That is why STIs are some of my favorite pathogens. They have evolved to transmit via the one thing we cannot avoid if we want to have any real reproductive success, and because the centerpiece of our psychology is maximizing our fitness, there are only two real ways to reduce the spread.What the hell are we going to do?? The other part of this equation is the consideration that people are not just deceitful or weak, but actually hindered drastically by evolutionary motives that are acted upon before thought or reason is even able to be brought up.
1) Increase perceived risk. You can do this one of two ways. Make the risk of non-disclosure too high. IE. you can ensure that a person who knows their status and does not disclose WILL be caught and sanctioned. The threat of punishment IS a deterrent if the certainty of being caught is high enough. Then it is just a matter of ensuring people get tested. Make it some sort of requirement for some necessity(like getting a credit card/passport/apartment/loan). Or make STI testing a part of the standard preventative care under a single payer healthcare system. Just draw some blood, and run a battery of tests for... many many different things, including STIs. If it becomes part of the medical culture to do this, no one will thing twice about it after a while.
Then you have to make sure that contact tracing is done with every new infection.
If the system cannot afford to do that, or there is not the political will, you can scare people into being careful with the disease. Part of the problem is that few people have seen the effects of things like HIV. Few young people have had to bury their friends after watching them waste away due to opportunistic infections, and the down side to all the medications is that the thread of horrific wasting death is not immediate. It is put off for 5-20 years (depending on strain, and how strong your immune system is, etc etc)
Effective sex ed would stress the horror of immune system collapse, and would also go over how HIV works in a molecular level (It scared the piss out of me when I read the chapter on the molecular evolution of HIV in my evolutionary biology textbook). It would also stress that you cant trust people. Seriously, if you think you are in a monogamous relationship there is a good chance that you are not(I like to tell SO's "I trust you, but I also want insurance in case my trust is misplaced, because statistically it probably will be at some point, just like your trust in me could be). Kids need to know how evolution effects their lives. It is not something that happened in the past it is something intimately tied into how they make decisions, and more importantly how everyone else makes decisions. Top all of that off with preventative measures, ways they can mitigate risk. Give them real statistics, give them everything, not just the stuff that makes their parents comfortable.
That would work.
But it wont happen, not in the US where people object to teaching their kids about evolution AND sex.
You have no idea. Cynical would describe me fairly well, except the metaphysical premise of cynicism, that people suck, does not apply. People do not suck. They are very very good at doing what they evolved to do... if it did not affect me personally I would be damn impressed.I suspect that you are probably more pessimistic then the average person and expect this pandemic to get a WHOLE hell of a lot worse before it gets better..
