AHF "reaching common ground on PrEP"

  • Posted by a hidden member.
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    Aug 20, 2015 7:01 PM GMT
    Michael Weinstein and the AHF have FINALLY reconsidered their "Truvada Whore" shaming tactics of PrEP users. My guess is that donations were dropping off, Weinstein is a HIV/AIDS bureaucrat and money is his goal.


    Did AIDS Healthcare Foundation Just Change Its Tune on PrEP?


    "Based on the current available scientific data, (which aren't that new, it's what the CDC based their recommendations on some time ago) their AIDS Healthcare Foundation offers the following principles for the administration of PrEP for the community's consideration," it reads. The 11 principles in the ad include the following:

    1. Those who have not and will not use condoms and are having multiple sexual partners are the best candidates for PrEP.

    2. Those who use condoms with every partner do not require PrEP.

    3. Every person who is going to take PrEP should be tested beforehand and retested quarterly for HIV and other STDs.

    4. The decision to begin PrEP should be thoroughly discussed with one's medical provider-including adherence, which should be monitored closely-and patients should be counseled to take the drug daily.

    5. Persons who start PrEP and then discontinue its usage should be counseled to use condoms.

    6. The goal should be to get every HIV + patient's virus to undetectable levels that would render them non-infectious (in which case their partner does not require PrEP).

    7. Reducing the total number of sexual partners you have will decrease your risk of contracting HIV and other STDs.

    8. In general, medical providers should engage in frank conversations about sexual risks with patients.

    9. More study is needed, particularly among marginalized populations such as women, youth, African-Americans, and Latinos about the likelihood of adherence to PrEP.

    10. In the future, an implant that delivers a steady level of medication or an injection that maintains blood levels for months will be preferable to daily dosing.

    11. Gilead Sciences, the manufacturer of Truvada, should not have undue influence over decisions made by the medical community or at-risk populations about the use of PrEP.

    While the principles made by AHF are new for them, they're not for anyone who has been working in PrEP and HIV prevention, according to Mitchell Warren, Executive Director of the global HIV advocacy organization AVAC, who said PrEP has had support among advocates since the cascade of scientific evidence of PrEP's effectiveness began in 2010."

    http://www.hivplusmag.com/prevention/2015/08/19/did-aids-healthcare-foundation-just-change-its-tune-prep


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    Aug 20, 2015 7:07 PM GMT
    "2. Those who use condoms with every partner do not require PrEP."

    To me this constitutes misplaced confidence. Why imply that 70-80% effectiveness (condoms) is just as good as 92-100% (PrEP)?
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    Aug 21, 2015 6:54 PM GMT
    robbaker saidThose on prep should still play it safe . Best way to have safe sex is to have no sex. I've rather choke my chicken watching porn icon_razz.gif


    They are playing it safe. And abstinence for most people is not sustainable. It's "till marriage" or whatever. It's temporary but is as safe as you can gets!
  • mar0302

    Posts: 273

    Aug 22, 2015 7:46 AM GMT
    PrEP and PEP have given gay men back some freedom, but at the same time there's always risk.. Unfortunately, PrEP isn't yet approved for use in the UK, although hopefully it will be soon..
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    Aug 22, 2015 12:03 PM GMT
    timmm55 said"2. Those who use condoms with every partner do not require PrEP."

    To me this constitutes misplaced confidence. Why imply that 70-80% effectiveness (condoms) is just as good as 92-100% (PrEP)?


    You are a very dangerous and agenda driven man and I hope that you continue to recieve the scutiny your manipulations have recieved so far. I have never seen credible evidnence to support either figures you present as being fsct but are as usual deliberate lies and manipulations.

    Obviously you work for GIllead directly or by s proxy such as a pharmecuitical distribution company, so I get that you are stongly advocating for Prep but why do you deliberatly promote distortions and fringe viewpoints about the only proven prevention method.

