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HIV Prevention and Testing => Do I Have HIV? => Topic started by: carnegie on May 17, 2020, 09:36:34 pm

Title: Testing anxiety and what about treatments
Post by: carnegie on May 17, 2020, 09:36:34 pm
Been nervous for a long time for getting tested. Tried to avoid it and the biggest thing holding me back is the daily-pill treatment. i had a long call with a psychologist at the clinic that has a specialized department for HIV. I once tested myself with a self testing kit a while ago. Doctors have failed to win over my confidence. Lots of them try to convince me I dont have it. I am ready to get tested but what is holding me back is the daily pill treatment. I am very sure i will fail adhering to treatment. I am blessed to live in an era where long-acting treatment just got green lighted.

I wanna know which countries are using this technique. what happens if you fail to keep taking your pills (because you forget to take your pills, because you partied too hard and sleep for two days. because you are ashamed to take them with you when other people are around. because you need to travel and dont really want to take pills with you for customs.

i know that my post is weird but this is how i feel inside. dont judge please!
Title: Re: Testing anxiety and what about treatments
Post by: Jim Allen on May 18, 2020, 01:53:11 am
Hiya,

What and when was your exposure? When did you take the self-test?

I'm sorry to read that you have fears regarding testing. You should be testing at least yearly for HIV and easier to acquire STI's.  End of the day knowing your STI status means you can treat and cure many things before they do any permanent damage or cause death.

Knowing your HIV status means you can start treatment to suppress the virus and live a long healthy life, also, by starting and staying on treatment you will reduce the levels of HIV in your body to a point that you can't pass it on sexually to others.

Testing and knowing your status would also mean no longer having to stress about it. Peace of mind is priceless

Quote
I am ready to get tested but what is holding me back is the daily pill treatment. I am very sure i will fail adhering to treatment.

Quote
what happens if you fail to keep taking your pills (because you forget to take your pills, because you partied too hard and sleep for two days. because you are ashamed to take them with you when other people are around. because you need to travel and dont really want to take pills with you for customs.

If you are living with HIV you will sooner or later forget to take your pill once in a blue moon. Nothing will happen! You aim for daily adherence but nobody is perfect. Set an alarm on your phone, take the pill at about the same time daily and get on with life.

Customs doesn't care that you are living with HIV with the exception of a minority of nations. I've travelled all over the world, they have never even asked or looked at my pills.

Finally, stop worrying about things that might not even apply to you.

Here's what you need to know to avoid HIV infection:
Use condoms for anal or vaginal intercourse, correctly and consistently, every time, no exceptions. Consider talking to your healthcare provider about PrEP as an additional layer of HIV protection going forward

Keep in mind that some sexual practices which may be described as ‘safe’ in terms of HIV transmission might still pose a risk for transmission of other STI's, so please do get fully tested regularly and at least yearly for all STI's including but not limited to HIV and test more frequently if unprotected intercourse occurs

Also, note that it is possible to have an STI and show no signs or symptoms and the only way of knowing is by testing.

Kind regards

Jim

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 https://www.aidsmap.com/about-hiv/adherence-hiv-treatment https://pdf.hres.ca/dpd_pm/00046296.PDF

The other thing to keep in mind is at some stage you might even miss a dose. Nobody is perfect even the most experienced people who take medication for one or another condition will miss a pill sooner or later, aim not to but if it does happen the odd time no need to panic either.

Relax, less stress and move focus on living your life ;)

Best, Jim

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5943894/
Adherence and virologic outcomes among treatment-naïve veteran patients with human immunodeficiency virus type 1 infection

A cohort study was conducted on HIV veterans initiating antiretroviral therapies in 1999 to 2015

In summary, this study showed how initial adherence differently influenced the viral suppression rate across different regimens. No evidence shows 95% adherence threshold is necessary. Patients with medium adherence (75%–<95%) can achieve viral suppression with the rate not statistically significantly different from patients with high adherence.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4839839/
Adherence to Antiretroviral Therapy and Virologic Failure

Paterson et al suggested that at least 95% adherence to unboosted PIs was required for virologic suppression. This 95% adherence cut-off point, based on what is now obsolete therapy, has been widely used as the level of optimal adherence needed to be met by patients taking newer agents and their combinations.

This meta-analysis synthesized 43 studies (27,905 participants) performed across >26 countries, to determine the relationship between cut-off point for optimal adherence to ART and virologic outcomes.

Irrespective of the cut-off point for optimal adherence, our findings support the tenet that optimal adherence to ART is associated with positive clinical outcomes. The threshold for optimal adherence to achieve better virologic outcomes appears to be wider than the commonly used cut-off point (≥95% adherence). Though patients taking ART should be instructed to attain ≥95% adherence, apprehensions of slightly lower adherence should not deter prescribing ART regimens at an early stage of HIV infection.


https://journals.lww.com/jaids/Abstract/2019/11010/Antiretroviral_Adherence_Level_Necessary_for_HIV.3.aspx

Antiretroviral Adherence Level Necessary for HIV Viral Suppression Using Real-World Data

A benchmark of near-perfect adherence (≥95%) to antiretroviral therapy (ART) is often cited as necessary for HIV viral suppression. However, given newer, more effective ART medications, the threshold for viral suppression may be lower. We estimated the minimum ART adherence level necessary to achieve viral suppression.

Results: The adjusted odds of viral suppression did not differ between persons with an adherence level of 80% to <85% or 85% to <90% and those with an adherence level of ≥90%. In addition, the overall estimated adherence level necessary to achieve viral suppression in 90% of viral load tests was 82% and varied by regimen type; integrase inhibitor- and nonnucleoside reverse transcriptase inhibitor-based regimens achieved 90% viral suppression with adherence levels of 75% and 78%, respectively.

Conclusions: The ART adherence level necessary to reach HIV viral suppression may be lower than previously thought and may be regimen-dependent.