Once on the brink of eradication, syphilis is raging again(npr.org)
npr.org
Once on the brink of eradication, syphilis is raging again
https://www.npr.org/sections/health-shots/2021/04/14/986997576/once-on-the-brink-of-eradication-syphilis-is-raging-again
342 comments
I'm very curious about the impact of PrEP. On one hand, condomless sex has absolutely exploded in the gay community since PrEP, and honestly, why not? As the saying goes, "Who wants to chew gum with the wrapper on?" But PrEP also requires frequent and regular STD testing, so these cases of syphilis should be caught and treated early before they have much of a chance to spread.
I would take a guess that lots of people take PrEP but skip the STD testing...
PrEP is prescribed, must be taken continually to be effective, and if a doctor prescribes it without STD tests they're committing malpractice.
Depends on the country. Here in the UK it's not offered by the NHS at all unless you're on one of their trials, so you have to buy it outright. Some organisations will offer it as long as you go get tested regularly, but you can order it online just as easily.
I order my PrEP online and do all my STD testing at home, since I hate having to reveal my sexual history to strangers constantly.
I order my PrEP online and do all my STD testing at home, since I hate having to reveal my sexual history to strangers constantly.
I think the NHS might have started offering it now, but that kind of got buried under all the news about the Covid pandemic.
Unfortunately on https://www.iwantprepnow.co.uk/prep-on-the-nhs/ it looks like it's still via closed trials, unless you're in Scotland or Wales. I'm not holding out much hope for it being generally available any time soon, based on how they've acted so far.
But a lot of people just buy it from illegal sites online to avoid the hassle/paperwork/cost/time of a GP visit.
Are people getting PrEP illegally? I would think that would be ridiculously expensive in the US as most states or insurance companies have some sort of plan to cover it (if not the coupon program from the manufacturer, Gilead. In New York State it's essentially free.
It would also be dangerous to be taking PrEP and not getting the required kidney function tests with it ever 90 days (the older version of PrEP can be hard on some people's kidneys).
I do see advertisements for legitimate mail-order services where you do consult with a doctor, and perform the tests at home.
Looking at one site, if you have no coverage, it's $164 for kidney and STI testing, $94 for just the required kidney tests. So some may just opt out to save money. But again, I would be surprised if there's many people paying out of pocket for the whole treatment.
It would also be dangerous to be taking PrEP and not getting the required kidney function tests with it ever 90 days (the older version of PrEP can be hard on some people's kidneys).
I do see advertisements for legitimate mail-order services where you do consult with a doctor, and perform the tests at home.
Looking at one site, if you have no coverage, it's $164 for kidney and STI testing, $94 for just the required kidney tests. So some may just opt out to save money. But again, I would be surprised if there's many people paying out of pocket for the whole treatment.
I just checked. I can get it rather cheaply from overseas pharmacies, and since these are not "Scheduled" drugs, I could do so legally.
You can get the kidney function tests yourself if you like on demand, as well, privately.
You can get the kidney function tests yourself if you like on demand, as well, privately.
What, why would someone order it from "illegal" sites online when there are plenty of good, reputable legal sites online that allow you to do all the testing at home?
> must be taken continually to be effective
Just want to add this here in case anybody's unfamiliar: PrEP can also be taken on an event-driven schedule, rather than the daily dose most people are familiar with. Under this regime, you take two doses two hours before sexual activity (or upto 24 hours earlier), followed by a single dose 24 hours after the first 2 pills, and a final dose 24 hours after that. If sexual activity can be planned or is infrequent, this 2+1+1 regime might be preferred.
Just want to add this here in case anybody's unfamiliar: PrEP can also be taken on an event-driven schedule, rather than the daily dose most people are familiar with. Under this regime, you take two doses two hours before sexual activity (or upto 24 hours earlier), followed by a single dose 24 hours after the first 2 pills, and a final dose 24 hours after that. If sexual activity can be planned or is infrequent, this 2+1+1 regime might be preferred.
Should you be giving this kind of medical advice on HN?
It's not medical advice nor did I invent it - it's just one of the regimes for PrEP recommended by the WHO. I know people on PrEP who were unaware of this regime, since the default consideration is the daily dose. Like all things, it's something to discuss with your physician.
As the WHO notes, the event-driven regime isn't generally recommended for adolescents who might have issues with compliance, or cis & trans women.
https://www.who.int/hiv/pub/prep/211/en/
As the WHO notes, the event-driven regime isn't generally recommended for adolescents who might have issues with compliance, or cis & trans women.
https://www.who.int/hiv/pub/prep/211/en/
Why not? It's not like he's writing prescriptions on HN.
And also to measure the other potential long term effects on liver, kidney. I'm not sure if i've been tested for 'bones' not sure how to do that. My doc says it's important to monitor.
PrEP requires a blood test every 3 months to check liver / kidney function, and they usually do an STD test at the same time.
Are they testing for all STDs or only for HIV? Also, the person taking PrEP is (potentially) only half of the equation. How often do people who test positive inform their recent partners?
The normal procedure here in Seattle anyway is to get a blood panel, rapid HIV test, mouth-, and anal-swab every three months as a requirement for being prescribed PReP. They check for syphilis, gonhorrea, HIV, chlamydia, and other blood-related issues That could be caused by the drug itself.
Most people I know engaging in especially frequent encounters get tested monthly. There are multiple free health clinics in the city so it isn’t just a game for the rich either.
Most people I know engaging in especially frequent encounters get tested monthly. There are multiple free health clinics in the city so it isn’t just a game for the rich either.
That seems like a crazy amount of effort just to have sex with strangers a little safer. I wonder if it backfires and people skip it and just take the risk.
Especially now that HIV isn't a dead sentence.
Especially now that HIV isn't a dead sentence.
>now that HIV isn't a death sentence
So long as the supply chains keep running, insurance keeps paying for the drugs (which can cost thousands of USD per month over the course of a patient's entire life), the drugs reach the patient, and the patient takes all their drugs on schedule.
If at all possible, I'd rather avoid a life-or-death dependence on global supply chains, pharmaceutical factories, and insurance agents most of all. People die every year for lack of insulin, and that drug is much cheaper, more well-understood biologically, and more widely available than HIV medications.
So long as the supply chains keep running, insurance keeps paying for the drugs (which can cost thousands of USD per month over the course of a patient's entire life), the drugs reach the patient, and the patient takes all their drugs on schedule.
If at all possible, I'd rather avoid a life-or-death dependence on global supply chains, pharmaceutical factories, and insurance agents most of all. People die every year for lack of insulin, and that drug is much cheaper, more well-understood biologically, and more widely available than HIV medications.
It's a ten minute visit, once a quarter. Usually, it's _just_ labwork, so you don't even have to worry about your providers schedule.
It isn’t about sex with strangers. It’s about any sex with anyone who isn’t /exclusively/ and /indefinitely/ having sex with only me.
Well, the silver lining, I guess, is that this appears to be the result of basically getting a handle on the AIDS situation to the point where it wasn’t a threat.
>With the risk of contracting a deadly disease falling to almost zero, condoms fell even more out of favor than they already were, says Park.
>"If one man is taking PrEP and the other one is virally suppressed, there's no HIV risk at all," she says. "So why use condoms if you don't mind having a touch of syphilis?"
Humans really do take for granted the efficacy of antibacterials and antibiotics across the board.
These sort of harmful bacteria are completely and safely treatable now in most people, but the real potential threat is breeding drug resistant strains of bacteria, microorganisms and viruses. We shouldn't treat these fantastic tools like a pass to do whatever, we should instead use them sparingly and curb behavior. There are plenty of simple preventative practices than can reduce ever needing such treatments while mostly being able to continue doing what you'd like. A huge amount of these infections could be reduced drastically just by using a condom.
Rely on those prevention approaches first and drugs/treatment second to reduce the risk of creating situations where treatments don't exist. This can be said about a huge swath of preventable disease in the US. A bit of diet, exercise, and an once of prevention is worth its weight in gold.
>"If one man is taking PrEP and the other one is virally suppressed, there's no HIV risk at all," she says. "So why use condoms if you don't mind having a touch of syphilis?"
Humans really do take for granted the efficacy of antibacterials and antibiotics across the board.
These sort of harmful bacteria are completely and safely treatable now in most people, but the real potential threat is breeding drug resistant strains of bacteria, microorganisms and viruses. We shouldn't treat these fantastic tools like a pass to do whatever, we should instead use them sparingly and curb behavior. There are plenty of simple preventative practices than can reduce ever needing such treatments while mostly being able to continue doing what you'd like. A huge amount of these infections could be reduced drastically just by using a condom.
Rely on those prevention approaches first and drugs/treatment second to reduce the risk of creating situations where treatments don't exist. This can be said about a huge swath of preventable disease in the US. A bit of diet, exercise, and an once of prevention is worth its weight in gold.
And one other thing: Cheap, anonymous tests for everyone. It should be the norm that when you hook up with a new person / one night stand that you show them your recent negative test result. At least where I live (Germany) you can already get them sent to your home for 50€ (https://samhealth.de/) and you can get free tests at your local health office (Gesundheitsamt) if you are not too shy to argue a bit. AFAICT it should be a net positive for society to completely subsidize home tests for everyone, but that is probably an uphill battle against conservative prejudices even in Germany.
> A bit of diet, exercise, and an once of prevention is worth its weight in gold.
All those cases of just eating less sugar / exercising more / sitting less are unfortunately really hard for most individuals. We really should strive to create environments where doing the good thing is as easy as possible. Like offering free daily work breaks for sport or having healthy lunch meals for children in school.
> A bit of diet, exercise, and an once of prevention is worth its weight in gold.
All those cases of just eating less sugar / exercising more / sitting less are unfortunately really hard for most individuals. We really should strive to create environments where doing the good thing is as easy as possible. Like offering free daily work breaks for sport or having healthy lunch meals for children in school.
> AFAICT it should be a net positive for society to completely subsidize home tests for everyone, but that is probably an uphill battle against conservative prejudices even in Germany.
Great, now we’re “prejudiced” for not wanting to subsidize other people’s risky sexual behavior.
Did it ever occur to you that if there is, as you suggest, a large health burden associated with casual sex culture (and, according to the article, drug use culture), that maybe the “conservatives” are correct to be “prejudiced” against it?
Great, now we’re “prejudiced” for not wanting to subsidize other people’s risky sexual behavior.
Did it ever occur to you that if there is, as you suggest, a large health burden associated with casual sex culture (and, according to the article, drug use culture), that maybe the “conservatives” are correct to be “prejudiced” against it?
Moral argument: functioning society's don't expect their member to act perfectly and always make the right choices. Would you expect a hospital not to treat you because you got injured while committing risky behavior (e.g. extreme sports, trying strange foods, or arguably driving a car)? Treatments like this support "repeat offenders" and the poor bastards who make a wrong choice once alike.
Pragmatic argument: It's better economically and for productivity for people to not have HIV, Syphilis, etc. It's far easier to provide treatment and testing then to tell people to stop having sex.
Pragmatic argument: It's better economically and for productivity for people to not have HIV, Syphilis, etc. It's far easier to provide treatment and testing then to tell people to stop having sex.
I think it's actually fine to charge higher premiums to people who take significantly greater risks than the average person. we already do this with car insurance for people who drive certain models, have been in at-fault collisions, have traffic infractions on record, etc. no one "needs" to go skiing or drive a fast car, but a.) we should let them and b.) they ought to pay a bit more into the pool.
