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Author Topic: PR  (Read 364 times)

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Offline DazedN2002

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PR
« on: June 07, 2019, 09:19:14 am »
I have lived with hiv for 21 years, and have been undetectable for almost all of that time.  I am compliant with my daily Truvada and Issentress.  Why would CDC recommend that my partner of six years (I'm cis male and she's cis female, if that matters) take Truvada for PREP?  If my viral load does ever spike without me knowing it, wouldn't the virus likely be Truvada resistant?

So far, on my doctor's recommendation, she has not gone on PREP.  We don't use condoms much any more, but I do not ejaculate inside her.

Thanks in advance for your help and explanations.

Offline Jim Allen

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Re: PR
« Reply #1 on: June 07, 2019, 10:48:16 am »
Hiya,

Quote
If my viral load does ever spike without me knowing it, wouldn't the virus likely be Truvada resistant?

Firstly why would your viral load spike? As long as you keep taking your meds correctly & consistently this should not be a concern. The whole idea is that PrEP would block the infection from taking hold and, resistant stains causing PrEP to fail have only been occurred 2-3 times so far in history.   

Quote
Why would CDC recommend

Ill cut you short there as generally speaking, over the years I have found the CDC policy to be somewhere between CYA (Cover your ass) and, simply paranoid. They also tend to hold onto outdated/disproved information so nothing surprises me, after 21 years, I somehow doubt it surprises you either.

I've seen many people living with HIV loose their shit over the years because the CDC said something daft. To be honest the choice is to ask them why & challenge them or ignore them.

Not sure if this was the offending page? https://www.cdc.gov/hiv/basics/prep.html

Quote
my doctor's recommendation, she has not gone on PREP.  We don't use condoms much any more

A person living with HIV (PLHIV), who is on Antiretroviral Therapy (ART) and has achieved an undetectable viral load (Less than 200 copies/ml) in their blood for at least 6 months, can not sexually transmit HIV.  It sounds like you and, your doctor have correctly identified your partner does not require PrEP.

Although it is your partners choice ultimately to make and, depends on the situation & your partners comfort levels. Recently I was talking to someone who's partner is UD living with HIV and, yet I recommended PrEP because of concerns with regards to addiction & adherence.

Finally, there are other STI's to be concerned about, so please do get fully tested regularly and at least yearly for all STI's and, test more frequently if condomless intercourse occurs

Best, Jim
HIV 101 - Everything you need to know
HIV 101
Transmission and Risks:
HIV Transmission and Risks
Read more about Testing here:
HIV Testing
Read about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read about HIV prevention here:
HIV prevention
Read about PEP and PrEP here
PEP and PrEP

Offline Doctor with hiv

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Re: PR
« Reply #2 on: June 07, 2019, 11:28:13 am »
Yes I agree with Jim
Actually Prep is for those who have multiple sexual partners
If you are in a monogamous relationship and ur UD then taking Prep or not hardly matters because if you know ur partner who is like fully adherent then it's completely fine..! M not a much fan of Prep either 🙈

Offline DazedN2002

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Re: PR
« Reply #3 on: June 07, 2019, 12:00:46 pm »
I very much appreciate your helpful and informative response.

Firstly why would your viral load spike?
Perhaps my fears are many years old, but I assumed there was an ongoing risk that the virus could break through and spike, even if I'm adherent.  Having said that, I've been undetectable for so long I realize that probably won't happen.

Ill cut you short there as generally speaking, over the years I have found the CDC policy to be somewhere between CYA (Cover your ass) and, simply paranoid. They also tend to hold onto outdated/disproved information so nothing surprises me, after 21 years, I somehow doubt it surprises you either.

I've seen many people living with HIV loose their shit over the years because the CDC said something daft. To be honest the choice is to ask them why & challenge them or ignore them.

Not sure if this was the offending page? https://www.cdc.gov/hiv/basics/prep.html

I rarely pay attention to what the CDC has to say about people with hiv having safe sex, since as you say their vested interest is to cover their asses (and not in a good way!).  But this forum asks readers to browse https://www.poz.com/basics/hiv-basics/pep-prep before posting, and that page says "The Centers for Disease Control and Prevention (CDC) recommends Truvada for those at high risk of HIV, including:

Those in a relationship with an HIV-positive partner."

Maybe it's time to put your caveats on CDC recommendations, with which I wholeheartedly agree, somewhere on that page.

Again, thank you for your comments and for your time in administering this forum.

"Dazed N Confused"

Offline Jim Allen

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Re: PR
« Reply #4 on: June 07, 2019, 12:25:31 pm »
You're welcome.

Look i think the context is not meant to be everyone living with HIV, but ill ping the CDC for you and, ask them to add (In certain situations) or something to that affect.
You can also send you feedback to the poz magazine, if you like.

Quote
Perhaps my fears are many years old, but I assumed there was an ongoing risk that the virus could break through and spike, even if I'm adherent.  Having said that, I've been undetectable for so long I realize that probably won't happen.

I do get it, but try to put this fear behind you. You have been suppressing the virus for a while now so If you keep taking your meds, there is no reason for this to actually be an issue. 

Best, Jim
« Last Edit: June 07, 2019, 12:55:01 pm by Jim Allen »
HIV 101 - Everything you need to know
HIV 101
Transmission and Risks:
HIV Transmission and Risks
Read more about Testing here:
HIV Testing
Read about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read about HIV prevention here:
HIV prevention
Read about PEP and PrEP here
PEP and PrEP

 


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