5 ms·

I’m not a doctor, but as a gay man: it’s my understanding HIV doesn’t mutate in the same way a disease like Covid does, at least not in the sense that there’s a

I’m not a doctor, but as a gay man: it’s my understanding HIV doesn’t mutate in the same way a disease like Covid does, at least not in the sense that there’s as many opportunities to spread (i.e. not airborne), so while HIV may actually mutate more in theory, it gets less chances to spread, so less completely-different variants become widespread. Also, as part of “stopping the spread” PrEP has existed for years. It’s still proven to be effective protection against contracting HIV even if directly exposed (though it’s a pill that must be taken every day rather than a vaccine). There’s also PEP that helps make you undetectable (untransmissable) if you do contract it (and as such, it’s no longer what many people still mistakenly regard as a death sentence). I honestly don’t know why everyone who is sexually active isn’t on PrEP (the federal government even mandates it be free to those without insurance in most cases)— it should be as common practice as wearing a condom and birth control, yet its existence isn’t even known to many people (especially among straight people).

wan23 5y ago
Small correction: PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis) are both protocols for using drugs to prevent infection. You generally take PrEP drugs every day if you think you're in danger of being exposed, or alternatively take PEP if you think you have been exposed to HIV without any kind of protection, sort of like a morning after pill (but every day for a whole month).
- Drdrdrq 5y ago
  > ...sort of like a morning after pill (but every day for a whole month). Does this mean that there is a cure, but it only works if taken shortly after exposure (and for a whole month)?
  - tragictrash 5y ago
    Not a cure, as that implies recovery from a full infection. It's preventing your body from becoming fully infected.
  - whizzter 5y ago
    It's a post-exposure treatment, don't think that qualifies as a cure. Same thing with the rabies vaccine, it'll only save your life if given before any symptoms occur (and the disease has entrenched itself in the body).
- roywiggins 5y ago
  Something I learned today: PrEP also works "on demand", so for some people it may not be necessary to take it every day. https://www.aidsmap.com/news/jul-2020/demand-prep-highly-effective-some-may-find-it-confusing https://www.aidsmap.com/news/jul-2020/demand-prep-highly-eff...
rswskg 5y ago
'should be as common practice as wearing a condom and birth control, yet its existence isn’t even known to many people (especially among straight people).' - not sure if you've seen who HIV effects, but if it especially effected straight people in the west (straight people in africa know full well about it) they would know about it.
baristavibes 5y ago
I agree in that no straight people (that i know) consider PrEP, although according to a quick search the HIV prevalence rate is twenty times lower in my country compared to the US. Obviously the human brain statistician goes out the window when comparing a lifelong illness with a few hours of discomfort, but would it be generally safe/worth it to put the entire population on PrEP during sexual activity? I heard that HIV patients have noticable side effects with their meds.
- hn_throwaway_99 5y ago
  As a person on PrEP, it is only recommended for people at higher risk of HIV. In the West, that does not include sexually active straight people unless you have other confounding factors (e.g. IV drug use, partners who are at higher risk, etc.). Essentially all gay men (or, more accurately, "men who have sex with men") are at higher risk, which is why it is recommended for them.
  - bradlys 5y ago
    Gay men living in cities also have many more sexual partners than the rest of the populous. The men I’ve met who have had 1000+ partners is exclusive to gay men. I’ve yet to meet a straight man who isn’t a celebrity that has gotten anywhere near that. Yet this order of magnitude (100-1000) is common among gay men. The risk levels for your average young straight man in the west are obscenely low these days. You’ll have sex with maybe 10 people in your entire life if you’re a try hard. Chances are astronomically low for most straights - especially if you practice safe sex until both parties are tested and monogamous. Straight people aren’t concerned because they’re simply not having that many sexual partners. Less than 10% of all male HIV cases came from having sex with a woman. Yet men who have sex with women are 95%+ of the population. There’s a risk but it’s really low. And I think it’s even lower now with the ways things are going - straight male millennials and zoomers are having less sex than any generation before it that we know of.
    - throwaway2037 5y ago
      I would also add East Asia (China, Japan, South Korea, Taiwan, Hongkong, Macao) to that list. The rate of HIV positive ("seropositive") status is still incredibly low. Ignore China for a moment because it is hard to believe any of their official gov't stats! These countries are definitely much more sexually active (more lifetime partners) than more socially conservative neighbors in South Asia (Indian subcontinent). Interestingly, in these countries, there is still ready access to sex workers in any medium-sized city and above, yet infection rates are still very low. I must confess: I wrote the above post strictly about heterosexuals. I have never read anything seropositive rates for gay men in these regions. (I write the last sentence with the assumption that gay women have a tiny risk to contract and spread HIV.) More about "seropositive": https://en.wikipedia.org/wiki/HIV-positive_people https://en.wikipedia.org/wiki/HIV-positive_people
abletonlive 5y ago
>I honestly don’t know why everyone who is sexually active isn’t on PrEP Side effects. People generally don't like to take drugs to prevent things if the chances of acquiring the illness is minimal. For example, if we had an approved vaccine for Malaria, we wouldn't just give it to everybody in the USA, and even if we did, many would not take it.
- Waterluvian 5y ago
  I had a physician explain that you need to treat the whole person (ie. address symptoms, serious issues, anything demonstrably problematic) because otherwise almost every person could be diagnosed with something and prescribed medications for. If you look for physiological abnormalities, you’ll find some. It’s why he said doctors discourage loading up on useless tests for no reason. And then you risk creating more side effects in an otherwise healthy, complaint-free person. A for-profit healthcare system wants this. Which is probably why the States medicates and prescribes so much more compared to other regions.
collegeburner 5y ago
Because most straight people don't need it, risk is much lower. Truvada is nephrotoxic and that's bad in the long term, many drugs are bad if taken for long periods. Condoms have no such side effects.
- rzz3 5y ago
  Discovy is not, or much less so.
tallanvor 5y ago
Truvada can be a bit hard on the kidneys. Before starting it you generally have to have some blood work done to check to see if you're likely to have issues, and at least for a period after starting it they usually want to do blood tests regularly to ensure the kidneys are functioning properly. So it's certainly not something that everyone can get. Descovy appears to be better, but I think it's not approved everywhere yet.

wan23 5y ago

Small correction: PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis) are both protocols for using drugs to prevent infection. You generally take PrEP drugs every day if you think you're in danger of being exposed, or alternatively take PEP if you think you have been exposed to HIV without any kind of protection, sort of like a morning after pill (but every day for a whole month).

