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Is exposure to HPV inevitable?

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I found the Cure Magazine article to be interesting-and I felt like I learned something.

 

I checked around and found some statistics. Apparently Head/neck/throat cancers are increasing (about 25% the last few decades in the UK).

 

With 150 strains of HPV the overall knowledge here seems pretty basic. Condoms appear to help-but they seem far from a silver bullet-and testing seems in a pretty basic stage.

 

I think we need to keep a perspective here though. Overall incidence of these cancers is 1/93 or so. I'm not sure how much the decision to swing or not really affects that risk. There are a lot of factors in play too.

 

My guess is this means if you do choose to swing, it would be a good idea to pay close attention to your overall health

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Again, these oral cancers happen many years or decades after the exposure to HPV. The damage was done long ago. If you are about 40 or older and somehow haven't been exposed to HPV before, then it's unlikely that a new exposure will cause oral cancer within your lifetime. You're far more likely to die of something else first, if that's any consolation!

 

And it's oral cancer in men that's linked to HPV (as opposed to cervical cancer in women). These men got HPV in their throats by performing oral sex on women who had HPV. Presumably a condom is not going to help much in that situation!

 

The risks of HPV are really a reason to get your pre-teen or teenager -- whether a boy or girl -- vaccinated. But for everyone else, it's a fairly minor concern compared to the many other STIs out there. The vaccine will help prevent future cancer cases decades from now, but wouldn't effectively help most of us now. For us adults, it's the HPV exposure from the past that put us at risk, not what our behavior in the future.

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One thing to remember about the vaccine is that it is only formulated for a specific 4 strains (2 high risk/cancer causing and 2 low risk/wart causing) so while it may be effective for more than that, it is by no means guaranteed to cover most exposure. It is just the 4 most common found in physical symptoms.

 

I totally agree that vaccinating anyone under 25 or so is a good idea - whether they are sexually active or not (preferably BEFORE becoming sexually active), but it isn't fool proof so being aware of your body as much as possible should be taught too. Noticing little lumps or odd feelings and talking to doctors about getting routine tests is just as important as the vaccines.

 

I've never used a dental dam in my life, but maybe by the time I decide to have kids I should make sure I teach them that condoms aren't the only barriers that should be used to help minimize exposure and risk... :)

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Just to help people relax a bit....

 

As a white male which is the second HIGHEST group in terms of oral cancer, my chance of getting it is .0157%.

 

Being I don't smoke or drink heavy or have other risk factors for it besides sex, my chance is approximately .004%.

 

As a white woman, your odds of getting it are .0061%

 

If you don't smoke or drink heavily your odds are now .0015%

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I have been trying to do a lot of research on HPV since I was diagnosed, but a lot of the information out there is so varied. My doctor told me, as I was in her office in tears after being diagnosed, that "everyone gets it". She said, "I have had sex, I have HPV. Ms so-and-so (the nurse) have you had sex? She has HPV. You parents have HPV. Your brothers and sisters have HPV." Now I don't know if I can take this for total truth, because not EVERYONE has HPV (do they?) but I think it is a pretty accurate description.

 

My question is to people that have been diagnosed- Do you tell your partners that you have been diagnosed? I would want someone to tell me if they had herpes or HIV or even something as treatable as crabs. But with the overwhelming exposure to HPV does it even make sense to bring it up and have it met with misconceptions from people that might not know anything about it?

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I would, simply out of respect for who I would be with. I would check the NIH website to see how prevalent it is, risks and treatability. Just my two cents worth.

 

Crazy is more complicated than most people think. ~ Dr. Walter Bishop

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The big issue with stuff like the information from NIH/CDC they aren't really used to dealing with intensively sexually active communities like the swinger community.

 

One organization that had that ability was the AIM Healthcare Foundation but they are no longer active (they used to provide STD testing to porn actors). L.A. Public Health hated those folks, but what got them was some of the confidential information on porn actors got leaked.

 

There is some data out there that is just counterintuitive. For example, a Canadian study shows non-drug using prostitutes had a lower chance of STD infection than the general population.

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I tend to tell people that we meet online or have conversations with beforehand. It doesn't always come up at clubs because we will have people kind of randomly join us at times, and it would be extremely awkward to stop having sex or whatever we're doing and saying "by the way, I have HPV!"

