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hyrix

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There's a significant difference in the risk and mechanisms of transmission between these two viruses. The modern effective reproductive number for HIV is less than 1, about 30-50% lower than ebola in similar subsaharan countries [1][2]. You can get ebola from contact with an infected person's sweat during the active phase [3]. You can get it from their semen years after they have apparently recovered [4]. We don't have treatments that work in this longer term. The drugs that we do have are used during the active infection period to reduce the probability of death during the crisis. Folks are working on reducing the longer term infectiousness but it's a ways off yet [5]. We also don't have pre- or post-exposure prophylactic treatments for the medical workers who are at the highest risk of infection or the family members--the most common transmission mechanisms for ebola are home caregiving and contact with traditional burial practices. In this context of containing an active outbreak, quarantine is mostly helpful in reducing pressure on the medical system for a short term.

Compare this with HIV, which can be rendered untransmittable with modern treatments, which is primarily a sexually transmitted disease, which has pre- and post-exposure treatments. It's simply not very efficient/effective to exile millions of people with a lifelong latent infection and little risk of transmission.

The instinct towards ostracism of those who are perceived as unclean is some pretty primordial lizard brain shit which was a great rule of thumb two thousand years ago, along with wearing garments made of only one kind of material. It's actually actively harmful to the process of stopping infection. It leads to fear, distrust, and reduced reporting, hindering the medical system's ability to reach the people who most need to be reached, and encouraging the spread of superstition and suspicion of pre- and post-exposure treatments. In both diseases, the actual infection risk is modest compared to an airborne virus like COVID.

[1] https://journals.lww.com/jphmp/Abstract/2022/03000/Estimatin...

[2] https://pubmed.ncbi.nlm.nih.gov/34189844/

[3] https://pmc.ncbi.nlm.nih.gov/articles/PMC4252165/

[4] https://pmc.ncbi.nlm.nih.gov/articles/PMC7875361/

[5] https://academic.oup.com/cid/article/73/10/1849/6168541?logi...

Just a couple of bros, traveling the countryside in each other's company. History is full of such roommates.

Just the other day we were thinking about how recent generations have gotten more conservative: https://news.ycombinator.com/item?id=45734620

The author proposes that it may reflect the incredible stability we've enjoyed in recent decades, which rewards more conservative "life planning":

Our super-safe environments may fundamentally shift our psychology. When you’re born into a land of milk and honey, it makes sense to adopt what ecologists refer to as a “slow life history strategy”—instead of driving drunk and having unprotected sex, you go to Pilates and worry about your 401(k). People who are playing life on slow mode care a lot more about whether their lives end, and they care a lot more about whether their lives get ruined. Everything’s gotta last: your joints, your skin, and most importantly, your reputation. That makes it way less enticing to screw around, lest you screw up the rest of your time on Earth.

Journalists don't just publish whatever comes into their mailbox--at least, good journalists understand the potential that they are being manipulated. We should be wondering to what extent these journalists vetted the source of the clip. It's not that journalists need to publish an identity, but they ought to serve as a filter as much as they do as a megaphone. Without a credible story about how the sender got ahold of the clip and its provenance, why would they even believe that it's real? With so little context, how could a responsible journalist publish this kind of character assassination without any more research than one phone call to the purported speaker?

Perhaps if there were a pattern of behavior behind the clip, supported by other testimony from the speaker's colleagues or previous incidents--not that it's the responsibility of journalists to conduct a trial in the court of public opinion, presenting the strongest arguments from each side--but, lacking any actual effort at all to establish the credibility of the source, this is just lazy, click-counting, ragebait--not journalism.

Partly, it's also on the laziness and gullibility of the general public--but these are well-established features of the audience that should be no surprise to a trained journalist. To publish such clips without any real work to validate them is basic negligence.

FM radio bands are in fact used for various emergency services, but they are more specialized in usage https://strykerradios.com/ham-radios/ham-radio-emergency-fre...

AM radio travels farther for the same energy consumption, as a feature of the lower frequencies used. That means they can provide emergency information to a much larger area for a given power supply. AM radio also doesn't rely on huge towers since the waves can bounce off the ionosphere and travel as ground waves.

AM radio receivers are also very simple to make--check out the crystal radio!

The really disturbing part of this whole issue is the way that online platforms perform a form of torture arbitrage between buyers in wealthy countries that have stricter animal cruelty laws and suppliers in countries that lack them. The platforms are fully aware at this point, but seem to rely on the grey areas of free speech and multinationalism. In my opinion, it calls for some kind of third party independent review system since the platforms remain complicit and have an obvious conflict of interest in giving up ad revenue and highly engaged users.