Drdrdrq 5y ago
> ...sort of like a morning after pill (but every day for a whole month). Does this mean that there is a cure, but it only works if taken shortly after exposure (and for a whole month)?
- tragictrash 5y ago
  Not a cure, as that implies recovery from a full infection. It's preventing your body from becoming fully infected.
- whizzter 5y ago
  It's a post-exposure treatment, don't think that qualifies as a cure. Same thing with the rabies vaccine, it'll only save your life if given before any symptoms occur (and the disease has entrenched itself in the body).
roywiggins 5y ago
Something I learned today: PrEP also works "on demand", so for some people it may not be necessary to take it every day. https://www.aidsmap.com/news/jul-2020/demand-prep-highly-effective-some-may-find-it-confusing https://www.aidsmap.com/news/jul-2020/demand-prep-highly-eff...

rswskg 5y ago

'should be as common practice as wearing a condom and birth control, yet its existence isn’t even known to many people (especially among straight people).' - not sure if you've seen who HIV effects, but if it especially effected straight people in the west (straight people in africa know full well about it) they would know about it.

baristavibes 5y ago

I agree in that no straight people (that i know) consider PrEP, although according to a quick search the HIV prevalence rate is twenty times lower in my country compared to the US. Obviously the human brain statistician goes out the window when comparing a lifelong illness with a few hours of discomfort, but would it be generally safe/worth it to put the entire population on PrEP during sexual activity? I heard that HIV patients have noticable side effects with their meds.

hn_throwaway_99 5y ago
As a person on PrEP, it is only recommended for people at higher risk of HIV. In the West, that does not include sexually active straight people unless you have other confounding factors (e.g. IV drug use, partners who are at higher risk, etc.). Essentially all gay men (or, more accurately, "men who have sex with men") are at higher risk, which is why it is recommended for them.
- bradlys 5y ago
  Gay men living in cities also have many more sexual partners than the rest of the populous. The men I’ve met who have had 1000+ partners is exclusive to gay men. I’ve yet to meet a straight man who isn’t a celebrity that has gotten anywhere near that. Yet this order of magnitude (100-1000) is common among gay men. The risk levels for your average young straight man in the west are obscenely low these days. You’ll have sex with maybe 10 people in your entire life if you’re a try hard. Chances are astronomically low for most straights - especially if you practice safe sex until both parties are tested and monogamous. Straight people aren’t concerned because they’re simply not having that many sexual partners. Less than 10% of all male HIV cases came from having sex with a woman. Yet men who have sex with women are 95%+ of the population. There’s a risk but it’s really low. And I think it’s even lower now with the ways things are going - straight male millennials and zoomers are having less sex than any generation before it that we know of.
  - throwaway2037 5y ago
    I would also add East Asia (China, Japan, South Korea, Taiwan, Hongkong, Macao) to that list. The rate of HIV positive ("seropositive") status is still incredibly low. Ignore China for a moment because it is hard to believe any of their official gov't stats! These countries are definitely much more sexually active (more lifetime partners) than more socially conservative neighbors in South Asia (Indian subcontinent). Interestingly, in these countries, there is still ready access to sex workers in any medium-sized city and above, yet infection rates are still very low. I must confess: I wrote the above post strictly about heterosexuals. I have never read anything seropositive rates for gay men in these regions. (I write the last sentence with the assumption that gay women have a tiny risk to contract and spread HIV.) More about "seropositive": https://en.wikipedia.org/wiki/HIV-positive_people https://en.wikipedia.org/wiki/HIV-positive_people

abletonlive 5y ago

>I honestly don’t know why everyone who is sexually active isn’t on PrEP Side effects. People generally don't like to take drugs to prevent things if the chances of acquiring the illness is minimal. For example, if we had an approved vaccine for Malaria, we wouldn't just give it to everybody in the USA, and even if we did, many would not take it.

Waterluvian 5y ago
I had a physician explain that you need to treat the whole person (ie. address symptoms, serious issues, anything demonstrably problematic) because otherwise almost every person could be diagnosed with something and prescribed medications for. If you look for physiological abnormalities, you’ll find some. It’s why he said doctors discourage loading up on useless tests for no reason. And then you risk creating more side effects in an otherwise healthy, complaint-free person. A for-profit healthcare system wants this. Which is probably why the States medicates and prescribes so much more compared to other regions.

collegeburner 5y ago

Because most straight people don't need it, risk is much lower. Truvada is nephrotoxic and that's bad in the long term, many drugs are bad if taken for long periods. Condoms have no such side effects.

rzz3 5y ago
Discovy is not, or much less so.

tallanvor 5y ago

Truvada can be a bit hard on the kidneys. Before starting it you generally have to have some blood work done to check to see if you're likely to have issues, and at least for a period after starting it they usually want to do blood tests regularly to ensure the kidneys are functioning properly. So it's certainly not something that everyone can get. Descovy appears to be better, but I think it's not approved everywhere yet.