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Alarming surge in drug-resistant HIV uncovered
- jimbob45 7y agoWell, PrEP is a miracle drug that has gone criminally underutilized in the fight to eradicate HIV. It would be nice to see governments really push it hard for a change.
- mm202018 7y agoIt’s insane that it is $1400/month out of pocket, and if you have a high deductible plan you’d still be paying $6k+ potentially before it’s covered.
- sjaknanxnnx 7y agoMy friend who’s on a high-deductible plan says they reimburse you for the portion that’s before your deductible. It’s actually kind of a sweet deal because you hit your deductible without being out any money. Then you don’t have to worry about paying for medical care for the rest of the year.
- mm202018 7y agoWho is “they”? There’s a copay card you can use from Gilead that helps pay your co-pay but not aware if that helps you hit out of pocket expenses before you hit your deductible or if that counts as your copay.
- sjaknanxnnx 7y agoThe way it was explained to me is: you use the Gilead card to pay you copay, and that counts toward your deductible. So, my last post was wrong to use the word “reimburse”.
- homero 7y agoI use a different medication where i pay the copay on a credit card and they rebate me a check
- ingenium 7y agoIt depends on your insurance, but on some it will.
- jlangenauer 7y agoWHAT!? Here in Germany, my PrEP costs me €40 per month, and I only have to pay that because it’s one of the rare things that insurance doesn’t cover here.
- tomlockwood 7y agoIn Australia its around $40 a month, so slightly less. Worth it!!! Still, too expensive for some people. Should be free.
- pasquinelli 7y agoI wonder why it's so much more expensive in the united states.
- trophycase 7y agoDon't ask lol
- galangalalgol 7y agoyeah, shocking. if you have diabetes or a thyroid issue or hiv or really any chronic disease that requires medication you are out 12k a year easy, 6 for your insurance premiums and 6 for the deductible and copays. if you are broke there are some provisions, but if you are above the poverty line you gotta pay.
- vinni2 7y agoIs this true for health insurances paid by the employers too? I am just curious since people say if you have a tech job you have nothing to worry about healthcare in the US.
- gnopgnip 7y agoIn many cases the premium is paid for by your employer entirely, and the max out of pocket is lower, like $4k a year. But it depends on the employer and what plans afte offered. Also about 20% of Americans are on medicaid, and generally do not pay any premiums, deductibles, or copays
- wjnc 7y agoI've checked and it's € 50 a month in the Netherlands for the pills. There is something else going on with that pricing. There are doctor fees on top of that, but a few checks a year will never consitute the $15k difference.
- dillondoyle 7y agoI can confirm in the US it is truly that expensive (which is fucking crazy). I have pretty good insurance (or at least the best I can get self-buying) but I still have to pay 30% of meds costs. That is something like $400 /month. Luckily Gilled will reimburse up to 7500 /year. Fucked up private insurance in US, they charge that much and then do the reimbursement so they can bill the huge monthly cost to plans / government that will cover it. We should be giving this out for free. My MD said Truvada might go generic next year, so perhaps there's hope.
- malandrew 7y agoIn the US, we’re paying obscene prices because no other country pays their fair share to recoup the cost of development plus bringing the drug to market plus a reasonable margin for the effort. The US should establish an agreement whereby US patients pay a LOT less but that the foreign patients need to pay the same. The amount the industry earns should be low enough to make it reasonably financially accessible to patients but high enough to prompt our best and our brightest to pursue new drug development as a career.
- ben_w 7y agoPricing is always and inevitably what the market can bear, not anything about “fairness”. If prices are too high or communities are too poor (communities not countries), those communities go without. Right now, the US is so expensive that in cases like this it makes sense for patients to fly to another country to get the medicine. That’s unsustainable.
