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The US is in practically no danger of a HIV running rampant, though, so it's kind of irrelevant. Yes, we'll lose some sodomites and drug addicts. We have people demanding fentanyl be allowed to run rampant for the same purpose on this very forum.
I think that HIV is rather irrelevant in the US because most people, including drug addicts have correct beliefs about it. They will try to use clean needles when injecting to avoid getting infected and so on.
I just look at this from public health point of view – if beliefs are causing people to make wrong health choices, then how can we change those beliefs?
Atul Gawande writes in detail how polio vaccination programs worked in India. The organizers knew that some people have beliefs that polio vaccine is causing disease or making people infertile etc. They also knew that shaming people or forcing vaccine doesn't work. If someone refuses, calmly explain why vaccine is beneficial and move on. In one episode the supervisor who otherwise was calm about all problems, got angry to vaccinator who berated a mother for refusing to vaccinate her child. He said, “she was listening to you before but now she will not listen at all”.
This approach was slow but successful, polio was eradicated in India. One has to be very stoic by allowing people to make wrong choices and then empathising with them when bad things happen without the slightest reproach.
Somehow we forgot all this and during covid acted very irresponsibly by forcing people to get vaccinated, by shaming them officially etc. Child vaccination rates predictably are going to fall and it will be hard work to improve them again.
With HIV beliefs in Africa, it's probably because we don't have vaccine against HIV so they never had contacts with field workers like that. Those people with HIV in Africa who happen to be involved in programs that provide treatment, quickly understand how all this work. But there is no a systemic reach like going from home to home to vaccinate or treat everyone.
The leaders could do that but they are tribal leaders. They have no capabilities to think or act rationally. It requires deep political scheming to entice them to implement such programs. The WHO is often accused to be working for China and other dictators but I don't see a way how they could not be. Otherwise those dictators are not going to listen to them.
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