1-5777587/teen-birth-rates-hit-another-historical-low-2025-cdc https://www.npr.org/2026/04/09/nx-s1-5777587/teen-birth-rate... - April 9th, 2026 Private Money Saves Colorado IUD Program As Fight Continues For Public Funding - https://kffhealthnews.org/health-industry/private-money-saves-colorado-iud-program-as-fight-continues-for-public-funding/ https://kffhealthnews.org/health-industry/private-money-save... - August 27th, 2015 (with all of that context shared, all vaccines and medical protocols that improve quality of life, as well as defend and empower the human, are welcome and needed, as quickly as reasonable)
  • ChrisMarshallNY 2mo ago
    It's still killing people like crazy (and spreading) in undeveloped nations. The new drugs are un-cheap. Also, I believe that we just DOGEd our only vehicle for distributing these to underdeveloped nations.
    • cguess 2mo ago
      [flagged]
      • noir_lord 2mo ago
        He’s a lovely individual really, just a boon to humanity all around.
      • xeonmc 2mo ago
        Considering his family history and his weird eugenic tirades, perhaps that was the intended effect to complete his fantasy cosplaying as a Roman general.
        • solid_fuel 2mo ago
          His actions were certainly motivated by both his racism and contempt for people from poor countries. Frankly he should spend the rest of his life in a small cell somewhere.
      • xienze 2mo ago
        > Musk has sentenced hundreds of thousands, if not millions, to death by dismantling USAID. Why haven't other countries stepped up to address this pressing need? I'm sure every other western nation could easily chip in collectively to cover the roughly $34B budget USAID had. Or do they just not care about these millions of people apparently sentenced to death?
        • cguess 2mo ago
          France and England are trying. The problem is money doesn't build supply lines overnight. Nor does it hire experts both locally and globally and get them there. Much of the data collected on patients by USAID can't just be handed over to another government for a myriad of privacy issues. Patients then have to know that their old clinic no longer exists and they have to go to a new one (is it in the same village anymore?). In the meantime viral counts go up, people get sick, infect their partners or newborn children. You can't just "pick it up later" without causing real harm. > or do they not care Do we not? Why can't we care, why is it now someone else's problem because Musk is still mad Mandela was let off of Robin Island?
  • cguess 2mo ago
    > but if someone is unwilling to go on PrEP, why would they suddenly be willing to get a vaccine? Because PrEP at even its best and most modern version requires an update every six months for life. If you're well-off and in SF or NYC or London that might be easy, but there's so many externalities such as: - People who misjudge the risk they're at, so don't go on the meds in the first place - People who live in regions where getting to a doctor even every six months is a challenge - The six-month injection is extraordinarily expensive and a life-time treatment, for a disease you don't even have yet. If instead it becomes a once-in-a-lifetime series of shot, like many other vaccines are already, we can start considering a path to extinguishing the disease, not just teaching people to live with it. Then there's the financial savings of a series of three shots once vs a lifetime of them.
    • tallanvor 2mo ago
      That's absolutely not correct. Truvada has had the same formulation since it was introduced in 2012. Descovy hasn't changed since it was approved in 2019. You may be thinking of STD tests and bloodwork that is done every 3-6 months depending on your risk level to ensure that you're still HIV negative and that your kidneys are functioning normally, as kidney issues is a rare but serious side effect, especially for Truvada. Now, what I believe is correct is that most people on PrEP would love to have a vaccine instead of needing a daily pill or even 2-6 injections per year as long as they remain sexually active.
      • sterlind 2mo ago
        I think by "update" they mean "re-up," as in you need another depot injection every six months.
  • HappMacDonald 2mo ago
    That's like asking "if someone is unwilling to practice abstinence, why would they be willing to wear a condom, or to flip a magic 'not fertile right at this moment' lightswitch?" A vaccine is something you do once and PrEP is something you have to continue to do over time and get overcharged out the ass for the entire time and worry about if it will remain available in the future.
  • soco 2mo ago
    All your arguments are sound, and I'm still missing your point. Pharma is interested in doing pharma, indeed. But who's interested in your solution, assuming you have one? A significant part of the current electorate (internationally, even) seems to abhor sex ed, condoms, abortions and all that. So tell me again please how you suggest we address teen pregnancy - in THIS world.
    • cj 2mo ago
      The person I was responding to says "HIV is not a solved problem" and "we need a new tool to solve it, a vaccine!" My argument is simply that new tools are great, but it's not what's going to solve the HIV problem. Distribution, cost, access, stigma, etc are the larger problems to deal with. (We need to solve all the reasons why people aren't using the existing tools)
      • serf 2mo ago
        people don't forego condoms in high income nations due to lack of access, distribution, cost, or stigma. they make the experience measurably worse for a maybe insurance. I don't know what fixes that reality other than (maybe?) mass-traumatizing youths with stories and photos of STI/HIV victims, essentially scaring them into wearing a rubber at the risk of scaring them out of sex entirely. ... which is why a vaccine sure would be nice.
