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Usually #WorldAIDSDay is a chance to reflect on how we managed to salvage some life-saving lessons about public health from the extraordinary misery of the AIDS crisis.
But all I can think about today is how many of those lessons are now victims of the COVID culture war. (1/11)
But all I can think about today is how many of those lessons are now victims of the COVID culture war. (1/11)
For me, a big one is that people do a poor job of risk management when the risk is connected to fundamental human needs & desires.
Sex is one of them. When we seek it out in those moments we need it most, we aren't doing so using actuarial tables & cost-benefit analyses. (2/11)
Sex is one of them. When we seek it out in those moments we need it most, we aren't doing so using actuarial tables & cost-benefit analyses. (2/11)
Most people naturally intuit that to be true from their own experience. But that truth was challenged by the scale & horror of the suffering brought about by AIDS.
Once the efficacy of condoms was understood, forgoing their use became unimaginable in the public discourse. (3/11)
Once the efficacy of condoms was understood, forgoing their use became unimaginable in the public discourse. (3/11)
"How can these people keep having unprotected sex knowing what awaits them if they do?"
Acceptance of that kind of risk when such a seemingly reasonable precaution was widely available ("just wear a condom!") was taken as definitive proof of gay men's unique perversity. (4/11)
Acceptance of that kind of risk when such a seemingly reasonable precaution was widely available ("just wear a condom!") was taken as definitive proof of gay men's unique perversity. (4/11)
Now, it's certainly true that many were infected before knowledge about how transmission occurred, and how to prevent it, was widespread.
It's also true that condoms weren't always as ubiquitous as they are now, which is the result of a concerted public health campaign. (5/11)
It's also true that condoms weren't always as ubiquitous as they are now, which is the result of a concerted public health campaign. (5/11)
But an uncomfortable truth is that many - surely at this point, most? - people in the US were infected after both that knowledge & condoms were widely available.
That's certainly what happened to me! Sometimes all the sex ed in the world can't save you from yourself. (6/11)
That's certainly what happened to me! Sometimes all the sex ed in the world can't save you from yourself. (6/11)
While that still tends to blow some minds, the left eventually seemed to get it & apply it to many issues - teen pregnancy, substance use, etc.
Narratives emphasizing the primacy of personal responsibility in public health outcomes were correctly understood to be junk. (7/11)
Narratives emphasizing the primacy of personal responsibility in public health outcomes were correctly understood to be junk. (7/11)
All that has been totally flushed down the toilet during COVID.
What's now clear is that while the science of public health learned its lesson from the AIDS crisis, the left merely adopted its rhetoric because they viewed it as favorable to populations in their in-group. (8/11)
What's now clear is that while the science of public health learned its lesson from the AIDS crisis, the left merely adopted its rhetoric because they viewed it as favorable to populations in their in-group. (8/11)
Gays get harm reduction & sympathy when they fall short. People who don't like masks but do like restaurants? They get "just say no" & hysterical public scorn if they don't.
I thought we'd moved passed the initial vitriol, but man it came roaring back over Thanksgiving. (9/11)
I thought we'd moved passed the initial vitriol, but man it came roaring back over Thanksgiving. (9/11)
Socializing, human connection, seeing your friends, hanging out with your family - this is all fundamental human behavior that people cannot sustain long-term celibacy from, no more than most people can from sex.
Another obvious truth, obliterated by the culture war. (10/11)
Another obvious truth, obliterated by the culture war. (10/11)
The answer here is the same as it's always been: to change behavior at a population scale, alter the incentive structure.
Pay people to stay home. Free PPE. Proper public health messaging, including about harm reduction. Avoid sounding like a huge sanctimonious prick. (11/11)
Pay people to stay home. Free PPE. Proper public health messaging, including about harm reduction. Avoid sounding like a huge sanctimonious prick. (11/11)
