

Life on HIV treatment – a personal perspective - bane
https://www.aidsmap.com/Life-on-HIV-treatment-a-personal-perspective/page/1255106/

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jacquesm
Heavy stuff, viruses are nasty and HIV is one of the nastiest. Fortunately
there has been fairly steady progress in halting the worst aspects of HIV but
the stigma remains and for some reason HIV sufferers are viewed in a totally
different light than say cancer or ebola victims.

When the epidemic hit in the 80's I worked with a bunch of people producing a
newspaper about Amsterdam and I vividly remember the first descriptions of a
new and mysterious disease that was attacking various subgroups in the
clubbing scene (mostly gay people and drug users at the time, since then it
has spread well beyond that and but even today the association with those
groups is strong, stronger than probably warranted, HIV is a disease that
certain groups are still more susceptible to but it's gone mainstream and
you'd be a fool to think that because you're not in an elevated risk-group
that you're somehow safe or immune).

~~~
steve19
i would say people are far more scared of someone recently suffering from
ebola than HIV!

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chimeracoder
Another way to look at this article: the latest (and arguably most promising)
HIV prevention techniques involve treatment-as-prevention[0]; in other words,
taking HIV antiretrovirals as prophylactics. Ten or fifteen years ago, this
wouldn't have been possible[1], because the treatments were unpleasant enough
that nobody would want to take them daily if they didn't have to.

This is an incredible paradigm shift for HIV prevention, because it completely
overturns the way we've been conceptualizing it. We've always thought of HIV
like polio, which we are eradicating with a vaccine. Instead, the end of
HIV/AIDS may very well come in the form of the same medications we've already
developed. More importantly, we already have a great distribution mechanism
for HIV medications in (e.g.) sub-Sarharan Africa, which means that we don't
need to re-train people and create new programs; we would just need to expand
the ones we already have.

None of this would have been possible with the drugs we had in the 90s, even
if we had wanted to get FDA approval for PrEP (which of course, would have
been political suicide).

[0]
[https://en.wikipedia.org/wiki/Tenofovir/emtricitabine](https://en.wikipedia.org/wiki/Tenofovir/emtricitabine)

[1] Technically the drug that's used for this today came out 14 years ago, but
it wasn't as commonly-used, and most of the drugs back then still sucked.

~~~
refurb
I guess my question would be, if people fail to practice safe sex, they could
easily fail to take their prophylactic medication as well.

~~~
chimeracoder
That's the same concern that was raised with birth control pills back when
they first came out, but they've proven to be incredibly effective when
measuring actual use (rather than "ideal" use, which is ridiculously
inaccurate).

Given how many people are already on at least one daily medication, adding
another pill is a pretty low barrier. It's much easier to remember to take a
pill every morning than it is to remember to (a) stock up on condoms, (b)
bring them with you on a date, (c) put one on in the heat of the moment, etc -
you get the idea.

This isn't just speculation; it's supported by the clinical trials and post-
clinical data as well, which is why PrEP is not only approved by the FDA, but
actively recommended by the WHO and other organizations.

~~~
refurb
I'm not questioning that it works for some, I'm just wondering how many it
actually works for.

