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I don't think the original assertion is "punching down" on poor people. While you're correct that poverty isn't the "only reason" for high HIV transmission, poverty certainly contributes to it, via lack of access to health care and lack of access to education. How is it less "punching down" to attribute it to social behavior and culture? Isn't needle sharing associated with poverty, or would you also call that "culture"?

by shadowtree2 hours ago|

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I was poor, grew up in social housing.

I did not use drugs.

"I share needles because I can't afford my own" is an INSANE take. Don't shoot drugs in the first place! Poor people are normal humans, they have willpower, agency. It is a rich people myth that poor people are cattle, devoid of any chance of doing the right thing.

It is culture, behavior, social norms. Being poor does not force you to abandon the nuclear family, does not force you to engage in criminal acts. (there is reverse causality though)

In the early 1960s South Korea had a per capita income lower than those of Haiti, Ethiopia, and Yemen, and about 40% below India's. Did all South Koreans become heroin addicts with HIV?

by pibaker18 minutes ago|

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Thanks for your contribution. Gonna hop on a jet to Zambia tomorrow and tell kids with HIV there that it's their fault they were born with the virus and maybe they shouldn't have shared needles.

by lukeschlather46 minutes ago|

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> Don't shoot drugs in the first place

like insulin? should a diabetic skip the insulin? In poor countries I wouldn't be surprised if the majority of HIV infections are not as preventable as you're imagining.

You can moralize, but even if only 10% of HIV infections are unavoidable, you're not contributing to solving the actual problem. (And by unavoidable I mean, unavoidable without investing in more needles, better sanitation, or prophylactics that the people "responsible" cannot afford.)

by sterlind36 minutes ago|

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assume you have a population of IV drug users. as a society, would you prefer to spend nothing and see them develop HIV, or to spend some and control the HIV?

you don't have to care about the drug users at all. even if you treat them as pests rather than humans, we frequently vaccinate pests for public health measures. pathogens will spill over to populations you do care about, they'll create a drain on the healthcare system, they'll harbor other opportunistic infections. it's not sanitary.

this is completely leaving aside that some drug addicts can and do turn their life around, and that HIV is a horrible illness nobody should have to deal with, even if it's "their fault."

by garciasn1 hours ago|

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Dry sex in SSA may be one of the contributing factors, but it’s never been truly proven out as a key contributor in any study I have read; they always address it but say more needs to be done to be certain.

Your comment makes it seem like a key factor when it’s not.

by shadowtree1 hours ago|

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In the Global Burden of Disease analyses, sub-Saharan Africa (SSA) had the highest age-standardized STI incidence rate of any world region — around 19,973 per 100,000 person-years, which is roughly double the global average of about 9,536 cases per 100,000.

Forecasts to 2030 expect sub-Saharan Africa to continue having the highest incidence rates of both HIV and other STIs of any region.

How come a specific region of the globe has this issue? "Poverty"?

Many regions in India are poor. Afghanistan. Pakistan.

Love the science based debate here, btw, thank you all for the downvotes. Facts, not feelings.

by cwillu10 minutes ago|

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It comes with the territory; IMO if you don't occasionally have a few comments go negative, you're probably not saying anything of value.

by xenospn3 hours ago|

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I’ve never heard that before. That explains a lot.