- Nasrudith 7y ago
- wsc981 7y agoPerhaps more countries should follow Thailand's approach: On January 25, 2007, Thailand’s interim government issued compulsory licenses–which require manufacturers to license generic versions of their patented drugs–for two Western medicines: Kaletra, an advanced anti-AIDS medicine manufactured by Abbott; and Plavix, a blood-thinning treatment to help prevent heart disease, produced by the France-based Sanofi-Aventis and U.S. firm Bristol-Myers Squibb. These attacks were preceded in November 2006 by a violation of Merck’s patent on the anti-AIDS drug Stocrin.[5] The government threatened to break patents on eleven more drugs.[6] Explaining the rationale behind Thailand’s decision, health minister Mongkol Na Songkhla said that “the move is permissible under international trade rules in the event of national public health emergencies. . . . We have to do this because we don’t have enough money to buy safe and necessary drugs for the people under the government’s universal health scheme.”[7] Source: http://www.aei.org/publication/thailand-and-the-drug-patent-wars/ http://www.aei.org/publication/thailand-and-the-drug-patent-... Perhaps "evergreening" is also an issue in the USA that might keep prices high for a long time? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3680578/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3680578/
- andy_ppp 7y agoQuoting like this makes it impossible to read on mobile. Not your fault but “speech marks” are fine.
- WillDaSilva 7y agoAre you using an app such as Materialistic or Hews, or just using your browser? For what it's worth I don't recall any problems reading quote blocks on Materialistic.
- rabbitonrails 7y agoLike most people, I am reading on a mobile browser and cannot read this quote.
- bobwaycott 7y ago
- rukugu 7y agoThat's insane. In Kenya, PrEP is offered free of charge in all public hospitals while in private hospitals, brand name drugs will set you back about $35, while generic equivalents cost about $4.
- vinni2 7y agoIt is insane! In Norway it is absolutely free!!
- ChrisRR 7y agoThat's insane. In the UK the NHS doesn't supply it yet, and GPs won't officially recommend it. But you'll find the NHS clinics quite often recommending prep purchase through international websites and referring you to HIV charities. It costs about £30 pm in that case which is about $40 Often they'll be running studies at the same time to assess the feasibility of Prep on the NHS.
- tapland 7y agoSweden just added it like 2 weeks ago. More to come hopefully.
- jdietrich 7y agoPrEP is now available on the NHS in Scotland and on a pilot basis in England, Wales and Northern Ireland. https://www.iwantprepnow.co.uk/prep-on-the-nhs/ https://www.iwantprepnow.co.uk/prep-on-the-nhs/
- ChrisRR 7y agoThanks for the info
- devoply 7y agoI think that's not the case in Cuba which heavily subsidized and dosed its population hence the high rates of resistance.
- Aloha 7y agoPrEP is hard to get, my doctor outright refused to prescribe it to me, they said they were not comfortable doing so
- rickycook 7y agothen get a new doctor. there is no medical rationale behind this, and they are letting irrational personal feelings get in the way of your good health
- Geimfari 7y agoNo that's not the case, the side effects of PrEP aren't minor. PrEP should not be prescribed so lightly.
- matthewmacleod 7y agoYes, that is the case. Tenofovir and emtricitabine are generally well-tolorated. They can affect bone density and kidney function and this should be monitored; the majority of people experience no side-effects.
- magic_beans 7y agoIf you have the time to browse HN, you have the time to browser your health insurance website for a new doctor!
- kgwxd 7y agoDid they give a reason for their discomfort?
- Aloha 7y agoLack of familiarity with the drugs mostly.
- jlangenauer 7y agoThe get a new doctor, one who values your health more than their antiquated morals.
- deleted 7y ago[deleted]
- dschuetz 7y agoHow do you know if PrEP also works in the high-resistance cases?
- lm28469 7y agoMiracle drug with unknown long term side effects* I wouldn't take it unless I was a non monogamous gay man[0], the risks out-weights the benefits in any other demographics imho. [0] not that I have anything against that per say, it's just statistically the most affected demographic
- nness 7y agoI don't follow your comment; The drug is intended for those people at risk of contracting the disease. Why would you take PrEP if you weren't at risk? (Your also discounting drug users; but unfortunately those addicted and at risk are also the least likely to have the means to acquire the drug.)
- lm28469 7y agoNot a day goes by without an article mentioning it in mainstream medias. They rarely mention the target in these articles.
- notyourday 7y agoIt is not about who the drug is being intended for -- it is about who the drug is being marketed to. For example there's a massive campaign targeting both men and women engaging in any sort of sexual activity that includes fluid exchange promoting usage of PrEP. One can see it in a subway and on local commercials on TV.
- joshuamorton 7y agoWhere?
- notyourday 7y agoNYC.