  • Muromec 2mo ago
    The hardest problems to solve that actually matter are in humanities.
  • tallanvor 2mo ago
    Unfortunately HIV is not a solved problem. Condoms? They break. More frequently than you might think. Truvada and Descovy are great and make a big difference, but they require either high adherence to taking pills daily or being able to plan ahead for 2-1-1 (for same-sex relations - it's effectiveness for heterosexual intercourse hasn't been determined). Apretude and Lenacapavir obviously require getting to a doctor or someone who can give you the injection either every other month or twice a year, is expensive, and can be very painful for some days afterward. And, of course, they're expensive. A vaccine is the only real option for dealing with HIV for good.
• deleted 2mo ago
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• maxerickson 2mo ago
  I thought the current panic was that young people (not necessarily teens) weren't having enough kids?
  • epistasis 2mo ago
    Which is in fact panic that teens are not having enough children, because that's where we have seen big drops... This whole "panic" seemed weird from the start, but once it becomes clear that it's from the lack of teen pregnancies it takes on an even creepier Epstein-like oddness.
    • MostlyStable 2mo ago
      It is entirely possible to believe multiple things at once: 1. The drop is fertility is bad for society 2. The drop in teen pregnancy is good, despite it's contributions to 1 3. We should try to fix 1. without undoing 2.
      • Night_Thastus 2mo ago
        I agree, but I don't think #3 is possible. For a variety of reasons, both biological and societal, the older people get the less likely they are to have kids, and fewer of them.
        • skissane 2mo ago
          Kiryas Joel, New York, has astronomically high fertility, but also extremely low rates of under-18 pregnancy - which proves the combination is possible.
          • Night_Thastus 2mo ago
            That is an exceptional outlier. It's almost entirely (>90%) made up of one religious group that has strict cultural rules about early marriage and having many children. That's not something typical outside of that one particular group, nor can you copy-paste that anywhere else. I think in fact it's the opposite. Because of how universal below-replacement rates are in EVERY developed nation, it shows just how independent it is from factors of culture, economics, environment, etc. It takes a seriously unusual situation like the one in Kiryas Joel for below-replacement to not be the norm.
• tempfile 2mo ago
  Right, but we know that HIV/AIDS essentially is a solved problem in rich countries, that the mentioned interventions are readily available in rich countries, and the only reason HIV transmission is high in poor countries is because, well, they're poor. We (humanity as a whole) have plenty of money, we could fund these things, we simply choose not to. I would caution against making an allusion to self control. It would be very cruel to act as if people who get a disease through no fault of their own could have avoided it, and most people who contract HIV could not. You may not have intended to make that allusion, but you did. > So I would say that it's very evidently not a practically solved problem, because if it were we wouldn't be looking to solve it still. This is obviously not what is meant by "practically solved problem". Everybody knows it is not actually solved.
  • jcul 2mo ago
    I recently read "Everything is Tuberculosis". It describes a similar issue with the rich / poor country divide. It's quite sad and difficult to read at times.
    • everforward 2mo ago
      Tuberculosis is different, in a very dark, utilitarian way. 4% of new TB cases are multi-drug resistant (19% of recurrences). Once it’s multi-drug resistant, if you’re poor then you get an incredibly depressing choice. Rich countries pay for expensive drug resistance testing. Poor countries have to answer an impossible question. You either do nothing and see if they live, or you try to guess what drugs will work and give them those. However, if you’re wrong and the treatment doesn’t work then the risk that you’ve just made the strain immune to one or more of the drugs in that cocktail skyrockets. They get asked to either do nothing, or do the best they can today knowing it will make tomorrow worse. TB is also shockingly infectious, which is sad. You can at least take steps to dramatically reduce HIV risk, it’s much much harder to avoid TB.
      • attila-lendvai 2mo ago
        > TB is also shockingly infectious let's keep HN as a place where people usually do at least a cursory research before they state things with such confidence... or inject a few words of doubt to signal that you haven't done the homework. if you feel the urge to fight this: i lived with someone infected with TB. e.g. measles is shockingly infectious. TB is not.
• neonstatic 2mo ago
  > And I would expect that the vast majority of people would oppose any idea of somehow punitively "dealing with" people who get some things wrong. Of course, and for good reason. The ones who know for a fact they are right, might in fact be wrong or malicious.
