

Say the unsayable: countries get the HIV epidemics they deserve - musiciangames
http://www.wisdomofwhores.com/2010/02/09/countries-get-the-hiv-epidemics-they-deserve/

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_delirium
Hmm, the general direction of this argument is uncomfortably close to, "gays
get the HIV epidemic they deserve" (even for some of the same reasons this
article cites).

In both cases we could probably have more rational discussions without that
"deserve" word, which involves moral connotations. How about discussing: what
kinds of sexual-relationship graphs are more or less conducive to the spreads
of which kinds of disease?

I would guess there are actually a lot of factors, and more than unprotected
promiscuity. Clearly unprotected promiscuity seems involved: the article's
discussion of some recent African experience points that out, and so does the
80s gay bathhouse culture. But there are plenty of promiscuous cultures that
appear _not_ to have high HIV prevalence, e.g. college-student bar-pickup and
frat culture has very low HIV infection rates, even for people with 30+
partners and regular unprotected sex.

~~~
praptak
"college-student bar-pickup and frat culture has very low HIV infection rates,
even for people with 30+ partners and regular unprotected sex"

Citation needed. I seriously doubt a major group of people can keep low
infection rates with 30+ partners and regular unprotected sex. The only
rational explanation would be regular HIV tests plus stopping on positive
result - seems implausible.

~~~
jcnnghm
In the US, AIDS is almost entirely confined to people that are either gay, or
needle drug users.

~~~
spamizbad
If by "almost entirely confined" you mean approximately 70-75%[1]. This
shouldn't be surprising: US culture pushes homosexuality underground, and is
mostly uninterested in treating IV drug users outside of a few liberal
enclaves.

[1] <http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5739a2.htm>

~~~
jcnnghm
Maybe you're looking somewhere I'm not, but the 0.8% figure under the 'Other'
Category would seem to support what I'm saying, since it excludes people
knowing sleeping with people that are known to have AIDS, Needle Drug users,
and gay males.

~~~
spamizbad
I really can't believe I'm having this argument in 2010.

You stated that it was confined to Gays and IV drug users. It's not. The
statistics show heterosexuals contracting it. Whether they get it because
they're sleeping with an IV drug user, someone who is homosexual, or another
heterosexual who is classified as "high risk" doesn't matter: they're straight
and they have HIV, therefor it's not "contained" to gays and IV users.

~~~
_delirium
I agree he phrased it too strongly, but you could accurately say that it's
effectively confined to MSM, IV users, and those two groups' immediate sexual
partners.

That sort of analysis is pretty common in epidemiology, describing a
particular outbreak as "confined to group A and immediate contacts of group
A". For example, when looking at diseases associated with health-care workers,
people in direct prolonged contact with them but who aren't themselves health-
care workers, like family members, are often counted as basically honorary
health-care workers (or at least treated as a group separate from the general
public).

------
sakri
The Vatican and their anti birth control stance should also receive a fair
share of the blame. Matter of fact, I think the pope should be charged with
crimes against humanity for this stance.

~~~
iaskwhy
I always disliked this kind of thinking. Let me begin by saying I'm agnostic
so I'm not actually church-biased.

The roman catholic church has rules and nobody is forced to follow those
rules. If some people like to think they are roman catholics then they should
follow those rules which include not having sex unless you are procreating.

Now you can say the church should evolve, become modern, and while that would
be fair, it's also fair for the church to stand by their ideals.

You can insist and say they have a fair share of responsability for those who
follow them which should make them evolve faster but people need to start
thinking for themselves and think about what's more important: being roman
catholic or using a condom?

I'd say there's only one way you comply to both: if you're married to someone
HIV positive and want to procreate. If that's the case, you might want to
think about your child which might carry HIV too.

edit: At the end of my post I said "your child which will probably carry HIV"
but apparently it's not a high probability as pointed by sounddust so I
changed it to "might carry". Thanks, sounddust!

~~~
Robin_Message
The problem is the Catholic church is in a position of social respect and
authority, and it spreads disinformation like:

Pope Benedict said on the eve of his trip that he wanted to wrap his arms
around the entire continent, with "its painful wounds, its enormous potential
and hopes".

HIV/Aids was, he argued, "a tragedy that cannot be overcome by money alone,
that cannot be overcome through the distribution of condoms, which can even
increase the problem". [1]

The Catholic Church is telling people in countries stricken by Aids not to use
condoms because they have tiny holes in them through which HIV can pass -
potentially exposing thousands of people to risk. [2]

The church can invent whatever rules it likes and people can chose to follow
them or not, but spreading lies about condoms is not acceptable.

[1] <http://news.bbc.co.uk/1/hi/7947460.stm>

[2] <http://www.guardian.co.uk/world/2003/oct/09/aids>

~~~
tptacek
The Vatican also says that priests must be celibate, and yet the Catholic
church in Africa is --- allegedly, according to Newsweek --- rife with married
priests. Let's not overestimate the influence of the Pope. It wasn't the
Catholic church telling people they could cure STDs by deflowering virgins.

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barrkel
I seem to recall research indicating that strict monogamy is associated with
higher incidence of HIV than more sexually liberated societies. The reason
seems to be that in strict societies, in the absence of casual sexual
encounters, many males frequent prostitutes, who become hyper-connected
vectors of disease. With more casual sexual encounters, the graph is less
connected.

And in polygamous cultures, there's a lack of women to go around, so there
should be a similar dynamic re prostitution.

Of course, it's not all this simple - there are lots of factors at work.