- nness 7y agoAssuming in the US? (can't think of another market where prescription drug marketing is unrestricted)
- nness 7y agoIn many countries it's easy and relatively cheap the get. It's horrible it's only available with insurance and high costs in the US. For those curious; in Australia, it's prescribed and costs about $50-60 p/month. In the UK, it varies; England and Wales are doing trails, and Scotland it's prescribed. Under the NHS, it's £9. In Canada, the generics cost upward of $300 per month. (https://www.prepwatch.org/ https://www.prepwatch.org/)
- quotemstr 7y agoUnless PrEP succeeds in eradicating HIV (which might be possible if enough people are on it to limit the spread of the virus), it seems tailor-made to breed resistance. We don't generally give antibiotics prophylactically. Using anti-retrovirals this way seems like a bad idea from a drug resistance perspective.
- blablabla123 7y agoI wonder if that's true though. I don't have a medicine background but I'm loosely following this development. I think the term drug resistance became popular with all these tuberculosis cases. What happened was that people got TB, they went to the doctor and got medicine. Then things got better and people felt healthy again so they stopped taking their medicine. BUT in reality they were supposed to take it for a longer period of time and then TB broke out again. And thus becoming drug resistant. https://www.who.int/tb/areas-of-work/drug-resistant-tb/xdr-tb-faq/en/ https://www.who.int/tb/areas-of-work/drug-resistant-tb/xdr-t...
- quotemstr 7y agoRight. For resistance to evolve, some part of the treated population must survive. (You can't evolve resistance to atomic weapons dropped on your head.) Is PReP really effective enough to ensure that there are no survivors? Sure, maybe it is, used correctly at therapeutic doses. What if it becomes common enough to get into the water at much lower doses? What if people split pills to reduce costs? ISTM that there are many potential avenues for evolving resistance.
- ShlomoS 7y ago>Is PReP really effective enough to ensure that there are no survivors? No, the first bug chaser to successfully contract HIV while on it was quite proud of his achievement. Clearly the virus can survive.
- ls612 7y agoHIV is sexually transmitted. It can’t survive in the water or the air. So the presence of anti HIV drugs in the environment shouldn’t have an impact.
- Geimfari 7y agoThe drug has several non-minor side effects, is prohibitively expensive, and is the same as the treatment for someone who already has the virus. I for one think it's improper to prescribe a drug with these nephrological side effects to a large number of otherwise healthy individuals, not even accounting for the cost.
- deleted 7y ago[deleted]
- agentdrtran 7y agoWhere did you go to med school?
- hcurtiss 7y agoWhat a snide reply. Is it necessary to be a doctor to have an opinion on healthcare policy?
- deleted 7y ago[deleted]
- jfengel 7y agoThey were speaking of medicine rather than policy, and getting it wrong. PReP is not the same course as treatment, and prophylaxis is always a thing given to healthy people rather than sick ones. The side effects are considered manageable: you watch for signs of liver problems and you don't give the drug to people prone to them. I'm not a doctor but I can read the prescribing information[1], which they don't seem to have done. [1] https://web.archive.org/web/20161221124917/http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/021752s047lbl.pdf https://web.archive.org/web/20161221124917/http://www.access...
- hcurtiss 7y agoArguing the facts is totally good. And you may very well be right (I don't know anything about the subject). But attacking the commenter's position because he/she is not a doctor (like you are not a doctor), struck me as poor form.
- tuxxy 7y agoThis is why PrEP is so important and everyone at risk should be on it. We need to spread PrEP use as far and wide as possible.
- AJ007 7y agoI don’t know enough about this, but if there is drug-resistant HIV couldn’t this affect PREP?
- chimeracoder 7y ago> I don’t know enough about this, but if there is drug-resistant HIV couldn’t this affect PREP? The resistance in this article is to efavirenz and nevirapine, neither of which is used in PrEP. They're not even in the same class of drugs - both are NNRTIs, whereas PrEP consists of two NRTIs (in a single pill).
- roel_v 7y agoI know nothing about this topic and I'll admit that I even had to google what 'PrEP' is, and I have a vague feeling I'm stepping into a minefield asking this question, but who is "everyone at risk" in this context?
- deleted 7y ago[deleted]
- Geimfari 7y agoThat would be men-who-have-sex-with-men, those with infected partners, sex workers, and intravenous drug users. That is a fairly large number of the population that would be placed on an expensive drug with several side effects.