• jimbob45 2mo ago
  No, there will always be the threat of teen pregnancy. Conversely, we could wipe out HIV permanently if enough public will across the world was directed toward it. I fully believe that HIV wouldn’t exist if PrEP had come out in the 80s when public hysteria was at an all-time high and the will to eradicate it was present.
  • sarchertech 2mo ago
    We haven’t even managed to wipe out polio, and that is a cheap, lifelong vaccine.
    • BizarroLand 2mo ago
      If we gave every living human on the planet the polio vaccine as soon as they were able to receive it, it would still exist in the wild somewhere. If new generations are not also given the vaccine, it will eventually return. Probably the same with HIV, although I could see it being somewhat more difficult for that to make a resurgence. If we inoculated the entire human race against it, it could possibly eradicate HIV for several generations, if not permanently.
      • sarchertech 2mo ago
        Humans are the only reservoir for polio, so that’s not true. We could theoretically wipe out polio just like smallpox because there are no animal reservoirs.
        • BizarroLand 2mo ago
          Huh. TIL. That boggles the mind though. Makes me wonder where it came from, or if perhaps its source was somehow killed off or otherwise destroyed, or if perhaps there is a reservoir somewhere that we simply are not aware of?
          • sarchertech 2mo ago
            There’s a fair amount of viruses that have no animal reservoir. Either they evolved from a different human virus, or from an animal virus. Measles for example evolved from a livestock virus called rinderpest and lost the ability to infect cattle as it became a specialized human virus.
• saghm 2mo ago
  > You could say the same about teen pregnancy being a practically solved problem, except there is still the problem of teen pregnancy. Or even something more mundane as driving consistently safely all the time to solve the problem of accidents. At the risk of derailing this conversation from the original topic, those two things are not remotely equivalent. There's no organized political movement trying to tell people that seat belts and speed limits are immoral, and you should only drive when you're willing to accept the responsibility that comes with the risks.
  • jonathanlydall 2mo ago
    Where I am from, organised political movements are not a factor of teen pregnancy and were not the least bit in my mind when I made my statement. And my two examples are completely arbitrary because my point applies to pretty much any problem which would be solved by people being “more careful”. So, political/religious elements aside, teen pregnancy and road safety are the same in terms of “if people were just more disciplined, there would not be these problems” (i.e. if teens who have easy access to contraceptives planned ahead before giving into impulsiveness; if drivers were more attentive to their behaviour), which I then pointed out is naive because the reality is that people aren’t perfect, they aren’t always disciplined, we’re all only human. Hence, we need other solutions to help with problems which don’t require ignoring that people are only human and lack perfect discipline. I agree that some organised movements can be a problem in that they can make other problems worse.
    • saghm 2mo ago
      My point is that teen pregnancy very much does have a solution that has empirically worked quite well at preventing it when it's actually practiced (i.e. high quality sex education and ample access to contraceptives), and pushing abstinence as a solution has demonstrably caused teen pregnancy rates in increase whenever it's used as a replacement for that; the only actual impetus for abstinence as a "solution" is ideological. I think teen pregnancy literally would be a solved problem (with instances being essentially a rounding error) in a society embracing what we actually have proven works well at preventing it; I've never seen any similarly successful mechanism at preventing injuries or deaths in automobile accidents be rejected by a society for ideological reasons. Trying to handwave away the things we know work to prevent teen pregnancy as "just be careful" feels overly reductive, because it's way easier to do correctly than managing to drive without ever having an accident.
• juliendorra 2mo ago
  Teen pregnancy (or unwanted pregnancy at all) has been extremely low in several countries, and the factors are not discipline but was of access, focus on health instead of morality, and public service campaign. If it is high in an otherwise rich country, it’s likely not a lack of discipline from teenagers but a lack of free and easy access to contraception and abortive means, social pressure and morality campaigns, lack of sex education (often by design sometimes by negligence after some period of activity)
  • jasonfarnon 2mo ago
    " likely not a lack of discipline from teenagers" You two might be using "discipline" pretty different. Your definition of discipline would encompass constant casual sex as long as contraceptives were used and any abortions were prompt, right?
    • jquery 2mo ago
      They’re talking about evidence-based solutions to the issue, yes. Discipline is probably the wrong word. Expecting teenagers to be disciplined is a fool’s errand.
    • kakacik 2mo ago
      'Discipline to avoid teen pregnancy', is it really hard to connect those few dots to what it actually means in behavior?
      • jasonfarnon 2mo ago
        It's easy to connect the dots, which is that an obfuscation was being applied.
• reenorap 2mo ago
  FYI teen pregnancy in the US is the lowest it’s ever been in the history of the country.
  • ElProlactin 2mo ago
    The overall US fertility rate is at/near all-time lows.