What's The Point Of Taking Anti-Aids Meds?

[PhoenixGeoff]

OP put it rather crudely, but he does have a point.

 

HIV is very expensive to treat.  Assuming you don't pay all of their medical expenses out of pocket (which very few of us are in a position to do), an HIV diagnosis guarantees that the medical services and prescriptions you receive for treatment over your lifetime will be significantly more than you pay in through insurance premiums, taxation for health care, etc.  That's an additional load borne by employers, other insured people who don't use their insurance and taxpayers.

 

So I think the first order of business for those of us with HIV ought to be to express gratitude that we do receive the care and treatment that we do.  Personally, I am enormously grateful that the citizens of the US in large part have paid for my continued good health (delivered through the VA, which gets far too little credit for the very many things they do right, IMO).

 

I do think there's a real moral problem here that we're not looking at.  Consider chasers.  If someone deliberately infects himself with HIV, he's not just hurting himself.  He does emotional harm to family and friends.  He exposes other sexual partners to HIV.  And he does impose a higher additional cost on to the medical system (arguing that others also add additional costs on to the system through their bad choices doesn't get you off the hook!)

 

Should someone like that receive treatment?  Obviously, the humane response ought to be to say yes, of course.  But I also think it's appropriate that part and parcel of that treatment ought to be addressing and changing the root of that self-destructive behavior.

 

Then there's the person who doesn't care about their status.  That was certainly me!  Again, denying treatment to such a person would be inhumane, but I also think such recklessness deserves a certain amount of scrutiny as well.

 

Taking a hard look at how and why someone became infected with HIV shouldn't be a form of punishment.  But I do think it's legitimate to ask if the things that led to someone getting HIV might also lead to other problems as well.  For instance, someone who's not taking their HIV medications as prescribed might contribute to the spread of treatment-resistant mutations of the virus, or of other STDs (gonorrhea is one that's becoming harder to treat, and that's directly caused by people not getting proper treatment). 

 

Or consider the possibility that being reckless with respect to HIV might also show up in other ways, like drug or alcohol abuse, DUIs, and other behaviors that increase one's own personal level of risk, and potential puts others in danger too.

 

In short, obviously I don't think society should just cut off people who have expensive medical problems to treat.  But I do think society does have a right to ask why those problems cropped up in the first place, and how they can be prevented.  And that's true whether the problem is HIV or obesity or any other preventable condition.

[cam1972]

Or we could start a complaint about who pays for all the fat basterds in the world, you know who i'm talking about all those bible bashers who can hardly walk around because they've stuffed themselves full of food, yes all those obese fat fat people. Do i or should i feel sorry for them no because again they have eaten all the food themselves & that in turn makes food prices go up. So we are left with paying for them too.

Ok... We don't like the generalizations made about gay people, right? So why do you feel the need to be hypocritical and make a generalization about "bible bashers"? I guarantee you that the vast majority of obese people never step foot in a church nor read a bible. While I agree with your point, I don't think pinning it on "bible bashers" is a fair thing to do. Are there Christians who are obese? Definitely. Is every obese person a Christian? No. Is every Christian obese? No. Is every gay person poz? No. Did every poz person chase? No. So generalizations aren't beneficial to an argument. They take away from the real issue. Attacking others only takes us down to other attackers level. And does nothing to encourage tolerance.

OP put it rather crudely, but he does have a point.

HIV is very expensive to treat. Assuming you don't pay all of their medical expenses out of pocket (which very few of us are in a position to do), an HIV diagnosis guarantees that the medical services and prescriptions you receive for treatment over your lifetime will be significantly more than you pay in through insurance premiums, taxation for health care, etc. That's an additional load borne by employers, other insured people who don't use their insurance and taxpayers.

So I think the first order of business for those of us with HIV ought to be to express gratitude that we do receive the care and treatment that we do. Personally, I am enormously grateful that the citizens of the US in large part have paid for my continued good health (delivered through the VA, which gets far too little credit for the very many things they do right, IMO).

I do think there's a real moral problem here that we're not looking at. Consider chasers. If someone deliberately infects himself with HIV, he's not just hurting himself. He does emotional harm to family and friends. He exposes other sexual partners to HIV. And he does impose a higher additional cost on to the medical system (arguing that others also add additional costs on to the system through their bad choices doesn't get you off the hook!)