- nerdjon 7y agoI would honestly just say anyone that is not in a monogamous relationship. Straight men/women can easily have it and one fuckup and you can be infected
- jxramos 7y agoI always felt like the only way you can eliminate the spread of a highly adaptive std is to develop a low barrier on-the-spot test administered just before intercourse at the latest or some point reasonably earlier in a date or whatever. This would still fail under the dormancy period viruses assume but it should improve the odds I'd imagine for those connected in one way or another to promiscuous sexual networks.
- ohyeshedid 7y agoThat's not a bad idea, but how does liability play out on a defective test, or a test used in a manner other than directed? Would you bet the rest of your life on a casual test like that?
- Mirioron 7y ago>Would you bet the rest of your life on a casual test like that? On an individual level, this doesn't guarantee much, but on a population level this could provide a huge benefit. You yourself might not feel confident based on the test, but it would likely severely limit the spread of STDs (as long as treatment is available and accessible).
- gizmo686 7y agoEven if treatment isn't available. The main benifit of a bed-side test isn't that it informs the person who is infected. It is that it informs the person who is not infected. Currently, most people who ask about STD status just take their partners word. Maybe a particuarly paranoid person will ask to see actual lab results, which could reasonably be months or years old at best (how often do you expect people to get tested?) or maliciously forged at worst (hopefully rare enough to be irrelevant at the population level). With a bedside test, you get up to date information (subject to the quality of the test) on if you are about to get exposed, and can avoid the exposure if necessary. There is still the cultural issue of needing to test your partner before an interaction, would might come across as prohibitively offensive.
- stickfigure 7y ago
- t34543 7y agoI had a scare and took PeP this year. I had to ER shop. First one denied me coverage and made assumptions. I ended up getting care at a cost of ~$6000 to my insurance. I paid $270. I have great healthcare but this is obscene. I don’t want to get sick and die. I was being careful but accidents happen.
- rdl 7y agoAre you sure it actually cost your insurance $6k? Usually they have a high rack rate and negotiate down.
- DanBC 7y agoPrEP was pretty expensive. It cost the NHS about £5000 per year in 2017.
- dahfizz 7y agoI assume you meant per person?
- martinald 7y agoNo per year per person. The NHS prescribes it long term for various high risk groups. $6000 for a 'one off' course of treatment sounds very expensive.
- chimeracoder 7y ago> No per year per person. The NHS prescribes it long term for various high risk groups. The NHS does not prescribe PEP long-term for anyone. For HIV+ people, it prescribes HAART, which everyone who has HIV should be on. HIV- people can take PrEP, which is different from PEP and does not include any NNRTIs.
- DanBC 7y agoSorry, yes, per year per person. I got that from here: https://www.tht.org.uk/sites/default/files/2018-02/Briefing%20PrEP%20-%20September%202016.pdf https://www.tht.org.uk/sites/default/files/2018-02/Briefing%... > It has been estimated that the average lifetime cost to the NHS for a person living with HIV is £360,000. Around two thirds (68%) of these costs were for anti-HIV drugs. The cost of a year’s HIV treatment is about £11,000 and of PrEP £5,000. The NHS obtains Truvada at a cost of £3,000–£4000 per person per year. People need to take HIV treatment for the rest of their lives but PrEP will generally be needed for a much shorter period. It is believed that the patent for one of the key drugs in Truvada, Tenofovir, expires in 2017, slashing the cost of the drug from this time. There has been a collective call on Gilead, from those involved in PrEP activism, to lower the price of Truvada for use in PrEP, as there are concerns that PrEP may not be deemed to be affordable.
- tim58 7y ago#What -- In several geographically distant third world countries HIV is becoming antiretroviral resistant in ~10% of cases. #Why -- No one is _really_ sure. The most popular hypothesis is that it happens when people go on and off the medicine. Why would people do this? Shame, access, and some mothers that went on only during pregnancy. WHO recommended a pregnancy only treatment until ~2015. #Impact -- These resistant breeds can spread, presumably just like the other varieties. The people with it have a much worse prognosis than those without. #PrEP -- All the other parent comments talk about it. Sure, it should be used more frequently. It's a bit of a pipe dream to see it used in the 3rd world.
