5 Reasons Why TasP is the Best HIV Prevention Method

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    Mar 16, 2016 10:16 PM GMT
    Smaller audience, bigger impact.

    An estimated 1.2 million people in the United States are living with HIV. Although new infection does occur frequently, those who are HIV-positive represent a more controlled group when it comes to advocating for safer sex and prevention. However, only 30 percent of people living with HIV are utilizing TasP by staying consistent with their treatment and maintaining a suppressed viral load. Plainly, TasP users represent a more targeted, at-risk audience who have a greater reason to use this prevention method. ​

    The added benefit of saving your life.


    Not only is TasP one of the most effective and under-utilized form of HIV prevention among the majority of people with HIV, but it also has one particular added benefit that makes it stand out from the rest. Unlike PrEP, PEP, or even condoms, the use of TasP to prevent HIV has the added benefit of saving an HIV-positive person’s life. Whereas an HIV-negative person can elect to use PrEP, a person with HIV must stay on treatment in order to maintain their health. Make no mistake, PrEP is a fabulous and highly effective form of prevention, but when it comes to the life-saving benefits of TasP, it’s all the more reason for the user to take advantage of this prevention tool.

    It empowers HIV-positive people.


    The majority of people with HIV are not seeking and maintaining treatment for their disease and therefore aren't taking advantage of TasP. Although there are multiple reasons why the majority of HIV-positive folks are not getting the treatment they need, (including that many don't know their status) it can also be attributed to the lack of empowerment people feel when they are first diagnosed. By educating both HIV-negative and positive people about the effectiveness and benefits of TasP, those living with HIV can be empowered by their treatment instead of viewing it as a symbol of stigma.​

    It reduces HIV stigma and promotes healthy conversation.


    If it’s difficult to talk about PrEP without getting bogged down into anecdotal discussions about worst-case scenarios and slut-shaming rhetoric, then talking about TasP is usually a non-starter. That's because the HIV stigma still very much exists.

    When it comes to PrEP and TasP, one is not better or worse than the other. But when it comes to advocating for PrEP, the inclusion of TasP removes the barrier between HIV-positive and negative people and encourages conversation about shared interests in preventing HIV. The use of TasP, and more importantly, the conversation about TasP can greatly reduce the stigma of living with HIV and promote healthy discussion between sexual partners.

    It works. It really works.

    TasP doesn’t work in conjunction with PrEP. It doesn’t work in conjunction with condoms. It just works, period.

    A HIV-positive person who is using TasP as their HIV prevention method has virtually no risk of transmitting HIV. TasP is the best way for anyone with HIV to protect themselves from transmission and to have a healthy sex life. Like PrEP, TasP does not prevent against other STIs and the person using TasP can choose to use additional prevention methods if he or she finds them necessarily.

    But make no mistake, TasP works. No disclaimers needed.

    http://www.hivplusmag.com/treatment/2016/3/11/5-reasons-why-tasp-best-hiv-prevention-method
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    Mar 18, 2016 5:36 AM GMT
    Just anecdotal information: I have had "the conversation" with a number of guys in the last couple of years. (Going through a slutty phase? And/or younger guys are on the ball about this stuff...) So, the few guys I've met who know and admit that they are positive, are NOT on any treatment. They just mumble something about being "undetectable" or "low titer."

    Well, I have not pressed anybody into a detailed scientific discussion, but in my limited sample size, people are choosing not to do this. Just an observation.
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    Mar 18, 2016 12:51 PM GMT
    mindgarden saidJust anecdotal information: I have had "the conversation" with a number of guys in the last couple of years. (Going through a slutty phase? And/or younger guys are on the ball about this stuff...) So, the few guys I've met who know and admit that they are positive, are NOT on any treatment. They just mumble something about being "undetectable" or "low titer."

    Well, I have not pressed anybody into a detailed scientific discussion, but in my limited sample size, people are choosing not to do this. Just an observation.