I can see the argument for that, however from my reading OP was arguing that people who take greater risks shouldn't get treatment at all or be "subsidized" by people who don't. You seem to be arguing (and correct me if I'm wrong) that people making riskier choices pay more for themselves to make up for that.
yes, that is exactly what I'm arguing. if everyone pays into a pool without any risk adjustment, that is effectively a subsidy to the risk-takers. I think that is a more fair way to understand rayiner's objection to "subsidies". I don't think he is seriously arguing that risk-takers should be denied care/testing/whatever altogether.
of course this is all hypothetical with the current state of US healthcare. step one has to be a reasonable cost baseline for people who don't elect a bunch of extra risk.
of course this is all hypothetical with the current state of US healthcare. step one has to be a reasonable cost baseline for people who don't elect a bunch of extra risk.
How is this different from healthcare as it is set out now or in the past? (Pre existing condition? Too bad. Too expensive to keep you around. Pay out of pocket.)
Hypothetically, you don’t need healthcare if you live/lived a near fundamentally perfect lifestyle. Accidents happen but then maybe don’t use knives or ever leave your home too.
Be a bubble boy.
Hypothetically, you don’t need healthcare if you live/lived a near fundamentally perfect lifestyle. Accidents happen but then maybe don’t use knives or ever leave your home too.
Be a bubble boy.
you are strawmanning me a bit.
> people who don't elect a bunch of extra risk
I'm not talking about preexisting conditions. I'm talking about conscious choices people make that increase their risk level. I'm not telling you how to live your life, but if our care is funded from the same pool and you live a riskier life by choice, I don't think it's unfair for me to ask that you pay proportionally more.
> people who don't elect a bunch of extra risk
I'm not talking about preexisting conditions. I'm talking about conscious choices people make that increase their risk level. I'm not telling you how to live your life, but if our care is funded from the same pool and you live a riskier life by choice, I don't think it's unfair for me to ask that you pay proportionally more.
> I'm not telling you how to live your life, but if our care is funded from the same pool and you live a riskier life by choice, I don't think it's unfair for me to ask that you pay proportionally more.
Charging people more for coverage is telling them how to live their life. And where is the line drawn? "Oh, you like to go 10mph over the limit? Higher medical coverage fees, sir. You're likely to get hurt. Oh, sir, you live in a rough neighborhood? Very likely to get shot sir, you should definitely have higher premiums, yes."
You may as well ask people to not have health insurance and just pay out of pocket for everything.
Btw - do you really think if you do this that costs will go down for you in this hypothetical system? They won't. Premiums will go up for everyone and the people who will profit are executive leadership.
Charging people more for coverage is telling them how to live their life. And where is the line drawn? "Oh, you like to go 10mph over the limit? Higher medical coverage fees, sir. You're likely to get hurt. Oh, sir, you live in a rough neighborhood? Very likely to get shot sir, you should definitely have higher premiums, yes."
You may as well ask people to not have health insurance and just pay out of pocket for everything.
Btw - do you really think if you do this that costs will go down for you in this hypothetical system? They won't. Premiums will go up for everyone and the people who will profit are executive leadership.
Very well and succinctly put
I don't really understand the distinction you're trying to draw between "make those who choose to live risky lives pay more" vs. "people who take risks shouldn't be subsidized by people who don't".
Aren't those the same thing?
Aren't those the same thing?
Moral argument: functioning societies don't move the burden of the consequences of known risky behavior from those doing such behavior to those who are not. In fact, that's a recepie for a civilizational death spiral.
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I think I'd need to see a better argument that we're moving the burden of consequences. Riding a bike with no helmet is known risky behavior; if they get hit by a car or fall or their bike and have to go to the hospital, would you say that's shifting the burden of consequence? People with Syphilis who get tested and help for it still pay their taxes, which helped fund their treatment. They still have consequences such as having to see a doctor, take medicine which may be unpleasant (ever have GI side-effects from an anti-biotic?), and of course they experience the side-effects of, you know, having Syphilis. The government isn't taking $20 out of your wallet to bribe the bacteria to not infect someone.
strange: drunk driving continues to cause grave personal, public health and economic harm to non-participants and has for, what, well over 50 years? yet the US seems to be largely "functioning".
By this standard we’re arguably at greater risk of civilizational death spiral, e.g., helping homeowners to rebuild in natural disaster-prone areas than trying to treat venereal disease.
If we're just handing out everything for free then I'd argue it's also better economically for people (and particularly kids) to have free eye care, free dental care, and a million other things I'd rather see subsidized over free Syphilis tests.
Economically, I absolutely agree and fortunately we have the power to do both. Plus Syphilis testing is very cheap, relative to most testing (about $20-$50 for early infections) and testing costs are only going down. Rapid testing is even cheaper, down to something like $5 per test.
Why does it have to be either/or?
I 100% agree with you and I'm sorry this is not the case in the country you live in. I keep forgetting how bad the health care system is in some parts of the rich and developed world. I agree with my sibling comments that fortunately you can have all of those for free, for affordable prices for society, if the right policies are implemented.
It's better economically and for productivity for people to not have HIV, Syphilis, etc.
Stop this. It isn't an economics issue. This is a moral issue. Your tract of reasoning is precisely why the world is growing so untenable for the human element. There needn't exist laws or programs or any other edifice by which regulation is effected. People need to be made to realize that they're being wholly indiscretionate and their disposition to do so comes at a cost, and it should be personal to make the point manifest.
Stop this. It isn't an economics issue. This is a moral issue. Your tract of reasoning is precisely why the world is growing so untenable for the human element. There needn't exist laws or programs or any other edifice by which regulation is effected. People need to be made to realize that they're being wholly indiscretionate and their disposition to do so comes at a cost, and it should be personal to make the point manifest.
With all due respect, the first half of comment is literally prefaced with "the moral argument". Personally I believe that argument should be enough, but you gotta play to the audience.
A prejudice is just a pre-conceived notion about something. So yes, if you have decided that casual sex is bad, you are prejudiced against it. Don't be so upset, it's not a problem.
Treating STIs is more expensive than testing, and also paid for through statutory insurance.
You yourself are making the distinction between the casual sex culture and STD testing. Diseases have a way of spreading and not testing for STD is a piss-poor way to change hookup culture for the better.
You can yell about it, concoct vindictive policies to punish people whose behavior you don't like, dress up these policies by describing them in purportedly scientific economic terms like "subsidizing," "externality," "free rider," etc., but ultimately, this is a futile position to take. People are going to do what they want.
If the effect of peoples' real aggregate behavior creates a negative effect that you might suffer from in the future, e.g. breeding antibiotic resistant bacteria, then the more effective position is to STFU with all of the moralizing and support policies that actually work, even if you have to pony up a bit to pay for them. It's cheaper for you in the long run -- you're not just paying to support risky behavior, you're paying so that behavior that is going to happen anyway doesn't put you at risk in the future.
Your options are to be angry today and sick or dead tomorrow, or to let it go, support effective policies today, and get a better shot at a successful tomorrow. Yelling at people doesn't work.
If the effect of peoples' real aggregate behavior creates a negative effect that you might suffer from in the future, e.g. breeding antibiotic resistant bacteria, then the more effective position is to STFU with all of the moralizing and support policies that actually work, even if you have to pony up a bit to pay for them. It's cheaper for you in the long run -- you're not just paying to support risky behavior, you're paying so that behavior that is going to happen anyway doesn't put you at risk in the future.
Your options are to be angry today and sick or dead tomorrow, or to let it go, support effective policies today, and get a better shot at a successful tomorrow. Yelling at people doesn't work.
> STFU with all of the moralizing
Parent is responding to accusations of "conservative prejudice." That is its own moralizing.
You can make the pragmatic argument that it's pointless to try to control the risky behaviors of others, or to expect the people engaged in those risky behaviors to bear the cost of them. But it's pretty insulting to then disparage others as "prejudiced" for not liking this deal, while having no criticism of the behavior itself. "People are going to do what they want" -- well maybe some people want to be upset about subsidizing behavior they don't approve of.
Parent is responding to accusations of "conservative prejudice." That is its own moralizing.
You can make the pragmatic argument that it's pointless to try to control the risky behaviors of others, or to expect the people engaged in those risky behaviors to bear the cost of them. But it's pretty insulting to then disparage others as "prejudiced" for not liking this deal, while having no criticism of the behavior itself. "People are going to do what they want" -- well maybe some people want to be upset about subsidizing behavior they don't approve of.
The snippet just before your quote was:
> then the more effective position is to
(emphasis added)
I agree with you that people have the right to be upset, to moralize, etc. My insinuation was that it isn't effective as public policy, which is the extra step that moralizing conservatives seem eager to take.
I'm fine if they want to sit in the corner and whine, but if they're going to use this whining to enact policies that don't work, and that haven't worked despite decades of trying, then I'm going to push back, and yes, I'm going to be a little insulting, especially seeing as they have no problem berating the people that they don't approve of.
People who insist on maintaining a delusion despite evidence that it doesn't work, and despite examples of other policies in other places that produce better results annoy me. Why should I have to pay for the externalities of their stupid opinions when I'm not the one the one having them? (See, it sounds just as ridiculous from the other side)
> then the more effective position is to
(emphasis added)
I agree with you that people have the right to be upset, to moralize, etc. My insinuation was that it isn't effective as public policy, which is the extra step that moralizing conservatives seem eager to take.
I'm fine if they want to sit in the corner and whine, but if they're going to use this whining to enact policies that don't work, and that haven't worked despite decades of trying, then I'm going to push back, and yes, I'm going to be a little insulting, especially seeing as they have no problem berating the people that they don't approve of.
People who insist on maintaining a delusion despite evidence that it doesn't work, and despite examples of other policies in other places that produce better results annoy me. Why should I have to pay for the externalities of their stupid opinions when I'm not the one the one having them? (See, it sounds just as ridiculous from the other side)
How much evidence is there that insulting others is an effective way to get them to change their opinions and support the policies you favor? If the basis of your annoyance is ineffectiveness, then I would expect you to feel a lot of annoyance at people who insult others and call them stupid as a strategy for changing their behavior.
Turning that question around: do you have any evidence that it's not effective? Do you have evidence of another argumentation style that's more effective?
I'm hard pressed to design a good, reproducible experiment on the question one way or the other.
I'm hard pressed to design a good, reproducible experiment on the question one way or the other.
I won't pretend to be familiar with the academic literature, but here is one paper I found: https://www.sciencedirect.com/science/article/abs/pii/002210...
> The field situation consisted of a park-bench discussion of a topical social issue, arranged by a public-opinion interviewer. Prepared experimental variations were introduced by one of the discussion partners, a confederate of the interviewer. In the critical variation, the confederate insulted the subject during discussion. In other variations, he tried to persuade but did not insult, or else simply gave certain arguments without intent to persuade. Attitude-change results supported the hypothesis of negative change in the insult condition.
Eleanor Gordon-Smith spent two years interviewing people who changed their minds, and suggests this:
> The strategy is this: Ask where people’s beliefs come from as well as what they actually believe.
https://www.marketwatch.com/story/this-is-the-difficult-secr...
