Preventive Medication and Insurance Coverage for HIV Transmission Risk

In this thought-provoking discussion, Malcolm and Simone Collins delve into the controversial topic of PrEP (Pre-Exposure Prophylaxis) and its implications for public health, personal responsibility, and healthcare costs. They explore the ethical dilemmas surrounding government-subsidized HIV prevention medication, questioning whether lifestyle choices should be funded by taxpayers and insurance premiums.

Key points covered:

* The effectiveness and cost of PrEP medication

* Government and insurance coverage of PrEP

* The moral and ethical implications of subsidizing sexual health choices

* Comparisons to other lifestyle-related healthcare costs

* The impact on insurance premiums and healthcare accessibility

* Cultural shifts in attitudes towards sexual behavior and public health

* The intersection of personal freedom, responsibility, and societal costs

This video offers a balanced yet critical examination of a complex issue, challenging viewers to consider the broader implications of healthcare policies and personal choices. It's a must-watch for anyone interested in public health policy, healthcare economics, or the evolving cultural landscape of sexual health.

Malcolm Collins: [00:00:00] Keep in mind straight people can get HIV too and straight people might need to prep as well. Straight people who wouldn't need prep are straight people who are in monogamous relationships and trust their partner. It is not the being gay that makes somebody need prep. It's the orgies. That makes somebody need prep, or the treating sex like a handshake among friends that makes somebody need prep. If you are straight, and you are doing that, you will need prep.

If you are gay, and you are monogamous, you will not need prep. When the Act was passed It was mandated that all insurance plans have to pay for this.

So if a person is sexually active. They have to pay for this

Obamacare has made things insane because insurance companies can't say, well, we won't take you. You need to go for a higher cost insurance. If you're going to make these lifestyle choices because at the end of the day, going to orgies is a lifestyle choice

It's not just that it's affecting insurance. A number of states just offer this for free to people who want it. People pretend like this stuff, money comes [00:01:00] from nowhere, but no, it's always from something. If it's going to this, it's, it's not going to sick kids and I actually want to point out the perversion of a society that sees it as a moral necessity to pay for a drug that enables sex whenever you want, but that doesn't see it as a moral necessity to pay for IVF, the creation of new human life.

Simone Collins: Oh, s**t.

Would you like to know more?

Malcolm Collins: Hello, Simone. I'm excited to be here with you today. Today's episode was inspired by actually an episode that Short Fat Otaku had done, opened my eyes to something I had no idea was going on. And it means when you ever look at your health care bills and you're like, why is Obamacare so unaffordable?

Why is it so unaffordable to force everyone on to the same health care plan? And the answer, it turns out, is gay orgies.

Simone Collins: Among other things, but definitely it seems gay orgies.

Malcolm Collins: In part, gay orgies, yes. So, we're [00:02:00] going to get to something, and I don't think that there is actually That easy, a moral solution to this.

Like at first it's gonna seem like, oh, obviously you should do X. But then when you think about it for a second, you're like, oh, but that'll have some really negative downstream effects.

Simone Collins: I don't know. I I, I have maybe some moral equivalence, so I'm, I'm excited to discuss this with you.

Malcolm Collins: So, what started was a Twitter fight. So I will describe to you the first tweet in this chain that led to the Twitter fight. Plant Mommy Posadis said, Realizing that sex doesn't have to be this sacred, all important thing and can instead just be an expression of affection between friends who are dear to one another is honestly the most life changing realization for me, surpassed only by realizing that I'm a girl.

So this is obviously a trans person they're pointing out here. And saying, well, because you don't, most girls don't realize they're girls. I don't

Simone Collins: know. I feel like I realized I was a girl when your mom [00:03:00] was like, did you know that you can dress nicely and wear makeup? And I'm like, Oh,

Malcolm Collins: wow. I want to reread.

What we're saying here, right? Because I actually think this ends up being important to the conversation.

Simone Collins: Yes.

Malcolm Collins: That the, the huge realization for them. That was the second biggest realization they've had in their life. That sex can just be an expression of affection between friends.

Simone Collins: Just a fun thing to do

Malcolm Collins: with your friends, getting drinks, going out, having drinks, going out, having sex.

Yes. Then a person responded to them, Mia Aren't we in another AIDS epidemic or something? Y'all are seriously trippin And then the original poster replied, I literally take pills every day that make it so I can't contract HIV. And then short fatter taco but it in here with the SpongeBob fish meme looking like,

And says, You need to take pills to not contact, to not contract.

HIV. You can't just not have sex with people who have [00:04:00] HIV. And this tweet blew up. It's at 9.3 million views now. It went super viral and for, with, with, with a lot of hatred as well, that's considered just a completely out of line thing for him to say.

That they should be, that he, from his cultural perspective, that he expects them to exercise any level of of sexual constraint.

