[est31]

For rich people (meaning the ~3 billion people that have some sort of access to medical infrastructure), it is a solved problem, but there are quite many people without any access to it. Even for those "solved problem" people, taking a pill every day to be protected is inconvenient. They might not take it every day, etc.

Also, even if it were a solved problem, the methodologies developed here can probably help with other viruses too in the future. This has already happened with the antivirals originally developed for HIV.

[lizknope]

I was 16 when Magic Johnson announced he had AIDS. That was the first time it felt real to me. I remember a couple of friends crying because we all thought he would be dead in 1-2 years. And here he is and seems to be living a normal life.

[SoftTalker]

He doesn't have AIDS, he's HIV-positive.

[kstrauser]

I understand the difference between those statements, but confess that I'm not clear on the important distinction. Are there situations where untreated HIV doesn't progress to AIDS? Is the virus more transmissible in someone with AIDS than someone who's still at the HIV-positive stage?

Asking here because I don't know, and I think an answer might help others know, too.

(And to clarify, I genuinely don't know, and I'm asking from a supportive POV.)

[freeone3000]

We are unaware of any situations where HIV+ doesn’t turn into AIDS without treatment.

But being HIV+ is simply having a virus, not actively dying. HIV+ status also never clears - later tests that are “negative” mean your viral load is undetectable, at which point you can no longer transmit HIV to others. Undetectable = Untransmissable.

[SoftTalker]

FTA, it seems that a (very) small number of people develop effective antibodies againt HIV.

"These antibodies are very, very rare, but they can be found in blood samples from a small number of people living with HIV.

The vaccine causes the immune system to produce more of these "broadly neutralizing" antibodies.

[kstrauser]

That all makes sense. A couple things I’m still not clear on:

* If someone has a negative test after treatment, but that’s not counted as “cured”, does that imply it could (or maybe will) come back if treatment is stopped?

* What’s the importance of the distinction between HIV+ vs AIDS, from a public health or human perspective? We don’t talk about influenza+ vs “has the flu”, at least as far as I know. Does HIV+ carry less stigma than AIDS?

Thanks for your earlier answer. I know this specific infection has lots of difficult history. It’s hard to formulate my questions without sounding suspiciously close to a sea lion or something, but I sincerely want to know. And yes, I could google it but then it wouldn’t be an interesting conversation, or one others could read and learn from.

[freeone3000]

* If someone has a negative test after treatment, but that’s not counted as “cured”, does that imply it could (or maybe will) come back if treatment is stopped?

Yes. HIV+ patients require antiretroviral treatment for the remainder of their lives. Most are able to manage with a pill regimen. This is not to say it is cheap or side effect free, but most HIV+ people are able to live normal lives with outpatient support.

(To link it back, PrEP is the same drug used to treat; ex, emtricitabine + tenofovir. Dosage, schedule differs. Other antiretrovirals may be chosen.)

* What’s the importance of the distinction between HIV+ vs AIDS, from a public health or human perspective? We don’t talk about influenza+ vs “has the flu”, at least as far as I know. Does HIV+ carry less stigma than AIDS?

Public health does talk about Inflenza (and other viral positive) individuals. Public messaging is usually with the term “carrier” - but in jargon, this implies that the individual will likely mot develop the disease themself, and will remain asymptomatic, which is untrue for HIV. NCoV-19, recently in the public eye more than any other virus, has a lot of literature around positive tests vs disease.

[compass_copium]

Again, inaccurate. You can get a PrEP shot twice a year now.

Access is a valid point. Perhaps the money being used to fund a superfluous vaccine should be used to fund access to PrEP in the Third World.

[thinkcontext]

> Perhaps the money being used to fund a superfluous vaccine should be used to fund access to PrEP in the Third World

An astounding statement. Is it not possible that a vaccine giving decades of protection would give better health outcomes than doing PrEP every 6 months?

[Muromec]

Or maybe we should solve poverty which is a proxy to all kinds of solved problems that somehow still exist