> The field situation consisted of a park-bench discussion of a topical social issue, arranged by a public-opinion interviewer. Prepared experimental variations were introduced by one of the discussion partners, a confederate of the interviewer. In the critical variation, the confederate insulted the subject during discussion. In other variations, he tried to persuade but did not insult, or else simply gave certain arguments without intent to persuade. Attitude-change results supported the hypothesis of negative change in the insult condition.
Eleanor Gordon-Smith spent two years interviewing people who changed their minds, and suggests this:
> The strategy is this: Ask where people’s beliefs come from as well as what they actually believe.
https://www.marketwatch.com/story/this-is-the-difficult-secr...
Nifty that somebody at least tried!
The paper has been cited only about 40 times in the half-century since it was written, but I found one recent interesting citation:
https://www.researchgate.net/publication/327127198_The_Monta...
I'm skeptical of the study for a variety of reasons, mostly coming down to the issue of what people tell researchers vs what they actually do. But it's good to know that somebody is at least trying.
The paper has been cited only about 40 times in the half-century since it was written, but I found one recent interesting citation:
https://www.researchgate.net/publication/327127198_The_Monta...
Uncivil remarks uniquely diminished the speaker’s reputation, and had little impact on the reputation of the targets of the attack, the perceived winner of the verbal exchange, the reputation of the speaker’s party, or the sense that the country is moving in the right direction. Incivility made the speaker seem less warm and did less to affect perceptions of dominance or honesty. This warmth deficit explained the reputational costs of incivility.
I'm skeptical of the study for a variety of reasons, mostly coming down to the issue of what people tell researchers vs what they actually do. But it's good to know that somebody is at least trying.
You raise a good point... essentially the same point I made earlier -- insulting people is as bad a strategy for changing behavior as yelling at them.
If I were trying to get moralizing conservatives to agree with me, then not insulting them would indeed be the first part of an effective strategy. However, I'm not trying to change minds, because that is also fruitless.
For the same reason that trying to convince ordinary people that their promiscuous lifestyles are bad won't actually change their behavior, trying to convince moralizing conservatives that their entire worldview is wrong isn't going to change their perspective.
This kind of person is not trying to achieve an effective outcome through policy, they're trying to use policy as a weapon against people they don't like. Debating the effectiveness of various policy options won't move that particular needle, so why bother?
If I were trying to get moralizing conservatives to agree with me, then not insulting them would indeed be the first part of an effective strategy. However, I'm not trying to change minds, because that is also fruitless.
For the same reason that trying to convince ordinary people that their promiscuous lifestyles are bad won't actually change their behavior, trying to convince moralizing conservatives that their entire worldview is wrong isn't going to change their perspective.
This kind of person is not trying to achieve an effective outcome through policy, they're trying to use policy as a weapon against people they don't like. Debating the effectiveness of various policy options won't move that particular needle, so why bother?
> I'm fine if they want to sit in the corner and whine, but if they're going to use this whining to enact policies that don't work despite decades of trying, then I'm going to push back, and yes, I'm going to be a little insulting
This is a little problematic for me. You are basically saying people have a right to whine, but not a right to try to remedy the situation causing their whining.
Say you live in a fictional country X. Country X has a problem called "Raw Water Fever" where people get these massive chronic migraines because they take untreated stream water and squirt it up their butts with a baster (this is called "basting" - and gives a nice euphoric effect due to some yet-undetermined combination of native bacteria in the water reacting with gut bacteria). Previous efforts to get people in country X to use treated water fail because they complain the treated water doesn't produce any euphoria. The country also tried outright banning basting, and that was also ineffective.
So, the government decides that the right solution to this problem is to reach into your wallet to subsidize free per-use testing kits for the whole country. These testing kits would be able to tell you whether the water you are about to squirt up your butt has the Raw Water Fever bacteria present.
If you protest, the government says that while are allowed to whine about them reaching into your wallet, that's about all you are allowed to do because they already attempted previously to ban basting and it was ineffective.
Are you cool with this, or would it leave a bad taste in your mouth? Now, say that basting is not country X's only source of problems, it has lots of other problems stemming from behaviors you don't partake in. The government wants to reach into your wallet for each of those problems too. How are you feeling at this point? Are you glad to give up your hard earned money to help citizens of country X continue their favorite behaviors safely? Or does it leave a bad taste in your mouth and make you want to move to a different country where the citizens' behaviors align more with your own?
This is a little problematic for me. You are basically saying people have a right to whine, but not a right to try to remedy the situation causing their whining.
Say you live in a fictional country X. Country X has a problem called "Raw Water Fever" where people get these massive chronic migraines because they take untreated stream water and squirt it up their butts with a baster (this is called "basting" - and gives a nice euphoric effect due to some yet-undetermined combination of native bacteria in the water reacting with gut bacteria). Previous efforts to get people in country X to use treated water fail because they complain the treated water doesn't produce any euphoria. The country also tried outright banning basting, and that was also ineffective.
So, the government decides that the right solution to this problem is to reach into your wallet to subsidize free per-use testing kits for the whole country. These testing kits would be able to tell you whether the water you are about to squirt up your butt has the Raw Water Fever bacteria present.
If you protest, the government says that while are allowed to whine about them reaching into your wallet, that's about all you are allowed to do because they already attempted previously to ban basting and it was ineffective.
Are you cool with this, or would it leave a bad taste in your mouth? Now, say that basting is not country X's only source of problems, it has lots of other problems stemming from behaviors you don't partake in. The government wants to reach into your wallet for each of those problems too. How are you feeling at this point? Are you glad to give up your hard earned money to help citizens of country X continue their favorite behaviors safely? Or does it leave a bad taste in your mouth and make you want to move to a different country where the citizens' behaviors align more with your own?
Sex is something hardwired into people. Basting in this example? Not so much.
Like just replace the word basting with the word sex in your example.
"The government tried outright banning sex"--sounds pretty ludicrous! Has any government even tried such a thing in all of history?
Personally, I welcome the prospect of my tax dollars being used to help people rather than kill and maim them. The amount each individual has to contribute for such a thing is likely incredibly low as well.
Like just replace the word basting with the word sex in your example.
"The government tried outright banning sex"--sounds pretty ludicrous! Has any government even tried such a thing in all of history?
Personally, I welcome the prospect of my tax dollars being used to help people rather than kill and maim them. The amount each individual has to contribute for such a thing is likely incredibly low as well.
Well, I was sort of thinking of drugs when I made the analogy, but the government policy response is similar (i.e. the government wants to reach into my wallet to subsidize free syringes, drug purity tests, etc.)
> Sex is something hardwired into people
This is an appeal to nature. We naturally want to do it, therefore we shouldn't try to resist it? There are many counter examples: violence, incest, tribalism, and other undesirable evolutionary behaviors are hardwired into people (and animals) too, yet our efforts to reduce/temper their influence and emergence can be quite effective (though not 100% effective). Why is sex any different? I think we could temper sexual activity with the right messaging (and more importantly, leading by example) to youth.
Something like "sex is something that should be reserved for a committed relationship, not a recreational activity you should do casually - the latter leads to a lot of problems in society. Nevertheless, the choice is up to you and here are the risks and things you need to know either way..." Obviously "accidents" would still happen, but the idea would be to address the root cause of sex-related issues in society instead of throwing your hands into the air and deciding to just treat the symptoms.
> Sex is something hardwired into people
This is an appeal to nature. We naturally want to do it, therefore we shouldn't try to resist it? There are many counter examples: violence, incest, tribalism, and other undesirable evolutionary behaviors are hardwired into people (and animals) too, yet our efforts to reduce/temper their influence and emergence can be quite effective (though not 100% effective). Why is sex any different? I think we could temper sexual activity with the right messaging (and more importantly, leading by example) to youth.
Something like "sex is something that should be reserved for a committed relationship, not a recreational activity you should do casually - the latter leads to a lot of problems in society. Nevertheless, the choice is up to you and here are the risks and things you need to know either way..." Obviously "accidents" would still happen, but the idea would be to address the root cause of sex-related issues in society instead of throwing your hands into the air and deciding to just treat the symptoms.
You could say it's special pleading on my part, but for the continuation of homo sapiens, sex is required (at least for now).
> violence, incest, tribalism, and other undesirable evolutionary behaviors
None of the explicitly mentioned things in this list are similarly essential to the continuation of humans and human civilization. Like violence may in reality be unavoidable, but that doesn't mean it's strictly necessary.
But I do agree that appeal to nature alone isn't very strong. Like to me, I guess it's moreso what seems like extreme impracticality in trying to control people's sexuality to a finer degree than is already in place.
> violence, incest, tribalism, and other undesirable evolutionary behaviors
None of the explicitly mentioned things in this list are similarly essential to the continuation of humans and human civilization. Like violence may in reality be unavoidable, but that doesn't mean it's strictly necessary.
But I do agree that appeal to nature alone isn't very strong. Like to me, I guess it's moreso what seems like extreme impracticality in trying to control people's sexuality to a finer degree than is already in place.
> I guess it's moreso what seems like extreme impracticality in trying to control people's sexuality to a finer degree than is already in place.
I agree trying to "control" people's sexuality is extremely impractical. That's why I think it needs to be more a cultural value that we collectively decide is worth teaching to kids (and leading by example), not something the government forces on us. I think that would work because it worked for me and my extended family as far as I can tell (with a few exceptions).
I agree trying to "control" people's sexuality is extremely impractical. That's why I think it needs to be more a cultural value that we collectively decide is worth teaching to kids (and leading by example), not something the government forces on us. I think that would work because it worked for me and my extended family as far as I can tell (with a few exceptions).
Isn't this still a form of control? Like the idea here is to psychologically manipulate people to have different values? What happens when some people don't respond to this proposed conditioning?
I would like to believe I have somewhat of a unique perspective on this. I was raised with the exact cultural values you talk about, and I ultimately chose to reject them (at least partially).
However, I do want to acknowledge what seems like a destabilizing, negative effect "hookup culture" or the like has had on society. Dating apps are part of this whole issue as well.
My own position is that I want to be in a committed relationship but never married. So I guess you could peg me as a serial monogamist.
I would like to believe I have somewhat of a unique perspective on this. I was raised with the exact cultural values you talk about, and I ultimately chose to reject them (at least partially).
However, I do want to acknowledge what seems like a destabilizing, negative effect "hookup culture" or the like has had on society. Dating apps are part of this whole issue as well.
My own position is that I want to be in a committed relationship but never married. So I guess you could peg me as a serial monogamist.
How exactly do you expect to impose this value on everyone else who doesn’t share it with you?
I — and I’d guess most Americans — got such messaging in health class. Can’t say it had much influence on my actual behavior.
School has limited influence on kids when compared to parents. If your parents don't see casual sex as a big deal, neither will you. If your mom got pregnant at 14, well, I guess it's not a big deal if you get pregnant at 14 either.
I grew up in a fairly wealthy little town where pretty much nobody was the child of a teen parent. It’s awfully facile, and to my own experience, to pretend the children of such parents are the only people having sex in high school.
Anecdotal evidence
Do you think I’m wrong to say that sex education courses, regardless of whether they’re abstinence-only or more modern, typically already include admonitions against promiscuous sex?
Certainly some governments have attempted to criminalize extramarital sex. However 1) limited efficacy 2) creates an extremely regressive society I think few Americans would welcome
Seems pretty obvious to me that conservatives would be as susceptible to prejudices as the rest of humanity. Stating that common prejudices amongst those who identify as conservative might negatively affect specific policies is not itself moralizing.