But this just opened a new world for me. I was like, wait, wait, wait, there's a pill that can keep you from getting HIV now. I did not know about this. But

Simone Collins: isn't it called PrEP? Like I'd heard of people taking PrEP. It

Malcolm Collins: is. We're

Simone Collins: going to go. Friends who take PrEP. Yeah.

Malcolm Collins: This pill is how it works, how well it works, et cetera.

Because that was one thing I didn't know. I also didn't know that the drugs around HIV are so good now that generally if you're on them, you're non contagious. So, you know, this is needed more for people who aren't already on drugs or don't know that they have HIV, i. e. This isn't really as relevant if you have a partner.

So somebody can be like oh, well, you need this if you have a partner with HIV, but not [00:05:00] necessarily anymore because now you can be made non contagious. If you want. So

Simone Collins: basically, as long as the partner is taking it, it's okay.

Malcolm Collins: Right. So this is really important. Specifically, mostly meant for orgies. Or,

Simone Collins: yeah, well, basically, if you can't guarantee that the people with whom you're sexually intimate are being very conscientious about taking this medication if they indeed are HIV positive, right?

So if one, you aren't being indiscriminate about having sex or two, you're having sex, but only with people where, you know, they're not HIV positive or three, you do know they're HIV positive, but you can 100 percent trust that they're taking this medication. You wouldn't need this. You wouldn't need PrEP.

Malcolm Collins: Yes but if you are treating a you know, sex is just something you do with your friends when you feel like it You know, and you're gonna need

Simone Collins: this medicine. Yeah, you're

Malcolm Collins: definitely gonna need he is not that she is not being irresponsible In taking this medicine. Yeah Safety first and and and she is not spreading hiv because she's taking this [00:06:00] medicine So, you know, I support that she has chosen this lifestyle, but then that got me thinking.

Okay, how much does this stuff cost? And who's paying for it? And who's paying for it. Now this gets interesting because this is where I was like, Oh, Oh, this is a moral quandary.

Anyway, so I'm just going to read to you cause I decided to ask perplexity about some of this stuff. So a month's supply of prep pre exposure prophylaxis medicine, specifically Trivetta.

Cost nearly 2, 000 without insurance while the generic version is approximately 60 per month. The total annual cost can exceed 21, 000 if purchased without any financial assistance or insurance coverage. However, most private health insurance plans, as well as Medicare and Medicaid, are required to cover the cost of PrEP without any out of pocket expenses due to provisions under the Affordable Care Act.

However, patients may still incur costs related to lab tests and doctor visits, which are [00:07:00] necessary for monitoring while on PrEP. And that's because it's very hard on your liver. If you, if you consistently take this, you will probably die from it.

So I dug into this a bit more because I wanted to make sure I was correct in this statement. And it turns out that most of the people who are on prep are regularly seeing doctors to monitor for dangerous levels of things like lactic, acidosis, or liver cancer. , which they are at. A much higher risk of, uh, so, well, it is almost certainly shortening your lifespan. It is not a.

Necessarily going to kill you.

If you were seeing the doctor regularly for it.

Malcolm Collins: It seems to be my understanding. Oh,

Simone Collins: boy. So they're

Malcolm Collins: also sacrificing their health and you know, lifespan for, you know, these in the moment indulgences.

Okay. And so. So

Simone Collins: basically if, if the government's supporting this, probably they're going for the generic version. You're being prescribed the generic version and the government or your insurance company. [00:08:00] No. Oh

Malcolm Collins: no. Sorry. I've got to keep going here because we've got to go. Who pays for this? Okay. Yeah.

Simone Collins: And which, which is being purchased the generic or the brand?

Malcolm Collins: To assist those who may not have insurance or whose insurance does not cover prep, several programs are available. Advanced access medication assistance program covers out of pocket costs 7, 200 per year. This is a Program that is run by Gilead Sciences, the manufacturer of trivia, and it's likely really just a a tiered pricing thing.

So people don't know companies do this, where they will create a another version of their product that they can still be cash positive on. But that only poor people can buy so that they can make money from those for people. And look like they're doing a nice thing, or really, they're just doing price discrimination.

Because, you know, they still want to sell the drug right to as many people as possible, but they don't want to lower the price for the people who can pay more. Right. The next one is Ready, Set, Prep, which provides pre travidia to individuals without prescription drug [00:09:00] coverage. This is a national program run by the U.

S. Department of Health and Human Services. It's available across the United States. And then co pay relief programs offer up to 7, 500 a year for out of pocket expenses. And this is offered by the Patient Advocate Foundation and is available nationwide.

Simone Collins: Okay, so hold on. They're not Paying for the generic, they're paying for the name brand.