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I tend to tell people that we meet online or have conversations with beforehand. It doesn't always come up at clubs because we will have people kind of randomly join us at times, and it would be extremely awkward to stop having sex or whatever we're doing and saying "by the way, I have HPV!"

 

lol yeah I can see that.

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The big issue with stuff like the information from NIH/CDC they aren't really used to dealing with intensively sexually active communities like the swinger community.

 

Really? A substantial effort has been devoted to understanding and managing STD's by the CDC over the years. NIH has funded considerable research around a variety of illnesses, HIV/AIDS being among the most prominent. Much of their work has been with sexually active communities because...that's where STD's are most prevalent.

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It is surprising how resistant swingers are to the inevitability of certain STD's. Because they are STD's they are treated as something more horrible than other viruses we get in a non-sexual way. Is getting a cold inevitable? Yes. Is having the flue inevitable over a lifetime. Yes. Both of these can kill or hospitalize. Does the flue kill more people than STD's? I would love to see the stats on it. There have been varieties of the flue that have killed millions nationwide and worldwide.

 

I think of HPV like the flue...you will catch it sometime in your life. The more sexually active you are, the more likely the chances are 100%. The problem with tests is the number of varieties of HPV there are. I have not heard of a test that includes every variety. So even if you test negative, you may be infected with a variety not included in that test. Some research suggests that most HPV is sequestered by the body fairly quickly, meaning you are no longer contagious. It may even be totally removed from our bodies over time.

 

Herpes is similar, though not quite so prevalent. HSV-1 is present in more than 50% of adults. HSV-2 is more on the order of 20%. So you have met plenty of people with HSV-1 and most likely several with HSV-2. You likely have had sex with HSV-1 and not so unlikely with HSV-2.

 

I don't get a cold every year and haven't had the flue for several. But I have had more than a few colds and experienced the flue a few times. I assume I've been exposed to HPV and herpes more than once also. All swingers should assume the same.

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SwingerGirl said:
I have been trying to do a lot of research on HPV since I was diagnosed, but a lot of the information out there is so varied. My doctor told me, as I was in her office in tears after being diagnosed, that "everyone gets it". . .

 

Your physician engage in a bit of hyperbole. For sexually active people, HPV is not inevitable. But it is probable.

 

 

SwingerGirl said:
. . . My question is to people that have been diagnosed- Do you tell your partners that you have been diagnosed? I would want someone to tell me if they had herpes or HIV or even something as treatable as crabs. But with the overwhelming exposure to HPV does it even make sense to bring it up and have it met with misconceptions from people that might not know anything about it?

 

My wife and I do not tell prospective swing partners. I developed detectable symptoms several years ago. For a period of a year, my wife and I continued our contact with swing people whom we already knew and who were aware of my visible symptoms but made no new contacts, a year being the time needed for my body to successfully control the virus. My wife never showed symptoms and nothing has ever showed with the tests associated with gynecological examinations. There is not doubt she carries the same virus. It sometimes does not show in a test. It is possible she picked it up at a time much earlier that I did.

 

I do believe that the majority of people in the lifestyle carry the HPV virus.

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When you have a treatment for HPV you must complete that because some time you feel that it is gone. But it stays in your body and come again some time. So must properly treat it and avoid having sexual relation with a person having HPV.

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. . . So must properly treat it and avoid having sexual relation with a person having HPV
Please describe to me, Landyn, this treatment for HPV.

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SW_PA_Couple said:
Please describe to me, Landyn, this treatment for HPV.

 

Erm..... yeah me too :) My doctor never mentioned any "treatment". I just go back every 6 months for a pap until my cells are normal. She also didn't suggest I don't have sex. She did say that I could catch other strains by having more sex, but I would be exposed to that whether or not I already had it....

 

I do have another question about this though. I was reading on the CDC website about the test for HPV. It says if you are a woman, you don't get the test until you are 30. I was under the impression that the only "test" you get is similar to the situation I went through. I went to the doctor and my cells were abnormal. She said it was "likely" caused by HPV. Now after reading that, I am confused. Can someone explain this test to me?

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Please describe to me, Landyn, this treatment for HPV.

 

Before the AIM Healthcare Foundation got shut down, they described treating HPV via removal of genital warts using liquid nitrogen (the standard way to remove warts).

