3 ms·

Yea but like, is everyone going to take PrEP all of the time? It’s great I’m sure if you’re planning on doing otherwise risky behavior, but in my experience, ri

Yea but like, is everyone going to take PrEP all of the time? It’s great I’m sure if you’re planning on doing otherwise risky behavior, but in my experience, risky sex is never especially premeditated. It’s just a “just this once”, and then suddenly you’re buying plan B.

toomuchtodo 5y ago
Compliance can definitely be a challenge with pharma in pill form, but even with a modest amount of effort, it would radically reduce transmission throughout a population as those who are able to adhere to the dosage schedule would act as a firebreak in the greater population. Like those who are vaccinated against high transmission communicable diseases. The UK is on track to eliminate HIV transmission within the decade [1] [2] assuming PrEP use within and near high risk populations. So, to answer your question ("is everyone going to take PrEP all of the time?"), that seems like a reasonable solution until a vaccine is approved for prevention and a CRISPR protocol is developed for therapy in the already infected. It may even take some time for HIV production to ramp, making prEP even more important so the at risk don't get complacent and an unnecessary bump in infections occurs. (it's important to note that kidney function should be monitored in those on PrEP) [1] https://www.aidsmap.com/news/nov-2017/uk-moving-towards-elimination-hiv-transmission https://www.aidsmap.com/news/nov-2017/uk-moving-towards-elim... [2] https://www.medicalnewstoday.com/articles/how-likely-is-england-to-achieve-zero-new-hiv-cases-by-2030 https://www.medicalnewstoday.com/articles/how-likely-is-engl...
- roflc0ptic 5y ago
  Oh, cool. I think I hadn’t thought my comment through very well - don’t need to get transmission down to zero, just r below 1. Prep plausibly helps with that
  - toomuchtodo 5y ago
    No worries at all, I hope this information was helpful!
jsperx 5y ago
There are long-acting (e.g. 8 weeks) injectable versions that are outperforming[1] the daily pill so that approach shows some promise. Not that anybody enjoys injections… [1] https://www.hiv.gov/blog/long-acting-injectable-form-hiv-prevention-outperforms-daily-pill-nih-study https://www.hiv.gov/blog/long-acting-injectable-form-hiv-pre...
- anakaine 5y ago
  Once every 8 weeks is entirely more palatable and manageable than a daily pill in my mind. Daily pill forgetfulness leads to things like unplanned kids. Unplanned kids are life altering, but generally not deadly, unlike a communicable disease like HIV.
  - vore 5y ago
    I don't want to downplay the severity of contracting a life-altering disease like HIV, but with modern antiretroviral therapy the life expectancy for HIV positive people is actually about 70-80 years, though not that ART is side effect free...
wbl 5y ago
If you're the sort of person who does risky things you tend to know. Hooking up every night in the Castro isn't something that just happens, even if the acts aren't particularly premeditated.
- roflc0ptic 5y ago
  Dunno, I think self deception is a powerful thing. I certainly have taken a number of sexual risks that, in retrospect, were really stupid, but I was able to rationalize at the time.

toomuchtodo 5y ago

Compliance can definitely be a challenge with pharma in pill form, but even with a modest amount of effort, it would radically reduce transmission throughout a population as those who are able to adhere to the dosage schedule would act as a firebreak in the greater population. Like those who are vaccinated against high transmission communicable diseases. The UK is on track to eliminate HIV transmission within the decade [1] [2] assuming PrEP use within and near high risk populations. So, to answer your question ("is everyone going to take PrEP all of the time?"), that seems like a reasonable solution until a vaccine is approved for prevention and a CRISPR protocol is developed for therapy in the already infected. It may even take some time for HIV production to ramp, making prEP even more important so the at risk don't get complacent and an unnecessary bump in infections occurs. (it's important to note that kidney function should be monitored in those on PrEP) [1] https://www.aidsmap.com/news/nov-2017/uk-moving-towards-elimination-hiv-transmission https://www.aidsmap.com/news/nov-2017/uk-moving-towards-elim... [2] https://www.medicalnewstoday.com/articles/how-likely-is-england-to-achieve-zero-new-hiv-cases-by-2030 https://www.medicalnewstoday.com/articles/how-likely-is-engl...

roflc0ptic 5y ago
Oh, cool. I think I hadn’t thought my comment through very well - don’t need to get transmission down to zero, just r below 1. Prep plausibly helps with that
- toomuchtodo 5y ago
  No worries at all, I hope this information was helpful!

jsperx 5y ago

There are long-acting (e.g. 8 weeks) injectable versions that are outperforming[1] the daily pill so that approach shows some promise. Not that anybody enjoys injections… [1] https://www.hiv.gov/blog/long-acting-injectable-form-hiv-prevention-outperforms-daily-pill-nih-study https://www.hiv.gov/blog/long-acting-injectable-form-hiv-pre...

anakaine 5y ago
Once every 8 weeks is entirely more palatable and manageable than a daily pill in my mind. Daily pill forgetfulness leads to things like unplanned kids. Unplanned kids are life altering, but generally not deadly, unlike a communicable disease like HIV.
- vore 5y ago
  I don't want to downplay the severity of contracting a life-altering disease like HIV, but with modern antiretroviral therapy the life expectancy for HIV positive people is actually about 70-80 years, though not that ART is side effect free...

wbl 5y ago

If you're the sort of person who does risky things you tend to know. Hooking up every night in the Castro isn't something that just happens, even if the acts aren't particularly premeditated.

roflc0ptic 5y ago
Dunno, I think self deception is a powerful thing. I certainly have taken a number of sexual risks that, in retrospect, were really stupid, but I was able to rationalize at the time.