POZ Community Forums
Main Forums => Living With HIV => Topic started by: Cojo on January 08, 2014, 10:56:48 am
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An interesting article was published on positivelite.com addressing drug resistant HIV. I've posted the link below, but need to challenge an assumption or two.
I am assuming this is not to be confused with reinfection. The article is when someone first acquires the virus and has not started treatment- otherwise the rate of reinfection (or superinfection) is 27% !
http://www.positivelite.com/component/zoo/item/ever-wondered-how-many-people-acquire-a-drug-resistant-strain-of-hiv
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The article is when someone first acquires the virus and has not started treatment- otherwise the rate of reinfection (or superinfection) is 27% !
Why are you using those words -- reinfection or superinfection? This link neither mentions those two terms nor is about them.
I'm not sure why this article would surprise anyone. An LTSer like myself already had resistance issues by the time viral load testing appeared in 1996 -- by then I assume I was probably resistant to most NRTIs on the market due to pre-HAART clinical treatment. Then the first protease inhibitor to the market made many patients cross-resistant to that entire class because they fucked up the clinical trials and the drug, in the first formulation during the first year (1996-7) didn't cause the drug levels in the bloodstream to be high enough due to absorption issues.
My point is that by then anyone like me infecting someone else would pass all that resistance profile along, and so forth again and again by other people, spreading from NYC and SF to the hinterlands. And voila, you have your magic link to that study.
Resistance profiles don't mean you are screwed in terms of treatment and are going to croak anyway, it just means your doctor needs to be skilled enough to sort out your treatment regimens, and only some resistance profiles are complicated. Most, I assume, are fairly straight forward certainly with the newer classes of HIV drugs that have become available.
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Hi Miss P
I'm using the terms re/superinfection as they are the point of my question.
Maybe I need to restate a different way to make more sense. My question is this
Is the 27% stat relevant to one's initial infection only, or is the chance of re/superinfetion also 27% once infected and on treatment
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Is the 27% stat relevant to one's initial infection only, or is the chance of re/superinfetion also 27% once infected and on treatment
They are talking about drug resistance acquired with initial infection. It has absolutely nothing to do with re/superinfection.
By the way, "superinfection" does not mean "super-strength", "super-dooper", "super-man" or any other type of phrase normally associated with the word "super".
It's a prefix - super as in superimposed. One infection on top of the other. When this happens, the person's ultimate health outcomes aren't necessarily going to be any different to what it would have been if they hadn't become infected with another strain of virus.
But again, acquiring a drug resistant strain in initial infection (which is what the study is about) has nothing to do with reinfection. Reinfection is exceedingly rare.
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Thank you Ann. You have clarified my hunch. I have read this before, and Leatherman has also clarified, but this study combined with my doctor's insistence that re-infection is common through me for a loop. I believe you btw :)
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combined with my doctor's insistence that re-infection is common
But it's not common -- unless he has a different definition of "common" that I do. Do you ask him for some further reading/studies to back up this assertion?
I've had four HIV specialists over a span of 2 decades and never had one bring up this issue. In fact, knowing my complicated resistance profile if this actually was common I'd think they'd repeatedly caution me not to ever have sex, or at least not without a condom. Quite the opposite, my current doctor lectures me on NOT having sex the past several years.
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I agree with you Miss P - I think he is misinformed or just anti-sex.
About you not having sex Miss....carpe diem :)
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About you not having sex Miss....carpe diem :)
I reminded my doctor that it's rather difficult to have sex when one has had four surgical procedures within two years and it's just not something I can expend the effort on at the moment. Not that I don't receive offers, naturally, though they all seem to be totescraycray.
My libido is still perfectly fine and I greatly enjoy both masturbation and pornography and in the end it's easier than ordering delivery.
But it's nice to have a doctor who is 1) straight and 2) engages in such discussions without my initiating it and 3) considers sex as integral to one's mental health. Now tell how many doctors out there are doing this?
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I think he is misinformed or just anti-sex.
Quite possibly a bit of both, with a heavier emphasis on anti-sex, leading to a wilful ignorance. Why look past a headline when on the surface, it can conveniently reinforce an anti-sex bias and be used to scare poz people into not having sex?
I've met quite a few health care providers who made it rather obvious, if not explicit, that they didn't approve of poz people having a sex life and they've always trotted out the superinfection scare-tactic*. Thankfully I've also met quite a few who were sex-positive (believed that a healthy sex life was part of overall health) and well-informed like Miss P's doctor.
*My clinic is in a teaching hospital and quite often I see a learner. It's usually them who bring up superinfection (and they rarely call it the more appropriate reinfection - reinfection isn't scary enough). It goes like this:
Learner: Are you sexually active?
Me: Yes, my partner is also poz.
Learner: Do you use condoms?
Me: No.
Learner: You MUST!!! You are running the very real risk of SUPERinfection!!!! (cue Psycho shower-scene music in the background)
Me: Chapter and verse on why they don't know what the hell they're talking about.
:)
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With depression rates higher in HIV patients -- and there are various reasons for this but much of it stems from stigma issues and sex issues -- it's really medical malpractice for doctors and clinics not to have both the correct information as well as to initiate proper conversations with their patients on the issue. Not just about transmission but of sex being integral to a healthy life. Now that life expectancies are supposedly "normal" (in fact, I just read that in some instances they exceed "normal" rates based on factors of where you live and socio-economic class which makes sense in our ever increasing society based on inequality) it is even more important.
Cojo, if your doctor is giving you bad information and making you feel uncomfortable about the subject of sex (and mind you, he may or may not and it also can be the patient making this projection due to shame, though I am not saying that is what you or anyone else is doing) you might wish to investigate other alternatives for a doctor.
Personally it annoys me when I read about such doctors and I have had the great fortune of not ever having a doctor like this. In fact, even when I went through my period of anal warts and gonorrhea back to back I don't recall stern warnings. (though perhaps I should have had a bit :)
note: the above is restricted to actual doctors -- support staff can be different, often not fully informed, etc. and I just ignore them.