    If they're not on treatment there is no way they're "undetectable."
    Basically you should take a claim to be "undetectable" at the same face value you take claims of being "negative". In other words, do you know this guy's name? Are you drunk? Is this a hookup? Or is this a man you've been dating awhile and had talks about sexual practices and he's invited you to peruse the papers he got from his doctor on his last visit?
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    Mar 18, 2016 1:54 PM GMT
    Wyndahoi said
    If they're not on treatment there is no way they're "undetectable."
    Basically you should take a claim to be "undetectable" at the same face value you take claims of being "negative". In other words, do you know this guy's name? Are you drunk? Is this a hookup? Or is this a man you've been dating awhile and had talks about sexual practices and he's invited you to peruse the papers he got from his doctor on his last visit?

    I also have to wonder if a reason a guy's not taking any meds for his HIV is because he can't AFFORD any meds, or to even see a doctor where he's living. If you can afford it, and have access to it, why would you NOT be taking meds to extend your life? This tells me he may be a guy lacking either a wallet or any welfare interests, or both, which could be a concern for someone considering a relationship with him.

    Or, as timmm55 states, struggling with the stigma of HIV. Which is overshadowing his own best self interests and welfare. An alien concept to me, because I'd be banging on the health providers door if I knew I was poz. Nor do I, or anyone else I know, stimatize those who do have HIV. I simply don't see that being done in this community. But I suppose it happens elsewhere.

    In any case, your point about being "undetectable" in a situation like this is valid. I doubt he even knows himself what his viral load is, at this minute, which is what matters. Not what he was a month or more ago. And while a low viral load is safer than a higher, it's no absolute guarantee the negative sex partner will not be infected.
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    Mar 18, 2016 2:58 PM GMT
    Art_Deco said
    Wyndahoi said
    If they're not on treatment there is no way they're "undetectable."
    Basically you should take a claim to be "undetectable" at the same face value you take claims of being "negative". In other words, do you know this guy's name? Are you drunk? Is this a hookup? Or is this a man you've been dating awhile and had talks about sexual practices and he's invited you to peruse the papers he got from his doctor on his last visit?

    I also have to wonder if a reason a guy's not taking any meds for his HIV is because he can't AFFORD any meds, or to even see a doctor where he's living. If you can afford it, and have access to it, why would you NOT be taking meds to extend your life? This tells me he may be a guy lacking either a wallet or any welfare interests, or both, which could be a concern for someone considering a relationship with him.

    Or, as timmm55 states, struggling with the stigma of HIV. Which is overshadowing his own best self interests and welfare. An alien concept to me, because I'd be banging on the health providers door if I knew I was poz. Nor do I, or anyone else I know, stimatize those who do have HIV. I simply don't see that being done in this community. But I suppose it happens elsewhere.

    In any case, your point about being "undetectable" in a situation like this is valid. I doubt he even knows himself what his viral load is, at this minute, which is what matters. Not what he was a month or more ago. And while a low viral load is safer than a higher, it's no absolute guarantee the negative sex partner will not be infected.


    We've had this conversation too many time Art Deco. Viral loads are not that fluid. If truly undetectable (<50) they may go up a little.....a blip to 75. Not to 500 where they are infectious. In 16 years of ART, with 3-4 tests a year I have never had a spike or blip. You are confusing the "right now" aspect with negative tests that don't reflect what happened since last night. Popularizing that myth is stigma. You are instilling an untrue fear. While a low viral load, say 300 is low, it could spike to 500. But while low is still good it is not undetectable. It takes weeks or months to reach UVL. If at all. A few don't reach UVL.

    Evidence? The Partners Study. UVL was <200 then. And no one got HIV even at that higher threshold. Or any other real world study has anyone gotten HIV when undetectable. Literally like Charley Sheen, you'd have to go OFF MEDS to become infectious again.

    Some people do have a problem with adherence due to drugs, homelessness, or stigma (family finding meds for example ). Some still think they need to wait till there are symtoms or t-cells are under 350. That's not true anymore.

    In San Francisco they get people on ART immediately. They are linked to care that day of a positive test. That's one reason they are down to 302 cases in 2014, from a yearly high of 2300.
    Cost is covered for most people through Ryan White programs.