Malcolm Collins: I assume that this has to do with U. S. patents, because my understanding is that you just can't get the generic in the U. S.

All right. So I dug into this more because it was very confusing to me is

white people are not buying the generic. So it appears that the primary reason people are not buying the generic is bureaucratic bloat. , so a lot of the insurance companies remember how all the insurance companies had to cover prep. Well, a lot of them never added the generics to their sort of approved drugs lists.

So they are paying for the much more expensive form. , so this cost is being passed on just because from the perspective of the customer, they don't really notice a difference for them. It's [00:10:00] free either way because you know, the Obamacare plan. , forces . , insurance companies to carry prep and because they don't carry the. Generic, , people are just buying the more expensive one because the cost isn't going to them that's appears to be what's going on here. , but it is going to you.

It is going to your child health insurance. , costs and stuff like that. , and another side here , is it, the generics only really came onto the market in 2021. , and because of that, A lot of the debate around should this be covered and how much it's impacted our healthcare system happened before the price drop.

Malcolm Collins: Okay So one thing to note here is when the Act was passed It was mandated that all insurance plans have to pay for this.

So if a person is sexually active. They have to pay for this and wants this drug. So that means that you know, outside of well, first, also, let's talk about this program that I was talking about that pays 7, 500 a year for out of pocket costs for [00:11:00] this.

I went to this program's website because this is a nonprofit.

Right. And I was like, okay, what did they tell people who are giving them money that the money is going to, right? They tell people that the, the money is going to food and nutritional expenses, utility bills, written or mortgage payment, temporary lodging, transportation costs, and childcare expenses.

So the money that is, and people are like, why, why is there a moral problem here? Well, it's because of an opt in lifestyle choice. This money now 7, 500 a year is, is going to allow for a lifestyle that I assume many of the people don't know that they are donating to enable instead of going to sick children.

Like you, you, people pretend like this stuff, money comes from nowhere, but no, it's always from something. If it's going to this, it's, it's not going to sick kids. It's not going to utility expenses. Well, I

Simone Collins: also think that the bigger issue is that We are now paying in the United States, [00:12:00] very high insurance premiums.

Like I, and, and our insurance covers very little. And when insurance companies are from a regulatory perspective, obligated to pay for services for certain people, that means that they're going to charge more to everybody else to be able to cover those costs. Again, somebody has to foot the bill. This is also families who are not able to get insurance at all because they can't pay for their premiums.

This is, this is offering crappier programs to their employees because their premiums are so high. This is people, you know, not. having deductibles they can ever meet. Like we're on a deductible plan that I think for our families, something like 12, 000 before our insurance starts to cover anything. We have to pay, we might as well not have insurance.

Malcolm Collins: Yeah. The, the, the Obamacare has made things insane [00:13:00] because insurance companies can't say, well, we won't take you. You need to go for a higher cost insurance. If you're going to make these lifestyle choices because at the end of the day, going to orgies is a lifestyle choice and we'll get into how much of a lifestyle choice it is in a second.

But I want to finish it with the pre prepared stuff before we get into any moral questionability of this. It's not just that it's affecting insurance. A number of states just offer this for free to people who want it. So, several States have established a program. That can cover the cost of prep, including lab tests and doctor's visits.

The states with such programs include California, Colorado, district of Columbia, Florida, Illinois, Indiana, Iowa, Massachusetts, New Mexico, New York, Ohio, Oklahoma, Virginia, and Washington. So, a lot of states. Quite a few states. Yeah. Totally. And quite populous states too. Yeah. So I, I want to, before we go into the discussion of this, talk about how it works and the current sort of state of AIDS treatment, because I think that is important to talk about it.

Yeah. It sounds also pretty cool. Like, I'm [00:14:00] glad that this exists and I'm glad that it's becoming less expensive. Yeah. I do have questions about the morality of this being covered by Medicaid and being mandated by the government. Because that means that you are mandating you know, people who might have pretty strong religious objections to this to essentially be subsidizing lifestyles that they believe, not us, but I can totally understand how somebody would have questions about this, even without having a problem with a person being gay or a person being trans, you know, you can be gay and trans and not go to orgies all the time.

You know, this is, this is a, subsection of these communities. You know, not all gay people are degenerates, you know. And I'm not saying that everyone who goes to orgies all the time is degenerate, but probably. You know, there's, there's probably some correlation there. But anyway, I mean, I'm, it's not for me to judge other people's lifestyles

And when I say it's not for me to judge, you know, who is it to judge? It's God to judge that, not me, God. I let people make their own choices [00:15:00] and deal with the consequences of those choices. It's not for me to Dole out those consequences. However, in our discord, somebody was asking, you know, do we really want, because a number, especially of gay men, like the real gay community, not the opt-in LGBTQ plus oh, I'm non-binary today community, but the real OJI gay community has been moving increasingly Republican over time. And some people on our discord were wondering, , is it actually good to bring these types of people into the Republican coalition? And one of the things that I have noticed with this community and a gay person within our discord was also saying, yeah, this observation that you had is very accurate of the community. Is it sort of split into two groups, which kind of hate each other. , one is sort of wholesome, mostly monogamous. , gay people who are looking for long-term partners and looking to raise families. And even, you know, as a Christian, if I believe that they live a life of sin, [00:16:00] Yes, but I don't see it as a particularly higher life of sin than a couple that is childless by choice. , you know, that they both are engaging in non reproductive sex for pleasure.

