army1987 comments on Open thread, September 8-14, 2014 - Less Wrong
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Quite a few people will pay $10 in order to not know whether they have herpes.
From Poor Economics by Esther Duflo and Abhijit Bannerjee
Thank you, that was very interesting.
It seems to me these people are paying in sanity what they can't pay in money - and the price they're paying is arguably higher than what the rich are paying, not even considering the physical health effects.
This might be one of the ways that being poor is expensive.
Indeed, 'being poor is expensive' is related to how they frame this fact. From the end of the same chapter:
These are all nice ideas but someone has to pay for them and it won't be cheap and 2nd of all. I know of plenty of people who are living in terrible conditions right here in this country. When one is poor everything is harder because you have to do everything yourself and pay out the nose for services that the wealthy get for far less. Whether in Africa or the US, poverty has a cost.
I'm interested in your calling it 'paying in sanity.' Are you referring to the insanity of believing in Bengali babus, or the fact that they're preserving their own sanity in some way by not going to a real doctor for things they know they can't afford?
The former. I'm speculating this tendency to rely on hope for serious problems while relying on science for small ones creates compartmentalization, which impairs rationality and increases religiosity.
The correlation between poverty and religiosity is obvious, this is just a speculative direction of causation. Irrationality would probably lead to poverty, but if poverty also led to irrationality, the two causations would reinforce each other and explain the robustness of the correlation.
"Whether you have herpes" is not as clearly-defined a category as it sounds. The blood test will tell you which types of HSV antibodies you have. If you're asymptomatic, it won't tell you the site of the infection, if you're communicable, or if you will ever experience an outbreak.
I had an HSV test a while ago (all clear, thankfully), and my impression from speaking to the medical staff was that given the prevalence and relative harmlessness of the disease, (compared to, say, HIV or hepatitis or something), the doubt surrounding a positive test result was enough of a psychological hazard for them to actively dissuade some people from taking it, and many sexual health clinics don't even offer it for this reason.
Thanks to its multiple infection sites, herpes has the unusual property that two people, neither of whom have an STI, can have sex that leads to one of them having an STI. It's a spontaneous creation of stigma! And if you have an asymptomatic infection (very common), there's no way to know whether it's oral (non-stigmatized, not an STI) or genital (stigmatized, STI) since the major strains are only moderately selective.
... and that's why you should prefer to sleep with rationalists. :)
But it might be rational to not find out if you believed you would have a duty to warn potential lovers if you tested positive, or were willing to lie but believed yourself to be a bad actor.
How is it rational to willfully keep others in ignorance of a risk they have every right to know about? The discomfort of honest disclosure is a minor inconvenience when compared to the disease.
A classic example of confusing is with ought...
You are right for the rationalist who gives substantial weight to the welfare of his or her lovers. But being rational doesn't necessarily imply you that care much about other people.
A rationalist that doesn't care about the welfare of their lovers and yet believes they have a duty to warn them about if they tested positive (but no duty to get tested in the first place, even if the cost is nonpositive)?
Are you advocating for prisoner defection?
In my game theory class I teach that rational people will defect in the prisoner's dilemma game, although I stress that you should try to change the game so it is no longer a prisoner's dilemma.
I hope you also talk about Parfit's hitchhiker, credible precommitment and morals (e.g. honor, honesty) as one of its aspects.
I spend a lot of time on credible threats and promises, but I don't do Parft's hitchhicker as it doesn't seem realistic.
Can this situation be modeled as a prisoner's dilemma in a useful way? There seem to be some important differences.
For example, if both 'prisoners' have the same strain of herpes, then the utility for mutual defection is positive for both participants. That is, they get the sex they were looking for, with no further herpes.
Not prisoner's dilemma, but successful coordination to which a decrease in the spread of HIV in the gay community is attributed: serosorting.
The base rate of HSV2 in US adults is ~20%. I would argue that if you're sexually active, and don't get an HSV test between partners (which is typically not part of the standard barrage of STD tests), you're maintaining the same sort of plausible deniability strategy as those who pay to not see the results of their apropos-of-nothing tests.
If you do think you have an ethical obligation to inform others of a risk like this, do when did you test yourself the last time for herpes?
If you must know, I'm a virgin. I have, however, engaged in erotic practices not involving genital contact.
If that wouldn't be the case, how often would you think you would test yourself?
I guess a minimum should be before and after each new partner, plus additional tests if I suspect infidelity.