You know what would be a fantastic sub-market for this? Bars and clubs in college towns. Regardless of whether you believe 1-nighters are moral or not, they're going to keep happening. Might as well promote safety and reduce the spread of STIs.
Edit: I don't mean this should be an alternative to traditional protection. It just adds another layer of certainty.
Already up to 1/2 of new HIV infections are from people who would test negative in this test; early stage infections. This is because people who have been newly infected are about 4,000% more likely to transmit infection than those who are in late stage infection.
If condom usage dropped even a small amount as a result of this test, it could considerably worsen the epidemic.
From a public health perspective this could be a terrible, terrible disaster.
...1/2 of new HIV infections are from people who would test
negative in this test...
I'm curious what the article means when it says "Researchers at Columbia University claim the mChip has a 100 percent detection rate." Are you sure the test is working the way you think it works? Could it be DNA-based rather than antibody-based?
I am -NOT- purposing this as a mutually exclusive alternative. This should be an addition to what's already happening. No one who goes through the trouble of using this is going to say "well she doesn't have HIV, so what the hell, no condom!"
If you're already practicing to be safe, you still worry about the possibility of something going wrong, and you contracting the infection anyway. With this, you can be more certain that nothing will go wrong. You would still use a condom just in case.
Your argument is like saying people engaging in random sexual activity should close their eyes because not seeing warts will lead them to believe the partner doesn't have warts - which may lower then chance they use a condom. This would offer more information, and if it turns out that person is HIV positive by the test, you'd be eliminating your chances of contraction altogether.
The problem is that there is a very real possibility that someone who would go to a bar and test their partner there would then proceed to have unprotected sex instead of using a condom. A test could give them a false sense of security.
While you personally might still use a condom, judging by the reaction to this in the comments on engadget, many would not, not realizing that they actually are putting themselves at greater risk.
When/if this makes this to the FDA, they're going to look at the overall public health risk. If they assess that such a test would lower condom usage, they'd be unlikely to approve it. If you want to market this as such, you'd have to prove that people using it are just as likely to use a condom, and I think you'll have difficulty with that.
The reality is that ELISA tests in the US are cheap and fast enough already; anyone who wants to test themselves faces little barrier. The cheapness of this test is important for countries where that is not the case.
I hear you, but you're arguing that less information is better, and I have a hard time with that. Especially when you're saying that half of new HIV infections could possibly be prevented by this test! I'm not ready to chuck that out with the bathwater.
The problem is one of information interpretation. If the test results were given as either "Positive" or "Unknown", this would solve the issue, yes?
The problem with epidemiology is that it's complex, and I mean that in a technical sense.
For instance, there's evidence that slowing the speed of an epidemic can result in a higher number of total infected.
I'm not at all saying this is bad. Cheap tests are good. However, we already know that test and treat- no matter how cheap it is- will not stop the current epidemic in the U.S. This is an advance in the cheapness of technology but it can't stop an epidemic, only (possibly) slow it. And even that could ultimately result in more people being ultimately infected, but that's not known for sure.
The only technology that can stop the epidemic currently are condoms. The only behaviors that can stop the epidemic are monogamy and using condoms. And it's possible technology such as this could reduce condom usage, and that's the disaster.
From a public health standpoint we need to watch out for anything that can alter behavior on a positive or negative scale. From the comments on engadget I would predict it would impact human behavior in a negative way, and that's what frightens me.
>And it's possible technology such as this could reduce condom usage, and that's the disaster.
// It's also possible that it could prevent promiscuous sexual activity between people that wouldn't have used condoms and are infected.
I wonder if parking sensors increased the number of parking crashes because people stopped looking out of their windows when parking??? Anyone got stats on that?
Well that guy from Wired that test drove the self- driving car with the sensors actually did crash the car the first time he tried to use it to parallel park...
At any rate, the analogy is weak. Testing partners for HIV only makes sense if you're planning to be in a monogamous relationship with them, and ideally should be done 6 months after the start of a monogamous relationship.
You should use a condom with a girl you meet at a bar no matter what. An HIV test doesn't help you at all.
Interestingly when I first got a cycle helmet was the first time I banged my head whilst cycling, though it was a direct factor (didn't account for the helmet when ducking under a tree). Seatbelts apparently cause some to take more risks.
I really don't think that is a good idea.
If people believe they won't get AIDS, which is the scariest STI, they'll be less likely to use protection, which will increase the spread of things like chlamydia (which has only minor side effects, like possible infertility) . Also, I bet the error rate goes up to a scary level once you have it being self-administered by drunk people.
Realistically, in the first world it's gay men who most need to worry about HIV, due both to the greater likelihood of it being transmitted by anal sex and the much greater preexisting incidence among gay men.
