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curiousaboutbb

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Posts posted by curiousaboutbb

  1. 21 minutes ago, C10H15N said:

    Sorry.  Biden is mentally incapable of functioning as President. 

    All politics aside, the bookmakers in Vegas (the only ones I trust on this) show he doesn't stand a chance of winning.   

    He will do much better than Trump. Trump has done the exact same mental mistakes if you want to call it that As Biden has. Maybe even worse! Mental capacity  is gonna be the selling point for the right though. It ain’t gonna work! Too many people are sick of Trump and his antics. At least Biden will have reasonable advisers around him to help him make decisions instead of thinking he is God and making all of them on his own! 

    • Like 4
  2. I wouldn’t switch without consulting your Doc.  Best way to be sure you take it is to get a daily pill box. Take it each morning as you brush your teeth.  If you aren’t sure if you have taken it you can check your pill box and see.

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  3. Syphillis, chlamydia and gonorrhea are pretty easily cured with antibiotics. Just make sure you are tested for them every 3-6 months. Syphillis can progress to a serious illness if left untreated. I get tested every time I go in for my PrEP check up. I have not caught any of them, but I am not an extreme barebacker. I only bb, but probably less than 20-30 guys a year. The things I would worry about most are HSV2 (herpes) and HPV. These are not curable. HEPC is also another worry although it is now curable most of the time. I hope this helps.

  4. Bottom line is It all comes down to money for an insurance company. Don't forget insurance companies negotiate the price of the drugs, they pay much less than the retail price. It is more cost beneficial to prevent HIV than to treat. I think it is something like 12,000 per year to prevent and almost 30,000 to treat. Add to this the fact you are dealing with high risk individuals (not if but when) it makes it even more beneficial to prevent. It's really a no brainier. Assurant has already reversed its decision not to cover and contacted those that received this letter.

  5. http://www.aidsmeds.com/articles/PrEP_drug_resistance_1667_26703.shtml

    This article appears to be talking about a similar thing. Two subjects converted on prep study. The strain they had was resistant to the emtricitabine. They seemed to think they developed resistance. I wonder if ther were just like the guy in the post being discussed. I am on truvada and it is a little unnerving.

    For the first time, a study has shown that, although rare, resistance to Truvada (tenofovir/emtricitabine) can develop if someone contracts HIV while taking the drug as pre-exposure prophylaxis (PrEP). In previous studies this had only been found to occur if someone turned out to be acutely, or very newly, infected with HIV when they started taking PrEP. (An HIV test may yield a false negative if conducted during an acute infection, possibly leading someone to enter a PrEP study under the false impression that he or she does not have the virus.)

    Publishing their findings in the Journal of Infectious Diseases, researchers analyzed plasma samples from the 121 study participants who contracted HIV in the Partners PrEP Study. They tested the samples for HIV that had resistance mutations associated with emtricitabine or tenofovir. The study was a Phase III, randomized, double-blind, placebo-controlled trial in which the HIV-negative member of 4,747 mixed-HIV status heterosexual couples was assigned to receive Truvada or tenofovir as PrEP, or a placebo.

    Out of those who tested HIV positive during the study, 25 were assigned Truvada, 38 were assigned tenofovir and 58 were assigned the placebo. Drug levels in the plasma indicated that 26 participants had taken PrEP during or after acquiring the virus. Out of this group, five people had evidence of resistance mutations associated with their PrEP regimen: four of seven (57 percent) of those who took Truvada, and one of 19 (5.3 percent) who took tenofovir. The difference in resistance rates between the two groups was the result of the development of the emtricitabine-related resistance mutation M184IV.

    Of the five participants who had drug resistance, three were found to have been acutely infected when they started the trial, leaving two people who were HIV-negative when they enrolled. These two people are key, because their cases indicate that there is a possibility of contracting HIV while taking PrEP and then developing drug resistance, although this chance is apparently rare.

    The authors state that that risk of drug resistance may be higher in those who are taking PrEP around the time that they are infected and in those who, because of infrequent follow-up testing, take PrEP for an extended period after contracting the virus. Truvada as PrEP is highly effective if taken daily as prescribed, but loses efficacy if taken less frequently. U.S. Food and Drug Administration protocol recommends that people taking PrEP undergo HIV testing every three months. The participants in this study were tested monthly.

    The study found that resistance was more likely to develop to the emtricitabine component of Truvada, meaning that only taking tenofovir instead of Truvada, which also emtricitabine in addition to tenofovir, would lower the risk of resistance. However, the authors state that this risk must be weighed against the 49 percent increased efficacy of Truvada over tenofovir as PrEP that was found in the Partners study.

    In an accompanying editorial, Robert M. Grant, MD, MPH, a professor at the University of California, San Francisco, who led the iPrEx study that proved PrEP’s efficacy among men who have sex with men (MSM) in 2010, and Teri Liegler, PhD, an associate professor at UCSF, write, “Fear of drug resistance is now raised as we consider rolling out PrEP.” However, they add, “Fomenting fear of drug resistance is also misguided if it distracts us from fear of HIV itself, by far the greater threat to human health.”

  6. Update Finally got my prescription for PreP today after 4 months of trying to get on it. With the copayment card I paid $0. Was actually glad my insurance didn't hassle me about it. Starting it in the morning hopefully the side effects will be minimal.

  7. Thanks RT. One other thing I find shocking is how long the process takes. We are not scheduled to meet back until august 15th to go over results. If I decide to go on it then, I am sure I will have to get insurance approval. Most likely it will be September before I actually get to start taking it.

  8. Ok so I started this thread back in April trying to find someone to prescribe PREP in Memphis. I wanted too update you on my lack of progress and get some feed back on my experience. I talked with a friend who suggested a doctor who is gay. I contacted his office and he was out on medical leave until September, so I continued my search. Talked to the local aids organization and they directed me to a planned parenthood type clinic. I contacted them in June and asked if they provided it. A lady said she would check and call me back. She called back and said yes they did provide it. I asked for the first available appointment and it was for a month away on July 22.

    I went in today and I must say I was a little disappointed. The nurse practitioner came in and asked the reason for my visit. I told her I wanted to talk about PREP. She said sure. She continued to explain that PREP was mainly for use in sero-discordant relationships or situations where there was repeated exposure to HIV. She then asked me several questions about sexual practices. Two of the questions were number of partners more than 1 and unprotected sex in the last 6 months. Both of which I answered yes. She said based on my answers I did not meet the clinical criteria for being on PREP. She went on to discourage it because of on going side effects such as stomach and intestinal issues. It was clear she was against it. She said she would prescribe it once testing was done but that insurance would likely not cover it since I didn't meet the clinical criteria. I asked her why was the clinical criteria different from CDC recommendations. She said that was the CDC guidelines for prescribing. I told her those have been updated to include MSM. She said she would review it and get back to me. She suggested we move ahead with testing and meet back once results were in. I then asked what type of test she would be using to test for HIV she said a rapid test. I questioned her further about I thought an RNA test was required since I have been active in the last month. She said no reason to use it. She ordered the baseline test for blood panel,kidneys etc and a full STI panel to include a blood HIV test, but not RNA test. I consented to the testing, but left the clinic feeling I was better educated than the practitioner.

    The nurse practitioner called me about 45 minutes later and said she had reviewed the updated guidelines and I would qualify. She also said the test she had ordered would be sufficient for testing before starting prep. I am concerned as to the adequacy of care. Although i had negative rapid test last month and I have no reason to believe I have been exposed to HIV is she doing the appropriate test? I don't have a lot of options here, what should I do?

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