STI co-infections on HIV viral load amongst individuals on antiretroviral therapy

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    Jun 30, 2015 8:12 PM GMT
    Virtually every study and statement on ART therapy has had this type of exception:


    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).


    http://www.acon.org.au/sites/default/files/What-is-Safe-Sex-Position-2014.pdf


    Why it matters:

    "Studies of HIV-STI interactions have been conducted mostly on individuals not receiving ART. Less is known about the impact of STI co-infections on HIV shedding from treated individuals. STI prevalence is high among HIV-infected individuals [17] and the proportion of these individuals on ART is quickly rising [18]. Thus, any potential increased HIV infectiousness due to STI co-infections among treated individuals could have important epidemiological consequences as treatment as prevention becomes more widespread."

    Their conclusion:

    "Direct evidence about the effects of STI co-infection on transmission from individuals on ART is very limited. Available data suggests that the average effect of STI co-infection on HIV viral load in individuals on ART is less than 1 log10 difference, and thus unlikely to decrease the effectiveness of treatment as prevention. However, there is not enough data to rule out the possibility that particular STIs pose a larger threat."

    http://www.biomedcentral.com/1471-2334/15/249#B18

    I have always wondered why the study caveats mentioned other SDIs and ART therapy. The theory seemed to be that IF HIV was to be transmitted from a person with a fully suppressed viral load, it might be with a co-factor of another STI.

    Since no HIV transmissions have occurred with full suppression. in all studies, regardless of STDs, I always questioned the inclusion. It still might be possible, with a specific type of SDI as yet unknown.



  • Posted by a hidden member.
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    Jul 01, 2015 7:24 PM GMT
    Always wear condoms.
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    Jul 01, 2015 7:32 PM GMT
    credo saidAlways wear condoms.


    The 90s thanks you.

    Condoms have a 70-80% failure rate with anal sex. They didn't tell us that in 90s did they?
  • Rhi_Bran

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    Aug 06, 2015 11:47 AM GMT
    timmm55 said
    credo saidAlways wear condoms.


    The 90s thanks you.

    Condoms have a 70-80% failure rate with anal sex. They didn't tell us that in 90s did they?


    Always. Wear. Condoms.

    I'd take 70-80% protection over nothing at all any day.
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    Aug 06, 2015 7:49 PM GMT
    Rhi_Bran said
    timmm55 said
    credo saidAlways wear condoms.


    The 90s thanks you.

    Condoms have a 70-80% failure rate with anal sex. They didn't tell us that in 90s did they?


    Always. Wear. Condoms.

    I'd take 70-80% protection over nothing at all any day.


    But there is better: if you use PrEP it is much better protection at 96%.

    If you can't or won't go on PrEP definitely use condoms. But condoms are seldom used 100% if at all.

    But the point of this tread is: STDs are "unlikely to decrease the effectiveness of treatment as prevention."

    While in new cases HIV and STDs are common co-infections, but once undetectable STDs are still possible, but STDs do not reduce the effectiveness of ART therapy, or increase viral load or the likelihood of HIV transmission.


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    Aug 06, 2015 11:36 PM GMT
    timmm55 said
    credo saidAlways wear condoms.


    The 90s thanks you.

    Condoms have a 70-80% failure rate with anal sex. They didn't tell us that in 90s did they?


    Condoms were created for vaginal sex, and the FDA has never approved them for buggery.

    HIV Cells Keep Duplicating Even When Treatments Are Working: Study

    http://health.usnews.com/health-news/articles/2015/08/06/hiv-cells-keep-duplicating-even-when-treatments-are-working-study
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    Aug 07, 2015 2:01 AM GMT
    Compaq said
    timmm55 said
    credo saidAlways wear condoms.


    The 90s thanks you.

    Condoms have a 70-80% failure rate with anal sex. They didn't tell us that in 90s did they?


    Condoms were created for vaginal sex, and the FDA has never approved them for buggery.

    HIV Cells Keep Duplicating Even When Treatments Are Working: Study

    http://health.usnews.com/health-news/articles/2015/08/06/hiv-cells-keep-duplicating-even-when-treatments-are-working-study



    They state: "It was believed that after many years of successful therapy, a patient's body would naturally rid itself of HIV."
    That is not the general consensus. They talked about 'curing' HIV through antivirals years ago, mostly as an idea. A few people, maybe 5% have gone off anti-virals and stayed undetectable but have not been cured either.