"A recent CDC study found that in 2008 one in five (19%) MSM in 21 major US cities were infected with HIV, and nearly half (44%) were unaware of their infection." -- eep
Heterosexual college-town hookups? Likely to give you all sorts of things, but probably not AIDS. But expect to see these quick AIDS tests in West Hollywood and the Castro real soon now.
Well, the first thing to note is that the numbers are for MSM - men seeking men. That includes men who identify as straight, bisexual, or other, but who have sex with other men. You may not consider this much of a distinction, but for people who study this, it changes things significantly.
And for straight men who don't want to have sex with other men, it should still be a concern when over a quarter of new infections are suspected to be due to transmission during heterosexual sex.
Ah, but what happens when someone just contracted HIV? It's estimated that this is when someone is most highly infectious, and the test won't tell you a damn thing.
I'd like it because it's a bit more convenient than going in every three months, but for testing a date? Bad idea.
Full disclosure: I am an HIV-negative gay man with poz friends and acquaintances.
It's counter-intuitive, but it's not a better idea.
Especially when drunk, people have unfocused attention. Signals of trust are amplified. "He's safe, and we don't have a condom, so just this once..." If you go into a hookup thinking every single person is HIV-positive with an entire host of other STDs, you are much less likely to get one.
You don't want to know how many people I've talked to who got HIV from someone they trusted, and "knew" was negative. On the other hand, by law of averages I've slept with at least 20 poz people. I don't know who they are, but I was smart enough to be careful.
The problem is that it could give you false confidence. A person who is recently infected will show up negative in this test. If you have unprotected sex with them, you are 4,000% more likely to get HIV from them than you are a person who tested positive!
As a current university student, it's not my paternalism. It kind of sucks, doesn't it?
But it's like lots of things in life: sometimes we can't have nice things because other people, who are much less mature and sensible than you, will misuse them, so nobody is allowed them.
Also, "paternalism" is an irritating dog whistle. We are talking about "public health policy", which also means such sensible things as that you can't have plastic surgery done in a car garage or buy cola sweetened with lead acetate or Cyclamate.
I oppose making a less safe substitute available and I think how people actually act is fair game to consider.
Condoms don't substitute for something equivalent that is safer (some people try to make out that they substitute for abstinence, but that is obviously not true since abstinence is obviously not equivalent).
This device could equivalently substitute for condoms (actually, it's probably cheaper and more fun than condoms as long as you don't mind a small pinprick), but it's less safe. Thus my opposition.
Surely then you are opposed to The Pill and other contraceptives that do not hinder the spread of STDs. A major, if not the primary, reason people use condoms under usual circumstances is to prevent unwanted pregnancies.
This device is not a substitute, nor will anyone with a conscience and a brain present it that way. It is something to be used in addition to existing technologies and sensibilities. It is about increasing available information so that people are able to make more informed decisions.
That's a different sort of information (how to act to protect yourself) and abstinence-only is not a public health policy. It is a pseudo-religious politician policy.
Now I think about it, you and me both should be fighting the catholic church and the american right over abstinence-only instead of fighting each other over exactly how HIV testing kits should be distributed.
I don't think anyone who will go to the trouble of testing their potential partners with this will forego using traditional methods as well. It's a lot more troublesome, after all.
I see what you're saying, but I'd argue it's more like opposing the introduction of comfortable new rubber seatbelts instead of those ugly, old-fashioned webbing ones. Who cares which one works better; people want the convenience only a rubber can give them.
No. An even better example than my first is opposing the installation of air-bags because they might cause people to stop using seatbelts.
Unlike this rubber seatbelt strawman, these tests actually work, and actually have a use. What is their use? Allowing people to make more informed decisions regarding their sex life and HIV. What is HIV in layman's terms? A death sentence. These chips will potentially allow people to avoid an untimely and painful DEATH, and you oppose them because you hypothesise that stupid people might ignore condoms as a result and get something instead that is either not deadly, or require nothing more than a few shots of penicillin.
Opposing the spread of such devices is beyond comprehension to me. It's flat out abhorrent.
You are wildly misinformed! HIV is not a death sentence in first world countries. It's an awful life to live, granted, but it's still a life to live.
The real concern here is that this test isn't accurate for as long as THREE MONTHS after initial infection, and that during that early stage you at at lease FOUR HUNDRED TIMES more likely to pass on the infection. It's not to be used to check if you're still healthy so now you can go bang that hottie at the bar, it's to be used to see if you have HIV and need to get treated.
Downvotes. Nice. I guess people really don't care about HIV in Africa.