 

Only certain HPV strains are involved in genital warts. From what I can gather only a few HPV strains have been all that well studied. We know what a few do, like the ones involved in cervical cancer and genital warts, but there are a lot of strains out there we just don't know well what they really do (if anything).

 

HPV/HSV2 are two of the biggest arguments around consistent condom use and probably support use of female condoms. I think sharing test results securely with partners via stfree.com is a good idea too, but rather few folks test for HSV and or test for HPV in men (women get HPV tests via pap smears, at least for the strains involved in cervical cancer).

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From the CDC on HPV...

 

"Anyone who is having (or has ever had) sex can get HPV. HPV is so common that nearly all sexually-active men and women get it at some point in their lives. This is true even for people who only have sex with one person in their lifetime."

 

"HPV tests are available to help screen women aged 30 years and older for cervical cancer. These HPV tests are not recommended to screen men, adolescents, or women under the age of 30 years. There is no general HPV test for men or women to check one's overall "HPV status." Also, there is not an approved HPV test to find HPV in the mouth or throat."

 

"There is no treatment for the virus itself, but there are treatments for the health problems that HPV can cause."

 

To read more about HPV: STD Facts - Human papillomavirus (HPV)

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CDC tends to be conservative on a lot of points-both politically and scientifically.

 

In general CDC is NOT oriented towards providing information to sexually active populations like swingers. "Officially" the only thing that prevents STD's is condoms or monogamy in their eyes.

 

When AIM was active, I think they had a better knowledge of the health issue of sexually active populations than anything I saw out of CDC. Yes, their treatments/tests were sometimes off-label or experimental.

 

On the other had: I know someone from Silicon Valley that told me about a company that wanted to take a testing technology for STD's into clinical trials that would test for a whole battery of STD's inexpensively-and they got stopped because of political pressure.

 

I've reviewed some of the literature on STD transmission-and I find a lot of it limited when it comes to models of why testing would/wouldn't work. I think what AIM did among porn actors worked remarkably well given the conditions they were working within - and with minor changes could work much better (for example I agree with LA Public health that porn actors should be screened for hard drugs).

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highlander said:
CDC tends to be conservative on a lot of points-both politically and scientifically.

 

In general CDC is NOT oriented towards providing information to sexually active populations like swingers. "Officially" the only thing that prevents STD's is condoms or monogamy in their eyes.

 

They seem to think even those won't prevent HPV.

 

Maybe their intention was not to relieve swingers who are worried about higher risk but their information certainly leaves me feeling we are at no greater risk for this. So I am more inclined to relax and enjoy an encounter.

 

I can't say what their stand on other diseases are nor how the information may or may not be slanted.

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They seem to think even those won't prevent HPV.

 

Maybe their intention was not to relieve swingers who are worried about higher risk but their information certainly leaves me feeling we are at no greater risk for this. So I am more inclined to relax and enjoy an encounter.

 

Just because a disease is transmitted sexually doesn't mean that is all there is to it. A Canadian report showed non-drug using prostitutes had a lower rate of STD's than the general public (the increased risk was entire concentrated among drug users).

 

That dutch study showed only a slight difference between swingers and the general public.

 

What one can really do is a real tricky question here.

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There is no cure for HPV. Similarly there is no cure for the common cold or the flue. There is now a vaccination for the flue, HPV, but not the common cold, with varying effectivenesses for each. Viruses are not easy to cure. A cure for the common cold would make millions, perhaps billions, but that hasn't managed to get us there. Viruses are tough buggers.

 

Our bodies have dealt viruses throughout evolution. HPV and HSV are sequestered by the body in most people and controlled. For HPV that may mean the bodies effectively get rid of it, and for HSV it may mean you are no longer contagious. But none of this is clear according to the evidence. It is hinted at, not proven.

 

The evidence points to virtually all sexually active adults getting HPV. Just as we all get the common cold. It is normal to have HPV. It is unusual to not have it. HSV (herpes) is similar in that more adults have one form or the other than don't have it. The treatment for HPV is for the warts that some strains cause. Most strains do not cause warts. Some strains cause cervical cancer and thus are dangerous, but are in the minority. Pap smears help catch possible cancer as early as possible.

 

Likely there are many varieties of virus present in our bodies. We have evolved to live with them. There are many varieties of bacteria home to our bodies. We don't live in "clean" bodies. We host many other life forms within us. That is natural and normal.

