[kazinator]

I'm not following the points in the above thread.

- people need to make the right decisions to take oral or injectable reverse transcriptase inhibitors

- people need to make the right decisions to take HIV vaccines

We are comparing two tools, not tools versus discipline.

In some ways these reverse transcriptase inhibitors are like a vaccine, in that they can be taken by people who don't have HIV, for protection.

They are inconvenient, requiring regular injections every few months or timing protocols for the oral versions.

An effective vaccine that lasts years would be much more convenient.

Without a HIV vaccine, the toolkit has a gaping lack; another tool is needed!

[fluoridation]

No, nothing is being compared. The question being posed is, if there are already tools to prevent HIV transmission (condoms, drugs, etc.) and someone doesn't use them, why would they use a vaccine?

[throwway120385]

Because a vaccine is much easier for the doctor to administer and manage. My GP won't put condoms on me but they do have a list of shots I get basically once and then never again.

[kazinator]

Right; that's a better framing.

1. Some people don't use tools. (For instance, we have spellcheckers, but people don't use them or ignore them.)

2. So of what use is another tool? (Why develop a grammar checker?)

See the problem? For the people who do use tools, there are useful differences among them. Some users of spell checkers will welcome the grammar checker.

Some of those who would use drugs to prevent transmission will gladly switch to the vaccine, which is more convenient for them.

But there is also this: the inconvenient drugs that block transmission are mainly used by HIV positive people and people who are exposed to them. Someone not in that situation is not going to get on a train of injections every three months. (I've never even heard of these drugs until this submission and its discussion threads.) Whereas a HIV vaccine could be something more interesting to the general population. There will likely be some people who get the vaccine who ignored the transmission-blocking drugs.

Sometimes when you add a different tool to the arsenal, non-users of the tool arsenal come around.

E.g. lots of DIY tinkerers use USB oscilloscopes, who have never owned a big one. The invention and marketing of the USB scope turned them into users. The vendors of that could have axed the idea by saying, what's the use of this idea: we already have oscilloscopes? Those who don't have them already are not going to be interested in this.

There are right tools for the right job, but also the right tools for the right people in the right circumstances.

[fluoridation]

>2. So of what use is another tool? (Why develop a grammar checker?)

This isn't quite the right analogy, because a vaccine doesn't do something different from PrEP, it just does it in a different way. At the individual level it might make a compelling case (but more of that in a bit), but for the systemic purpose of eradicating the disease, not so much; not until it's given out during childhood like other vaccines.

>But there is also this: the inconvenient drugs that block transmission are mainly used by HIV positive people and people who are exposed to them. Someone not in that situation is not going to get on a train of injections every three months. (I've never even heard of these drugs until this submission and its discussion threads.) Whereas a HIV vaccine could be something more interesting to the general population. There will likely be some people who get the vaccine who ignored the transmission-blocking drugs.

The fact of the matter is, HIV is a shitty virus, by which I mean it's an inefficacious one. It has a bad spreading mechanism and it has effects that are too severe and too obvious. The reason people ignore those drugs (besides them being expensive) is that HIV is so rare, and there are overall better methods to avoid catching it. So most people will likely never have sex with a carrier, and of those who would, most will already be using condoms. Among this latter group, I don't know that a vaccine is that compelling. HIV is not the only infection you can contract from unprotected sex. If you have a stranger in front of you with whom without a vaccine you would have used a condom, would you have unprotected sex with them after having been inoculated? While it might make sense to get the vaccine anyway as a second layer of defense, in all likelihood it won't have any effect on your personal safety.