This whole conversation is only serving to make me more and more cynical than I normally like to be. I'm beginning to get the strong impression that there are some members of society that would actually be disappointed if a total cure that could be widely deployed to this plague were found. Like HIV is the enforcer for their idea of proper morals and skin color. I've heard this idea bounced around in LGBT communities before but never really paid it much credence until now.
No, I think where the disagreement lies between you and other posters is that they believe that people are stupid and if they had such a test they wouldn't use condoms... This argument is made for college town and the US (and Europe). And call me cynical but I agree with it, people are dumb, misinformed and would most likely think that they're ok if the test is negative and not bother with condoms. This would actually increase the number of people with aids since people who just contracted aids and are highly contagious will show as negative because they don't have any antibodies yet...
For Third world countries, it's a different matter, I think this test is great. It helps a real problem by providing a convenient way to test for aids to doctors in remote villages and might help slow this awful epidemic...
That argument is absolute shit. The reason people in the demographic of "college towns" use condoms is because they don't want pregnancies, not because they are actually afraid of HIV.
Therefore: 1) This is also an argument for banning The Pill and the like in college towns. Clearly an idiotic idea. 2) Knowing their partner does not have HIV will not prevent people most people from using a condom if they were going to otherwise.
College kids don't worry about HIV to begin with. They will either wear a condom, or won't. Knowing their partner does not have HIV won't effect the decision since that is the default assumption anyway. People inclined to not make this assumption are also intelligent enough to realize that this test has false negatives.
This segues nicely into an idea that occurred to me the other day.
I was knocking around the idea of a website where you sign up with just an email and are issued a unique id, potentially with the ability to generate new ones on the fly. When you hook up with someone, you load an app on your phone or a website, and it generates a QR code. Each partner scans each others code and the website logs the encounter.
At some point, someone is going to get an STD/STI. When this happens, the infected parter can go to the website and with just a few clicks, you can send a notification to your recent (for some medical definition of recent), and they'll be notified to get themselves checked.
Now, the whole HIPAA compliance thing (or compliance in general, since the US isn't the only government affected here) would be a bitch and a half, and getting user adoption would be hard ("you use website.com? slut!"), but if it was safe and caught on, I could see it having a real effect on infection rates.
Some really common infections (chlamydia, gonorrhea) show no symptoms in a lot of cases, so just getting that easy notification could really help people identify that they have the disease, and so they could get quicker treatment.
I just wish I had the skill and finances to try it. Maybe some kid that wants to take a run at YC funding could use this as their idea?
Do your research. At least three different companies produce and distribute a Vatican-approved condom under license. Its innovative latex-derivative material has been engineered under Church supervision to block the HIV virus while allowing sperm to pass unhindered.
UPDATE: Folks this is indeed one of the oldest jokes ever told. I’m not surprised nobody is laughing, my ability to tell a joke it matched only by my ability to compose rhyming couplets extemporaneously. But I am surprised nobody identified it as such.
raganwald is usually pretty good about it [edit: meaning, of course, that I usually enjoy his posts], but this one was so close to the edge because of all the controversy last year that I thought I may have missed something.
> Its innovative latex-derivative material has been engineered under Church supervision to block the HIV virus while allowing sperm to pass unhindered.
This is either a joke or the stupidest thing I've heard all month.
Anyway, the RCC does allow people to use condoms when the primary purpose is disease control and not contraception.
It's certainly possible that, when condoms are made widely available in a region, this will result in more people having sex. Likely, even. The Vatican's position is that this increase in people having sex outweighs the lower average chance of transmission.
This is empirically false. But it needn't be inherently. Suppose you offered people some other form of protection that decreased the chance of transmission of HIV by 90%, and for some reason in response to this people widely abandoned the use of the condom. This would increase the overall prevalence of HIV by a wide margin.
Take a model where this device decreases the chance of transmission of HIV by 0%, while making some decent sized chunk of people more likely to have unprotected sex because of a false sense of security.* In that case, passing this out at night clubs would likely significant increase HIV's prevalence.
I see a definite use for it, but more in the way of buying a 4 pack every year and not having to go to a clinic.
*I think this model is likely correct, given what we know about the epidemiology of HIV.
It's a risk. But the same could be said for condoms in nightclubs.
Generally, the best public safety campaigns work are "defense in depth". You discourage sex in general, discourage unsafe sex, discourage casual sex, discourage polygamy, provide condoms, and encourage tests. It all generally works, as long as you don't treat any of it as a magic bullet.
It's the extremists who either think a) abstinence is the only protection; or b) causal sex is fine as long as you take precautions; who cause problems, as they tend to discourage defense in depth.
So ideally, they would have an ambiguously enthusiastic "Over 90% accurate!" blurb, and be packaged with a condom or two.
Edit: I don't mean this should be an alternative to traditional protection. It just adds another layer of certainty.