8 replies to this topic

[tampanugget]

HIV Drugs May Prevent Infection in Healthy Individuals


Read more: http://healthland.ti.../#ixzz16w1huRnH


I don't know of any of my fellow mongers saw the news reports on the above referenced study, but it sounds very promising.

Practising safe sex plus using the anti-virals seems like the way to go. I don't know about anyone else, but I'm thinking about getting a prescription prior to going to the LOS to indulge. I'm still going to use a condom, but this therapy will give me a little extre peace of mind.

What does anyone else think??

[rxpharm]

It's really not a good idea unless you are 100% sure your partner has HIV/AIDS.

The reason being that the AIDs virus will mutate and become resistant to the antiretroviral drugs used to treat it. Using these drugs more often in the hopes of preventing an infection on the off chance your partner might have HIV/AIDs will increase the likelihood that resistance will develop. In addition to this all these medications have side effects, so you may experience those if you go ahead with this strategy. Also you need a prescription for these medications, so you will have to tell the MD what you are up to, at least in your home country. I am not so sure these are available in Thailand as they don't always have the latest medications to treat HIV.

[melc]

It's really not a good idea unless you are 100% sure your partner has HIV/AIDS.

The reason being that the AIDs virus will mutate and become resistant to the antiretroviral drugs used to treat it. Using these drugs more often in the hopes of preventing an infection on the off chance your partner might have HIV/AIDs will increase the likelihood that resistance will develop. In addition to this all these medications have side effects, so you may experience those if you go ahead with this strategy. Also you need a prescription for these medications, so you will have to tell the MD what you are up to, at least in your home country. I am not so sure these are available in Thailand as they don't always have the latest medications to treat HIV.

Say what!?!?

I'm a long time lurker compelled to post because I hate the abuse of science and or statistics, ESPECIALLY by those who should know better. The paper is open access and can be found here: nejm.org/doi/pdf/10.1056/NEJMoa1011205.

#1. Their inclusion criteria was "high risk" activity and NOT limited to those with 100% certainty that their partner was HIV+. Only ~20% had contact with someone known to be HIV+ in the last 6 months. So your first assertion is just wrong. I guarantee you that anal sex with Thai TS prostitutes qualifies as high risk.

#2. The virus must be present in your body for intermittent use of an antiviral cocktail to induce drug-resistance. HIV- individuals cannot cause mutation of a virus they do not have. If they are found to be HIV+, then intermittent use of HAART is detrimental, of course. Upon testing positive you would then stop the prophylaxis, stop your sexual practices, inform your partner(s), and so on. The appropriate time to institute HAART is controversial and opinion is changing. They used to wait until 500 CD4, but new studies have shown mortality benefit to earlier treatment.

#3. This is a high-quality RCT demonstrating benefit to prophylaxis with the FTC-TDF combo for high risk MSMs. This is NOT hypothesis-generating, this is irrefutable, practice-changing proof. Your doctors and insurance will begin prescribing and adding drug coverage for those that self-identify as high risk and are interested in treatment. The conversation is easy. (Maybe don't go to your regular doctor.) "I'm an MSM and would like HIV prophylaxis as described by the iPrEx study."

#4. The adverse drug events are reported in the study. Maybe you should, ya know, try to read it? Of most concern were Cr elevations and nausea. The Cr elevations were transient and many of the subjects restarted the regimen without recurrence.

Those are the facts. No offense intended and I mean no personal disrespect, but this represents a significant step in control of the HIV virus. To spread misinformation without having read the study is irresponsible.

[larrylarry]

BMs may want to check this site out as it is a little more user friendly than the actual study. interestingly enough one of the sites for the study was Thailand.


http://globaliprex.net/english.html

[tampanugget]

As I said in my original post I'm thinking about starting the anti-virals. I think combined with safe sex practices are a good way to avoid AIDS. I work in a hospital and let me tell you that you don't want to be HIV positive (I will spare you the grim details). I am always agast at some of the the gay websites promoting "bug chasing." I think the big thing (as it is with most medications) is faithful adherence to the dosing schedules (this is not something you can just take when the mood strikes). Sorry about the downer topic, but I thought it might be good to pass on information that could save lives.

[Mike8]

Do not take these drugs!

I have taken them for a month and they really wear you out, you will feel really really really bad.

When I went to the doctor she calculated 2 sides.

One was my risk of dying from the drugs (I believe it was one in 100,000 or so) and the other side was actually being infected with HIV.

I don't know where there is such a big secret about it but transferring HIV is actually quite hard:

This is from a South Australian Government website:

Risk of HIV acquisition when the source is KNOWN to be HIV infected

Receptive anal intercourse 1:120
Use of contaminated injecting equipment 1:150
Occupational needlestick injury 1:1000
Receptive vaginal intercourse 1:1000
Insertive anal or vaginal intercourse 1:1000
Receptive fellatio with or without ejaculation Not measurable
Insertive fellatio Not measurable
Cunnilingus Not measurable
Bites Not measurable
Exposure of intact mucous membrane - conjunctival, oral
or nasal mucosa Not measurable
Exposure of non-intact skin Not measurable
Community needlestick injury No measurable

So even if you hit yourself on a NEEDLE with infected blood on it your risk is only 1:1000.

I'm not saying you shouldn't use condoms but please stay away from PEP mentioned by the OP.

On the packet of the drugs (which, by the way, cost 800$ for a months supply here in AUS) it says: side effects: ..., death,...

I have done it and yes I lost about ten kilos but you won't look nice after that, your cheeks are gonna fall in and you'll look like a person that's actually infected.

It's really bad stuff!

[fridgemagnet]

As I have posted before, on TLF, I lived with an HIV+ve ladyboy for 2 years, no safe sex - but no receptive anal sex for me (she was lady only) and I did not get infected. I was advised that the risk was very small.
Apparently the viral load, which correlates with infectivity, is high when first infected, drops down low for a few years, then goes back up in the last stages( before death). My GF was in the low period of infectivity - also I'm circumcised, which cuts your chances of infection for HIV, and most other STDs, by around 50%.
So... some people are horrified by my casual attitood here, but all in all I recon the risk is small - not so if you are keen on getting fucked - then the risk is much higher.
So be sure of your partners' STD status before getting it up the bum - or cover up, but beware, thai condoms split more easily than the ones you get in the west.

[rxpharm]

Hi Mike8,

Thanks for sharing and while not everyone will experience the side effects, they can be serious - so taking prophylatic anti-retrovirals to reduce your changes of contracting HIV is not a simple and risk free matter. Also thanks for sharing about the one month costs of the medication.

[lemarquisdesavoie]

Further to the above, recent studies of people taking these drugs long term show a progressive deterioration in organ function.

If you are HIV+, that's a trade off many would accept. If you're not, you are simply adding another risk.

So if you are looking for a prophylactic, condoms and safe sex are a more sensible option as the meds are in no way a panacea in and of themselves. They are for people who are infected and don't want to die next month or next year.

You seem to be proceeding on the assumption that these are some kind of miracle drug. The science is not that exact.

If, on the other hand, you want to be a guinea pig and take part in some unofficial clinical trial to test the prophylactic effects, then you're a braver man than I. And I hope they pay you big time