AIDS Vaccine Is Partially Successful 317
ifchairscouldtalk writes "A Phase III 'RV 144' study in Thailand succeeded in reducing HIV infection rate in trial with 31.2% effectiveness. The study was conducted by the Thailand Ministry of Public Health and used strains of HIV common in Thailand. It is not clear whether the vaccine, which combines AIDSVAX with Aventis Pasteur ALVAC-HIV canarypox vector, known as 'vCP1521,' would work against other strains in the United States, Africa or elsewhere. Strangely, the vaccine had no effect on levels of HIV in the blood of those who did become infected, providing 'one of the most important and intriguing findings' of the trial, according to Dr Fauci, director of the National Institute of Allergy and Infectious Diseases, which is one of the trial's sponsors."
HIV Vaccine (Score:5, Informative)
Re:HIV Vaccine (Score:5, Informative)
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Jesus did - I quote:
"Look after the shop, I'm just going to grab a pack of cigarettes."
Man, that was almost two thousand years ago... It doesn't sound like you were supposed to be in charge for this long - something must have come up.
Re:HIV Vaccine (Score:5, Interesting)
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Well, not everyone, actually. There are nutjobs in Africa (SA Minister of Health, a few years ago -- not sure if Zuma's stuck in a new one) who believe that HIV does not cause AIDS.
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We've finally got a bunch in power that accepts the correct medical reasoning behind HIV and AIDS. Ten bloody years late, but they're trying now.
No hurry (Score:5, Funny)
the deffinition of an eon (Score:5, Funny)
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Most slashdotters won't have anything to worry about either way. Playing warcraft and evercrack while stuffing your cheese hole with doritos, cheetos, and coke all night every night is a great preventative measure against major HIV risk factors. ;)
Warcraft is now considered foreplay (Score:5, Funny)
I take it you haven't seen this ad.
http://www.craigslist.org/about/best/lax/878989144.html [craigslist.org]
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I suppose when exactly that happens depends on your karma... get it? like, not in this life? funny, right?!
You must be an american script writer.
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Re:No hurry (Score:5, Funny)
Cool! Hopefully by the time I become sexually active it will have improved much more!
How I pity you young folks that never lived through the '70s. It was a GREAT time to be a nerd. Nerds were still paraihs, but hippies were "cool", and all a nerd had to do to become a hippie was to stop getting haircuts, buy a new pair of glasses, and throw away the pocket protectors. Birth control was cheap and effective, abortions had been legalized by the SCOTUS, and there were no STDs that couldn't be cured with a shot of pennicillin.
It was the only decade in my life (maybe in history) where strange women would walk up and say "wanna fuck?" without wanting you to buy her twenty dollars worth of crack. [slashdot.org]
Aids killed all that. God but I miss the seventies!
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Right, because herpes and HPV didn't exist until 1980 :P
20/20: HIV super-spreader among 50s women (Score:3, Interesting)
The point is that some demographics thin
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you are far more likely to hit a hole in one in golf than to catch HIV in the United States
So as long as I don't play golf, I'm ok, right?
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Re:No hurry (Score:4, Insightful)
That is no more bigotry than it is to say that heterosexual sex carries a higher risk of pregnancy.
Inspiring.... (Score:4, Insightful)
How in the hell could you ever do a controlled experiment like this on people if you dont control their exposure to the infection causing material? The only way you can determind improvements of real thing over placebo is if you intentionally expose the test subjects to the virus...which would be a death sentence.
Their results could mean that the group recieving the test vaccine came into contact with the virus 31.2% less.
Re:Inspiring.... (Score:5, Insightful)
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You mean, as in all the air in your room jumps to one side and you do a total recall impersonation before it jumps back = 'fairly unlucky'.
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Their results could mean that the group recieving the test vaccine came into contact with the virus 31.2% less.
And how the fuck would that work? They're random groups, no one knows who got what. That means anyone is still as likely to get in contact with HIV. If you took two groups and gave them both placebo then you might have something like 75 in on and 70 in the other, cause that's the kind of margin the randomness allows for. 74 and 51 clearly means that it's something the vaccine does.
Re:Inspiring.... (Score:4, Insightful)
here is how:
1)get the infection rate of the population
2)take a random sample from the population
3)do a double blind study of the vaccine
4)at the end of x years, compare the rate of infection of both your experimental group and your control group. If the control group is with in the statistical bounds of the population infection rate and the experimental group's infection rate is below that rate at a statisticaly significant level, then you can conclude the vaccine has a positive impact on infection rates.