    ""The good news is that we did not see any worsening over time, but the bad news is that these findings really cast doubt over whether HIV can be 'cured' by increasing immune cell responses against it -- a strategy that now looks like it will eventually fail," Geretti concluded."

    ART therapy (Treatment as Prevention) has never been called a cure. HIV has been found 'hidden' in many places. There are attempts to flush it out.

    There are no sudden outbursts of HIV while on treatment. If viral load increases it's because the patient has stopped using medication or there is drug failure.

    It has nothing to do with this thread anyway.

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    Aug 07, 2015 9:26 PM GMT
    Compaq said
    timmm55 said
    credo saidAlways wear condoms.


    The 90s thanks you.

    Condoms have a 70-80% failure rate with anal sex. They didn't tell us that in 90s did they?


    Condoms were created for vaginal sex, and the FDA has never approved them for buggery.

    HIV Cells Keep Duplicating Even When Treatments Are Working: Study

    http://health.usnews.com/health-news/articles/2015/08/06/hiv-cells-keep-duplicating-even-when-treatments-are-working-study


    False and misleading information by Timm55 is expected given his previous efforts of distorting the truth. I myself have never knocked a guy back due to HIV status and I appreciate the honest disclosure from Poz men. The stats read as being manipulations and some deliberate truth distortion.

    Timm55 are you getting the message
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    Aug 07, 2015 10:25 PM GMT
    Sydneyrugbyjock73 said
    Compaq said
    timmm55 said
    credo saidAlways wear condoms.


    The 90s thanks you.

    Condoms have a 70-80% failure rate with anal sex. They didn't tell us that in 90s did they?


    Condoms were created for vaginal sex, and the FDA has never approved them for buggery.

    HIV Cells Keep Duplicating Even When Treatments Are Working: Study

    http://health.usnews.com/health-news/articles/2015/08/06/hiv-cells-keep-duplicating-even-when-treatments-are-working-study


    False and misleading information by Timm55 is expected given his previous efforts of distorting the truth. I myself have never knocked a guy back due to HIV status and I appreciate the honest disclosure from Poz men. The statics read as being manipulations and some deliberate truth distortion.

    Timm55 are you getting


    Distortions, false, misleading of what? Read the links.

    .....am I "getting"....what? You didn't finish the sentence.

    They are 'stats' not 'statics'.

    The thread has already been hijacked twice. 1) "use a condom" and 2) HIV Cells Keep Duplicating Even When Treatments Are Working: Study

    Neither have anything to do with ART therapy with coinfections of other STDs.

    1) Has been argued to death. I don't disagree with using condoms. Just do it 100% of the time.

    2) "these findings really cast doubt over whether HIV can be 'cured' by increasing immune cell responses against it". Again, ART therapy isn't a cure, few even thought it could be.
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    Aug 09, 2015 1:40 PM GMT
    Prep 96% effectiveness is
    inaccurate and outdated. I have consistantly been reading reports which site 86% at best for Prep assuming taken as medically directed. 5 cases of people contracting HIV dispite being on Prep posted by WHO in January 2015. Regardig The figures regarding condom effectiveness are 96% not prep
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    Aug 09, 2015 8:07 PM GMT
    Sydneyrugbyjock73 saidPrep 96% effectiveness is
    inaccurate and outdated. I have consistantly (consistently) been reading reports which site 86% at best for Prep assuming taken as medically directed. 5 cases of people contracting HIV dispite (despite) being on Prep posted by WHO in January 2015. Regardig (regarding) The figures regarding condom effectiveness are 96% not prep


    Nope, unless you have newer stats since July 2015.

    "Just how effective is PrEP? Several studies have shown a figure of 86 percent efficacy. However, compared to birth control, where prevention is close to 99 percent, is this effective enough?

    The panelists responded to this question by saying that most of the people who contracted HIV during the controlled studies had actually not taken all the pills. They maintained that PrEP could be close to 100 percent effective if the participants take the pills on schedule. Simply put, if PrEP is used consistently, it could make a very real difference to slowing down the course of the HIV epidemic, especially when used in conjunction with condom use and reductions in risky sexual behavior."

    http://www.elsevier.com/connect/pre-exposure-prophylaxis-an-end-to-hiv-or-a-social-controversy

    That has been the case in every PrEP study.
    Say you have 500 people in a PrEP study. They all have tested negative. They are all given PrEP.
    So why isn't it 100%?