This guy is reasonable. Kudos to making reasoned and nuanced observations regarding both sides of the argument.
>STFU with all of the moralizing and support policies that actually work, even if you have to pony up a bit to pay for them. It's cheaper for you in the long run
>Your options are to be angry today and sick or dead tomorrow, or to let it go, support effective policies today,
You're asking for one portion of the populous to take on the burden cause by lack of restraint by another. There is legitimate reason for "moralizing" here. This is the point where what "two people do in the privacy of their bedroom" spills over into affecting everyone else.
It's ironic that "yelling at people doesn't work" yet we see just as much yelling and moralizing by the people who want the freedom to do whatever they want even when their actions DO negatively affect others.
>Your options are to be angry today and sick or dead tomorrow, or to let it go, support effective policies today,
You're asking for one portion of the populous to take on the burden cause by lack of restraint by another. There is legitimate reason for "moralizing" here. This is the point where what "two people do in the privacy of their bedroom" spills over into affecting everyone else.
It's ironic that "yelling at people doesn't work" yet we see just as much yelling and moralizing by the people who want the freedom to do whatever they want even when their actions DO negatively affect others.
This is always the hard part with public health policy, you can barely make any demands before people say screw this and ignore you, as we've learned from asking people to wear masks :/
You are suggesting something like how mafia works. STFU and pay for your protection or else.
Do you think people are having unprotected sex to punish you?
No. Did you read the post I was replying to?
I did. But unless you think the act is vindictive and specifically intended to punish, the analogy to a protection racket doesn’t make a lot of sense.
The person I was replying to implied that if we don't do things the way he thinks it should be done, we might end sick or dead. And to say STFU and except my wisdom as pure gold is also ill mannered and unkind.
Lots of things are ill mannered or unkind yet have little in common with a protection racket. His point is that people are going to engage in risky behavior regardless and we have the choice to attempt to mitigate the consequences or just stick our hands in the sand.
That is a false choice. Prevention is better than cure. Supporting safe sex or sex in steady relationships seems to work much better so far than his ideas that nothing can be done we should all just chip in.
I reject the thinking that "people are going to do what they want" and we are helpless to influence their behavior so we should just accept whatever they are doing no questions asked and work around it with public policy if it causes a problem. The reason I reject it is because I would argue "what people want to do" does not spontaneously arise in their minds, but rather is influenced by popular culture, marketing, and more.
Take alcohol for example. You might say "you can't prevent people from drinking, look at Prohibition, it was a complete failure, don't even try", and in a certain sense you are right. You can't prevent all people from drinking.
However, you can prevent many people from drinking (or at least, reduce the total amount of drinking to more moderate levels) by:
- Not glorifying alcohol via pop culture and movies (especially American binge drinking at age 21)
- Restrict/regulate alcohol advertisements and marketing to reduce the influence of "drinking = happiness" messaging
- etc.
Or, stated in other terms, you can exacerbate your country's alcohol-related issues by glorifying alcohol and enshrining it in popular culture.
In the same vein, maybe we wouldn't have as big of a problem if we didn't glorify casual sex encounters so much in our media. If popular media/culture instead glorified things like self-restraint, commitment, etc, I'm sure some % of people would be influenced.
Take alcohol for example. You might say "you can't prevent people from drinking, look at Prohibition, it was a complete failure, don't even try", and in a certain sense you are right. You can't prevent all people from drinking.
However, you can prevent many people from drinking (or at least, reduce the total amount of drinking to more moderate levels) by:
- Not glorifying alcohol via pop culture and movies (especially American binge drinking at age 21)
- Restrict/regulate alcohol advertisements and marketing to reduce the influence of "drinking = happiness" messaging
- etc.
Or, stated in other terms, you can exacerbate your country's alcohol-related issues by glorifying alcohol and enshrining it in popular culture.
In the same vein, maybe we wouldn't have as big of a problem if we didn't glorify casual sex encounters so much in our media. If popular media/culture instead glorified things like self-restraint, commitment, etc, I'm sure some % of people would be influenced.
So what do you actually want to do? Create a board of censors? Bring back the Hayes Code?
> I reject the thinking that "people are going to do what they want" and we are helpless to influence their behavior so we should just accept whatever they are doing no questions asked and work around it with public policy if it causes a problem. The reason I reject it is because I would argue what people want to do does not spontaneously arise in their minds, but rather is influenced by popular culture, marketing, and more.
Hmm, let's see how well that worked with sexually active teenagers in the bible belt, shall we?
https://www.healthline.com/health-news/abstinence-programs-i...
https://www.npr.org/sections/health-shots/2017/08/23/5452891...
https://www.publichealth.columbia.edu/public-health-now/news...
Hmm, let's see how well that worked with sexually active teenagers in the bible belt, shall we?
https://www.healthline.com/health-news/abstinence-programs-i...
https://www.npr.org/sections/health-shots/2017/08/23/5452891...
https://www.publichealth.columbia.edu/public-health-now/news...
If one of the attempts did not work, it doesn't mean that none of them will.
Excellent point! Seems like some are more interested in pushing their own beliefs and morality on others rather than examining the evidence of what makes effective (or ineffective) public policy.
That just proves that Sunday school can’t do much in the face of a culture that overwhelmingly normalizes casual sex in TV, movies, music, etc. That doesn’t mean that societies committed to the opposite don’t exist. And many do—such as much of Asia. We can argue about the merits of say Bangladeshi society (where I’m from) but we have almost completely escaped the global AIDs epidemic.
Bangladeshi society focused more on education and healthcare initiatives, not propaganda -- at least according to wiki
>However, you can prevent many people from drinking (or at least, reduce the total amount of drinking to more moderate levels) by:
actually doing something effective like taxing the purchase of alcohol to such a level that people don't do as much of it unless they are alcoholics.
So all we have to do is tax when people purchase their genitalia for the weekend.
actually doing something effective like taxing the purchase of alcohol to such a level that people don't do as much of it unless they are alcoholics.
So all we have to do is tax when people purchase their genitalia for the weekend.
Gay man here, on prep in a long term open relationship.
To date I have yet to come across anything in mainstream media that comes close to 'glorifying' the type of relationship I have with my partner, or non-monogamy in general. Can you give any examples of this?
I'd also argue I'm in a committed relationship, but I'm not going argue semantics.
To date I have yet to come across anything in mainstream media that comes close to 'glorifying' the type of relationship I have with my partner, or non-monogamy in general. Can you give any examples of this?
I'd also argue I'm in a committed relationship, but I'm not going argue semantics.
Yeah, I would argue "long term relationship" is a sign of commitment.
I'm more talking about shows and movies that make it seem like non-committal hookups and switching sexual partners rapidly for any reason is cool and totally normal:
- How I Met Your Mother (Barney)
- The Office (everyone has slept with everyone by the end)
- Game of Thrones
You could argue the "good" characters like Tyrion typically showed more commitment in their sexual activities than "bad" characters like Theon who just knocked up random women for fun. But even then you have instances where the "heroes" like Arya have one night stands with no consequences (because HBO wanted to be edgy).
- Friends
I'm more talking about shows and movies that make it seem like non-committal hookups and switching sexual partners rapidly for any reason is cool and totally normal:
- How I Met Your Mother (Barney)
- The Office (everyone has slept with everyone by the end)
- Game of Thrones
You could argue the "good" characters like Tyrion typically showed more commitment in their sexual activities than "bad" characters like Theon who just knocked up random women for fun. But even then you have instances where the "heroes" like Arya have one night stands with no consequences (because HBO wanted to be edgy).
- Friends
Have you considered the possibility that this might have more to do with the fact that serial monogamy is already widespread (and has been since before it was commonly depicted on television) and the shows have a relatively limited cast of characters?
Even if not, are we asking the government to step in and ban Friends? Because if not, I don’t see how this observation gives us anything approaching a solution.
Even if not, are we asking the government to step in and ban Friends? Because if not, I don’t see how this observation gives us anything approaching a solution.
Continuing to raise awareness of the consequences of assuming risky behavior is a reasonable action that could be taken. With widespread messaging, the burdens of the consequences of risky behavior greater fall solely onto those who engage in the behavior, rather than being distributed evenly across society
“Raising awareness” sounds pretty much useless.
No evidence provided.
Of course it is useful - if you don’t know of a thing, you don’t know the consequences of engaging in that thing. It’s as axiomatic as the trite and age old saying “knowledge is power”. Your comment is completely disingenuous.
Of course it is useful - if you don’t know of a thing, you don’t know the consequences of engaging in that thing. It’s as axiomatic as the trite and age old saying “knowledge is power”. Your comment is completely disingenuous.
I don’t think the problem here is people aren’t aware that venereal disease is a possible result of unprotected sex. You have provided just as little evidence for your assertion to the contrary.
> Even if not, are we asking the government to step in and ban Friends? Because if not, I don’t see how this observation gives us anything approaching a solution.
Absolutely not. Government should not have to solve every problem in society. The solution is for us (consumers) to not watch shows that promote values we don't agree with. And if you do agree with them... you reap what you sow.
Absolutely not. Government should not have to solve every problem in society. The solution is for us (consumers) to not watch shows that promote values we don't agree with. And if you do agree with them... you reap what you sow.
So in other words you don’t have any solution.
I have a solution, just not a solution the government can implement.
I'll be honest I've not seen the first two series so I'll avoid speculating. I'm sure you are absolutely right.
In the case of Game of Thrones, a lot of the more 'liberal' sexual encounters were really put in for shock value or an excuse for nudity, for example Oberyn's orgy scenes. I never really got the feeling it was trying to normalise these things, but that was just my interpretation.
Similarly for Friends my interpretation was characters like Joey were to be the punchline of a joke, not to say his behaviour was normal. It felt more to laugh AT him, not to normalise it.
My experiences of mainstream media seems to largely focus on the young bachelor(ette) who has casual sex as a 'phase', or the monogamous faithful couple who've grown up and matured. Despite this narrative, I really don't believe monogamy works for a fair percentage of the population. This leads to either two states:-
1. They never form close romantic relationships, leading to more casual sex and probably larger risk of spreading STDs.
2. They do engage in a monogamous relationship, only for it to turn sour because of the tensions it causes. In some cases this leads to a party cheating on the other. These people almost never go to STI clinics to get tested for fear it will ruin their relationships.
How about instead the mainstream media embraced the idea of wanting to have multiple sexual partners is fine regardless of your stage of your life or your relationship status? That way, we can have make sure that everyone is informed of the risks and getting the medical treatment they need to keep themselves and others safe (particularly regular testing). As soon as you start demonising it and saying you shouldn't feel that way, people will do it anyway and just hide it instead.
In the case of Game of Thrones, a lot of the more 'liberal' sexual encounters were really put in for shock value or an excuse for nudity, for example Oberyn's orgy scenes. I never really got the feeling it was trying to normalise these things, but that was just my interpretation.
Similarly for Friends my interpretation was characters like Joey were to be the punchline of a joke, not to say his behaviour was normal. It felt more to laugh AT him, not to normalise it.