~~~
shawndumas
'frequent prostitutes' != 'strict monogamy'

~~~
khafra
I think it's safe to say that without extensive and widespread genetic
engineering or effective mind control, a strictly monogamous _culture_ will
have many members who frequently patronize prostitutes.

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puredemo
I don't think "deserve" is the word to use here. They get the epidemics that
their cultures perpetuate, sure, but that happens everywhere.

I hear Mormonism is rampant in Salt Lake City..

~~~
jongraehl
It's funny that you compared Mormonism to an AIDS epidemic.

But why wouldn't you say SLC deserves its Mormonism?

~~~
puredemo
Well, it's a (slightly) tongue in cheek comparison.

I wouldn't say SLC 'deserves' its Mormonism. I was lucky enough to be raised
agnostic / atheist. However, my parents also taught me that I should never
take entrepreneurial risks in life. Because of that, I wasted over ten years
working in dead end corporate jobs. But did I really deserve that?

By default, children inherit the beliefs of their parents. It's very difficult
to break out of beliefs that you have followed for your entire life. If it
took me ten years to figure out that corporate jobs were a dead end, imagine
how long it would take someone to learn to think critically about religion
when it claims their soul and essence are in jeopardy, or to break free of a
culture that teaches women are inferior to men.

------
compay
What an idiotic premise. Nobody deserves to die from having sex.

~~~
CWuestefeld
_Nobody deserves to die from having sex._

The way the world works rarely follows our notions of what's fair or unfair.
The laws of nature do as they will, and they are capricious.

Statements like yours really don't make any sense at all.

~~~
frankus
From the point of view of nature, nobody deserves anything. Shit just happens.
It doesn't make sense to layer morality on top it, which is what the title of
the article can be read as doing.

There are lots of ways to be stupid an irresponsible, but there is a very
human tendency to treat ways of being stupid and irresponsible that involve
sex as wicked rather than foolish.

It's a blind spot in our rationality that we have to compensate for, and the
tone -- if not the substance -- of the article seems to fail to do that.

------
maxklein
I think this is nonsense. I doubt that the Southern Part of Africa is more
promiscuous than West Africa or Brazil or Sweden.

Yet the difference in infection rates are massive. And why does a warzone like
Liberia have 1.7% infection rates?

See my post on this: <http://blog.cubeofm.com/suprising-facts-about-aids-
in-2010>

To quote from the UN report:

"There has been a pervasive stereotype that in countries where men have
multiple concurrent partners, there is a higher rate of AIDS. Well, according
to the UN paper, "there is no significant correlation between prevalence of
sexual concurrency and HIV prevalence at the country or community level."

That article is just wrong.

~~~
musiciangames
From her book: "All of Africa is poor. But not all of Africa has very high
rates of HIV. HIV reaches very high levels only in areas where there are lots
of simultaneous sexual partnerships, lots of untreated STIs and lots of
uncircumcised men".

Here is the geographic distribution of male circumcision
[http://upload.wikimedia.org/wikipedia/commons/7/79/Global_Ma...](http://upload.wikimedia.org/wikipedia/commons/7/79/Global_Map_of_Male_Circumcision_Prevalence_at_Country_Level.png)

80-100% in most of West Africa.

Western countries such as Sweden have had education on the real causes of HIV
transmission for many years, and encourage use of condoms, discourage sharing
needles.

Brazil has had a fine response to HIV, including refusing to sign the US's
'loyalty oath' to receive PEPFAR money. This requires the recipient country to
sign a statement saying they oppose prostitution. Brazil chose instead to
regulate it, and lost $US50million in funding.

The author is an epidemiologist, who has lived in Kenya and Indonesia, working
with gays, prostitutes and drug users (as well as 'waria' for whom we don't
even have a word). She has been an author of many of the reports of UNAIDS
itself. To dismiss the article as 'just wrong' appears misguided.

I'd really recommend you read her book- it's very readable.

------
Tichy
"over half a billion dollars of PEPFAR money a year, in part to promote
abstinence, monogamy and condom use"

I am a bit surprised to hear that Americans pay other countries to promote
abstinence and monogamy.

Also, men in power everywhere have lots of sex, it is natures way. I don't
think the president single-handedly infected the nation with HIV. Not that I
have any sympathies for him, just saying.

I always felt it was hypocritical to demand a pure christian marriage life
from presidents.

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dalore
To be fair in the past the west took advantage of Africa, often saying it was
for their own good. So look at the current plight with a bit of history and it
makes sense why they don't trust the west.

No one certainly deserves to have an epidemic.

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angilly
I just want to point out this has (virtually? completely?) nothing to do with
"hackers" -- and that's a good thing. It's nice to have a little variety on
Hacker News from time to time. Thanks for posting this.

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JoachimSchipper
Note that this is _not_ necessarily true on a personal level (the adulterous-
partner argument).

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hackermom
I'd like to put it a bit differently: you never get what you _deserve_ ; you
get what you _take_ \- and in the south of Africa, they've really been
grabbing hands full of AIDS the past two decades.

There's an old saying that fits this metaphorically: _"you reap what you
sow"._ Please enjoy your harvest. Let forth finally a smaller generation, of
better health.

~~~
kral
The last period makes me think about a generation immune to HIV. And about a
short story by David Brin, The Giving Plague
(www.davidbrin.com/givingplague.htm). Nice reading.

