HIV, Prep, and the Age of Being “Undetectable” Posted on 03 December 2014

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    Dec 13, 2014 4:47 AM GMT
    This is for Art Deco, the Doctor is in his Gayborhood.



    "Dr. Patrick Kenney is a specialist in Infectious Diseases at Midland Medical Center on East Oakland Park Blvd., and specializes in the treatment of HIV/AIDS. Dr. Kenney completed his Infectious Disease fellowship at the University of South Florida Morsani College of Medicine. We interviewed him on a range of topics related to HIV in South Florida including the area’s alarming infection rate, advances in treatment and the precise significance of being HIV positive but “undetectable.”


    http://floridaagenda.com/2014/12/03/hiv-prep-and-the-age-of-being-undetectable/
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    Dec 15, 2014 8:15 PM GMT
    MuchMoreThanMuscle saidJust read that article and here's an excerpt:

    DR. KINNEY: "HIV has become easier to manage than diabetes, honestly. I must stress, however, that the success of the treatment lies heavily in the compliance of the patient."

    I remember this was once discussed in a thread here and it caused a shit storm between members who mostly disagreed.

    Now a second medical professional asserts the very same remark. I see a pattern here.


    I've come across the diabetes/HIV comparison a few times lately, from Doctors......
  • Rhi_Bran

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    Dec 16, 2014 12:14 AM GMT
    DR. KINNEY: "HIV has become easier to manage than diabetes, honestly. I must stress, however, that the success of the treatment lies heavily in the compliance of the patient."

    I remember this was once discussed in a thread here and it caused a shit storm between members who mostly disagreed.

    Now a second medical professional asserts the very same remark. I see a pattern here.


    I don't understand what you're trying to say.

    The lifespan of HIV patients and diabetics patients may be comparable today given proper treatment, but HIV and at least certain instances of type-2 diabetes are avoidable with good lifestyle habits and you don't want to be in a position where you need to receive treatment for either of them. They're costly to manage and will still shave years off of your life.
  • Rhi_Bran

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    Dec 16, 2014 4:08 AM GMT
    Hummm. I still can't seem to discern what your point is.

    Even with Prep and condoms combined, even if your chances of contracting HIV from an infected person or passing it on if you're infected is some small decimal approaching 0, it still makes no sense to take that risk. Adding any value of risk when there could be zero when it comes to sexual health is just nonsensical. I wouldn't play Russian Roulette with my health on the line even if there were a thousand chambers instead of six.

    The only instance in which I can see this being relevant is regarding monogamous sero-discordant couples.
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    Dec 16, 2014 1:17 PM GMT
    Rhi_Bran saidHummm. I still can't seem to discern what your point is.

    Even with Prep and condoms combined, even if your chances of contracting HIV from an infected person or passing it on if you're infected is some small decimal approaching 0, it still makes no sense to take that risk. Adding any value of risk when there could be zero when it comes to sexual health is just nonsensical. I wouldn't play Russian Roulette with my health on the line even if there were a thousand chambers instead of six.

    The only instance in which I can see this being relevant is regarding monogamous sero-discordant couples.


    +1
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    Dec 16, 2014 9:12 PM GMT
    sftgfop said
    Rhi_Bran saidHummm. I still can't seem to discern what your point is.

    Even with Prep and condoms combined, even if your chances of contracting HIV from an infected person or passing it on if you're infected is some small decimal approaching 0, it still makes no sense to take that risk. Adding any value of risk when there could be zero when it comes to sexual health is just nonsensical. I wouldn't play Russian Roulette with my health on the line even if there were a thousand chambers instead of six.

    The only instance in which I can see this being relevant is regarding monogamous sero-discordant couples.


    +1


    Big +1 for "The only instance in which I can see this being relevant is regarding monogamous sero-discordant couples." Many people can't understand even that.



    Of course! But that is not the real world, is it? Otherwise there wouldn't be 50,00 new infections every year in the US alone.

    If you have sex, you are already playing Russian Roulette. There is no such thing as "safe sex". You have already surpassed zero.

