"the only reason HIV transmission is high in poor countries is because, well, they're poor."
This is factually untrue.
Being poor does not equal a HIV transmission rate. There is no 1:1 correlation.
A single protected (condom) sexual act between a male and female averages somewhere around 0.1-0.5% chance of pregnancy, and during the fertile window it could still be around 1% or more even with a condom.
Chance of HIV from one act of unprotected vaginal sex with an HIV-positive partner: ~0.08% male-to-female.
The high HIV transmission rates are NOT correlated with wealth, but social behavior. Unprotected anal sex with many partners? High risk. Now, Africa - the practice of dry sex contributes a ton to HIV transmission. Cultural belief that a dry vagina increases pleasure, hence woman use sand, chalk or bleach to dry out their vaginas, massively increasing HIV risk. Needle sharing of drug users? High HIV risk.
Not a class issue, no reason to punch down on poor people. Poor people have agency and many do not infect themselves with HIV in the first place.
I don't think the original assertion is "punching down" on poor people. While you're correct that poverty isn't the "only reason" for high HIV transmission, poverty certainly contributes to it, via lack of access to health care and lack of access to education. How is it less "punching down" to attribute it to social behavior and culture? Isn't needle sharing associated with poverty, or would you also call that "culture"?
"I share needles because I can't afford my own" is an INSANE take. Don't shoot drugs in the first place! Poor people are normal humans, they have willpower, agency. It is a rich people myth that poor people are cattle, devoid of any chance of doing the right thing.
It is culture, behavior, social norms. Being poor does not force you to abandon the nuclear family, does not force you to engage in criminal acts. (there is reverse causality though)
In the early 1960s South Korea had a per capita income lower than those of Haiti, Ethiopia, and Yemen, and about 40% below India's. Did all South Koreans become heroin addicts with HIV?
like insulin? should a diabetic skip the insulin? In poor countries I wouldn't be surprised if the majority of HIV infections are not as preventable as you're imagining.
You can moralize, but even if only 10% of HIV infections are unavoidable, you're not contributing to solving the actual problem. (And by unavoidable I mean, unavoidable without investing in more needles, better sanitation, or prophylactics that the people "responsible" cannot afford.)
Thanks for your contribution. Gonna hop on a jet to Zambia tomorrow and tell kids with HIV there that it's their fault they were born with the virus and maybe they shouldn't have shared needles.
People enjoy drugs, people enjoy sex. If your solution to driving fatalities is not to drive, you have not solved anything.
Not having sex and not doing drugs isn't any sort of "right thing" other than because sex and drugs are dangerous. If sex and drugs were less dangerous (or made not dangerous at all) there would be no reason to tell people not to do them.
The wealthy use drugs and have sex all the time. They just have clean needles and nice doctors. You've completely bought into the moral explanation for poverty - which is that moral decay causes poverty, but poverty does not cause moral decay. But you think that this is a defense of the poor, rather than a defense of the exploitation and contempt for the poor by the rich.
The poor are not worse than the rich even if they do drugs, have sex, or swear on Sunday.
assume you have a population of IV drug users. as a society, would you prefer to spend nothing and see them develop HIV, or to spend some and control the HIV?
you don't have to care about the drug users at all. even if you treat them as pests rather than humans, we frequently vaccinate pests for public health measures. pathogens will spill over to populations you do care about, they'll create a drain on the healthcare system, they'll harbor other opportunistic infections. it's not sanitary.
this is completely leaving aside that some drug addicts can and do turn their life around, and that HIV is a horrible illness nobody should have to deal with, even if it's "their fault."
Dry sex in SSA may be one of the contributing factors, but it’s never been truly proven out as a key contributor in any study I have read; they always address it but say more needs to be done to be certain.
Your comment makes it seem like a key factor when it’s not.
In the Global Burden of Disease analyses, sub-Saharan Africa (SSA) had the highest age-standardized STI incidence rate of any world region — around 19,973 per 100,000 person-years, which is roughly double the global average of about 9,536 cases per 100,000.
Forecasts to 2030 expect sub-Saharan Africa to continue having the highest incidence rates of both HIV and other STIs of any region.
How come a specific region of the globe has this issue? "Poverty"?
Many regions in India are poor. Afghanistan. Pakistan.
Love the science based debate here, btw, thank you all for the downvotes. Facts, not feelings.
Tangent - I still mourn the death of WeAreHunted. What a great music discovery site that was, unmatched in its ability to give you a curated feed of new artists to check out.
WeAreHunted was sold to Twitter at the time to launch as Twitter Music! What an idea, music discovery, right in your big feed. Brilliant.
This was the time when Twitter also launched Vine - to also shutter it.
Great ideas, killed prematurely as TikTok took them and ran away with them. TT is now my #1 music discovery service, not great, just the only one that actually works.
And for some non-geoblocked music, if you want to actually purchase the song as MP3, there's no way unless you have a Mac or Windows PC to install iTunes (too bad for Linux users).
https://uk.7digital.com/ has a lot of songs available in MP3 format, but not as many as on iTunes.
It's a shame, as AI will improve healthcare on an unprecedented scale.
I cannot get a specialist without referrals and endless appointments to spend more than 30min to discuss how to fix a serious issues. Claude? Hours and hours of back and forth. Public models now beat the specialized ones like OpenEvidence. Source: https://www.nature.com/articles/s41591-026-04431-5
Diagnostics is getting blown apart by AI, the best cancer screening will be available in even remote corners of this world.
We were constrained by the available brain mass of highly trained specialists - and this bottleneck is getting removed.
Hard not to be optimistic on AI if you're in healthcare.
China and Russia are simple examples of the fallout of "cutting king's heads".
So awesome in China that they went straight back to a lifetime emperor now.
The French Revolution and its fallout (communism, fascism) killed more humans than any other historic movement, triggering 2 world wars, including numerous genocides.
Blaming an event that happened in 1789 for the first and second world wars seems incredibly far fetched. Maybe we should blame the aggressors who started the wars.
This is factually untrue.
Being poor does not equal a HIV transmission rate. There is no 1:1 correlation.
A single protected (condom) sexual act between a male and female averages somewhere around 0.1-0.5% chance of pregnancy, and during the fertile window it could still be around 1% or more even with a condom.
Chance of HIV from one act of unprotected vaginal sex with an HIV-positive partner: ~0.08% male-to-female.
The high HIV transmission rates are NOT correlated with wealth, but social behavior. Unprotected anal sex with many partners? High risk. Now, Africa - the practice of dry sex contributes a ton to HIV transmission. Cultural belief that a dry vagina increases pleasure, hence woman use sand, chalk or bleach to dry out their vaginas, massively increasing HIV risk. Needle sharing of drug users? High HIV risk.
Not a class issue, no reason to punch down on poor people. Poor people have agency and many do not infect themselves with HIV in the first place.
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