    You are a menice and I hold you and others like you personally responsible for any significant spike in STI infections of which you claim incorrectly Prep protects against. You should be the one in shame the way you have set back attitudes to HIV Poz guys as partners. Well done buddy
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    Aug 22, 2015 4:35 PM GMT
    Sydney, then I will hold you "personally responsible" for every new case of HIV infection.

    If you think PrEP is on the fringe you need to do your homework.


    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 22, 2015 4:36 PM GMT
    STI infections of which you claim incorrectly Prep protects against.


    I never said it prevented other STDs. PrEP prevents HIV. PERIOD.
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    Aug 22, 2015 9:52 PM GMT
    timmm55 said"2. Those who use condoms with every partner do not require PrEP."

    To me this constitutes misplaced confidence. Why imply that 70-80% effectiveness (condoms) is just as good as 92-100% (PrEP)?


    Please provide context to your frivilous use of information. The figures above are both disputed by many reputable sources, particularly the context of your 70-80% effectiveness of condoms when used correctly and what is the context of your Prep figure of 92% plus, what rate of compliance with the prescription medication is required


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    Aug 22, 2015 10:37 PM GMT
    Of course there are different stats for PrEP studies. Some study to see what percentage of people will take it. And the dosage required to be effective.

    "In a clinical trial funded by the National Institutes of Health, uninfected men taking Truvada were 44 percent less likely to contract HIV than men taking a placebo. But when researchers looked only at men who had detectable levels of the drug in their blood, indicating that they took it regularly, they found that there was a 92 percent risk reduction. In other words, those who skipped doses were significantly less well-protected against HIV."

    https://news.vice.com/article/how-some-us-doctors-are-hindering-hiv-prevention


    "In the past few years the number of HIV prevention options has increased and some people are interested in, or are already using, newer strategies. As a result, frontline service providers are being asked challenging questions: Are condoms the most effective strategy available? How do they compare to other strategies?"

    Heterosexuals: The analysis found that the rate of HIV transmission was 80% lower among couples who reported always using condoms.

    Are male condoms also effective at reducing HIV transmission when used by gay men or other men who have sex with men? Several studies have explored this question and estimated a similar effectiveness rate of 70 to 80% for consistent condom use during anal sex


    http://www.catie.ca/en/pif/spring-2013/condoms-tried-tested-and-true


  • Posted by a hidden member.
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    Aug 22, 2015 10:58 PM GMT
    PrEP need to be taken every day.

    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.

    2X a week only results in a 44% reduction. Not impressed? Neither was I......but

    Participants took Truvada four to six times a week at 21 percent of visits and seven times a week at 12 percent of visits. There were no infections in either category, for an incidence rate of zero for both, with an estimated range of HIV incidence of zero to 0.61 per 100 person-years for those adhering four to six days a week and zero to 1.06 in those adhering perfectly. (That means that if 10,000 people matching the demographics of the group receiving PrEP took PrEP every day for one year, an estimated zero to 106 of them would contract HIV.)

    So if you take it 4-6X a week it is 100%.

    Based on the findings in this study, the researchers estimate that taking Truvada four or more days a week is 100 percent effective at preventing HIV.

    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

    In a nutshell 0-2 times a week isn't enough. 4-6 is approximately 92-100%. 7 days a week (as the CDC recommends) should be 100%.

  • Posted by a hidden member.
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    Aug 23, 2015 11:58 PM GMT
    The expanding HIV prevention toolkit

    In the past decade the number of HIV prevention options available to reduce the risk of HIV transmission has increased. Some of these strategies are generating a lot of excitement because they may provide an option for people who don’t want to, or are unable to, use condoms. These include the following:

