But in order to have a good approximation of the effectiveness, we would need people to get infected. If I simplify, I would get vaccinated and stop using protection (i.e. condoms) during intercourse, but then I may catch it and end up living for life with HIV (contrast to COVID where you still have fairly reasonable chances to recover from). How would trials work for things like this?
Please correct me if I'm wrong, but I hope you see where I'm going with this.
Not sure what the issue is. Tens of thousands of people get HIV each year; all you need to do is give some of them the vaccine and see if those people get HIV as much as the people you didn't give the vaccine to.
People are already getting infected, we don't need to do anything for that to continue to happen.
Easier said than done. In 2019, the estimated number of HIV infections in the U.S. was 34,800 and the rate was 12.6 per 100,000 people. Consider that normal clinical trials are a few hundred people. Men who have sex with men are ~25x more likely to get HIV, so you are still looking at 1 in 3,000 per year. You are talking about some pretty huge trials here even if you are focusing on MSM only.
But in order to have a good approximation of the effectiveness, we would need people to get infected. If I simplify, I would get vaccinated and stop using protection (i.e. condoms) during intercourse, but then I may catch it and end up living for life with HIV (contrast to COVID where you still have fairly reasonable chances to recover from). How would trials work for things like this?
Please correct me if I'm wrong, but I hope you see where I'm going with this.