August 5th, 2010

[LINK] "Many Wouldn’t Give the Shot a Shot, Says New U of T Research on HIV"

This news (via Torontoist's Wyndham Bettencourt-McCarthy), especially given the exceptionally emotionally charged nature of HIV/AIDS as opposed to, say, the whopping cough, as well as anti-vaccine sentiment.

[A] new research paper by University of Toronto professor Peter A. Newman and graduate student Carmen Logie says that even if a perfectly effective vaccine were created, over a quarter of Canadian and U.S. residents would choose not to use it.

Newman, who is currently an associate professor at U of T’s Faculty of Social Work and a Canada Research Chair, along with Social Work PhD candidate Logie, reviewed more than thirty quantitative and qualitative studies that surveyed individuals throughout North America. The paper, which was published this month in AIDS, the official journal of the International AIDS Society, analyzes the surveys of more than twelve thousand people, including those deemed at higher risk for HIV such as ethnic minorities, injection drug users, and men who have sex with men.

The potential effectiveness of a vaccine played a major role in the choice of many individuals, Newman says. "People are much more likely to take a vaccine if it’s highly effective, and are much less likely to if its [success] rate is 50%, even though on a population level that would knock the disease down significantly." If a 50%-effective vaccine existed, only 40% of people surveyed would choose to be vaccinated (compared to the 74% who would if it was totally effective).

While fears about the dangers of vaccines were a factor, "the bottom line is it’s totally impossible for anyone to get HIV with a vaccine [if developed]," Newman says. "There would not be live HIV in the vaccine." However, Newman and Logie’s analysis found that structural factors, such as availability and accessibility, also had a significant effect. "These practical obstacles are so important because there’s a lot [when dealing with vaccination] that’s out of our control, but these are things that are," he adds. Newman highlights the importance of making the vaccine as readily available as possible and integrating it into the health care system. For example, making it available at the regular doctor's office would de-stigmatize the vaccine by eliminating that unwanted walk into an AIDS clinic. According to Logie, other deterrents could include high cost, transportation, clinic locations, and hours of operation.

Newman saw parallels between people’s reactions in his study and the vaccination campaign during Ontario's H1N1 scare last winter. "It’s even hard to get the flu vaccine to all the people who need it—we saw that with H1N1, and that’s an extraordinarily low-risk vaccine," he says. Despite public health warnings and campaigns, the lack of quick access and availability of the vaccine led to a mere 32% of Ontarians getting the shot. And two weeks ago, reports emerged that those who did get the vaccine helped prevent an estimated fifty deaths and one hundred thousand visits to doctors’ offices.

[LINK] "Biology as a historical parameter"

Over at GNXP, Razib Khan has a rejoinder to the historians who don't believe that the mass depopulation of the New World by the diseases brought in the post-Columbian era was possible: the real, horrific, example of Tahiti, where populations fell to less than ten thousand in the 1840s (curiously, or not, about the same time that Tahiti became French).

One of the implicit aspects of Belich’s skepticism is that population crash models in the New World are rooted in inferences, not concrete censuses. But I recently stumbled onto a “test case” for contact between Europeans and indigenous people where we have some good data sets, Tahiti.

The initial data point of ~50,000 in 1767 is a low boundary estimate. But the subsequent data points are more concrete, from missionary surveys, or censuses. Even excluding the estimate the pre-contact population of Tahiti island seems to have dropped by one half in a two generation period. This is greater than the average decrease of the Black Death in Europe.

I think the reason for these massive population collapses when isolated groups meet more cosmopolitan ones is simple: they compress many generations of natural selection and immunity acquisition into just a few. In the historical record we know that the 2nd century A.D. witnessed the outbreak of plagues in the Roman Empire, and the subsequent decline and fall was concomitant with the endemic status of malaria in the Italian lowlands. The great Plague of Justinian in the late 6th century has been fingered as the causal factor behind the rise of Islam, the replacement of Celtic Britons by Anglo-Saxons, and the end of the Classical World more generally. Populations isolated from the grinding pathologies of Malthusian agricultural interlude just experienced it in all its glorious misery in a very short burst.

Islands can be quite vulnerable to epidemics, not only because of their isolation but because of the compactness that makes the rapid spread of a disease possible.

[LINK] "As gayness becomes a given"

Writing in Xtra!, Brent Ledger has an interesting article talking about how GLBT-themed and -peopled stories (and GLBT themes and people within larger narratives) are becoming increasingly nuanced, increasingly concerned with individual difference, as acceptance of queers becomes taken for granted.

Until very recently, gayness has been presented not just as a problem but as the problem. And while that’s true for most of us at one stage of our lives or another, at least until you come out and accept yourself, it’s misleading when applied to a life as a whole. And also as a theme, quite frankly, boring.

Some parts of the culture are still stuck at the earlier stage of development.

Just look at some of the films at this year’s Inside Out festival, items like Israel’s Eyes Wide Open or Peru/Columbia’s Undertow. They’re love stories, but what matters is not so much the relationship per se as its acceptance by the wider world.

As that acceptance grows more widespread, though, we’re starting to see more stories where it’s less us-versus-them and more all-about-us. Gradually, we’re learning to take gay for granted. Instead of being the end of the story — character comes out, all’s right with the world — it’s just the beginning.

[. . .]

The trend is even more marked on a show like
Modern Family, where the gay couple is so obviously just there. Accepted, integrated and appealing (or not) on the basis of personality alone.

Some people object to their supposed lack of physical affection. But this is exactly the sort of couple who are well past pawing each other in public. They’ve got a kid, they’re established, they know where they stand with each other. They’re dumpily, kvetchingly normal. And that’s why they’re important. Not interesting, but important, the necessary complement to the “sexual outlaws” so prevalent in early gay culture, and in many ways far more transgressive.