Asymmetrical Information

Where does that figure of $300 annually needed to fight AIDS come from? William Easterly's estimate is closer to $1500.

... very little to do with differences in sexual behavior ...

What about the practice of multiple concurrent relationships?

...very little to do with differences in sexual behavior...

I don't get it. Where do the difference is the heterosexual transmission rate come from?

I read Emily Oster's article, but she contradicts herself. In the first section she does state that "the fact that Africa is so heavily affected by HIV has very little to do with differences in sexual behavior." But then later she says that the problem also has to do with the fact that "in the United States, the discovery of the HIV epidemic led to dramatic changes in sexual behavior. In Africa, it didn't."

If she is saying that the sexual behavior differences result in higher rates of the other diseases, like herpes, that subsequently increase the risk of HIV, then it still comes down to behavior.

Sexual behavior is a secondary cause of HIV transmision, not a primary-- their sexual actions cause the situation (sores) that allows hetrosexual men to get HIV. (By letting body fluids go between the bodies.)

Emily Oster was somewhat contradictory, but I'd attribute it to her trying to avoid being too politically incorrect and destroying her career before it starts. She's also an academic writing for a general-interest publication, which might not be an easy task.

I am going to write something controversial.

I've thought for a long time if the conservatives want to promote abstinence, then they need to not discuss on moral grounds, but health grounds.

They need to take a page out of the smoking and food activists and start questioning how much STDs cost us from a medical and social cost perspective.

Especially if there's a more concrete form of socialized medicine.

Look at the HPV vaccine - geez, I have to decide whether or not to give my children the shot. When with knowledge and judicious choices, they might never be exposed.

"Economists like me don't trust that argument. We assume everyone is fundamentally alike; we believe circumstances, not culture, drive people's decisions, including decisions about sex and disease."

Jane, I trust you aren't this kind of economist ("stupid")?

The notion that culture doesn't seriously influence people's decisions is just dumb.

In Africa, it's much more common that men and women practice female anal-receptive sex as a method of birth control. That's a part of the behavioral equation that goes unmentioned much of the time.

In Africa, it's much more common that men and women practice female anal-receptive sex as a method of birth control. That's a part of the behavioral equation that goes unmentioned much of the time.

Would that cause female-to-male transmission, which is quite common in Africa?

I agree with the concept of reducing STDs in Africa, but this idea has actually been tried. There were several (four?) trials in different parts of africa where people were treated with antibiotics and transmission rates assessed. One of the first trials showed decreased transmission but some of the other trials showed not effect.
A couple of other points-bacterial vaginosis is not an actual STD but is very common in parts of Africa. Epidemiologically it increases HIV transmission, but it is not an ulcerative disease. HSV-2 is common, but we don't have any way to treat it at this point.

In Southern Africa, "dry intercourse" is supposedly preferred. Women even go to the trouble of putting substances inside themselves to dry out the vagina. The resulting small lesions seem to me to be likely to promote transferring just about any STD one can think of, both ways.

It is extremely politically incorrect to point out that Uganda has reduced the percentage of persons with AIDS in the population by stressing chastity (abstinence) before marriage and fidelity after marriage, with "oh, yeah, and here's some condoms, too" a distant third. It is very un PC because this flies in the face of all the revealed truth that UN and Bono and everyone else "knows" about Africans, disease, sex, life, and probably the universe. Since it is an inconvenient truth, it cannot be true...

HSV-2 is common, but we don't have any way to treat it at this point.

There are some drugs, herbs, and suppliments that have an effect against herpes virus strains.

Ganciclovir. Pau d'arco. Chamomile. Ascorbate. etc. Have all shown an effect. HSV-2 might not be cureable, but it is treatable. Of course, simple malnutrition is enough to lower someone's immune response.

... second half posted here to avoid the bot filters.

Personally, I think the same approach would be good for the US. There's been so much attention paid to AIDS deaths, and so little paid to excess morbidity and mortality due to undiagnosed chlamydia, for instance. CMV (the virus that causes Mono) stays with people for their lifetime. 50-80% of Americans have it. It can reemerge later in life. There's been suggestions that it is implicated in chronic fatigue, and high titers of CMV in the blood have been associated with significant mental decline as well as carcinogenesis. It's spread by saliva.

But you hear almost nothing about these common, destructive diseases which probably cause more overall damage to even the US population as a whole by any measure compared to diseases like HIV.

link

p.s. Last link belongs with the information on herpes cures, as it's about an NIH trial on a herpes vaccine currently underway. I can imagine few things that would do more good.

So the argument that AIDS in Africa is about sex after all basically boils down to "these primitives engage in butt sex because that's the only way they know to avoid pregnancy"? And people are seriously stating this??

CMV does not cause mono; that's epstein-barr.

Epstein-barr can cause mono. So can CMV.

Infectious mononucleosis is an acute viral infection that can cause high fever, sore throat, and swollen lymph glands, especially in the neck. Unlike the more common form of mononucleosis, caused by the Epstein-Barr virus, this type is caused by cytomegalovirus (CMV).

Feynman - just because you can state a fact in a nasty fashion doesn't make the fact untrue. If you had $300 a year in income, you probably wouldn't be buying Trojans yourself.

Peter - yes. Anything that brings infected female blood in contact with male genitalia - such as anal sex and dry sex, both of which create small lesions or tears - increase the female-to-male transmission rate of AIDS. Anal sex is the primary worldwide vector.

Levels of rather common infectious antigens have been correlated with loneliness and are lowered by antidepressants. Loneliness is associated with lower levels of Natural Killer Cells. Delicacy leads one to make that statement, 'a method of birth conrol'; more interestingly it is probably due to emotions suggested by a previous commenter. I think the studies which have shown that treating other STDs does not affect the incidence of AIDS are worth reviewing.

I've read that AIDS in Africa is defined differently than is AIDS in the USA. The African definition is basically a catch all since labs are scarce. There is a lot of political science involved here that does not amount to real science.

leon -

Just curious, is that from Deusberg or one of the HIV dissidents?

It was in Fidelity Magazine in the last couple of years. I think there was some skeptism expressed over AIDS but it is hard to argue with how things may be defined and then redefined politically and not on the basis of science. Other examples of that will readily come to mind.

I've also read that AIDS in Africa is defined mainly by checking off a list of symptoms, because as leon dixon noted there just aren't enough labs to go around. The result is that surely some number of people who are suffering from a combination of parasite infections, disease and chronic conditions are diagnosed with AIDS when they do not have HIV. Some number of people who are carrying HIV but who aren't as sick are surely not diagnosed at all. Africa is a messy place, to put it mildly, in a lot of ways.

And yes, politics plays a huge role in such things, sad to say.

I've heard the same regarding diagnosis in Africa, but from Deusberg, et al. It's worrisom that so many companies were willing to send over AZT, one of the least effective and most toxic anti-AIDS drugs. The stuff had once been used for chemotherapy against cancer, but was discontinued because of toxicity. It decimates the immune system and causes AIDS-like symptoms in those who use it.