Wednesday, 4 April 2018

The High Cost of Preventing AIDS

     Currently, there are just over 25,000 Australians living with HIV, and the new infections number just over 1,000 each year. By and large, the incidence of AIDS is low because of the use of anti-retroviral treatment. As you are no doubt aware, HIV is the virus, and AIDS the active disease it produces after a lapse of five to ten years. No cure exists, but the disease can be held at bay by anti-retroviral drugs. It is a life sentence, because if once the medication is ceased, the virus is ready to swing back into action and destroy the immune system. Once that happens, an unpleasant death is certain. However, lately a new medication has come onto the market.
     Before we start, understand that "safe sex" is considerably less safe for the homosexual than the heterosexual, for reasons which are rather difficult to explain without being gross. Basically, the vagina is an organ of accommodation - it is, after all, designed to allow the passage of a baby - and usually well lubricated. The exact reverse is the case for the rectum. Thus, condoms are far more likely to break during sodomy than during sexual intercourse. Just the same, they are not useless.
     Recently, however, a new drug, Truvada has been added to the Pharmaceutical Benefits list, which means that most of its costs will be borne by the taxpayer. Also known as PrEP, for Pre-Exposure Prophylaxis, it prevents the virus from getting established in the first place but, like the oral contraceptive, it must be taken every day.
     Now, I can see problems. Out-of-wedlock pregnancies have increased, not decreased, since the Pill became available. Indeed, in the early years, when contraceptives were handed out to teenagers at school, it turned out that the girls who took them were more likely to become pregnant than those who didn't.  (The same result was recently found in the UK.) The reason was not hard to divine: those who received them took them inconsistently, while many of those who didn't were using an even more effective contraception: chastity. I can't help suspecting that widespread used of Truvada will result in more HIV infections, as people give up using condoms, but use the drug inconsistently. Also, the disuse of condoms leads the way wide open to every other venereal disease, many of which are quite horrific and incurable, and are far more common among homosexuals.
     Also, Truvada costs about $10,000 a year. That's an awful lot of money for the taxpayer to fork out merely to permit some people to adopt a promiscuous lifestyle. After all, HIV is a pretty easy infection to avoid.
     We might, therefore, ask how much anti-retroviral drugs cost to actually treat the infection once it has been contracted. I am not in a position to evaluate the requirements of all the medicines on these lists - they may very well need to be taken in combination - but the most common appear to run in at between $3,600 and $12,000 per year. Again, that is an awful lot of money for the taxpayer to fork out merely to protect people from the effects of their chosen lifestyle.
    Let's look at it another way. Only a fraction of those who don't take PrEP will contract HIV. Many will use condoms, some will - hell forbid! - be abstinent, and others will just be lucky. If we are totally callous, and care only about finances, it is probably cheaper to pay for treatment for one person who gets the infection than to supply ten people with medical prophylaxis.
    However, I am not that callous. Just the same, we should be aware that homosexuals have more money to spare than the rest of us, simply because they have no children to support. The sums involved, although apparently large, are well within the discretionary spending power of the average unmarried wage earner. Would it not be reasonable, subject to an income test, to expect them to pay up to (say) $5,000 a year for either protection or treatment?
    No doubt some will denounce this suggestion as an example of a horrible "homophobic" attitude towards homosexuals. On the contrary, they are already being receiving special favours. It is only because they are a small minority that this raid on the public purse has gone under the radar. If HIV were widespread among heterosexuals, as it is in Africa and PNG, there would be a new push towards chastity, and ordinary mums and dads, who do not regard VD as a normal lifestyle risk, would jack up against paying to protect the lifestyles of their promiscuous confrères.
    Note, also, that although impotence is a recognized medical disorder, and it affects both partners in a marriage, Viagra is not covered by the Pharmaceutical Benefits Scheme. I am not saying that it should be; I am merely pointing out that the sex lives of heterosexuals is apparently regarded as their own business, not that of the taxpayer. Perhaps the same standard could apply to homosexuals.