Like that is. Bad from my perspective. , but again, so I don't, I don't, you know, should we let, should I, you know, as a state be breaking up couples who don't want to have kids like no. So I don't see a problem with the other type of couple. And I should note here that I think they're living significantly less lives of sin

then then somebody who is out there having, you know, straight sex with a different girl every other week and going to night clubs and partying all the time. , but then the other community has just gone full on like degenerate to generate degenerate mode. , and it is, and you'll see this in another episode that we actually recorded alongside this episode, but that's going to go live on different days is just. How fully degenerate the stuff they're fighting for is these days.

It will shock you. Believing Americans have essentially a constitutional right to orgies is [00:17:00] low scale on the degeneracy.

Malcolm Collins: so, I will read about how it works and what it is. is a preventative medication for individuals at high risk of contracting HIV. It is designed for those who do not have HIV but may be exposed to it through sexual activity or injection drug use.

And, and keep in mind straight people can get HIV too and straight people might need to prep as well. Straight people who wouldn't need prep are straight people who are in monogamous relationships and trust their partner. So really the thing here, and I think a lot of people will say like, you're being homophobic or you're being transphobic.

But the truth is, is that it is not the being gay that makes somebody need prep. It's the orgies. That makes somebody need prep, or the treating sex like a handshake among friends that makes somebody need prep. If you are straight, and you are doing that, you will need prep. If you are gay, and you are doing that, you will need prep.

If you are gay, and you are monogamous, you will not need prep. And the vast majority of cases, now there are minor cases that we'll get to in a [00:18:00] second, and if you are straight and you are monogamous, you will not need prep. So this is about a lifestyle choice, not like an inborn difference between individuals, or maybe is it, we'll get to that in a second.

Okay. Prep involves taking medications that can significantly reduce the risk of HIV infection. When taken consistently, it can lower the risk of getting HIV from sexual intercourse by 99 percent and from sharing needles by at least 75%. So that's the only thing that that exists. Yeah. There are two main forms of PrEP.

Daily oral medication. This is a pill taken once a day., an injection that is administered every two months, which may be more convenient for some individuals. Who should consider PrEP? PrEP is recommended for individuals who meet the following criteria. Having a sexual partner who is HIV positive.

No consistent use of condoms during sex. Having been diagnosed with a sexually transmitted STI in the past six months. Which basically means they're sleeping around a lot. Injecting drugs and sharing needles or having an injection partner with HIV. An injection partner? You just use a different needle, you [00:19:00] f ing nutjob!

Hold

Simone Collins: on! I I doubt I doubt that those are common cases. They're just, they're just outlining all the scenarios. No one wants to share, Malcolm, trust me, no one wants to share a needle. They just get more blunt, you know, it's not fun. So, yeah, this is not, I don't think it's a common scenario. Especially because there are so many needle distribution programs now, not an issue.

Malcolm Collins: Yeah I was asking about what's the probability that somebody who's on normal HIV medication today is contagious to their partner? Based on recent research, people with low HIV viral loads have extremely low risk of transmitting HIV through sex.

A systematic review of eight studies involving 7, 762 couples found that the risk of sexual transmission of HIV is almost zero when the HIV positive partner has a viral load of less than 1, 000 copies per milliliter. Three studies showed no HIV transmission when the HIV positive partner had a viral load of less than 200 copies per milliliter considered [00:20:00] undetectable.

Across all studies analyzed, there were only two cases of transmission when the HIV positive partner's most recent viral load With less than a thousand copies. However, these cases had long intervals between the viral load testing and transmission, complicating the interpretation. So, basically, it's never been confirmed that somebody with a low load has transmitted HIV.

 CDC stated that people who take antiviral therapy art daily as prescribed and maintain an undetectable viral load have a quote unquote effectively no risk of sexually transmitting HIV to an HIV negative partner. This concept is known as quote unquote undetectable or untransmissible or U equals U.

And it's actually so low now that there is a, a sperm bank for HIV positive individuals. That's inclusive of them. So I'll talk a little bit about this sperm bank. Because I mean, this shows you how low it's perceived is within the community based on the latest scientific evidence and updated regulations.