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Expanded use of HIV testing as a preventive measure could have been done much earlier than it has. AIM got hounded for claiming their testing program worked for porn actor. I seriously question the scientific soundness of those claims-and yes. I have read some of the literature.

 

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There is no cure for HPV. Similarly there is no cure for the common cold or the flue. There is now a vaccination for the flue, HPV, but not the common cold, with varying effectivenesses for each. Viruses are not easy to cure. A cure for the common cold would make millions, perhaps billions, but that hasn't managed to get us there. Viruses are tough buggers.

AIM claimed to have some success treating HPV related warts. As I remember their claims: treatment of warts tended to accelerate clearing of some strains. I haven't seen good pro/con analysis of that specific claim-but I'm inclined to think there is at least a chance they were right.

 

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Our bodies have dealt viruses throughout evolution. HPV and HSV are sequestered by the body in most people and controlled. For HPV that may mean the bodies effectively get rid of it, and for HSV it may mean you are no longer contagious. But none of this is clear according to the evidence. It is hinted at, not proven.

I would love to see a true cure for HSV-and I think with funding and proper incentives it could happen. I think that is a lower priority than it should be for political reasons. I also think that ramping up testing technology and making it more affordable to detect when someone was contagious for HSV might be done-and would be worth seriously exploring.

 

I'm REALLY disturbed when I hear stories from what I think are credible people saying that folks are having trouble testing such technologies for what appear to be political reasons.

 

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The evidence points to virtually all sexually active adults getting HPV. Just as we all get the common cold. It is normal to have HPV. It is unusual to not have it. HSV (herpes) is similar in that more adults have one form or the other than don't have it.

I would not say "normal" so much as "expected in the current environment". The question of the incidence of HSV/HPV historically is an interesting one I haven't seen well investigated yet. Urban environments are pretty new in historical terms. I think that historically folks were less monogamous than religious conservatives would like us to think. Hysteria/conservatism around sex is a fairly recent adaptation in evolutionary terms.

 

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Likely there are many varieties of virus present in our bodies. We have evolved to live with them. There are many varieties of bacteria home to our bodies. We don't live in "clean" bodies. We host many other life forms within us. That is natural and normal.

one point that Kary Mullis makes: we just don't understand this viral/microbial ecosystem very well yet. Most of our knowledge is around a few pathological conditions. Even there the long latency stuff is slowly emerging.

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Not to sound like a conspiracy person, but cures for many diseases probably exist already. There is more money to be made in treating illness, than there ever will be curing it.

 

Crazy is more complicated than most people think. ~ Dr. Walter Bishop

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CuriousNJCouple said:
Not to sound like a conspiracy person, but cures for many diseases probably exist already. There is more money to be made in treating illness, than there ever will be curing it.

 

I think there is some of that. It is largely just an unintended consequence of the system set up. I don't think the political aspect is conspiratorial. I think is more like group hysteria. I've only met one guy who would come out and say he thought AIDS was a good thing. That guy was a hard core racist that thought the presence of AIDS made it less likely white women would have sex with black guys-and he was very up front about that. I think a lot more folks behave like he did-but would never dare utter what he said. I think is just easy for folks to get unfeeling around a disease they think won't affect them or folks they care about.

 

The thing with STDs: I really think swingers have their own specific issues-and need their own stuff like healthcare foundations oriented toward them. AIM was a good idea-but they got into areas that were just too politically volatile for the level of funding/organization they had. Ultimately they were funded by the porn industry. I really liked the work they did-but I think that maybe a step back is needed on this. I'm wondering just what _can_ be done without setting off the public health folks into error mode. AIM focused on a pretty extreme population-I think fewer than 1% of swingers actually fit into the kind of profile we saw there.

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highlander said:

AIM claimed to have some success treating HPV related warts. As I remember their claims: treatment of warts tended to accelerate clearing of some strains. I haven't seen good pro/con analysis of that specific claim-but I'm inclined to think there is at least a chance they were right.

 

But HPV often exists without those and it's the HPV itself that sources claim there is no current cure for.

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Conspiracies are a seductive psychology. Science is slow and methodical precisely because it's not easy to separate the wheat from the chaff in understanding. The feeling that there are cures out there being held back by the powers that be is psychologically seductive. But where is the evidence?

