So in my mind this makes it technically impossible for HIV to be an STD.
To say that this makes it not an STD is to misunderstand what an STD is.
An STD is not a disease whose transmission method is specialised to the act of copulation. It is merely a disease which is so difficult to transmit at all that only the most intimate of contact has any substantial chance of doing so. What is important about the sexual contact is not the sex, but the blood contact.
In HIV we have something that is so difficult to transmit that even conventional heterosexual intercourse has difficulty. Closer blood contact is required for a high chance of transmission, such as in anal intercourse (the intestinal lining is fragile and not adapted to contact with foreign bodies) or injection from infected needles. This has been known practically since the start from the epidemiology, before any pathogen was identified.
I’m not in quite agreement with both of your points. Yes of course HIV is transmissable only through blood, but I don’t agree with that being a good criteria for use of the term “sexually transmitted”, especially when other STD’s such as gonorrhea are actually effective—they are measurably hundreds of times more sexually transmissable than HIV. This is probably due to both evolved mechanisms that those STDs have (such as ulceration formation) and overall low virality and transmissability of HIV.
So it is ingenous I think to change the categorization. HIV is clearly at an extremum, and perhaps would be better classified as a weakly transmissable blood borne disease, not an STD.
The evolutionary relevance is important here. How did this evolve?
To say that this makes it not an STD is to misunderstand what an STD is.
An STD is not a disease whose transmission method is specialised to the act of copulation. It is merely a disease which is so difficult to transmit at all that only the most intimate of contact has any substantial chance of doing so. What is important about the sexual contact is not the sex, but the blood contact.
In HIV we have something that is so difficult to transmit that even conventional heterosexual intercourse has difficulty. Closer blood contact is required for a high chance of transmission, such as in anal intercourse (the intestinal lining is fragile and not adapted to contact with foreign bodies) or injection from infected needles. This has been known practically since the start from the epidemiology, before any pathogen was identified.
I’m not in quite agreement with both of your points. Yes of course HIV is transmissable only through blood, but I don’t agree with that being a good criteria for use of the term “sexually transmitted”, especially when other STD’s such as gonorrhea are actually effective—they are measurably hundreds of times more sexually transmissable than HIV. This is probably due to both evolved mechanisms that those STDs have (such as ulceration formation) and overall low virality and transmissability of HIV.
So it is ingenous I think to change the categorization. HIV is clearly at an extremum, and perhaps would be better classified as a weakly transmissable blood borne disease, not an STD.
The evolutionary relevance is important here. How did this evolve?