Sperm [00:21:00] and egg donation from HIV positive individuals with undetectable viral loads can be safely done without transmitting HIV to the recipient or the resulting child under certain circumstances. The donor must have sustained undetectable viral load, less than 200 copies for at least six months prior to the donation.

The donor must be on an effective anti retroviral treatment for at least six months. And the recipient must be informed about the donor's HIV positive status. And this is, and I'll post it on screen here called sperm positive. I. And the two women on it are two fat women, of course.

There's a baby. A lesbian, fat, interracial couple with a baby. Nothing that there's anything wrong with it, they just look very stereotypically like SJW. Which is fine. I mean, I guess that's the type of person who would want this, right? You know? I don't, I don't I actually think people expect me to be like Morgan says if a couple is informed that that's what they're doing and they're doing this I don't know for them.

Well, Malcolm,

Simone Collins: you know, if in the end you are, you know, someone who [00:22:00] through things that happened in your past, I mean, listen, people, I don't think consensually choose to have unprotected sex. sex with someone who's HIV positive, you know, it happens once, whatever. And then, you know, that's something you have to live with for the rest of your life.

I think it's great that these people are still able to have kids if they want them. That's fantastic. So, yes, I think we can all agree that this is a fantastic medical treatment. And that I'm really glad that this exists and that it's available as an option. This is great.

Malcolm Collins: Yeah, but the question is, is it ethical to force families to subsidize this?

Simone Collins: And this is where I feel like it's, it's less of a gray area than you are. Now I understand from a governmental and policy perspective that it's, you know, you, here's a chance for a government to, you know, To quash the spread of a very dangerous disease where there is collateral damage, you know, when you don't openly control it in this way.

Malcolm Collins: Yeah, and I want to highlight the collateral [00:23:00] damage that he's talking about here. You know, during the AIDS epidemic, little kids died from like blood transfusions or like, you know, you step on a needle in a park , As the rates, it's not just the people who have consciously chosen a behavior that you disagree with who end up suffering because drugs like this are not widely available.

Anyway, he did.

Simone Collins: Yeah. At the same time, I, I do have. Some doubts about this, because as you point out, this is a lifestyle choice. You do not have to have sex with people in a way that would require you to take this medication. And when I think about the, like trying to find an equivalent, it's not charged.

You know, this might be like, okay, well maybe, you know, my life is better. You know, this is part of my identity, right? My identity is that I am, you know, gay and I have sex in this way. And it's just like part of my expression. It's part of what I do to have fun. But I think a lot of people. You know, [00:24:00] identify as, you know, social butterflies who like to go out and, you know, have a nice brunch once a month.

Right. Let's just say, let's say that the actual cost to governments and insurance companies like marginal is 60 per person to be like 65 per person, bare minimum. Right. So what if also, you know, for some people to live a happy, fulfilled life, they, they, you know, went out. To brunch with their friends once a month, because that made them happy.

And that costs, you know, for them, you know, good boozy brunch, 65 per person. Should the government also subsidize that because it's part of their life. It makes them happy. They wouldn't be as happy if they didn't do it.

Malcolm Collins: I thought the thing that you said to me really moved my mind on this is you're like, yeah, what, what if somebody wants like a nicer apartment, right?

Like does the government have to subsidize that nicer apartment? Because it would, you know, it's better. They'd be much more comfortable. Yeah. You know, they're in a long distance relationship with someone, right? Does the government [00:25:00] have to subsidize their plane flights? Or they like to travel to Europe once a year, you know, that's part of who they are, you know, does the government have to subsidize that?

Is it moral? To have families that are struggling to get by, that are struggling to, you know, keep their, whether whose kids have diseases and stuff like that, to be taking from like kids cancer funds to fund this, is that moral?

Simone Collins: Yeah, and

Malcolm Collins: that's

Simone Collins: where I really question it.

Malcolm Collins: I, I think you're right here, but here's the, the, the question I would have, because this is where I do support it.

I do support it in instances where somebody has a committed monogamous marriage and their partner is HIV positive. In that case, do you still not support? Now, you remember they, they can be basically non transmissible, but it's still recommended they take it. I, I guess, I guess I wouldn't even support it there.

And I'll explain why. It is a not [00:26:00] that we are saying this drug should not be accessible to anyone who can afford it. There are tons of things involved with a monogamous marriage that people choose to afford to have sex, for example, right? Like. If you're in a monogamous marriage, but you don't want to have kids yet, should the government be forced to pay for your condoms?

Or birth

Simone Collins: control. Yeah, and like there are plenty of religious groups that are not really in favor of insurance companies by default covering the cost of birth control. pills for example, or,

Malcolm Collins: Yeah, I mean, even between a husband and wife I, I, I, I even still think, so keep in mind, we're not talking about gay couples here.