    Antiretroviral treatment – which reduced the risk of HIV transmission by 96% among heterosexual serodiscordant couples in a randomized controlled trial (RCT).12
    Pre-exposure prophylaxis (PrEP) – which reduced the risk of HIV transmission by 40 to 70% for gay men13 and heterosexual men and women14,15 in RCTs. Further analysis suggested that PrEP may have reduced HIV risk by up to 90% among those who always took their pills.13,14
    Post-exposure prophylaxis (
    PEP) – which reduced the risk of HIV transmission by up to 80% in an observational study of healthcare workers exposed to HIV in the workplace.16
    Observational studies suggest that behavioural strategies such as serosorting, strategic positioning and withdrawal may slightly reduce the risk of HIV transmission.17

    This is from your link and doesnt back up your 92% figure. But here lets look at the context you refused to post

    http://www.aidsmap.com/Condom-efficacy-in-gay-men/page/1324955/

    Home
    News HIV Basics Topics Resources Translations
    E-atlas
    About us
    Resources HIV transmission & testing
    You are hereHIV transmission & testingHIV transmissionProtective measuresMale condomsCondom efficacy in gay men
    Condom efficacy in gay men
    Limited data suggest that condoms have similar efficacy in gay men as in heterosexuals.
    Regular condoms are as effective as extra-strong condoms for anal sex.

    There are many lines qualifying how the figures our BB King likes to throw around as "scientific fact".
  • Posted by a hidden member.
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    Aug 24, 2015 1:28 AM GMT
    You idiot!

    Last half of 2nd paragraph:

    Adjusting for the number of partners (though not for their HIV status), attempted consistent condom use was 76% effective in preventing new HIV infections.
    This is a retrospective epidemiological study with nothing like the same degree of rigour as the studies of HIV serodiscordant couples, but it does yield an estimate of condom efficacy at least similar to the lower figures in Weller and Davis2 and Pinkerton.3

    76% is right in line with 70-80% I quoted from the other study.

    Again YOU keep proving what science says. It isn't selective quoting. Posting the entire article wouldn't change that salient fact. What do you *think* it says?
  • Posted by a hidden member.
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    Aug 24, 2015 1:51 AM GMT
    Sydneyrugbyjock73 saidThe expanding HIV prevention toolkit

    In the past decade the number of HIV prevention options available to reduce the risk of HIV transmission has increased. Some of these strategies are generating a lot of excitement because they may provide an option for people who don’t want to, or are unable to, use condoms. These include the following:

    Antiretroviral treatment – which reduced the risk of HIV transmission by 96% among heterosexual serodiscordant couples in a randomized controlled trial (RCT).12
    Pre-exposure prophylaxis (PrEP) – which reduced the risk of HIV transmission by 40 to 70% for gay men13 and heterosexual men and women14,15 in RCTs. Further analysis suggested that PrEP may have reduced HIV risk by up to 90% among those who always took their pills.13,14
    Post-exposure prophylaxis (
    PEP) – which reduced the risk of HIV transmission by up to 80% in an observational study of healthcare workers exposed to HIV in the workplace.16
    Observational studies suggest that behavioural strategies such as serosorting, strategic positioning and withdrawal may slightly reduce the risk of HIV transmission.17

    This is from your link and doesnt back up your 92% figure. But here lets look at the context you refused to post

    http://www.aidsmap.com/Condom-efficacy-in-gay-men/page/1324955/

    Home
    News HIV Basics Topics Resources Translations
    E-atlas
    About us
    Resources HIV transmission & testing
    You are hereHIV transmission & testingHIV transmissionProtective measuresMale condomsCondom efficacy in gay men
    Condom efficacy in gay men
    Limited data suggest that condoms have similar efficacy in gay men as in heterosexuals.
    Regular condoms are as effective as extra-strong condoms for anal sex.

    There are many lines qualifying how the figures our BB King likes to throw around as "scientific fact".


    If you read the link to the actual study, it was written in 2011. Old by science standards, and improved upon since.

    Please noting in their study it was men and women in the up to 90%. Also note that the combo did not work for those women. The article mentions a vaginal PrEP gel, it was not successful.

    womenprep_zpstzgjmnsj.jpg