POZ Community Forums

HIV Prevention and Testing => How Can I Prevent HIV? => Topic started by: Si79 on January 13, 2018, 01:59:48 pm

Title: Truvada as part of ART
Post by: Si79 on January 13, 2018, 01:59:48 pm
As Truvada protects HIV negative people from infection, I was wondering if Truvada as part of ART treatment for HIV positive people protects against reinfection or so called superinfection?
Title: Re: Truvada as part of ART
Post by: Jim Allen on January 13, 2018, 02:16:36 pm
Hi

Why the interest regarding the so called "superinfection"? Prehaps you can give us some understanding/context of why you are asking.

Look its something is extremely highly rare to start with and to be honest its doubted by some. There was a recent thread on this and maybe you will find some of the answers you are looking for there. https://forums.poz.com/index.php?topic=65688.0

Truvada is indeed used as PrEP, but just looking at this is very limited and if we take PEP for a moment it is also highly effective for HIV negative people and can be a  wide range of drug combinations.

Anyhow HIV treatment that is working would act as PrEP, as it would have to a strain of HIV which is resistant to the drugs the HIV positive person is taking to even have the ability to talk hold in the body.

Jim
Title: Re: Truvada as part of ART
Post by: Si79 on January 13, 2018, 02:23:36 pm
Hi Jim, thanks for your reply. I asked the question as Iím undectable and wondered if itís safe for me to not use condoms? I know I canít pass it on but wondered what the chances were of me getting a resistant strain. As Truvada provides high protection for negative people was thinking about changing onto a regimine that includes it so I can stop using condoms
Title: Re: Truvada as part of ART
Post by: Jim Allen on January 13, 2018, 02:43:40 pm
To be frank superinfection is not really a concern, even if your combination does not include Truvada. 

Look do look after yourself, a far more realistic concern is co-infections and why complicate matters. So my advice is do protect yourself, use condoms for anal or vaginal intercourse, correctly and consistently and please do get fully tested regularly and at the very least yearly for all STI's. Test more frequently if unprotected intercourse does occurs.

Not much I can add to this on the superinfection topic but Ill quote leatherman on this topic, as I think he explains it the best (He can always add to this thread)

Other senior forum members may also chime in the thread should they wish to do so. 

reinfection is very rare. I doubt you'll be case #20 after 35+ yrs of HIV data collection.

there are a couple of points that always need to be made during a "reinfection"/"superinfection" conversation:

1. in most of the cases when someone HIV+ became infected with another strain of HIV, the reinfected person  had a high viral load (so they were already failing therapy or were not adherent to their meds) along with the other partner who also had a high viral load (because that's how transmission works ;) )

2. don't forget, your antiretroviral regime will probably work as a prophylaxis against any incoming HIV, the same way PEP and PrEP work

summing up, UD means not only will you not transmit HIV but it also means that you have the proper levels of meds (and the proper low level of HIV :) ) in your system so that even if you are exposed to more HIV, and perhaps a different strain, you have a great deal of protection heading off "reinfection"(obviously it's pretty good protection since there have only been 19 cases :D )


Jim
Title: Re: Truvada as part of ART
Post by: Si79 on January 13, 2018, 04:40:03 pm
Thanks a lot for the info, really helps! P
Title: Re: Truvada as part of ART
Post by: Mightysure on January 15, 2018, 03:05:04 pm
There's nothing magical about Truvada that protects negative people from infection. It's about how the drugs stop viral replication, just like other drugs on its class. Truvada is the one prescribed as PrEP because it's the one studied and approved by the FDA as such.
If superinfection is even a thing, whatever regimine you're on would protect you from it. Truvada doesn't have any inherent protective powers. Its just preventing viral replication before the reservoir is estsblished.
Title: Re: Truvada as part of ART
Post by: CaveyUK on January 17, 2018, 04:52:37 pm
Yeah, put superinfection out of your head - it requires a set of variables to be in place, and isn't something routinely seen.

I can absolutely understand the desire to ditch condoms for casual sex, I really do. And if you are playing with other poz people then it's a big tempter.

But don't forget those other pesky STIs that can transmit far easier, and if you do decide to go condomless then make sure you are screened regularly. You may not be re-infected with HIV, You may even protect yourself from Hep-B (Truvada also treats that), but it's still not cool to be a walking petri-dish of other infections if you can help it, not to mention some that can really do a number on you from a co-infection perspective (Hep C especially).
Title: Re: Truvada as part of ART
Post by: mecch on January 18, 2018, 11:08:41 am
Si79 - when I got HIV, I stopped screwing for a few months and then I was undetectable. Then I discovered some of my fuck buddies were HIV+ and now I was, and we all wanted to bareback of course. Then I discovered I could go to sex clubs and bareback and not worry I would get HIV.  Then I discovered that my new "freedom" led to a year of miscellaneous STIs - including fairly gross things (IMO) such as anal chlamydia, and then I got HEP C. And then the advice my HIV doc gave me about just using condoms even though I was + with + partners - made more sense.  The HEP C treatment is 80K in Switzerland and the insurance does NOT have to pay it if the Doctor says a slow burn HEP C infection isn't "critical".  Fortunately I was the minority that self cures it.  80K saved, lesson learned.
Title: Re: Truvada as part of ART
Post by: lucbr on January 22, 2018, 01:23:22 pm
Can I take this thread to ask a question?
I did oral job on a guy recently and then after a week a started to have some weird symptons (not fever, but really weird) and i am UD since november, I take my meds regularly and etc. You say the risk is really low, but is there a risk he could have it and have drug resistance or it's all in my mind?

I should rely on the effectiveness of my treatment and forget "reinfection" at all?
Title: Re: Truvada as part of ART
Post by: Jim Allen on January 22, 2018, 01:35:28 pm
Forget about HIV reinfection, its simply not a real world issue to start with.

Just remember to test regularly and at least yearly for easier to transmit STI's and test more frequently if unprotected intercourse occurs.

Jim