Optimistically, this rule could create tighter feedback loops due to increased community engagement with planners so that databases get updated more quickly and speed limits are perhaps dialed in to match real conditions--the mismatched limits that you mention might have been established with expectation of a neighborhood buildout that never happened, or may be an oversight in low population areas--or they may be there for good reasons.

As it stands, speed limits are not usually enforced and are basically ignored by drivers, so (optimistically) this may encourage communities to make them more realistic limits, as opposed to suggestions.

The way to reduce speeds is not to make the road more dangerous but rather to signal the expected speed correctly. The article a sibling commenter linked makes this point:

[...] The premise is simple: drivers will make occasional mistakes—veer a bit out of their lane, fail to brake hard enough, etc.—-and if the street is wide, with high visibility in all directions, and free of immediate obstacles such as trees and fences, those mistakes won’t be catastrophic. The problem: this street feels too forgiving to a driver. Too safe and comfortable. So drivers speed up. The engineers didn’t account for this aspect of human psychology.

Drivers behave as expected when they can't see around obstacles, the lane feels tight, and there are curves and other features that reduce visibility. These roads aren't inherently more dangerous, they just give drivers less margin for taking excessive risks.

But the truly interesting aspect lies in how the device employs informational algorithms to make its movements more human-like. When you select its AI mode, a new interface appears with a velocimeter. When their penis has been inserted, the user hits start and a series of waves appears on-screen. “The AI is able to recognize the movement and intensity of stimulation in real time, to adapt and synchronize its motor and power according to the user’s preferences,” explains Di Ippolito. While the user moves the toy to the rhythm of a standard handjob, its artificial intelligence is able to adjust its speed and vibration to achieve maximum pleasure. For a product that is marketed as easy-to-use, Di Ippolito says that, “with Sensonic technology, you can feel sonic pulses throughout masturbation.”

And what happens to the data the toy collects? “When it is not connected to wi-fi, the AI mode encrypts data in real time to adapt to the user’s movement and intensity. You can personalize the patterns and save them, all without any need of a wi-fi connection,” says Di Ippolito. In doing so, sex toys like this one can, “provide specific stimulation, intensify pleasure, lead to exploration of the body and sexual fantasies, and can improve a couple’s communication and intimacy,” she says.

The tank is not the vehicle, the grill is the vehicle! People own their grills and swap the tanks. No one worries that much about the tanks because they are effectively interchangeable across brands (after some lawsuits and FTC intervention) and their performance is now regulated. Batteries are a great comparison and need the same kinds of consumer protections.

Prevention of HIV 2 years ago

Usually when a study is halted early it’s because of obvious harm to the experimental group from the treatment which means there would be no possible benefit and it would make continuation unethical.

A meta analysis of early stopping in randomized clinical trials has found no evidence that early stopping hides side effects or inflates benefit—and I challenge you to produce any examples of a phase 3 trial of an infectious disease treatment that was stopped early which later showed unduly harmful side effects for marginal benefit.

This trial showed 100% efficacy.

A major consideration of RCTs is also the benefit denied to the public by withholding a viable treatment. HIV remains a global epidemic with no existing good solutions for poor countries.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5133138/

Prevention of HIV 2 years ago

They stopped the study because of the incredible efficacy and lack of side effects. This was a phase 3 clinical trial so they have already cleared substantial hurdles in safety requirements (clinical trials are about both efficacy and side effects).

But for argument’s sake, there are even more sides than efficacy and safety: there are substantially different risk profiles for different potential patients, and a long acting treatment with no daily pill is more valuable for some people.

One of the reasons that long acting injectables could have a big impact on transmission in Africa is because there’s stigma around PrEP usage, especially for women. Obviously, there is now a big conversation about the cost and who pays, but the potential here is indisputable.

https://www.niaid.nih.gov/news-events/nih-statement-prelimin...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10879468/

Prevention of HIV 2 years ago

Transmission has never been found when the number of copies of the HIV RNA are below 200 copies/mL--the quantity of virus matters.

For context, the typical ejaculation from someone untreated contains between 10,000 and 1,000,000 copies/mL. With treatment, the average is 1-10 copies/mL.

Besides HPTN 052, there have been three other studies--PARTNER, PARTNER 2, and DISCOVER, of real-world (condomless) usage in mixed serotype couples

https://www.idsociety.org/science-speaks-blog/2021/u--u-the-...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8942556/