My experiences of mainstream media seems to largely focus on the young bachelor(ette) who has casual sex as a 'phase', or the monogamous faithful couple who've grown up and matured. Despite this narrative, I really don't believe monogamy works for a fair percentage of the population. This leads to either two states:-
1. They never form close romantic relationships, leading to more casual sex and probably larger risk of spreading STDs.
2. They do engage in a monogamous relationship, only for it to turn sour because of the tensions it causes. In some cases this leads to a party cheating on the other. These people almost never go to STI clinics to get tested for fear it will ruin their relationships.
How about instead the mainstream media embraced the idea of wanting to have multiple sexual partners is fine regardless of your stage of your life or your relationship status? That way, we can have make sure that everyone is informed of the risks and getting the medical treatment they need to keep themselves and others safe (particularly regular testing). As soon as you start demonising it and saying you shouldn't feel that way, people will do it anyway and just hide it instead.
Attempt to derail parent argument by citing inadequacy of reflection of anecdote in a general survey of literature/media
Pretty much every sitcom today glorifies casual sex and avoidance of committed relationships. “How I Met Your Mother” for example.
Btw. I have a friend who likes fast reckless driving. Now we could yell about it or just except that some people like to drive with no regards to theirs and others safety and not punish them for it and maybe even pay fines for them?
>STFU with all of the moralizing
Why subsidize an activity that puts health at risk? Sure, people will do what they want, but this just incentivizes people to put themselves at risk and makes everyone else pay for it.
Why subsidize an activity that puts health at risk? Sure, people will do what they want, but this just incentivizes people to put themselves at risk and makes everyone else pay for it.
You have it completely backwards. This policy isn't subsidizing risky sex. It's the opposite--subsidizing STD testing to make casual sex less risky.
> People are going to do what they want
Sure, but that doesn’t stop us from trying to influence people in other areas, so why should it stop us here. By this argument we should abolish all laws because what’s the point of telling someone “don’t murder” when “people are going to do what they want”?
Your post makes it sound like you are also against taxing cigarettes or taxing cars with big engines or banning guns since we should not (or it would be pointless) to influence behavior in such ways.
Sure, but that doesn’t stop us from trying to influence people in other areas, so why should it stop us here. By this argument we should abolish all laws because what’s the point of telling someone “don’t murder” when “people are going to do what they want”?
Your post makes it sound like you are also against taxing cigarettes or taxing cars with big engines or banning guns since we should not (or it would be pointless) to influence behavior in such ways.
> People are going to do what they want.
That’s obviously not true. Asian countries for example have far lower rates of drug use, sex outside of marriage, etc. than western countries. For example Bangladesh, the country where I’m from, has virtually no prevalence of HIV. (And it actually has quite a good system of health reporting so it’s not just failure to collect data.) Societies can in fact shame and coerce people into avoiding harmful behaviors.
That’s obviously not true. Asian countries for example have far lower rates of drug use, sex outside of marriage, etc. than western countries. For example Bangladesh, the country where I’m from, has virtually no prevalence of HIV. (And it actually has quite a good system of health reporting so it’s not just failure to collect data.) Societies can in fact shame and coerce people into avoiding harmful behaviors.
The "conservatives" seem to be prejudiced against casual sex behaviors for the wrong reasons: religious dogma, moral panic, personal bias etc...
The dollar cost of casual sex culture is not a reason I have heard cited as an argument against casual sex in pop conservatism. If you want to get into what costs society a greater amount, gay men getting syphilis is going to be way farther down the list than people having large numbers of children. We heavily subsidize that form of sexual activity.
The dollar cost of casual sex culture is not a reason I have heard cited as an argument against casual sex in pop conservatism. If you want to get into what costs society a greater amount, gay men getting syphilis is going to be way farther down the list than people having large numbers of children. We heavily subsidize that form of sexual activity.
The question is whether you want to deal with the STD health problem or not. Moralising doesn't get you anywhere.
People are engaged in this behaviour either way, it doesn't require subsidy.
What you do by enabling everyone to self-monitor is solve the collective harm of harmful viruses spreading.
So do you want to preserve your moral sensibility, or do you want to stop the spread of viruses?
I think it is perfectly reasonable to say, of people who choose the former, that they aren't very praiseworthy people.
People are engaged in this behaviour either way, it doesn't require subsidy.
What you do by enabling everyone to self-monitor is solve the collective harm of harmful viruses spreading.
So do you want to preserve your moral sensibility, or do you want to stop the spread of viruses?
I think it is perfectly reasonable to say, of people who choose the former, that they aren't very praiseworthy people.
> Moralising doesn't get you anywhere.
Society is terrible at this, though. Issues like this tend to become proxy wars for other things.
I mean, look how mask wearing has become moralized. It should never have become a silly political fight, it should've been people helping people get masks and avoid disease. Instead, we have all sorts of nonsense like idiots burning masks or arresting someone alone on a deserted beach for not having a mask.
Society is terrible at this, though. Issues like this tend to become proxy wars for other things.
I mean, look how mask wearing has become moralized. It should never have become a silly political fight, it should've been people helping people get masks and avoid disease. Instead, we have all sorts of nonsense like idiots burning masks or arresting someone alone on a deserted beach for not having a mask.
You're advocating taking money from those who don't participate in these health-risking activities to subsidize those who do, and you're chastising the parent post for moralizing? How absurd.
It's not a subsidy. It's the cost of avoiding public health crises.
The people disproportionately getting STDs have short time horizons. Regardless of the incentives in place, they're going to be having risky sex. It's less costly for society to pay for widespread testing and the occasional treatment than it is to pay for widespread treatment and no testing.
I always love reading your comments...
You know, it's interesting that we highlight the health burden of other activities like smoking and some governments want to go as far as banning salt and sugary soda for the same reasons.
But on this one topic we treat people like they're monsters for suggesting we should be choosier about our sexual encounters. Not just that sexual freedom is prioritized in our society, but _exercising_ that freedom is treated like a virtue. Despite all of the obvious costs and despite the fact that most people end up being less active than we'd expect and on the other side of that spectrum a lot of people come to regret their choices.
You know, it's interesting that we highlight the health burden of other activities like smoking and some governments want to go as far as banning salt and sugary soda for the same reasons.
But on this one topic we treat people like they're monsters for suggesting we should be choosier about our sexual encounters. Not just that sexual freedom is prioritized in our society, but _exercising_ that freedom is treated like a virtue. Despite all of the obvious costs and despite the fact that most people end up being less active than we'd expect and on the other side of that spectrum a lot of people come to regret their choices.
There's a huge cost associated with child-rearing as well but that's just part of human civilization, as is lots of sex and, while we're at it, drug use.
There are many countries where sex outside of marriage and drug use occur at very low rates. As a result they have escaped the attendant social problems, such as single parent households, the AIDS epidemic, etc.
"prejudices" was a bad wording. I'm sorry to have ignited that much emotional heat which deters from good discussion culture. My usage of "prejudice" was the best kind of correct: technically correct. I was thinking about how nearly everyone that I had a personal discussion with lost their view point about how subsidizing STI tests was a bad idea after I told them about personal experiences of some acquaintances of mine. So those people were (technically) prejudiced, as a close inspection of such cases changed their judgement.
Nonetheless, the word itself has strong connotations and it's mostly neither nice nor effective to tell someone to their face that they are prejudiced. And I can't assume it to be the case about a potential reader of my post.
Regarding whether it is good policy, even with a conservative value system, my sibling comments have already presented most of the points I would make.
Nonetheless, the word itself has strong connotations and it's mostly neither nice nor effective to tell someone to their face that they are prejudiced. And I can't assume it to be the case about a potential reader of my post.
Regarding whether it is good policy, even with a conservative value system, my sibling comments have already presented most of the points I would make.
This is a really gracious comment, thanks for being so understanding.
>> that maybe the “conservatives” are correct to be “prejudiced” against it?
Because the most vocal "conservatives" are often the ones that, in private, are the most casual about sex. Not a day goes by without a news story about a conservative politician caught in some sexual scandal/coverup/fiasco. It is to the point that if I see any powerful man advocating abstinence I just assume he has a couple girlfriends stashed somewhere. Thou doth protest too much.
Because the most vocal "conservatives" are often the ones that, in private, are the most casual about sex. Not a day goes by without a news story about a conservative politician caught in some sexual scandal/coverup/fiasco. It is to the point that if I see any powerful man advocating abstinence I just assume he has a couple girlfriends stashed somewhere. Thou doth protest too much.
Do you drive a car? Do you eat red meat? Do you burn fossil fuels or rely on any kind of electricity? Well done. We are all subsidizing your risky lifestyle.
When you are willing to retire to a plot of land and live entirely upon it, including starving each winter, then you may throw stones at "subsidizing" other people's risky behavior. Until then, you don't get to pick and choose which behavior we subsidize and which we do not.
Alternatively, we can pass a law that says citizens can choose which kinds of risky behavior they are willing so subsidize with their taxes.
When you are willing to retire to a plot of land and live entirely upon it, including starving each winter, then you may throw stones at "subsidizing" other people's risky behavior. Until then, you don't get to pick and choose which behavior we subsidize and which we do not.
Alternatively, we can pass a law that says citizens can choose which kinds of risky behavior they are willing so subsidize with their taxes.
Other people's risky sexual behaviour can harm you even if you (normally) don't engage in it yourself; it's not like skiing where people can break only their own necks. You can do two things to minimize the harm:
(a) try to reduce the number of people who engage in risky sex—through changing people's views, different upbringing and whatnot;
(b) try to mitigate the consequences of their behaviour—by subsidizing testing for infections and treatment.
Note that there's no dichotomy here.
I don't know if there's a good, reliable way to do (a); also, some people can be against it for ideological reasons. But (b) in the meantime is straightforward to implement and is known to be efficient. Why not implement (b) and make it work it while we are arguing about (a)?
> maybe the “conservatives” are correct to be “prejudiced” against it?
Conservatives should not be stigmatized for supporting (a), this is not prejudice, they can have the view they have on sex. But I don't see a single reason, except prejudice, that can make you go against (b), which is simply practical.
(a) try to reduce the number of people who engage in risky sex—through changing people's views, different upbringing and whatnot;
(b) try to mitigate the consequences of their behaviour—by subsidizing testing for infections and treatment.
Note that there's no dichotomy here.
I don't know if there's a good, reliable way to do (a); also, some people can be against it for ideological reasons. But (b) in the meantime is straightforward to implement and is known to be efficient. Why not implement (b) and make it work it while we are arguing about (a)?
> maybe the “conservatives” are correct to be “prejudiced” against it?
Conservatives should not be stigmatized for supporting (a), this is not prejudice, they can have the view they have on sex. But I don't see a single reason, except prejudice, that can make you go against (b), which is simply practical.
For the people living in London: https://www.shl.uk/. Home delivery and completely free.
> It should be the norm that when you hook up with a new person / one night stand that you show them your recent negative test result.
While I agree, €50 for an ONS is not exactly cheap.
While I agree, €50 for an ONS is not exactly cheap.
One would think an order of magnitude of the bar tab is not too much to ask.
From a libertarianish perspective, the best way is not a subsidy, but letting the price of the test drop into readily affordable levels.
This also helps less developed and rich nations than Germany. A USD 10 comprehensive test for basic STDs would be a huge game changer in Africa.
This also helps less developed and rich nations than Germany. A USD 10 comprehensive test for basic STDs would be a huge game changer in Africa.