I'm talking about a husband and wife, where one of them is HIV positive. I unfortunately think it is not the government's responsibility to cover this. I would like to see the price continue to drop and for it to be more affordable, but I think at the end of the day I Sex is a recreational activity.

It's an option.

Simone Collins: Yeah. Like, well, and if we're, if we're going to, if we're going to subsidize [00:27:00] recreational activities, then the question is, well, why aren't we subsidizing all of these other things? You know, you know, what if, what if this person is, you know, anxious and they really hate taking public transportation because, you know, they're autistic, like I'm autistic.

I had a huge fear of public transportation for a very long time. Like, should the government pay for my Ubers? Like. You know, there, there are all these questions that this, this opens up and it just, yeah, I, I don't, I don't know really, unless we're capable financially of subsidizing a whole bunch of other things, which we're not.

How can this be justified? I guess, so there's, you know, we have to come back to the public health question of what about, you know, the children who may be born, who may have HIV because this wouldn't be subsidized. That's I, you know, I, that's where I start to get like, you know, and kids get hurt, I draw a line, you know, I can't deal with it anymore.

So that's, that's one potential issue. You know, I also think about the fact that like a lot of people from [00:28:00] a, this is my identity and lifestyle perspective, make a lot of financial decisions that are unsustainable for them. You know, like, let's say like, I'm the person who identifies with, you know, having a boozy brunch once, you know, every month.

And then they put that on credit card debt. And then their debt sort of spirals out of control and then they can't retire and their children are forced to take care of them in old age or, you know, worse, they become, you know, a burden on the state and all these sort of bad things happen. So I would also argue that it's not just with, you know, HIV risk where people.

Can cause a lot of damage to others, like collateral damage by being irresponsible and pursuing their hedonic pursuits, such as eating out or taking an Uber instead of public transportation or walking, for example. So, so we can't even say that like, Oh, this is different. You know,

Malcolm Collins: this is the other interesting thing.

That's come down from this is that this went viral, that short saying. [00:29:00] You need to take pills to not contract HIV. You can just not have sex with people who have HIV. Was such an offensive thing within this modern cultural context that we're in. Advocating Any form of restraint is seen as a sin.

I think that that's one element of it, but I also think, because keep in mind, this isn't a gay versus straight thing. This is a orgies, sex with strangers versus non sex with strangers thing. Is that now a culturally sacred practice to the urban monoculture? Is the orgy Now something that they consider almost like a sacred religious tradition.

which must be subsidized by the state. Well, so was the reaction mostly negative

Simone Collins: or was it a

Malcolm Collins: lot

Simone Collins: of people?

Malcolm Collins: Mostly negative, mostly negative and horrified negative. Like this guy needs to be off the internet. They said that he [00:30:00] was trying to commit genocide. They said that he was, you know, it was extremely, extremely negative.

And you know, here I want to put the South Park clip of them all having gay sex in the human race because that's sort of where I feel the urban monoculture is going these days. It's like they They don't have a reason to keep going. And so they've invented this strange orgy ritual. And, and, and now it's become a sacred cow for them.

. These unemployed men have been having sex for several days. Joining me now is their spokesperson, , what exactly are you trying to accomplish? We're doing the only thing we can do. We have to take matters into our own hands.

We're trying to turn everyone gay so that there are no future humans. Present day America. Number one.

Malcolm Collins: And I think that people outside the urban monoculture, because there's some things with the urban monoculture where you just don't realize that there's like this new sacred line that's been created. And that if you cross it, you get like beaten down. And, and the factor of sancteness of being able to have [00:31:00] sex whenever you want with whoever you want without any consequences is now like a sacred thing.

Simone Collins: Yeah, I, I'm noticing that it's, it's something that as a candidate for state rep, I'm also coming across, like I, I get a lot of candidate questionnaires from groups that may or may not endorse me as a candidate, right? That may or may not donate to me too, like they sort of want to say, like, these are our, you know, official candidates that are approved because they are with us on policy.

And just today I received an email from a big LGBTQ plus group in Pennsylvania. And I was like, Oh, this is awesome. Like I can fill this out and they'll see that I, you know, like we're, we're super supportive of, you know, basically LGBT rights. And then I start going through the questionnaire and it's not really about, about rights or freedom.

It's about making. [00:32:00] people with, who, who choose to classify in certain LGBTQ plus categories, a protected class. It's about regulating protections and privileges for them that go above and beyond standards to which normal people are held. And I got really uncomfortable, like looking at the questions and I'm just not going to

Malcolm Collins: fill it out.

I think, I actually think maybe we should do an episode on the questionnaire.

Simone Collins: Oh yeah, maybe we should. Cause it was. You know, I went in and I was like, Oh, this is gonna, you know, like slam dunk. This is going to be great. You know, I can, I can show to centrists and, and, and Democrats in our district that like, Oh, you know, actually, you know, we're, we're pretty socially progressive.