 

Many attempts have been made toward a vaccination for HIV, claims have been made, and people embarrassed when they didn't come to fruition. HIV is a tough nut to crack. There are those who would like to believe that solutions are being held back instead of the more prosaic it's very difficult to cure HIV. Vaccinations have been invented that work well for a number of very nasty diseases. Those cures weren't held back by the powers that be. In fact they are currently being refused by conspiracy believers who think vaccinations are nasty tools of those powers that be.

 

DaggersNRoses makes the excellent point that fixes for warts are not cures for HPV.

 

I disagree with the comment that more money is to be made from treating illness than from curing. A real cure for the common cold would make really big money for the company to create it. They'd cash in on it in a heartbeat if they could actually do it.

 

Normal is the proper word for actual virus presence in humans rather than a concept of a state without virus that "should" be normal. Virus and humans have a long evolutionary relationship. Current normal seems to be HPV in the vast majority of adults.

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But HPV often exists without those and it's the HPV itself that sources claim there is no current cure for.

 

HPV is a _huge_ family of viral strains. The strains involved in genital warts include HPV-6 and HPV-11. As I understand it:

the strains involved in genital warts tend to create concentrations of viral material around the area where we find warts. That is possibly why the AIM Healthcare foundation docs reported they were seeing a clearing of HPV-6 and HPV-11 virus from the systems of folks that had their warts removed. I've seen reports that some HPV strains do get periodically cleared from the system of some people-it isn't quite like HSV where the virus _never_ goes away completely once a patient gets infected. Some folks actually do clear an HPV strain from their system-no existing test will show they still have symptoms of HPV or are able to infect others. I don't think it is scientifically accurate to think in terms of "HPV". There are dozens of strains here-only a few of which are clearly identified as being associated with pathological conditions.

 

What AIM discussed in their "Porn 101" Video is the closest thing to a treatment for HPV I've seen. I wouldn't call it a "cure"-but is appears to make natural healing more likely than if the condition is ignored. I have seen nothing about this in a peer reviewed journal supporting or refuting the AIM doc's claims-but I tend to think the AIM docs were accurate in their reports.

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Lascivious L&L said:
Conspiracies are a seductive psychology. Science is slow and methodical precisely because it's not easy to separate the wheat from the chaff in understanding. The feeling that there are cures out there being held back by the powers that be is psychologically seductive. But where is the evidence?

A big piece of evidence suggesting problems with the US approach on STD's is the fact that Cuba-a poor, 3rd world country, has a lower rate of HIV infection than Puerto Rico. A bunch of US epidemiologists claimed quite publicly that the Cuban emphasis on testing and quarantine would not work. I personally don't see that as a scientifically accurate claim. There are all kinds of potential criticism of the Cuban approach on grounds like human rights or moral considerations.

 

Anyhow, I do NOT think this stuff in conspiratorial in nature. My great grandfather treated STD's decades ago as a practitioner of Native American herbalism (the stuff he did is still taught in schools of herbal medicine today-and was probably better than anything out there until antibiotics came along). Anyhow he had _intense_ community pressure around what he was doing for moral and religious reasons.

 

Folks can get very fixed in a scientific area. This paper discusses some of this issue. Could Gambling Save Science?

 

Part of the question is how to assess the real consensus at any time on an area-properly taking into account minority opinion. Another is how to keep science focused on predictive accuracy and removed from religious and political considerations.

 

 

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Many attempts have been made toward a vaccination for HIV, claims have been made, and people embarrassed when they didn't come to fruition. HIV is a tough nut to crack. There are those who would like to believe that solutions are being held back instead of the more prosaic it's very difficult to cure HIV.

I agree HIV is hard to approach directly. The only reported "cure" I've seen involved a bone marrow transplant. The one report of a vaccine actually having a preventive effect came from a friend of mine that used to work at CDC. He claimed the reason that Gardisil was fast tracked the way it was is that there was some statistical evidence that using Gardisil for prevention of HPV had an indirect effect of making subjects less likely to get infected by HIV. HIV is kind of hard to get by itself. A big chunk of HIV infections also involve other STD's and if you treat or prevent those other STD's you'll make acquisition of HIV much less likely.

 

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I disagree with the comment that more money is to be made from treating illness than from curing. A real cure for the common cold would make really big money for the company to create it. They'd cash in on it in a heartbeat if they could actually do it.

Why would they invest in a hard direction of research when minor treatments could generate similar revenue?