    Will HIV Ever Be Safe Enough for You?
    Soon thereafter, Oprah Winfrey arrived with cameras for a town hall forum about the incident. Fear was the order of the day. "If there's just one chance in a million that somebody could catch that virus from a swimming pool," the town's mayor told Winfrey's worldwide audience, "I think I did the right thing."

    Sure. Why not react in the most extreme way possible, if there is a chance in a million?
    http://www.huffingtonpost.com/mark-s-king/will-hiv-ever-be-safe-eno_b_4956884.html

    I honestly believe most people are honest, to a point. (The INTENTIONAL pathological liars and psychopaths are actually rare). If people say they are Negative they actually think they are. If they say they are Undetectable ....they probably are. (I can provide a 10 year paper trail easy enough).

    And most Negative people when selecting a partner go by "Gut Instinct". And choose a Negative person. In the last 30 years of the anti-HIV campaign that seems reasonable, but See below.

    I posted this article below (no responses).
    http://www.realjock.com/gayforums/3971535

    Men with undiagnosed HIV


    "Men who are living with HIV without being aware of it cannot take HIV treatment and cannot make informed decisions about their sexual behaviour, so are more likely to pass HIV on. Around one in five gay men living with HIV in the UK – a little under 8000 men – are undiagnosed.

    The modelling found that undiagnosed men made a disproportionate contribution to onward transmission, with around 63% (credible range: 49 to 80%) of transmissions coming from them. Moreover, most of the undiagnosed men passing on HIV have a CD4 count above 350 cells/mm3 and so are unlikely to notice problems with their health.

    Within the group of men living with HIV who are not taking HIV treatment, a majority are undiagnosed. In this analysis, around 85% of HIV transmissions come from men who are not taking HIV treatment (credible range: 78 to 92%)."
  • Rhi_Bran

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    Dec 16, 2014 10:42 PM GMT
    @ timmm: Yes, but I was making the assumption that the serological status of the people in the hypothetical was definitely known. Of course you shouldn't be having sex with people whose status you do not know for certain, if you care about your health.
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    Dec 17, 2014 4:44 AM GMT
    Rhi_Bran said@ timmm: Yes, but I was making the assumption that the serological status of the people in the hypothetical was definitely known. Of course you shouldn't be having sex with people whose status you do not know for certain, if you care about your health.


    And I agree 100%

    And you give them both credit for intelligence, to decide and negotiate what is "safer" sex in 2014. And there are valid choices.

    In the totally unknown scenario, condoms are the best initial choice. PrEP is a definite additional layer of protection, one where you can be proactive. They are quite different in protection. Condoms are per use. PrEP is more a protective bubble.

    Just being in a relationship doesn't make it safe, quite the contrary. Without being monogamous, well, being single isn't any worse. If you think your lover is Negative (he may assume it also) and are repeatedly exposed to HIV, the likelihood is greater to acquire HIV.

    If one is on PrEP and the other is Undetectable the chances are virtually impossible. It already been shown that PrEP doesn't make people "Truvada Whores".....

    This is (good) news to me: “Despite concerns that use of ART might increase sexual or injecting risk-taking,” the researchers conclude “available research suggests that unprotected sex is reduced among HIV-infected individuals on treatment.”

    "The reasons for the positive impact of ART on sexual risk taking remain unclear. The authors suggest two possibilities: the mutually reinforcing effect of ART and prevention messages, and the tendency of people taking antiretrovirals to be more health-conscious and thus less likely to have risky sex."

    http://www.iasociety.org/Article.aspx?elementId=16142

    It can also be that PrEP and Undetectable has reached the high risk people it needs to reach. And that is good too.

    And ACON

    "There are now at least five strategies that reasonably constitute‘safe sex’, provided
    that certain parameters are met. "

    "3. Men living with HIV who only have sex without condoms when they have a sustained
    undetectable viral load (UVL) and
    in the absence of sexually transmissible infections (STIs)."

    Being Undetectable is part of a safer sex strategy.