Stats 101 (Score:3, Insightful)
No, you don't need to control their exposure. You can study the infection rate for the general population, and provided that your study group isn't unusually different from the general population (say, by being all sexually active gay men), you can expect a similar infection rate over time.
yes, there are potentially statistical deviations that could occur, but the larger the sample group and
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Wow, I already knew that people on Slashdot had a very tenuous understanding on economic or scientific topics, but damn, most of you have an awfully tenuous grasp of statistics too!
If they weren't tracking and testing all sexual partners I do not understand how they could come up with any statistically valid result.
Why would they need to track anyone? People are still going to do what it takes to catch HIV in the same way in both groups. Why would you want one group to catch HIV more than the other, bes
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There's a reasonably probability that the half with the "real" vaccine will have less car accidents, thus showing progress in my vaccine! TLDR:
What statistical methodology leads you to think that the half with the "real" vaccine will have 30% fewer car accidents?
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Statistical significance. [wikipedia.org]
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Your comment is the exact opposite of true. This vaccine offered a 30% less chance of acquiring HIV, but once acquired offered no protection against AIDS. It's the first vaccine trial ever to show efficacy against HIV infection, but had no effect on HIV levels in the blood in the infected. All participants started HIV-negative.
I think you need to re-read the article.
News for Nerds ? (Score:5, Funny)
How is that news for nerds ?
None of us will ever get laid, so that's not stuff that matters...
</cliché>
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And drunk women.
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i'm just sayin'...
Effectiveness (Score:4, Insightful)
Furthermore, the low effectiveness is actually a liability; the end result could be mutations in the HIV virus that make it immune to the vaccine. This is part of the reason why the influenza vaccine has limited effectiveness - influenza, like HIV, has a tendency to mutate quickly. If a new strain comes along, like H1N1 for influenza, you're defenseless.
Finally, I think there's a problem with how the vaccine will be perceived. If the vaccine is only 30% effective, I think people will see that as being too risky to even get the shot. There's already (too much IMO) FUD out there against vaccines in general. If you think that you can get influenza from the flu vaccine, there's a strong aversion to taking the HIV vaccine. For a 30% chance at being immune, that's no good. If it were 100%, that would be a totally different story.
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False dichotomy. You are simply wrong when you say anything but herd immunity is useless. The people who don't die of AIDS thanks to this vaccine would very much disagree with you.
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Ye, gods, if ever there was a comment that needs an RTFA, it's yours.
There are two direct quotes in the article that make it clear this is not a vaccine that will ever be made available to the public because it's not effective enough. The story here is that a vaccine with statistically interesting effectiveness is *possible*. We weren't even sure that one was up till now.
Re:Effectiveness (Score:4, Insightful)
I think the big deal here is that they were able to create something that has an effectiveness greater than 0.
I'm not an expert on the subject, but I guess it's easier to go up from 30% effective than from 0% effective.
amend my theology (Score:4, Funny)
But I thought AIDS was sent by God as a scourge of teh gheys. So God must hate the 68.8% it doesn't work for, then.
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Have you ever considered that maybe God loves the unborn AIDS viruses more?
Once you've had AIDS (Score:5, Interesting)
HIV has long been known to hide somewhere in the body after drugs have eliminated the actual virus particles. They found where recently; it integrates its sequence into the DNA of T-cells, and the promoter at the start of the viral sequence is capped by a repressor protein. Once it comes off its DNA binding site, viral proteins start getting transcribed again.
They actually developed a drug that can kick it off there and make your AIDS come back again.
BREAKING NEWS! (Score:3, Funny)
I have developed my own vaccine to HIV!
Simply subscribing to Slashdot makes you statistically 50% less susceptible to HIV!
I will take my 1 million dollar award in ten 100,000 dollar bills.
Seriously the study needs to be repeated and verified before anyone gets too excited.
It is not surprising that this was developed in Thailand due to the large sex trade there. Which makes me wonder about the demographic of the test subjects. Because of the large number of sex trade workers, any significant number in one group or the other will taint the results. If they were ALL sex trade workers that would be something different, however the article does not examine that detail. It could be that one group just happened to get 30% more sex trade workers than the other.
Also Slashdot I hate you and your stupid editor (not the person, the thing I am trying to type in).
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You should go teach the doctors and scientists what they are doing wrong.
Re:Lulz (Score:5, Informative)
The total working group for this test was around 16,000 people. Only 125 actually became infected with HIV during those 3 years. The infected portion shows about 1/3 more in the placebo group. So yes, the sample is statistically significant, and someone wasted a mod point.