In the US we are deterred from getting STD testing because the cost will be variable and sometimes very high, depending on what insurance you happen to have (or not) at the time.
"a touch of syphilis" - "It's just a flesh wound". I've never had it, but the web doesn't paint a pretty picture.
> A bit of diet, exercise
If you're talking about Syphilis diet and exercise could make the problem worse. Your opportunities for random hookups are more frequent when you are fit.
If you're talking about Syphilis diet and exercise could make the problem worse. Your opportunities for random hookups are more frequent when you are fit.
> diet, exercise
Against syphillis?
I suppose we've had the trifecta of bad HN comments: diet and exercise as a magic ward against all sickness, victim-blaming the AIDS crisis, and suggestions of recording everyone's sexual activity on the blockchain. I've flagged the story for this.
Against syphillis?
I suppose we've had the trifecta of bad HN comments: diet and exercise as a magic ward against all sickness, victim-blaming the AIDS crisis, and suggestions of recording everyone's sexual activity on the blockchain. I've flagged the story for this.
No, clearly not against syphilis, against a variety of other preventable diseases (read the sentence before the excerpt). I'm generalizing that we jump to treatment over prevention in health. In the specific case of syphilis, a condom is a great start.
In retrospect, it could generalize even further than health because humans tend to follow "if it ain't broke, don't fix it." We cling to fixing things we break vs exercising even a bit of caution to reduce the chances of breaking things as a strategy, even when prevention is sometimes trivial or were talking about our own health.
In retrospect, it could generalize even further than health because humans tend to follow "if it ain't broke, don't fix it." We cling to fixing things we break vs exercising even a bit of caution to reduce the chances of breaking things as a strategy, even when prevention is sometimes trivial or were talking about our own health.
[deleted]
Archive link: https://archive.is/v8Kbk
I couldn't get past the cookie consent screen. Might require JS. Don't care. Went straight to Archive.is.
I couldn't get past the cookie consent screen. Might require JS. Don't care. Went straight to Archive.is.
NPR has a text-only version: https://text.npr.org/986997576
The issue is presumably that free, easily accessible and anonymous testing is not available in San Francisco.
Where it's available, you just do a blood test every 3 months, test for HIV and syphilis and start therapy if positive.
Where it's available, you just do a blood test every 3 months, test for HIV and syphilis and start therapy if positive.
Maybe this will change post-Covid? In my city (not-US) you can order an STD test kit online, provide a small blood sample (pin prick and then fill small tube from finger) + urine sample, post it back (free), and get the results texted back to you (or on your online account) in a few days. It's 100% free. Maybe governments will see more value in catching these things and stopping them before they spread further.
In my country sending biohazard materials through the post is illegal. You need specially-licensed couriers to transport it. This is in fact a reasonable restriction. The same restriction that applies to explosives or nuclear materials.
There's also the very real problem of personal data security here, at many levels.
This sounds like a poorly conceived services ripe for exploitation.
There's also the very real problem of personal data security here, at many levels.
This sounds like a poorly conceived services ripe for exploitation.
Could you explain some of the risks you see? The service is run by the NHS (national health service) and materials are posted back in sealed containers + fixed in a box. The chance of the materials coming into contact with a postman are minuscule. He could jump on the package and it would likely stay in tact.
Agreed. Last time I went for an annual physical I decided to get some blood work done, including some STD tests. With insurance I had to pay close to $200.
We really shoot ourselves in the foot in the US by (among other things) not having easier access to testing of all sorts.
We really shoot ourselves in the foot in the US by (among other things) not having easier access to testing of all sorts.
Didn’t we shoot ourselves in the foot by choosing to have unprotected sex because basically if feels better and that’s what people care about more right now? We’re talking about preventable diseases here.
As always, when someone presents a solution with "just," it's hastily-conceived and leaves out a lot.
You have only two STDs in your list. Many more exist. You've got your herpes, your clap, multiple strains of HPV. Then you've got nasty old Hep C lurking around, making A and B look like chumps. There's oodles of them and treatment isn't just a wave of the script pad for some.
You have only two STDs in your list. Many more exist. You've got your herpes, your clap, multiple strains of HPV. Then you've got nasty old Hep C lurking around, making A and B look like chumps. There's oodles of them and treatment isn't just a wave of the script pad for some.
Are those tests practical? In the article, it says that diagnosis is not easy.
Diagnosis of syphilis is pretty straightforward, given a reasonable-sized blood sample - there are several simple tests (which tend to have quite high false-positive rates, which is good for a screening test) and then you can do something more complex and specific like imuno-fluorescence.
Speaking as an ex microbiologist.
Speaking as an ex microbiologist.
It's just a normal blood test, routinely done as part of STD screening along with the HIV test.
You can have a lot of different partners between tests. Seems like a huge gap.
And not just Syphilis unfortunately. In Amsterdam and surrounding cities Hepatitis C is on the rise in MSM on PreP.
It’s worth noting that the article describes how syphilis is common in high risk groups engaging in high risk activities in a high risk part of the country, rather than the general population at large. However it seems inevitable that it will spill out into the wider population too.
It can only spill if it’s not already present. Since it’s already present, the STD will have a larger “concentration gradient” to “flow” faster.
But, really, the STD rates will always be lower among the boring “square” population than the adventurous, promiscuous, one.
I’m sure this will be about as popular a soiled diaper here, but “promiscuity” and “adventurous” sex is mathematically welded with risk. Monogamy, and vanilla sex are essentially risk free (barring a botched blood transfusion or something along those lines)
But, really, the STD rates will always be lower among the boring “square” population than the adventurous, promiscuous, one.
I’m sure this will be about as popular a soiled diaper here, but “promiscuity” and “adventurous” sex is mathematically welded with risk. Monogamy, and vanilla sex are essentially risk free (barring a botched blood transfusion or something along those lines)
The trouble is that most people are somewhere between one partner for life and regular participation in sex with strangers and that gap is enough for plenty of relatively square people to end up affected.
Monogamy can also be considered a source of risk depending on circumstances.
People who want to have lots of sex, will still feel those desires in a monogamous relationship. Monogamy might make them less likely to act on those feelings, but it will make them less likely to test regularly, and stop them from being open with their partners about risks, and prevents clear communication about establishing safe sex practices.
If my partner has sex with someone else, I want them to feel safe enough to tell me. That way I can make decisions such as using protection with them that I might not otherwise, or getting tested myself, which I would not be able to otherwise.
People who want to have lots of sex, will still feel those desires in a monogamous relationship. Monogamy might make them less likely to act on those feelings, but it will make them less likely to test regularly, and stop them from being open with their partners about risks, and prevents clear communication about establishing safe sex practices.
If my partner has sex with someone else, I want them to feel safe enough to tell me. That way I can make decisions such as using protection with them that I might not otherwise, or getting tested myself, which I would not be able to otherwise.
> Monogamy, and vanilla sex are essentially risk free
Except you cannot guarantee the other person will actually be monogamous. We saw this with the initial AIDS epidemic in the '80s/'90s, when uber-square supposedly-monogamous (and supposedly heterosexual) individuals turned out to be anything but - to the shock of their official partner.
Except you cannot guarantee the other person will actually be monogamous. We saw this with the initial AIDS epidemic in the '80s/'90s, when uber-square supposedly-monogamous (and supposedly heterosexual) individuals turned out to be anything but - to the shock of their official partner.
It looks that at least one aspect could have a technical solution. I'm talking about this part: ""And if the sex didn't go well, then sometimes they will block the person from their app and they don't even know how to reach that person again."
It looks like the apps could have an emergency notification mechanism to help with that. Phone companies must implement 911, hookup companies should be required to implement an infection notification mechanism.
It looks like the apps could have an emergency notification mechanism to help with that. Phone companies must implement 911, hookup companies should be required to implement an infection notification mechanism.
That could be great, because it could also enable "someone you've been with reported sick, get tested" which would remove a lot of awkward interactions / barriers for reporting. Then again... do we really want dating apps with more or less full network and history of STIs of its users?
A possibly good idea, but needs protections against false alarms (such as somebody pranking anonymously all their previous contacts), or people will start to abuse it and later other people will start ignoring the alarms.
I am not sure how to solve this. Perhaps a certified doctor could trigger that alarm and nobody else.
I am not sure how to solve this. Perhaps a certified doctor could trigger that alarm and nobody else.
Seems like it'd be dipping into HIPAA territory at that point.
That would have nothing to do with HIPAA. HIPAA generally only covers patient information held by health providers, payers, etc. It only applies to "covered entities", which is a specific set of entities. It's a myth that HIPAA applies to health information generally. There's even dispute about whether or not HIPAA applies to doctors and medical services who don't accept insurance ( https://www.lebauerconsulting.com/hipaa-is-my-cash-practice-... )
(although some states have more strict health privacy laws)
(although some states have more strict health privacy laws)
Well, it's self-disclosure, and it could be implemented in such a way that your health information isn't really shared with anyone. A message like "One of your recent matches reported a concern about an STD. It might be a good idea to get tested." doesn't necessarily reveal much personal information.
This would be a voluntary self-disclosure. Similar to current restaurant COVID contract tracing projects.
You're saying that, in such a scenario, dating apps might be considered health care providers in some jurisdictions?
HIPPA is a societal choice. We can change it.
It seems to work for covid trackers app. Can't the same techniques be applied to dating app data ?
I see quite a lot of potential for abuse, and very low benefits for the apps to implement that process properly.
the suggestion was 'required'. being compliant with local laws surely should be one of the benefits.
How about having a doctor and clinic be in the loop in order for someone to actually be notified?
What we really need is a standard for signed certificates (verified claims) from labs, showing that you tested for X recently and the result. People will start asking for these before sex.
We have concert passes in our Apple Wallet but not these?
What we really need is a standard for signed certificates (verified claims) from labs, showing that you tested for X recently and the result. People will start asking for these before sex.
We have concert passes in our Apple Wallet but not these?
Or a blockchain for sex! We can verify who slept with who and got what virus.
Actually, maybe let’s not do this
Actually, maybe let’s not do this
Why would you use a blockchain? Google “verifiable claims”.
I am talking about a completely private and voluntary MECHANISM to have a way to PROVE that you went to a clinic for X and got result Y. What cultural and subcultural norms arise from that is anyone’s guess but why not have that OPTION available? Right now every clinic has its own incompatible way to prove to yourself — and no one else — the results of a test you took a lot effort to get.
I am talking about a completely private and voluntary MECHANISM to have a way to PROVE that you went to a clinic for X and got result Y. What cultural and subcultural norms arise from that is anyone’s guess but why not have that OPTION available? Right now every clinic has its own incompatible way to prove to yourself — and no one else — the results of a test you took a lot effort to get.
If the tests refered to earlier tests they would form a Merkle tree, not a blockchain. A Merkle tree is not a bad idea, because it is privacy preserving whereas a blockchain isn't.
That'd be a boon for genealogists.
You can ask for such a a thing now but most people do not. I think especially if you’re pursuing the kind of extreme level of sex described in this piece it’s not likely
Not sure how this would actually work. You usually have hundreds of matches and few substantial conversations per every sexual encounter. I feel like the signal to noise ratio would make it impractical to get tested every time anyone I ever matched with reported an STI. Would you need to report having had sexual contact with someone to improve accuracy? I know I wouldn’t be providing that data to Tinder.