- vsef 7y agoWell, to be more clear on the #what: These are strains resistant specifically to efavirenz and nevirapine. Both drugs are members of the same class of anti-retrovirals, NNRTIs, which aren't prescribed together, they are two alternatives of the same type of drug and are used in combination with other drug classes. None of the people have resistance to anti-retrovirals in general, they have resistance to a particular class which is no longer recommended in the US (as a first treatment) but is still a go-to in Africa. There are multiple other drug classes that can be put together for effective treatment. In the US, Efavirenz (brand name Sustiva) used to be one of the first-line recommendations, but has been replaced by other drugs with fewer side effects and higher barriers to resistance. Importantly, no currently recommended starting regimens contain a member of the NNRTI class. All 4 of the current US recommended regimens now contain an integrase inhibitor (Dolutegravir, Bictegravir, or Raltegravir) https://aidsinfo.nih.gov/guidelines/brief-html/1/adult-and-adolescent-arv/11/what-to-start https://aidsinfo.nih.gov/guidelines/brief-html/1/adult-and-a... The integrase inhibitors have exceptionally few side effects and are also very high barrier to resistance. Dolutegravir which is mentioned at the end of the article is especially good in this regard, to the point that it is the only drug currently used in an only 2 drug (vs 3 drug) combination therapy. The main thing that needs to happen is for these areas to transition off of these particular NNRTIs.
- dtornabene 7y agoWhat purpose does the phrase "geographically distant" serve here? Seriously, why include that? Because, for one thing, while this site was started by an american, in america, its absolutely read all over the world, and two, HIV rates are highest in these "geographically distant third world countries". This is a really strange thing to post.
- himlion 7y agoProbably because homosexuality doesn't fit their 19th century worldview
- bsagdiyev 7y agoOr some people take it and engage in risky sexual behavior because they're now on it. I know more than a few people like that. Not everyone is a backwards hick, you're just virtue signalling.
- gleb 7y agoUpToDate.com: STI incidence among MSM using PrEP Men who have sex with men (MSM), particularly those who have indications for pre-exposure prophylaxis against HIV (PrEP), are at high risk for sexually transmitted infections (STI). In a study of nearly 3000 MSM in Australia who were initiating PrEP, the incidence of new chlamydia, gonorrhea, or syphilis over the subsequent year was 92 cases per 100 person-years [2]. Nearly half of the participants were diagnosed with an STI during the study period, with 25 percent of participants accounting for 75 percent of all STIs diagnosed; the risk of STI was proportional to the number of sexual partners and frequency of group sex. These data highlight the importance of frequent STI screening for MSM using PrEP. 2. Traeger MW, Cornelisse VJ, Asselin J, et al. Association of HIV Preexposure Prophylaxis With Incidence of Sexually Transmitted Infections Among Individuals at High Risk of HIV Infection. JAMA 2019; 321:1380.
- dillondoyle 7y agoPrEP treatment also mandates regular STI testing. I wonder if it's possible to control for the higher diagnosis rate (e.g. would have been infected anyways just now know about it). And what is a comparable rate for the same population pre-PrEP?
- matthewmacleod 7y agoWe should remember though that what this demonstrates is a high correlation between PrEP use and risky sexual behaviour. It does not suggest that PrEP use encourages that behaviour - I don’t doubt that in some cases it does, but it’s difficult to think it does so generally.
- rusticpenn 7y agoActually going on and off medicene is one of the ways of fighting HIV as the less robust strain kills the more robust strain and then the medicene is more effective...
- matthewmacleod 7y agoThis is absolutely not true, and it’s irresponsible to spread this kind of obvious misinformation.
- ChrisRR 7y agoDo you have a source for that?
- DanBC 7y ago> But drug-resistant HIV might develop when people interrupt treatment, she suggests. [...] > People living with HIV might go on and off the drugs for several reasons. They didn't mention the fact that in most countries for most medications people just don't take meds as they should. We see this for meds that are crucial to keep the person alive. Many organ transplants fail because the person fails to take meds correctly afterwards. We see this where patients need to pay for their meds and further treatment (the US) or where they get free meds and further treatment (the UK). This isn't a few percent of people who take meds. It's over a third of them, maybe about half of them. It's a big problem.