    Some are actually positive and don't know it, yet. They are still in the "window" of conversion. That alone will knock down the percentages.

    Then, they have to take the drugs as prescribed. A week of 7 does before a sexual contact. And 1 pill a day after that. Some do not even follow that.
    In one African study less than half of the participants took the medication at all, they only did the study to access medical care and didn't trust the experimental medicine. So in that study those who didn't use it are included in the results. Every person in a study is included in the final percentages, even if they were positive already or didn't take the meds, or took them inconsistently.

    July 22, 2014

    100% Efficacy for Gays Who Adhered in PrEP Study; Most Didn’t


    (The 44% is often quoted by Michael Weinstein of the AHF)

    "Participants showed evidence of taking the drug less than two times per week at 26 percent of the visits. Nine infections detected during these visits meant an incidence rate of 2.25 per 100 person-years and a 44 percent reduction in risk when compared with the non-PrEP group."

    "By comparison, the original iPrEx study showed a 92 percent risk reduction among those who had any Truvada in their systems, with an estimate range of 40 to 99 percent efficacy. A subsequent study of the iPrEx data used statistical modeling to estimate that four doses a week reduced the risk of HIV by 95 percent, with a 90 percent to more than 99 percent estimate range, and that daily dosing reduced the risk by 99 percent, with an estimate range of 96 to more than 99 percent."

    http://www.aidsmeds.com/articles/iPrEx_OLE_results_1667_25922.shtml

    Now for condoms....

    Consistent condom use in anal sex stops 70% of HIV infections, study finds

    http://www.aidsmap.com/Consistent-condom-use-in-anal-sex-stops-70-of-HIV-infections-study-finds-but-intermittent-use-has-no-effect/page/2586976/

    Condom effectiveness for HIV prevention by consistency of use among men who have sex with men in the United States.

    RESULTS:

    Among MSM reporting any anal sex with an HIV-positive male partner, we found 70% effectiveness with reported consistent condom use (compared with never use) and no significant protection when comparing sometimes use to never use. This point estimate for MSM was less than the 80% effectiveness estimate reported for heterosexuals in HIV-discordant couples reporting consistent condom use. However, the point estimates in the 2 populations are not statistically different. Only 16% of MSM reported consistent condom use during anal sex with male partners of any HIV status over the entire observation period.

    http://www.ncbi.nlm.nih.gov/pubmed/25469526

    I don't believe in conspiracies, certainly not AIDS related. But in the 90s condoms was all we had. They were never approved by the FDA, and certainly not for anal sex. It was literally all we had. I *think*, and it's just my opinion, that they withheld the actually poor performance of condoms since there wasn't anything else. Only now are we finding out about this? But now there are alternatives.

    Also the testing in studies is different. Note with condoms "effectiveness with reported consistent condom use(compared with never use)."
    While the testing of PrEP, because it is testing over all efficacy, include those who don't use the meds, were actually already POZ or on a low dose "that most of the people who contracted HIV during the controlled studies had [b]actually not taken all the pills."

    The over all efficacy of condoms, if you include the number who don't use them (as the PrEP studies include)would be much lower.
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    Aug 09, 2015 8:49 PM GMT
    Go ahead and spread your lies and since by definition it includes spreading the gift of HIV and other STI's, I hope yours and the other gift givers are received by warm and open arms and diseased anuses, prep is a farce a fad which will be increasingly discredited as much as the crap you continue to poor on about condoms. Your still a barebacking for all even if someone is HIV Poz. How silly I was to think you may have moderated your distortions you peddle to vulnerable people who are willing to engage in acts such as barebacking for people on Prep.

    Self reporting is the common denominator in this and it causes distortions due to any multitude of reasons but hey who cares you say as long as people bareback you will feel happy and you will try to get your message out there even through an underhanded thinly cloaked agenda message
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    Aug 09, 2015 9:21 PM GMT
    Sydneyrugbyjock73 saidGo ahead and spread your lies and since by definition it includes spreading the gift of HIV and other STI's, I hope yours and the other gift givers are received by warm and open arms and diseased anuses, prep is a farce a fad which will be increasingly discredited as much as the crap you continue to poor on about condoms. Your still a barebacking for all even if someone is HIV Poz. How silly I was to think you may have moderated your distortions you peddle to vulnerable people who are willing to engage in acts such as barebacking for people on Prep.