You probably already are, via location tracking. Two matches’ phones reading the same wifi access point all night suggests an extremely limited set of implications.
> the same wifi access point all night
I see you are not familiar with most Grindr hookups.
I see you are not familiar with most Grindr hookups.
Using that logic basically everyone in P-Town would get a notification whenever anyone else in P-Town reported an infection.
I think this is a great idea, making it much easier to do semi-anonymous STD notification. Sadly, after googling "grindr std notification" I found a bunch of articles around mid-2018 about Grindr "investigating" such a feature, but it certainly never implemented it, and no other info on it in the past 3 years.
Let's allow people you've blocked to anonymously send you "U HAZ AIDS" friendly notifications, what could possibly go wrong.
I wonder if we can develop vaccination against syphilis.
With all the progress made because of Covid, it might just be possible. Syphilis has been a big vaccination challenge.
Edit: Why I am getting downvoted for this of all things? Do people hate syphilis victims so much? Not everyone who catches syphilis is a raging cheater.
With all the progress made because of Covid, it might just be possible. Syphilis has been a big vaccination challenge.
Edit: Why I am getting downvoted for this of all things? Do people hate syphilis victims so much? Not everyone who catches syphilis is a raging cheater.
I thought syphilis couldn't have a vaccine because it's a bacteria?
There are vaccines against some diseases caused by bacteria:
Plague vaccine - https://en.wikipedia.org/wiki/Plague_vaccine
Diphtheria vaccine - https://en.wikipedia.org/wiki/Diphtheria_vaccine
BCG vaccine against tuberculosis - https://en.wikipedia.org/wiki/BCG_vaccine
Typhoid vaccine - https://en.wikipedia.org/wiki/Typhoid_vaccine
Cholera vaccine - https://en.wikipedia.org/wiki/Cholera_vaccine
Plague vaccine - https://en.wikipedia.org/wiki/Plague_vaccine
Diphtheria vaccine - https://en.wikipedia.org/wiki/Diphtheria_vaccine
BCG vaccine against tuberculosis - https://en.wikipedia.org/wiki/BCG_vaccine
Typhoid vaccine - https://en.wikipedia.org/wiki/Typhoid_vaccine
Cholera vaccine - https://en.wikipedia.org/wiki/Cholera_vaccine
Do people seriously believe antibiotics are magic shots that make you whole again? Syphilis is associated with serious sequela, some that only show up years later.
When humans build a great tool to eradicate a disease, people think it's a free pass to do anything. Sometimes I think we deserve whatever pandemic is thrown at us.
When humans build a great tool to eradicate a disease, people think it's a free pass to do anything. Sometimes I think we deserve whatever pandemic is thrown at us.
I was recently shocked to learn that a large percentage of my friend group sincerely believes we will be the first generation to live forever due to advances in medical science. I think an unbridled optimism in medical technology is part of certain subcultures.
Factory farming is accelerating the rise of superbugs
jMyles(1)
Maybe we’ll eventually deploy nano-tech antibiotics.
But what if the nano-bots get a virus!
But what if the nano-bots get a virus!
Antibiotics, and bacteriophage viruses, kinda are nanotechnology (albeit in the same limited sense that steel dates back a thousand years).
You might like bacteriophages — viruses which eat bacteria: https://en.wikipedia.org/wiki/Bacteriophage
You might like bacteriophages — viruses which eat bacteria: https://en.wikipedia.org/wiki/Bacteriophage
Kurzgesagt has a cool video on phages. But I meant the grey goo kind of nanobot
We are the goo ;) (I want to finish that “goo gatchoo”, musical puns aside, we are what grey goo is capable of and what it ends up looking like).
Interesting idea, never considered that angle. Perhaps I should clarify that like my goo to obey commands written in ACGT, and not some future kind using C
Not sure why the downvotes, this is a known fact. Cows are meant to eat grass for instance but because we feed them corn and soy instead (slightly cheaper), they get diseases they otherwise wouldn’t get. So their foodstuff is also laced with antibiotics, which people eating the meat and milk in turn absorb.
Even if you feed livestock a totally optimal diet (e.g. grass for cows) they'll convert it more efficiently (read: they'll grow bigger from the same amount of feed) if you supplement it with low dose antibiotics.
It's shockingly dangerous and should be illegal.
It's shockingly dangerous and should be illegal.
According to Wikipedia, it is illegal in the EU since 2006, and in Sweden since 1986 (and partly so in the US since 2017).
I thought the main issue was that antibiotics make the livestock put on weight faster, and the dose to do that isn’t quite enough to kill of the bacteria? So the bacteria get a chance to evolve immunity?
its even worse with pig farming in populated developing countries (china), amount of antibiotics fed to pigs is staggering
Interesting that this has been downvoted. Isnt antibiotics abuse as livestock fattening helper absolutely breeding resistance and there's also a concept of horizontal gene transfer between germs after they have been passed to farm workers
Anyone ever suspect that someone is following them and downvoting everything they post? :-D
I didn't downvote it, but your comment was pretty useless as far as knowledge building goes. You merely made a claim about something that's controversial, non-obvious to most of the population and has more nuance than you let on.
In this case, explicitly mentioning the antibiotics abuse and how that leads to resistance would've made a big difference in quality. Going further and explaining feasible ways about how to deal with it and how to manage the economical and lifestyle impact of possible solutions in a feasible manner would've been even better.
In this case, explicitly mentioning the antibiotics abuse and how that leads to resistance would've made a big difference in quality. Going further and explaining feasible ways about how to deal with it and how to manage the economical and lifestyle impact of possible solutions in a feasible manner would've been even better.
It isn't really the burden of the statement maker to enunciate his arguments to the nth degree lest suffer the pangs of mob downvotes. At least it shouldn't be, on a decent realm of discourse. If anything, the downvotes just show a low level of informedness of the average HN user.
Exactly. The word “superbugs” implies antibiotic resistance, and anyone who is skeptical or curious about the connection between factory farms and antibiotic resistance due to HUMAN activity can look it up.
I could go to the nth degree and speak about how capitalism creates a lot of negative externalities, including factory farming, pollution, depression and the current state of the news. In fact take the latter — here is a website for what the problem is, what the solutions are, and how to fix it... as well as an hour long interview that goes into all the details:
https://rational.app
https://m.youtube.com/watch?v=M8HbvC6vqIY
I often go into amazing detail and write blog posts about each topic... but if I link to them on HN, I would usually get accused of throwing out “20 claims at once” and “shilling my blog” and my videos and solutions (that I give away for free). You just can’t win with some people...
I could go to the nth degree and speak about how capitalism creates a lot of negative externalities, including factory farming, pollution, depression and the current state of the news. In fact take the latter — here is a website for what the problem is, what the solutions are, and how to fix it... as well as an hour long interview that goes into all the details:
https://rational.app
https://m.youtube.com/watch?v=M8HbvC6vqIY
I often go into amazing detail and write blog posts about each topic... but if I link to them on HN, I would usually get accused of throwing out “20 claims at once” and “shilling my blog” and my videos and solutions (that I give away for free). You just can’t win with some people...
Throwing links as an answer (instead of using them as an addendum or because it's a valid source) is considered bad practice in discussion since usually they're not a direct rebuttal to specific points made.
If you were making a detailed argument about the issues with unregulated capitalism, and I would just respond with "Go read some Mises", it's just a lazy cop-out that doesn't address the problems you're presenting and lowers whatever value the comments may have to a reader, even if I had a point or not.
If you were making a detailed argument about the issues with unregulated capitalism, and I would just respond with "Go read some Mises", it's just a lazy cop-out that doesn't address the problems you're presenting and lowers whatever value the comments may have to a reader, even if I had a point or not.
I am not telling you to read “some” Mises. I am giving you a link to the exact arguments, all you have to do is click it and view it
Yes, it is their burden, specially when you're treating a subject that has a lot of depth.
You cannot form a decent realm of discourse when every comment is low-effort. This is the kind of thing that (for now, and only up to a certain degree) separates Hacker News from things like popular subreddits that only chant trendy opinions or act as venting boxes without much actual factual discussion going on.
FWIW I'm just as guilty as the GP of doing the same at times, and I should be called out for it as well whenever it happens. Sometimes we don't know what we don't know, know too much and take things for granted, or can't tell when our biases are showing. It is up to the community as a whole to keep the standards high.
You cannot form a decent realm of discourse when every comment is low-effort. This is the kind of thing that (for now, and only up to a certain degree) separates Hacker News from things like popular subreddits that only chant trendy opinions or act as venting boxes without much actual factual discussion going on.
FWIW I'm just as guilty as the GP of doing the same at times, and I should be called out for it as well whenever it happens. Sometimes we don't know what we don't know, know too much and take things for granted, or can't tell when our biases are showing. It is up to the community as a whole to keep the standards high.
asiachick(1)
> Factory farming is accelerating the rise of superbugs
Downvotes don't change facts. The browbeating over people misusing antibiotics at the individual level is a lot like plastic producers guilting consumers over recycling when the root cause is from industry.
Factory farming uses antibiotics purely for profit, the health of the animals is only an ancillary benefit. Animals fed antibiotics grow larger, driving higher profits. It's a tragedy of the commons situation, since the abuse of antibiotics has major negative externalities for us all, but the profits are reserved for the owners of the factory farms.
Downvotes don't change facts. The browbeating over people misusing antibiotics at the individual level is a lot like plastic producers guilting consumers over recycling when the root cause is from industry.
Factory farming uses antibiotics purely for profit, the health of the animals is only an ancillary benefit. Animals fed antibiotics grow larger, driving higher profits. It's a tragedy of the commons situation, since the abuse of antibiotics has major negative externalities for us all, but the profits are reserved for the owners of the factory farms.
This. I have been saying this all along... including the entire non biodegradeable plastic analogy.
We need a UBI funded by Pigovian taxes on pollution and other negative externalities. It’s the only way I can see ending these situations sustainably!
We need a UBI funded by Pigovian taxes on pollution and other negative externalities. It’s the only way I can see ending these situations sustainably!
qrbLPHiKpiux(2)
creamytaco(17)
Meth, not even once
Isn’t meth one of those things taken out of despair? Is there a root cause here that Isn’t being dug into?
I’m sure it is but I’m not sure how much overlap there is between that group and the meth-fueled orgy group.
I think if you’re taking highly addictive stimulants and doing things you later acknowledge as unsafe like unprotected sex I would speculate something is going wrong in your life that’s compelling you to participate in self destructive activities and that you should get help for the root causes of it.
I disagree. Google "meth and sex", and pretty much everything you read will say that meth will make sex feel absolutely amazing. So it could be the case that, especially when people are young, they know the dangers but think "hey, I know myself, I can do it once or twice without getting addicted"
The problem with meth is that it's so very addictive that you don't necessarily need to be in a pit of despair to get hooked.
The problem with meth is that it's so very addictive that you don't necessarily need to be in a pit of despair to get hooked.
Right, but my question then becomes why are young 20 somethings being exposed to meth without the support necessary to avoid taking it or not needing it in their lives? I was young, 20 something too, with access to meth— but I had more in my life than drugs, and I didn’t need it to party or have a good time, and I had mentors I could talk to about it.
Is something going wrong where there are deeper problems here that the article isn’t addressing, is my question, because it’s not like drastic increases in meth-related diseases spontaneously appear in 20 year olds.