Re:Lulz (Score:4, Informative)
Re:Lulz (Score:4, Informative)
Unfortunately, as the article notes, the sample groups may themselves be problematic. A previous study of another vaccine that was found to *increase* infection rates may not have been dangerous; they just neglected to control for circumcision and intravenous drug use. Given this study dates back to before the end of the previous study, their samples may be skewed the opposite direction. Circumcision has been found to reduce the risk of infection by 40-70%. IV drug use is insanely dangerous (I don't know the exact multiplier, but it is rather high). If the test group had a couple hundred extra circumcised individuals, or a dozen or so IV drug users, it could easily skew the results.
Of course, this is still overlooking another problem with the vaccine. It's not one injection, or even one plus a booster or two. It's a two vaccine regimen, with six injections of each component, for twelve total shots (they may eventually be combined, but that all depends on whether the components react with each other outside the body). And the duration of the protective effect is unknown, and likely short (since the vaccine doesn't seem to trigger the production of antibodies). Even if it was incredibly cheap, it's hard to get people to follow up for a second MMR shot, or keep up to date on their tetanus, both of which protect against diseases which are easier to catch without engaging in risky behavior. Can you imagine asking people to pay a few hundred dollars (a guess based on the cost of Gardasil), and visit the doctor half a dozen times to get such a relatively small benefit (reducing risk by about a third, with only two years of testing)?
Even if we assume the samples are good, this is only a first step, and a very short one at that.
In response to the PP: I suspect the confidence level is 95%. Most published studies require that level of precision, and no one likes to hamstring themselves by demanding greater confidence; after all, they spent a lot of money and rejecting the drug would waste it. Of course, if you've ever played D&D, you know how often you get fumbles or critical successes. 95% means the odds of it being insignificant could be as high as the odds of fumbling a roll.
Statistics [Re:Lulz] (Score:5, Informative)
someone do some analysis on the statistics and tell us all something and get +5
Sure. It's Poisson statistics [gsu.edu], so the standard deviation is the square root of the count.
placebo: 74 plus or minus 8.6
vaccine: 51 plus or minus 7.1
The statistical significance of the difference (23) is equal to the standard deviation of the sum (not the difference!) of the counts, so:
difference between placebo and vaccine:
23 (=31%) plus or minus 11
= (2.06 standard deviations)
Assuming they set their criteria for statistical significance at two standard deviations, then they are significant.
Re:Statistics [Re:Lulz] (Score:5, Informative)
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When was the last time you heard of a study where the resutls weren't statistically significant. At this point, I ask whether the property of statistical significance is itself statistically significant.
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While your analysis is correct it is actually an approximation since a Poisson distribution is not Gaussian. This particular problem actually has it's own set of exact statistical tests; for a reference see here: http://www.jstor.org/stable/2289537?cookieSet=1
Using a two-tailed Liddell's Exact test the significance is p=0.039 (assuming 8000 people in each group).
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I feel farty so I'll let it out.
A primary assumption in your analysis is that the underlying phenomena is correctly represented with a poisson distribution. It may be a good assumption, but I am sure it's still arguable. This is one of the reasons why employing stats is a bitch.
Sorry for the stink.
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This study used 16,000 volunteers within the population. Only 125 got HIV? That's less than half the rate within the population. I think we need to know more about the subjects in the study to know more about the value of these results. I had no idea there was a 50% placebo effect in HIV treatment!
What I find most i
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Of course there is a rather large placebo effect in HIV vaccine trials: the free education every participant will probably get.
As HIV is probably the only disease that you can be completely avoided by rather small changes in habits and behavior, a 50 percent lower infection rate by simple education seems plausible enough. It's only 50%, because the participants also have wives or husbands that they thought were faithful AND probably did not undergo the same education.
The same viral load *could* mean that th
So Sad (Score:2)
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and 2 sigma ~= 95% (assumes gaussian as someone noted, but usually is a reasonable approximation)
This is a very typical confidence level for reporting data. (the next typical level up being 3 sigma or ~ 99.7%.)
It means there is a 5% chance the difference is purely accidental.
That's exactly what was reported on the BBC this morning.
As an aside, why doesn't the summary give credit to the people actually leading this study?- namely the US Army.
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Why is it that on slashdot of all places that should be full of nerds we get idiots that don't grasp basic statistics and people that mod it up? As long as you got a proper control group it's simple to say "If we assume the true probability is the same, how unlikely is it that we get these results?" Of course there's something about the level of confidence - a 99% confidence means there's a 1% your observation is random fluctuations. But the whole "we reject math and logic because the numbers feel to small"
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Because not all of us have had statistics. I won't be taking my statistics class until next year and that's only because I'm going back to school to add to my degrees.