 

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Normal is the proper word for actual virus presence in humans rather than a concept of a state without virus that "should" be normal. Virus and humans have a long evolutionary relationship. Current normal seems to be HPV in the vast majority of adults.

One big question is what the prevalence of these viruses was in history-and just how is their presence impacting the health and longevity of contemporary people.

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It is remarkable and delightful to find such thoughtful conversation about important medical topics on an 'adult' site. It's a reminder that adults can think, converse and act as adults around sexually important topics. While I don't agree with every nuance in the thread, the facts that Kary Mullis has been name-checked, literature has been cited, and scientifically important questions are being posed is really quite extraordinary. It's a great privilege to be part of this online community.

 

The question of viral emergence and prevalence is an important one. Bacterial, plant and animal viruses have been around for a very long time, and their role in exchanging nucleic acids (DNA, RNA) across individuals and species is well established. What has changed so much if the mobility of individuals and species. Aircraft move people and their pathogens across vast distances in a matter of hours. Important pathogens such as HIV, Hep C are of ongoing interest to pharmaceutical companies and investigators. Pathogens that are less common or thought to be less noxious--HSV and HPV for example--attract less interest. Sort of a law of supply and demand. Someone with HSV or HPV lesions will understandably feel short-shrifted by drug companies and researchers alike, especially if they have a secondary complication such as encephalitis or cancer, but these are rather rare compared to the chronic illnesses of HIV and Hep C.

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CuriousNJCouple said:
Not to sound like a conspiracy person, but cures for many diseases probably exist already. There is more money to be made in treating illness, than there ever will be curing it.

 

Multiple issues with this logic.

 

First, developing a drug costs lots and lots and lots of money. Lots as in 9-10 digits. Why would someone spend a billion dollars developing a cure for a disease, but then not sell it?

 

Second, drug development trials are public domain. The US government even has a searchable website where you can go to read the reports on trials. If these cures existed, anyone would be able to look them up. They wouldn't be secrets.

 

Third, drug patents don't last very long. After looking up that cure that Merck or Pfizer inexplicably developed but never deployed, all another investor has to do is wait for the drug to come off patent and start producing it. Meaning that anyone or their mother can start a factory pumping out pills for said cure. Manufacturing drugs is dirt cheap. This is essentially the business model for Forest Laboratories.

 

Fourth, perhaps this is true, but it fails to take into account market strategy. Say three companies are making drugs that treat herpes. Then one company makes a cure for herpes. Perhaps that company would want to sit on the cure because the treatment is more profitable in the long run. But it's not nearly as profitable as the fact that this wonder drug would quickly gain a 100% market share and put its competitors out of business. Also, just because a disease has been cured doesn't mean it's going away. Strep throat can be cured. People still get strep throat and still buy antibiotics to treat it.

 

Source: scientist.

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I agree HIV is hard to approach directly. The only reported "cure" I've seen involved a bone marrow transplant. The one report of a vaccine actually having a preventive effect came from a friend of mine that used to work at CDC. He claimed the reason that Gardisil was fast tracked the way it was is that there was some statistical evidence that using Gardisil for prevention of HPV had an indirect effect of making subjects less likely to get infected by HIV. HIV is kind of hard to get by itself. A big chunk of HIV infections also involve other STD's-and if you treat or prevent those other STD's you'll make acquisition of HIV much less likely.

 

I used to be in a lab that studied HIV so I can explain these things a bit more when I have some more time on my hands. However, two quick points.

 

The "cure" for HIV isn't working. UPenn still has some people functionally cured of HIV with the treatment you're referring to, but the infection comes back when you take them off of antiretroviral drugs. Plus, at least one of the guys died. The problem is that we can't eliminate all the reservoirs in the body where HIV remains latent. Remember the big article a few months ago about a baby being cured of HIV? It was bullshit. The scientist quoted clearly said that the child was functionally cured (which is quite different from being actually cured), but the columnist heard the words "cured" and "HIV" in the same sentence and ran with it.

 

Other STD infections make HIV easier to contract. HIV is actually pretty hard to catch- you need a huge viral load because the virion is so damn fragile and it needs to come into contact with a bleeding wound or a mucus membrane. Chances are much better for the infection to catch when it contacts a bleeding sore on a mucus membrane. Such lesions are commonly caused by other STDs. Eliminate other STDs, you reduce the window for HIV transmission.

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