Is something going wrong where there are deeper problems here that the article isn’t addressing, is my question, because it’s not like drastic increases in meth-related diseases spontaneously appear in 20 year olds.
I mean, it's been well studied that there is a surge in risk taking behaviors among late teen/early 20-something men across literally all human societies, which is why you see a spike in accidental death for this group.
The problem is for most types of risk taking, if you survive it, you make it to be a late 20-something man and move on. With meth (and other drugs), it keeps you addicted.
The problem is for most types of risk taking, if you survive it, you make it to be a late 20-something man and move on. With meth (and other drugs), it keeps you addicted.
I really think a lot of young people going for a hedonistic sex and drugs lifestyle are simply being drawn for a very different reason than people in depressed Rust Belt towns.
Could there maybe be another explanation, such as that drugs and sex are incredibly, ridiculously and uniquely fun human experiences? That's my wild speculation.
throwaway for obvious reasons...
meth seems to be the catalyst for the bad behavior done either recreationally (orgies) or while in bad situations arising from a cluster of root causes. I'm only going to address the latter:
the article mentions homeless women who trade sex for shelter. My sister is literally trying to be homeless right now. She has serious mental issues and can't live with anyone for long before she ruins their life and gets kicked out. this is a 20-year-long pattern. She even has access to therapy and shelter, but doesn't accept it. she has adhd and is probably somewhat spectral. she has a very narrow idea of how she wants to live her life: get an easy part-time job, live alone, and pay low rent. But this is not easy when she also freaks out on people, accusing them of abuse, physically assaulting them, etc. So she sometimes starts relationships with people to get access to shelter for short periods. Who knows what she's compromising on behind those closed doors. Could be unprotected sex and offers of drugs. I know for sure pot, alcohol, and cigarettes, but how much farther does it go? I know she's experiment with cocaine and psychedelics. Our family is devastated by all of this, has no idea what to do next, having taking advice from many caring friends, health professionals, etc.
So it's not just one root cause, there are numerous issues of economics, shelter, mental illness, biology, personal responsibility, modernity, inequality, alcoholic parents, realistic expectations and so on that all build on each other creating a "strange attractor," or quite a simply, a "drain."
When our species/culture was all outdoors anyway, I think crazy people like her used to fit in on the fringes. Raising a child had lots of beneficial influence from different types of people instead of just one alcoholic parent like in our case, or lots of phony impressions from self-filtered social media and brain-wave-engineered advertisements. Inequality in native tribes wasn't as extreme and we didn't have "rich kids" in class to compare ourselves to. Once daily living required keeping track of lots of things, like money, and sustaining professional relationships, the fringes of living got narrow and harsh. Then, when having an acceptable online life got added: passwords, service payments, visible resume, working phone, with charge locations, even more people fell through the cracks. They're the ones you seen in tents, in the woods, on the streets. And there is no easy solution... Fix half of the factors I listed above and the rest of the pattern will persist. This doesn't even address how many of these people end up in jail. If there's anything we can do, it's to find small ways to make "traditional life" a little easier for people who can't handle all of this.
meth seems to be the catalyst for the bad behavior done either recreationally (orgies) or while in bad situations arising from a cluster of root causes. I'm only going to address the latter:
the article mentions homeless women who trade sex for shelter. My sister is literally trying to be homeless right now. She has serious mental issues and can't live with anyone for long before she ruins their life and gets kicked out. this is a 20-year-long pattern. She even has access to therapy and shelter, but doesn't accept it. she has adhd and is probably somewhat spectral. she has a very narrow idea of how she wants to live her life: get an easy part-time job, live alone, and pay low rent. But this is not easy when she also freaks out on people, accusing them of abuse, physically assaulting them, etc. So she sometimes starts relationships with people to get access to shelter for short periods. Who knows what she's compromising on behind those closed doors. Could be unprotected sex and offers of drugs. I know for sure pot, alcohol, and cigarettes, but how much farther does it go? I know she's experiment with cocaine and psychedelics. Our family is devastated by all of this, has no idea what to do next, having taking advice from many caring friends, health professionals, etc.
So it's not just one root cause, there are numerous issues of economics, shelter, mental illness, biology, personal responsibility, modernity, inequality, alcoholic parents, realistic expectations and so on that all build on each other creating a "strange attractor," or quite a simply, a "drain."
When our species/culture was all outdoors anyway, I think crazy people like her used to fit in on the fringes. Raising a child had lots of beneficial influence from different types of people instead of just one alcoholic parent like in our case, or lots of phony impressions from self-filtered social media and brain-wave-engineered advertisements. Inequality in native tribes wasn't as extreme and we didn't have "rich kids" in class to compare ourselves to. Once daily living required keeping track of lots of things, like money, and sustaining professional relationships, the fringes of living got narrow and harsh. Then, when having an acceptable online life got added: passwords, service payments, visible resume, working phone, with charge locations, even more people fell through the cracks. They're the ones you seen in tents, in the woods, on the streets. And there is no easy solution... Fix half of the factors I listed above and the rest of the pattern will persist. This doesn't even address how many of these people end up in jail. If there's anything we can do, it's to find small ways to make "traditional life" a little easier for people who can't handle all of this.
That was a very thoughtful and lovely post. Thank you for sharing that.
It seems that chemsex goes hand in hand with STDs. Russian AIDS epidemic seems to be connected to mephedrone just like this thing is connected to meth.
> Experts point to the advent of dating apps, less condom use and an increase in meth.
This comes with the explosion of casual sex in recent times. Also STI throat cancers are on the rise from the explosion of oral sex. [1] maybe due to the novel widespread availability of internet video pornography and increased normalization in media relative to past decades.
[1] https://www.webmd.com/sexual-conditions/hpv-genital-warts/ne...
This comes with the explosion of casual sex in recent times. Also STI throat cancers are on the rise from the explosion of oral sex. [1] maybe due to the novel widespread availability of internet video pornography and increased normalization in media relative to past decades.
[1] https://www.webmd.com/sexual-conditions/hpv-genital-warts/ne...
There is no such explosion. Younger people are having less sex than the older generation. https://jamanetwork.com/journals/jamanetworkopen/fullarticle...
That’s interesting. It may be the case that sexual activity is decreasing per capita but unprotected casual sex with distant strangers is increasing as a percentage of all sexual activity.
I wonder if the decrease in male sexual activity is associated with the observed decrease in male testosterone levels (and sperm counts): https://m.huffpost.com/us/entry/us_59fcc5fbe4b0d467d4c224b3
I wonder if the decrease in male sexual activity is associated with the observed decrease in male testosterone levels (and sperm counts): https://m.huffpost.com/us/entry/us_59fcc5fbe4b0d467d4c224b3
Parent posted didn't mention age...
The article isn't about how old people are getting syphilis.
I'm quite sure the normalisation of analingus, and general anal play, in the media will also see a corresponding rise in intestinal parasites in years to come!
Reminds me of this article I read: http://www.newnownext.com/ive-contracted-my-third-gastrointe...
FTR that article is from 2009, which is only three years after the arrival of the first HPV vaccine (2006). I'm not sure when broad vaccinations have started, seems around that time. For boys/men they started even later. Furthermore, these cancers often have incubation times of years to decades, so we still don't see the full effect of the vaccination campaign. A newer source would certainly be helpful.
This trend has continued in a more recent analysis of the data (https://www.cdc.gov/mmwr/volumes/69/wr/mm6915a1.htm):
> During 2007–2016, the incidence of cancers of the oral cavity and pharynx combined increased, despite decreases in several anatomic sites, including the nasopharynx, hypopharynx, lip, and floor of mouth. The overall increase appears to be driven by increases in cancers of the tonsil, base of tongue, oropharynx, and other cancers of the oral cavity and pharynx, which are HPV-associated, as well as by those of gum and anterior tongue.
> During 2007–2016, the incidence of cancers of the oral cavity and pharynx combined increased, despite decreases in several anatomic sites, including the nasopharynx, hypopharynx, lip, and floor of mouth. The overall increase appears to be driven by increases in cancers of the tonsil, base of tongue, oropharynx, and other cancers of the oral cavity and pharynx, which are HPV-associated, as well as by those of gum and anterior tongue.
Thanks for linking this study. It seems at first that it proves your point, but note that not everyone is vaccinated against HPV. Older people in fact aren't. If you look at table 2, you'll see that cancer rates have gone up for the general population, but in the group aged 20-39, the rates have gone down for many cancers. I put this onto the high vaccination rates in that population. The data is only from 2016, and in the 2013-2018 period there has been a big jump in vaccination rates in the 18-26 population, so I expect this decline to continue.
> It seems at first that it proves your point, but note that not everyone is vaccinated against HPV
The efficacy of the HPV vaccine in preventing throat cancer doesn’t refute the observation that practicing oral sex increases one’s likelihood of contracting throat cancer.
> I put this onto the high vaccination rates in that population.
I don’t think you can draw that conclusion from this data.
> The data is only from 2016, and in the 2013-2018 period there has been a big jump in vaccination rates in the 18-26 population
Can you provide a source?
The efficacy of the HPV vaccine in preventing throat cancer doesn’t refute the observation that practicing oral sex increases one’s likelihood of contracting throat cancer.
> I put this onto the high vaccination rates in that population.
I don’t think you can draw that conclusion from this data.
> The data is only from 2016, and in the 2013-2018 period there has been a big jump in vaccination rates in the 18-26 population
Can you provide a source?
> > The data is only from 2016, and in the 2013-2018 period there has been a big jump in vaccination rates in the 18-26 population
> Can you provide a source?
https://www.cdc.gov/nchs/data/databriefs/db354-h.pdf
> Can you provide a source?
https://www.cdc.gov/nchs/data/databriefs/db354-h.pdf
Absent serious consequences (pregnancy, HIV) why would you regularly use condoms? The article covers what I consider to be the critical point. If you don't care about getting Syphillis enough to change your behavior then why should we care enough about it to spend public funds trying to eradicate it?
It is very unlikely to have negative consequences, and while they can be severe with things like blindness, so can downhill skiing and we don't spend public funds to remove the danger of downhill skiing. Hell we often spend public funds building skate parks which come with their own small risk of serious debilitating injury and we do it because the people who engage in that behavior are aware of the danger and don't consider it serious enough to abstain from the pleasure. And most critically those of us who want to avoid the danger can quite easily do so, as with Syhpillis.
I don't see a problem worthy of the publics attention here let alone the publics funds.
It is very unlikely to have negative consequences, and while they can be severe with things like blindness, so can downhill skiing and we don't spend public funds to remove the danger of downhill skiing. Hell we often spend public funds building skate parks which come with their own small risk of serious debilitating injury and we do it because the people who engage in that behavior are aware of the danger and don't consider it serious enough to abstain from the pleasure. And most critically those of us who want to avoid the danger can quite easily do so, as with Syhpillis.
I don't see a problem worthy of the publics attention here let alone the publics funds.
Are you aware of the consequences of untreated syphilis?
https://en.wikipedia.org/wiki/Syphilis#Tertiary
https://en.wikipedia.org/wiki/Syphilis#Tertiary
Are ski injuries infectious? Seriously, what sort of thought process produces these comments.
I’d suggest reading further into the article where they describe the problems with congenital syphilis, then.
And research anything about syphilis at all