While I understand the basics of statistics and how they are generated, don't ask me to do any computations.
Then again, some people are simply beyond help when it comes to accepting facts or well established principles.
Re:Lulz (Score:4, Insightful)
that's all well and good, but if you don't understand statistics, you probably shouldn't be complaining about the statistics in a study that is undergoing peer review.
I'm not saying you're complaining about the study, I just don't think the excuse you presented holds water.
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But the whole "we reject math and logic because the numbers feel to small" sounds like the results of retarded anti-schooling.
Welcome to America, here's your churro.
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Why is it that on slashdot of all places that should be full of nerds we get idiots that don't grasp basic statistics and people that mod it up? As long as you got a proper control group it's simple to say "If we assume the true probability is the same, how unlikely is it that we get these results?" Of course there's something about the level of confidence - a 99% confidence means there's a 1% your observation is random fluctuations. But the whole "we reject math and logic because the numbers feel to small" sounds like the results of retarded anti-schooling.
True, but I don't think it's anti-math, I think it is a deeply ingrained sense that anytime anyone breaks out statistics, its because they're using it to lie about something. I blame it on the overuse of them in overbearing advertising (4/5 doctors agree that the Happy Time Fun Company antibacterial whatever, made from all organic compounds, will kill 99.9% of bacteria*)
* (in microscopic fine print) Bacteria that was killed was either harmless bacteria or crazy moon bacteria you will never interact wit
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It would be unethical to expose all participants to HIV. They did the next best thing.
There's nothing wrong with the basic idea of the study design. Of course, they may have fucked it up, but that's a different situation.
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Re:Lulz (Score:4, Informative)
Didn't the article say that one group got a vaccine, and the other got a placebo?
"Col. Jerome H. Kim, a physician who is manager of the armyâ(TM)s H.I.V. vaccine program, said half the 16,402 volunteers were given six doses of two vaccines in 2006 and half were given placebos."
Oh yea, that's what it said.
I don't see anything wrong with the basic kind of study. As I said, they may have fucked it up somehow, such as fucking up the selection of the participants and grouping them.
And why would they want to control against additional groups? They're measuring one thing. How effective is the vaccine. Your proposal to control against other groups are actually separate studies. They can and should be run independently at first. I can totally understand them not wanting to add complexity to a study that already has more than 16,000 participants.
So, I still don't see any valid objection as to why this kind of study won't work or is flawed somehow. In fact, this basic type of study is done all the time.
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Re:Lulz (Score:4, Informative)
This [hivresearch.org] page and this page [clinicaltrials.gov] indicate that the study was double-blind. If it was, then I do not see how your worry is reasonable. If both groups were unaware of whether they received the treatment or not, then I do not see how one group that happened to be the control group would reliably act differently than the experimental group. Am I missing something? Or are you claiming that once people believe they have the vaccine, that they will have more unprotected sex and thus increase their risk of contracting HIV?
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'Or are you claiming that once people believe they have the vaccine, that they will have more unprotected sex and thus increase their risk of contracting HIV?'
Of course they would. Perhaps you enjoy having sex with a piece of rubber but some of us prefer actual contact. Eliminating STD's and circumcision are two of the greatest causes known to man.
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This seems a bit overhyped to me, and doesn't really seem like a well-run clinical trial. It may be something of a first step, but if it is, there's still a long way to go.
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This seems a bit overhyped to me, and doesn't really seem like a well-run clinical trial. It may be something of a first step, but if it is, there's still a long way to go.
Well of course - the /best/ trial would be to inject volunteers who received both the placebo and teh vaccine with HIV. Unfortunately, that's not really an option...
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Because the people who did the trial asked "what is the probability that the difference in infection rates is due to dumb luck rather than any effect of our vaccine", and mathematicians have been studying how to ask this question in a rigorous way for a long damn time.
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No, they just went to a population where HIV is already relatively common and a large number of people don't usually take adequate precautions against it (i.e. use condoms) and then studied the effects of the vaccine on that population's total infection rate over time. It's not the greatest way to test this (since you have no way to tell if it's just down to random variations in the two population's levels of exposure) but doing it properly (i.e. deliverately exposing people) is pretty unethical to say the
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Formerly known as not successful.
I... don't recall the world ever being black and white. I'm pretty sure what you're doing is called "oversimplifying".
Re:Vaccine Is Partially Successful (Score:4, Funny)
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Apparently you've never watched old movies. Seriously, color is a recent invention.
If you mean color presume you mean discovery, and if you mean invention I presume you mean color TV. And I hope your world isn't your TV young man.