    Self reporting is the common denominator in this and it causes distortions due to any multitude of reasons but hey who cares you say as long as people bareback you will feel happy and you will try to get your message out there even through an underhanded thinly cloaked agenda message


    What Agenda? Are you going to continue with these half baked slogans even with 100s and 1000s of scientific studies?

    Let's start with "Go ahead and spread your lies (I provided links to studies, you did not) and since by definition (what definition? You really need to clarify!) it includes spreading the gift of HIV (I'm undetectable.....BREAKTHROUGH: Study Shows Zero HIV Transmissions When Undetectable http://www.hivplusmag.com/treatment/2015/07/23/breakthrough-study-shows-zero-hiv-transmissions-when-undetectable) and other STI's,



    "prep is a farce a fad which will be increasingly discredited" Wrong again! PrEP Could Be a Game Changer In the Fight Against HIV/AIDS
    http://sfbaytimes.com/prep-could-be-a-game-changer-in-the-fight-against-hivaids/



    Every once in awhile you show a glimpse of knowledge and understanding. Then you backslide into ridiculous accusations, you should know better.

    You really have to be intentionally stupid. I've linked several, many, articles to your specific claims. I've researched finding, some specifically to your accusations. Proven you wrong. Yet you come back again and again with the same inane retorts of "BB Agenda" and other equally inept comments.


    I'm done with your comments. From now all I'll merely paste your country's Australia's SAFE SEX guidelines to anything gassy you belch out:

    There are now at least five strategies that reasonably constitute‘safe sex’, provided that certain parameters are met.
    They are:
    1.The use of Condoms during casual encounters between men of unknown or discordant serostatus.
    2.HIV negative men taking effective pre-exposure prophylaxis (PrEP).
    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).
    4.Effective use of serosorting between HIV positive men.
    5.Effective negotiated safety agreements.

    http://www.acon.org.au/sites/default/files/What-is-Safe-Sex-Position-2014.pdf
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    Aug 15, 2015 4:22 AM GMT
    Here is a study from your country which negates much of your disingenuous use of 'facts' much of which I choose not to bore people with easily picking apart the reliability of many of the studies you quote from which are primarily reliant on self reporting which is always open to manipulation.

    http://www.cdc.gov/hiv/basics/prep.html

    There you go I selected a study which goes against what you truley believe which slips out in your responses. Every RJ member knows it as do you and your Cheer squad (3-4 people)
  • Posted by a hidden member.
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    Aug 15, 2015 6:23 AM GMT
    Sydneyrugbyjock73 saidHere is a study from your country which negates much of your disingenuous use of 'facts' much of which I choose not to bore people with easily picking apart the reliability of many of the studies you quote from which are primarily reliant on self reporting which is always open to manipulation.

    http://www.cdc.gov/hiv/basics/prep.html

    There you go I selected a study which goes against what you truley believe which slips out in your responses. Every RJ member knows it as do you and your Cheer squad (3-4 people)


    Thanks again for a link to showcase another PrEP principle.

    You provided the ACON link awhile back, although, like this, it doesn't say what you think it does.

    You said PrEP was, at best 86%. I already posted this : "By comparison, the original iPrEx study showed a 92 percent risk reduction among those who had any Truvada in their systems, with an estimate range of 40 to 99 percent efficacy. A subsequent study of the iPrEx data used statistical modeling to estimate that four doses a week reduced the risk of HIV by 95 percent, with a 90 percent to more than 99 percent estimate range, and that daily dosing reduced the risk by 99 percent, with an estimate range of 96 to more than 99 percent."

    Again you are on the wrong side of medical science......even to the links you provide. If you can't read and make up statistics, you should not commit them to scrutiny, in writing. You are making a fool of yourself.

    In other words keep your ignorance to verbal sparring, where it's not recorded either.

    The CDC figure of 92 is based on a 2011 study. Newer studies with better adherence show even better rates.

    This ad is from the CDC link you provided. Can it be any clearer?

    prep92_zpszd0dk125.jpg