    My experience in P.S. is the opposite. I only know two POZ guys who aren't on TasP. One is having problems getting medical. The other doesn't think it's necessary yet. Some think they are just on a drug "cocktail" that is keeping them well, unaware of the societal benefits, or that it's referred to ART or TasP. I was talking to my ex, he didn't know. But sex hasn't been on the table for him anyway.

    BTW he was undetectable, then went on a Drug Holiday. He didn't want to take meds anymore. Dumb I know. 2nd time around it took 9 months to become UVL.
  • mar0302

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    Mar 19, 2016 9:51 AM GMT
    I agree, undetectable is the new safe.. similar to Prep.. but, the problem is that viral loads can fluctuate if people don't adhere. Even in the partners study which was mentioned, they eliminated people that weren't undetectable (or if they didn't show up) - 16% of the cases eliminated were because the HIV-positive partner developed a viral load above 200 copies/ml.

    Basically, you can't be certain if someone is undetectable at the time that you have sex with them unless they're adhering and recently tested. In a relationship, you'd potentially know this, but it still requires a lot of trust. I have a mate of mine in California that was in a relationship with a guy that was + and he became detectable and infected him.

    I'd suggest both prep and tasp together.. added protection. But, if someone is truly undetectable then it is generally safe.
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    Mar 20, 2016 6:42 PM GMT
    mar0302 saidI agree, undetectable is the new safe.. similar to Prep.. but, the problem is that viral loads can fluctuate if people don't adhere. Even in the partners study which was mentioned, they eliminated people that weren't undetectable (or if they didn't show up) - 16% of the cases eliminated were because the HIV-positive partner developed a viral load above 200 copies/ml.

    Basically, you can't be certain if someone is undetectable at the time that you have sex with them unless they're adhering and recently tested. In a relationship, you'd potentially know this, but it still requires a lot of trust. I have a mate of mine in California that was in a relationship with a guy that was + and he became detectable and infected him.

    I'd suggest both prep and tasp together.. added protection. But, if someone is truly undetectable then it is generally safe.


    Partners Study was NOT a test of how many could maintain their UVL. It was a test of the infection rate with UVL. And the four who did become infected with an UVL partner.....got it outside of their relationship. That was proven genetically.

    Adherence is key.
    "Some couples were excluded from this analysis. In most cases, this was because they did not attend follow-up appointments but in 16% of cases it was because the HIV-positive partner developed a viral load above 200 copies/ml, and in 3% of cases because the HIV-negative partner took PEP or PrEP."



    "At the start of the study, the HIV-positive partner had been on ART for five years in the gay couples and for 7-10 years in the heterosexuals; the proportion reporting an undetectable viral load was 94% in the gay men and 85-86% in the heterosexuals."

    http://www.aidsmap.com/No-one-with-an-undetectable-viral-load-gay-or-heterosexual-transmits-HIV-in-first-two-years-of-PARTNER-study/page/2832748

    Viral rebound occurs most often with ART naive patients in the first year. They may reach UVL but can't maintain the schedule for varied reasons. Even though on average the heterosexuals had been on it longer, less were undetectable......the newer subjects I think.

    The longer you are on TasP the better the results. Once you have developed the right regimen (some people have toxicology problems initially).

    Of course just being on ART does not automatically make you undetectable in 6 months:

    "While the news from this and the 2011 study confirm that HIV viral loads can be suppressed to a level where it cannot be transmitted, Cohen cautioned that ART is not a proxy for a vaccine. It can however, break the chain of transmission, he told the News and Observer.

    In addition, Cohen said, researchers were still unclear as to how long a person remains contagious after starting treatment. In four cases of the over 1,700 mostly heterosexual couples in nine countries studied from 2005 to 2010 a sex partner was infected shortly after treatment began, but researchers concluded in those cases that the virus had not been suppressed yet."

    http://www.hivplusmag.com/treatment/2015/07/23/breakthrough-study-shows-zero-hiv-transmissions-when-undetectable

    You can still get HIV if your partner is on ART, either because of an outside affair, inconsistent use of ART, or just starting ART.
    PrEP or condoms would be a good bridge when someone starts ART, until they are truly clinically undetectable.