Hacker News new | ask | show | jobs
by chimeracoder 3452 days ago
> A device for this exists already. Is he going to invest all that money in Durex or Trojan?

First of all, sex is not the only way to contract HIV.

Second - and most people don't know this - condoms are not FDA approved for anal sex. They're not even tested for anal sex, and the testing requirements for condoms are specifically limited to vaginal sex[0].

But even if we look at vaginal sex, condoms are rather ineffective compared to other prevention methods, even when you look at success rates under perfect use. And perfect use is not what's relevant - what you need to look at are success rates under actual use). In this regard, condoms fail horribly as an HIV prevention tactic.

Decades of unscientific education or education based on faulty science have caused people to subjectively underestimate their risk of contracting HIV when using condoms, and to subjectively overestimate their risk when using other prevention methods.

For example, how would you rank these behaviors in terms of risk levels?

* Having sex, with a condom, with more than one partner of unknown HIV status * Having sex, without a condom and without PrEP, with a single, HIV+ partner with an undetectable viral load * Having sex, without a condom while taking PrEP, with multiple partners of unknown HIV status

Surprisingly, the first is the riskiest, and the second and third are comparable levels of risk. (The second is actually believed to be slightly less risky than the third, but the difference is not even statistically significant, let alone practically significant).

The common counterargument to this is that condoms prevent more than just HIV - except even then, people dramatically overestimate the protection that condoms provide. HIV is pretty much the only (common) sexually transmitted disease that can be transmitted through vaginal or anal intercourse but not through oral sex or other forms of physical and sexual contact. Since most people only use condoms for intercourse, the added protection they provide for other STDs under these scenarios is a lot less than people imagine.

In fact, STD transmission rates are actually lower among people who use PrEP for HIV prevention. The common explanation for this is that people on PrEP have to get routine checkups (every 90 days, usually), and this provides a convenient time to do other STD testing as well. For most people, the problem is that they simply don't do routine STD testing at all, which means they can have asymptomatic STDs (chlamydia, gonorrhea, syphilis, etc.) for much longer, which makes them harder to treat, and pass them on to more people in the interim.

[0] http://www.imstilljosh.com/fda-condoms-not-approved-anal-sex...

1 comments

> For example, how would you rank these behaviors in terms of risk levels?

Under 1% for all examples given.