- dilippkumar 7y agoThis article in Scientific American’s April 2019 [0] is an excellent article that introduced me some of the details of HIV treatment. While it isn’t related to the primary focus of the parent article, it gives some useful context. >> At the end of this first stage, the viral load stabilizes at a level that can, puzzlingly, last for many years. Doctors refer to this level as the set point. A patient who is untreated may survive for a decade with no HIV-related symptoms and no lab findings other than a persistent viral load and a low and slowly declining T cell count. >> Eventually, however, the asymptomatic stage ends and AIDS sets in, marked by a further decrease in the T cell count and a sharp rise in the viral load. Once an untreated patient has full-blown AIDS, opportunistic infections, cancers and other complications usually cause the patient's death within two to three years. >> The key to the mystery was in the decade-long asymptomatic stage. What was going on then? Was HIV lying dormant in the body? Other viruses were known to hibernate like that. The genital herpesvirus, for example, hunkers down in nerve ganglia to evade the immune system. The chicken pox virus also does this, hiding out in nerve cells for years and sometimes awakening to cause shingles. For HIV, the reason for the latency was unknown. ... >> When the researchers reran the experiment, fit the data to the model's predictions and estimated its parameters again, they obtained results even more staggering than before: 10 billion virus particles were being produced and then cleared from the bloodstream each day. Moreover, they found that infected T cells lived only about two days. The surprisingly short life span added another piece to the puzzle, given that T cell depletion is the hallmark of HIV infection and AIDS. >> The discovery that HIV replication was so astonishingly rapid changed the way that doctors treated their HIV-positive patients. Previously physicians waited until HIV emerged from its supposed hibernation before they prescribed antiviral drugs. The idea was to conserve forces until the patient's immune system really needed help because the virus would often become resistant to the drugs. So it was generally thought wiser to wait until patients were far along in their illness. >> Ho and Perelson turned this picture upside down. There was no hibernation. HIV and the body were locked in a pitched struggle every second of every day, and the immune system needed all the help it could get and as soon as possible after the critical early period of infection. And now it was obvious why no single medication worked for very long. The virus replicated so rapidly and mutated so quickly, it could find a way to escape almost any therapeutic drug. >> Perelson's mathematics gave a quantitative estimate of how many drugs had to be used in combination to beat HIV down and keep it down. By taking into account the measured mutation rate of HIV, the size of its genome and the newly estimated number of virus particles that were produced daily, he demonstrated mathematically that HIV was generating every possible mutation at every base in its genome many times a day. Because even a single mutation could confer drug resistance, there was little hope of success with single-drug therapy. Two drugs given at the same time would stand a better chance of working, but Perelson's calculations showed that a sizable fraction of all possible double mutations also occurred each day. Three drugs in combination, however, would be hard for the HIV virus to overcome. The math suggested that the odds were something like 10 million to one against HIV being able to undergo the necessary three simultaneous mutations to escape triple-combination therapy. >> When Ho and his colleagues tested a three-drug cocktail on HIV-infected patients in clinical studies in 1996, the results were remarkable. The level of virus in the blood dropped about 100-fold in two weeks. Over the next month it became undetectable. [0] https://scientificamerican.express.pugpig.com/2019/03/13/how-calculus-was-the-unsung-hero-in-the-fight-against-hiv/ https://scientificamerican.express.pugpig.com/2019/03/13/how...
- drchewbacca 7y agoWon't all drugs targeted at microbes fail eventually? Surely they create a strong selective pressure which favours the resistant strains. The wider and more frequently the drug is used the faster this process occurs?
- hashmal 7y agoThe targets have time to become resistant when treatment is misused (wrong dosage, interruption, intermittent use, etc)
- bluGill 7y agoThat is a real worry in all areas where chemicals are used to selectively kill something undesired. It isn't just microbes, weed killers have the same problems. There is a real worry that in "a few years" (how long is not defined) antibiotics will cease to be useful and deaths will skyrocket from things we currently considered minor infections. There is some hope though: having a resistant trait is only useful if it helps you survive. Most resistant traits are "costly" to keep around. Thus if we stop using some treatment - completely stop - in 100 years it will likely become useful again as those "microbs" without resistance out compete those with it.
- krisalty 7y agoI think the scare of the HIV epidemic in the 90s is gone. Just from looking at how we have progressed thus far, just looking at HIV medication alone, gives me hope against news like this. Resistance will happen, but we will always outsmart it.