I... don't recall the world ever being black and white. I'm pretty sure what you're doing is called "oversimplifying".
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Re:Vaccine Is Partially Successful (Score:4, Insightful)
Not at all. What this shows is that the vaccine likely works for some subset of the population. That doesn't mean it doesn't work at all. Viagra for example only works for about 60% of men but people don't go screaming that it doesn't work.
Bottom line here is that vaccine or no, you should still practice safe sex (afterall, HIV isn't the only bad disease lurking around out there). However, if this thing has a ~30% chance of making you immune to the disease with no other ill effects then it's certainly worth reducing your chances by that much.
Basically, to break it down, your chances of getting aids comes down to 3 factors (4 now with this in place):
a * b * c * d
Where
a = the chance that your partner is infected
b = the chance that you catch the disease during an encounter with an infected partner (having intercourse with an infected person doesn't guarantee infection)
c = the chance that your protection fails (only comes into play if you used protection - otherwise it's 100%)
d = the chance that your vaccine was ineffective (only comes into play if you actually got vaccinated - otherwise this is 100%)
Everything that is scientifically proven to reduce the final result, even if it doesn't go to 0% in the end, is a success in my opinion.
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Don't marry anyone who may ahve secretly been sleeping around, don't get a blood transfusion, odn't mkae a mistake.
Sheesh, What kind of idiot is against an HIV/AIDS vaccines?
"This can and does happen with vaccines."
What? cite please.
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AIDS is relatively easy to prevent. Don't be a slut, don't do drugs, etc. and the chances of contracting it are miniscule.
Hey my gf is a slut and we go through some decent lengths to keep her safe. Other people just randomly hook up "once in a while" and pick up diseases almost instantly. It's relatively hard to prevent if you don't want to mold yourself into some repeated image society wants for you... I happen to prefer my partner express what she really wants, and carry her on that path. I had one girl I asked out that was a fucking crazy nympho but "didn't want to be a slut" even though she was all steamy over like eve
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A vaccine is designed to give you a mild form of the disease that you're trying to prevent.
That is incorrect - although exposing a person to the mild form is a method.
The whole idea is to provoke an immune response (and "teach" the immune system to react ) to something similar to the disease.
This could be, as you say, a weakened form of the disease - or it could be another disease (google cowpox smallpox ), or it could be a protein or some other substance that the body identifies with the disease. For example, some of the recent cancer vaccines are products of chemical synthesis (pharmaceut
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Er... they *all* underwent the same sex and infection-control education courses, according to the BBC article. Medical researchers don't throw people to the wolves just for the sake of science... at least, not any reputable ones whose research they expect to be followed up.
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There is plenty of education forced down your throat at every turn about HIV/AIDS, if you don't know about it, it is your fault.
There's a lot of misinformation out there too. For example, consider all of the conspiracy theories about AIDS. In places where the populace is not well-educated, it's no surprise that these beliefs take hold, particularly in light of past abuses like the Tuskegee syphilis experiment.
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"modern society" != Thailand (or most places in Africa, etc.)
If you don't know about it and you're an American, then yes -- it's your fault. But the rest of the world is not like this.
An African friend of mine told a story where a well-meaning group of aid workers went to a rural village in Africa and explained to them that using condoms during sex would protect against HIV. They didn't have model penises so they had people use their thumbs to practice putting condoms on. A year later, the village had order
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The highest-rising infected group is heterosexual women in their 20s.
Look it up.
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Sure. Put the vial of vaccine in the condom. Leave the complex in your bathroom.
Go about your typical monastic, Slashdot lifestyle.
You'll be pretty safe*.
* yes, there is a low likelihood you will be exposed to the HIV virus from non sexual exposure. You can also get hit with a meteor. Accurate to one significant figure (if that). Pay your taxes. Do not taunt ha
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From your attitude I take it you're involved in science somehow, have a clue what's going on, and consider yourself qualified.
It's clear grandparent doesn't understand the concept of a blind study (where the test subjects don't know what group he's in). Considering that the whole point of science is the acquisition and dissemination of knowledge, rather than being condescending to him you might try explaining how these trials are done so that's not a factor.
Thanks for making people think we're all elitists.
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Physicists (at least the batch I work with) consider a 2SD signal in the same way: "Hm, this is interesting, let's look at this some more."
If they were physicists they would have proven nothing, just like these guys proved nothing. "Prove" is a funny word. But they have demonstrated something promising.
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You should still take precautions. Plenty of the tourists to Thailand do, by only sleeping with girls under 14. That means the girls have only had 5-6 years or so to contract the disease.