And then I'm going in and I'm like, well,

Malcolm Collins: We are not. Are you realizing that we're not socially progressive? Apparently not. Apparently I'm a, an evil bigot. Like what socially progressive means now is that you believe that class, like, like human, our society should be divided. [00:33:00] Into different cast groups that have different levels of rights to human dignity.

Ethnicity is one divider here, but gender is another opt in divider. You can opt into this like non binary identity and be treated as

Simone Collins: suddenly get all these well Per per their preference suddenly get all these additional protections and privileges. What are some again? That are not afforded to other people.

Malcolm Collins: So I have a thought

Simone Collins: experiment for you about sort of, you know, where are we going to end up on prep? Right. Because we've kind of already said the state shouldn't subsidize people's lifestyle choices. You know, especially if, if they're culturally based and, you know, kind of like, well, you don't have to, you don't have to pursue this, or you could pay for it yourself if you really need to, right, it's a nice to have not a necessity, a necessity.

We've known. young people who definitely use like government healthcare and who definitely use and who we really like. And you know, if there was a world where like the government stopped [00:34:00] paying for PrEP, like, what if we were sitting across from them, like having drinks, you know, and we're having this conversation and they're like, yeah, well, but I use PrEP.

You know, and I can't afford it, you know, if, if suddenly the state's not paying for it anymore. Like, do you want me to get AIDS? You know, what do we say to

Malcolm Collins: our young friends? I want you to exercise. And I think that this is a really interesting thing that within the urban monoculture, explaining to someone that there are consequences for their actions, and that they need to exercise a degree of personal austerity for their own financial or health safety.

Is seen as sinful and so within their cultural framework, I'd be like, I understand that there's no way that you can really understand what I'm saying to you, but from any sane cultural perspective you are sometimes asked to exercise some degree of discretion and austerity. And an episode that we're going to do after this, we actually go into an organization that is campaigning to try to have it be that gay [00:35:00] individuals cannot be persecuted for lying to another gay individual about them not having HIV.

So I can understand why people are freaking out out there if, if that's what their culture is fighting for, is, is that people can just go out there and do whatever they want, and there should never be any consequences for any of their actions. But I'd say, do, do I feel bad that I'm saying that your culture actually does learn, need to learn to sometimes exercise austerity and sometimes to change cultural norms around risks?

Yeah. I mean, I, I point something out. I think

Simone Collins: actually here's, here's where I would probably come down. I'm like, I'm actually trying to model a conversation with this young person who I quite like. Okay. Cause I don't have a problem with him sleeping around and having fun. Like it's, it's actually kind of cute.

Cause you know, we, we used to like kind of talk about like people that he was dating and stuff and like whatever, you know, like I would feel the same if it was a young woman, you know, this is fun stuff. You know, love, young love. I would say, listen, okay, like we can look for some of these programs.

The generic [00:36:00] version can be as low as 65 a month. Let's find a program where you can get it 65 a month. Okay. What do you have to do? To get an incremental income of 65 a month. Okay. You can probably, you know, create an account on TaskRabbit or, you know, creating a task or an account on any like gig worker platform.

And for like one weekend a month, spend five to six hours doing some gig work to get the 65 to pay for the medication that will make sure that you can do this all safely. I guess that's what I would say. Like, what

Malcolm Collins: if it turns out it's not 65 a month and it's actually 2000 a month, like the first estimate said,

Simone Collins: then we're going to have to work out how you can make, honestly, like, I'm super okay with just being like, if you want to have that lifestyle, like let's get that lifestyle

Malcolm Collins: or how do you cut 2000 a month in expenses?

Simone Collins: Yeah. And like, and life is about trade offs. Like, you know, we, we didn't make the government pay for our IVF and actually more and more people keep reaching out to us being like, Hey, how can I get my IVF paid for? Like [00:37:00] you're going to have to find a way to pay for it. We gave up travel. We gave up fun. We gave up every luxury in life.

We lived on a mattress in the warehouse district outside Miami for a year in a studio

Malcolm Collins: apartment. So just like mattress on the ground. Like, I think we shared

Simone Collins: one chair between the two of

Malcolm Collins: us. Maybe there were two, there were two chairs. Well, because we don't sleep in the same bed. I had a tent in the room.

And you had the mattress right next to me. Yeah. Which I absolutely love. It was nice.

Simone Collins: But no, but we sacrificed. And I think the thing is in the end, it wasn't that bad because when you know what you care about and what you don't care about, it's actually easy to make those sacrifices and a lot of people pay for things they don't really need.

So then we probably talk with this friend and be like, okay, well, like, what do you really care about? Like, what can we cut out? That is not as important as you having sex with like fun people.

