Except when the government is responsible for spreading the disease. 50% of all new infections come from intravenous drug use, and an even larger percentage are secondary to drug users. If you're gay then it's not illegal to use condoms, but if you're a heroin user then you can literally get put in jail for trying to use clean needles.
What's more, many black communities in the US have higher HIV rates than sub-Saharan Africa. Why? Because so many black males are in prison that it completely changes the sexual dynamics for everyone left on the outside. And further, many of those in prison contract the virus and then end up spreading it throughout the larger community once they get released.
Many pharmacies have programs for drug users to buy clean needles, no-questions-asked for exactly this reason.
I am not negating what you said, I'm am sure there are elements of the program (or accessibility) that make it a less-than-perfect solution, but it does exist.
unfortunately, not being a drug user i couldn't benefit from it. Once i needed to buy a syringe, and when i'd ask for it (it was here in Bay Area), they would make big eyes and refuse. Surprised, i tried a couple other places - the same. Until, at another place, they sold it to me and made sure that it packed so when i'm walking to the car, it wouldn't be visible.
I was reading yesterday that coastal health is releasing a free crack pipe + cleaner kit.
Granted we are likely a bit more progressive then the rest of the country.
Injecting rooms are a different story though...
// You know what's not illegal. Stopping injecting yourself with dirty needles.
While the linked rag's piece is sensationalized, the Nature Medicine article on this device is more useful. http://www.nature.com/nm/journal/vaop/ncurrent/full/nm.2408....
These tests absolutely fall under the FDAs jurisdiction; after all, pregnancy tests do! If research was done that found that people would ignorantly use these tests in lieu of condoms, that would worsen the HIV epidemic considerably, and the FDA would likely not approve them for off the counter usage.
I'm libertarian minded, so my feelings about this are more complicated from that. But you brought up public health, and from a public health standpoint there absolutely is an interest in denying people access to technology that would worsen an epidemic!
Do you see any evidence that it will not?
I don't. Care to explain?
Newer tests have been developed that test for presence of the virus's RNA, shortening the window period to about 21 days (if I recall correctly), but they are more expensive and much, much less widespread.
The irony is that such a technology could easily worse the epidemic in the U.S. because of such ignorance.
Instead, it's a cheap, easy and effective way to test people (especially pregnant women) so they can begin a medical regime, rather than not having any realistic means to test and risk further spread and health damage.
That sounds like a negative result DOES mean you don't have it, but a positive result DOESNT mean you do.
Edit: I guess this is just misleading and you actually can get false negatives.
They're correct to say it has a 100% detection rate (assuming it does, but we have no reason to suspect otherwise), but I think this is quite misleading - it's detecting HIV-specific antibodies, not the virus itself.
if (test_taken == true) { test_result = true; }
No negatives means no false negatives. ;)
But seriously, this is the classic trade-off between high sensitivity (no false negatives) and high specificity (essentially no false positives). Usually, the lower you set your threshold for detection the more likely you are to tell some people they have the disease when they actually don't. Where you set that bar depends on what you're trying to accomplish and forces you consider the harms associated with telling people they have disease when they don't or missing disease in someone who does.
While I'm sure that everyone on HN understands the seroconversion window period, this is simply not the case in the larger community. Ignorance about HIV is widespread. I cannot even begin to count the number of people who believe that pulling out before ejaculating affords some sort of magical protection from the virus. These are the same people who upon seeing a negative result would assume that they're safe without condoms.
The CDC states that the window period for detectable HIV antibody formation is three months; however, this figure is based on first generation HIV tests and is considered somewhat conservative. Public health experts like H. Hunter Handsfield state that detectable antibodies usually form in four to six weeks.
Whatever figure you choose to believe, it's a pretty significant time period. And it's a deadly one. It's during the window period that an HIV infected person is most infectious. Their viral loads are off the chart and they can unknowingly infect multiple people in a short period of time.
The "cure" for HIV is the same as it has always been: education and safer sex practices. HIV is largely a preventable disease. I would be okay with personal test kits if they were bundled with extremely clear educational packets printed in multiple languages. But this particular kit is advertised too much like a silver bullet to assure me that the manufacturers are anywhere near that responsible.