- wtdata 7y agoPrEP has negative side effects (besides being quite expensive for the state), condoms on the other side, don't have side effects, and are cheap. It's a matter of having some sense of personal responsibility really.
- nerdjon 7y ago1. Condoms break 2. Some people are allergic to them 3. There are some activities that you really don't want to do with a condom 4. How about we just don't fucking shame people for not wanting to use a condom as long as both (or all) parties agree. Especially when there is a drug like prep.
- wtdata 7y ago> How about we just don't fucking shame people for not wanting to use a condom as long as both (or all) parties agree. Especially when there is a drug like prep. That depends if it's those people bearing the full cost of buying PrEP, or if they expect the state/insurance companies to do it for them.
- nerdjon 7y agoWhy not, in most not ass backwards places you can get free condoms. Maybe it should not cost $1300 a month for no good reason in the US.
- wtdata 7y agoThe good reason is that PrEP has negative side effects, it's expensive, and you don't need it if you show some personal responsibility and use a condom. Nobody should be expected to be financing your personal preferences when it comes to the way you prefer to have sexual intercourse.
- nerdjon 7y agoSeriously, people need to stop with this negative side effects bullshit. Yes there are side effects, there are fucking side effects to almost anything medical. The side effects are minimal at worst considering you have to go into the doctor every 3 months for testing (both for the side effects and a full STD panel). If they notice an issue they take you off of it. Condoms are not 100% though, neither is prep. Its just another option and if the US was not being gouged in the price of prep, the cost would not be much different than the cost of condoms depending on how frequently you are having sex. I am showing personal responsibility by both myself and my husband using Prep and getting tested regularly.
- bhouston 7y agoBecause we haven't eradicated HIV but just slowed it down, it is the perfect situation for it to develop drug-resistance.
- lebuffon 7y agoWhat a shock! LOL. Of course there is a drug resistant strain now. Its called evolution! The one proven way to eliminate a virus from the population is vaccination. ie: remove all hosts (carriers) However eliminating a disease is far less profitable than putting people on expensive drugs for their entire life. How much money has been spent on a vaccine? Why is it so low? Global business has no sense of common good. Humanity will have to decide which is the better route to take but big money will warp leader's decisions every time. Sad...
- zcid 7y agoWhy do we spend billions of dollars on a lifestyle disease instead of putting that money towards other concerns like cancer? Why does our society worry about a disease that is largely the result of poor choices over other ailments that are solely due to bad luck? We spend far more on HIV research than any other single disease: https://report.nih.gov/categorical_spending.aspx https://report.nih.gov/categorical_spending.aspx
- EamonnMR 7y agohttps://en.wikipedia.org/wiki/Lifestyle_disease https://en.wikipedia.org/wiki/Lifestyle_disease note that cancer is on that list, and HIV is not.
- VeninVidiaVicii 7y agoLifestyle disease? I don't think I've ever read anything more calloused. Frankly, the attitude that "you deserve to die because you had sex" is unacceptably retributive.
- jMyles 7y agoYour message seems, at least to me, to be quite judgmental. I'm interested in helping people who make bad choices and people who have bad luck. It's not clear to me that one group deserves more compassion than the other. The comparison to cancers is a bit odd - HIV is generally not regarded as a lifestyle disease, while of course many cancers do have a lifestyle component. HIV is communicable; the time and money spent to target specific populations in an effort to reduce incidence of a communicable disease of course pays dividends in that fewer people will subsequently be infected. And looking further down the road (albeit perhaps with optimistic glasses), with enough effort, it may be possible to eradicate it without our ever having discovered a true cure. So it makes at least some sense to work in that direction, but those efforts of course have a high cost.
- bluGill 7y agoI find it odd that HIV is not a lifestyle disease. Everything I know about it says that someone is at zero risk if they take lifestyle precautions. Is there some risk to someone who doesn't do drugs and is in a monogamous relationship? That is they might catch it from someone near them (like the flu from a cough). Or is the definition of lifestyle disease different from what I intuitively think it is, so HIV doesn't qualify. I'm with you on helping people who have made bad choices. However I do agree with the poster above: HIV seems to be getting an out sized share of research compared to other things that kill more people.
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