Malcolm Collins: And I actually want to point out a how, how the perversion of a society that sees it as a moral necessity to pay for a drug that enables sex whenever you want, but that doesn't see it as a moral [00:38:00] necessity to pay for IVF, the creation of new human life.

Simone Collins: Oh, s**t.

Malcolm Collins: Yeah. I didn't even think about that.

Simone Collins: I think, you know, where we fall is people should not be granted privileged status based on group membership to pursue their cultural values that we believe in cultural sovereignty.

And the way that we support that is by saying, you do you don't force you on us and don't make us pay for your lifestyle. And that's, that's fine. And I, you know, I think. That's a, a pretty fair stance. So, when it

Malcolm Collins: comes to Yeah, but unfortunately, it will be seen as transphobic. Because, I don't know. Like, I don't know.

Like, it's actually homophobic and transphobic to try to try this issue to gays or trans people. Because To type, pay for PrEP. Yes, because straight people are at almost as much risk if they are out having orgies. Well, a little less because transmission rates are less, but they're still at risk too.

This is, this is not an, a gay straight, this is an orgy, not an orgy issue.

Simone Collins: I mean, you know, it

Malcolm Collins: All right. [00:39:00] I'll get the kids and I'm going to go get the other kids.

Simone Collins: Okay. I love you. Bye bye. Hey, Octavian.

Octavian Collins: Yeah, I got the toys right here at the box. Stacy doesn't need any more toys, only just a teddy.

Simone Collins: Yes, because we don't like having a lot of clutter everywhere, right, buddy?

Octavian Collins: Right.

Simone Collins: Right. Can you tell everyone to like and subscribe, please?

Octavian Collins: Oh, yes. Go ahead. Um, Do I gotta describe on here?

Simone Collins: No, ask them. Say, please like and subscribe.

Octavian Collins: Please

Simone Collins: like and describe. Okay, life and describe, people. Life and describe.

I love you, buddy.

Octavian Collins: Love you, too.

Do you want a blackberry? Oh, yeah, You want to go out and get a blackberry with me? Here, have the fans seen you toasting? [00:40:00] I'll get it by myself. That's the way. You go get it by yourself.

We

Simone Collins: were

Octavian Collins: great. What were you talking,

Simone Collins: what were you talking to mama about? He told everyone to, to life. And describe to like, and subscribe to life. And describe to life

Octavian Collins: and subscribe. I did not, did it? No,

Simone Collins: no, no. To life. And describe to life and describe.

Octavian Collins: OC Octavian,

Malcolm Collins: Sometimes, are you not able to do a fun thing that you want to do?

Octavian Collins: Well, I do like doing a fun thing. I just like toy trains.

Simone Collins: Should the government, Octavian, should the government pay for your toy trains?

Octavian Collins: Food not on train, dad. I cannot eat it. Oh, you can only

Malcolm Collins: eat food on trains now?

Octavian Collins: Yeah.

Malcolm Collins: This is in relation to the sushi train we got them.

Octavian Collins: Yeah! I find it's not food. Good

Simone Collins: job, Toasty. Octavian, should the government buy you trains?

Octavian Collins: Yes, I really like food on trains. [00:41:00]

Malcolm Collins: So you like it, and therefore the government should give it to you. Yeah. We're gonna have to watch out for you, buddy.

Simone Collins: Hey, remember, he likes communism.

Malcolm Collins: And remember, Octavian,

Simone Collins: real communism has not been tried.

Hi, Titan.

Malcolm Collins: What do you want to tell mommy? Hi,

Simone Collins: Titan. What do you want to say? Hi, Titan. So

Octavian Collins: I just took a walk. Oh, you just took a walk?

Simone Collins: Titan wants the mic too. Can you ask Titan a question? Octavian? Sharon is Karen. You know, they, they just, they, what they do know, and I call it Sharon Karen, as in like bad woman, Karen.

They, they, they go up to one of their siblings, they immediately like snatch something, like they do something a*****e ish, and then they say Sharon Karen which is just so appropriate. It's the Sharon Karen.

Malcolm Collins: What do you think of that, Titan?[00:42:00]

I love you, Titan.

Alright, you can come down. I'm sorry for all holding you.

Octavian Collins: Ah! I love it when the news is like, you hit your child? How could you, how could you ever, ever lightly hit your child? And then you

Simone Collins: see our children and you're like,

Octavian Collins: oh,

Simone Collins: they're clearly terrified of you, Malcolm. They're clearly terrified.

Octavian Collins: Oh, yes it is.

Simone Collins: Oh, yeah. All right, Malcolm. I love you. We're gonna hit end recording. Bye!

Octavian Collins: I love you! I love you, Mom! Can you tell Mommy you love her?