Should someone like that receive treatment? Obviously, the humane response ought to be to say yes, of course. But I also think it's appropriate that part and parcel of that treatment ought to be addressing and changing the root of that self-destructive behavior.

Then there's the person who doesn't care about their status. That was certainly me! Again, denying treatment to such a person would be inhumane, but I also think such recklessness deserves a certain amount of scrutiny as well.

Taking a hard look at how and why someone became infected with HIV shouldn't be a form of punishment. But I do think it's legitimate to ask if the things that led to someone getting HIV might also lead to other problems as well. For instance, someone who's not taking their HIV medications as prescribed might contribute to the spread of treatment-resistant mutations of the virus, or of other STDs (gonorrhea is one that's becoming harder to treat, and that's directly caused by people not getting proper treatment).

Or consider the possibility that being reckless with respect to HIV might also show up in other ways, like drug or alcohol abuse, DUIs, and other behaviors that increase one's own personal level of risk, and potential puts others in danger too.

In short, obviously I don't think society should just cut off people who have expensive medical problems to treat. But I do think society does have a right to ask why those problems cropped up in the first place, and how they can be prevented. And that's true whether the problem is HIV or obesity or any other preventable condition.

I agree. Whole heartedly. But I think there's a better way of doing it than attacking people. I don't believe for one minute the OP had any good intentions for posting. His statements make it out that everyone on here wanted the virus. To put it in a term everyone will understand: bullshit. That said, I have felt from the beginning that those who chase or deliberately infect have self worth issues. Or don't have any regard for their well being or anyone else's. I have found from experience that if you try to educate a chaser, more often than not, he just moves on to someone else that will infect him. I've also found that they can be extremely uneducated. They think it's a pass to fuck with anyone they want with no fear. That is a foolish notion since it cuts your pool of men who are willing to fuck a poz guy down quite a bit. I've had far less sex since being poz than I did before being poz. And they also don't think of the ramifications of being poz when it comes to one's health. But while I think education is key, I still believe it's something deeper emotionally or mentally. But again, I don't think the OP had any of this kind of conversation in mind when he posted. He was purely attacking. While I don't dwell on having HIV every moment of every day, I don't need some asshat coming on here and making me feel even less human for having it. Edited February 4, 2016 by cam1972

[subbytch]

Society pays whether one treats HIV or doesn't. 

 

Society pays whether one assists the homeless or doesn't.

 

Society pays whether one educates children or doesn't. 

 

The argument of "why should society pay..." is meaningless. It's made even more meaningless when one starts their critique referring to people with HIV as living "deviant lifestyles." 

[bbzh]

I saw the original post in this thread when it first appeared and thought, "ok here we go, a chain yanker - someone on here to stir the pot just to get a reaction." I was actually fairly ok with the post until I got to the word "deviant" and then things went left.

 

This whole discussion here since then has been fascinating. I too wonder if one day that (proven) barebackers could face discriminatory practices in the insurance market. I'm not talking about poz people on meds who take them regularly. I think the insurers won't go after them, because while they are costly for the insurance pool, they are at least not spreading the virus. And I am of the opinion (and my doctor is too) that it is much cheaper to keep poz men alive with medication than to let them spend many years being sickly and out of work - and therefore not contributing to society by working and paying taxes. 

 

But the question of who should fund PrEP intrigues me. Should an insurer/society subsidize medication for someone who is negative and could stay negative if he/she practiced safe sex? Hmm. I could see people having an issue with that. To use an analogy, would I want to pay higher car insurance premiums because I am in a pool with reckless teenager drivers who race each other on the weekend? I'd probably be the first to say, segregate those kids in a pool and charge them astronomical premiums. And most people would be fine with that too. We already are using telematics in cars to reward good drivers and punish bad ones.

 

But health insurance somehow raises this prickly issue of what's moral or fair or humane. If I have some rare illness that I am genetically predisposed to get, should I be segregated and charged higher premiums? Hmmm a very very slippery slope. 

 

I don't know what the answer is. I do know many of these drugs out here cost pennies to manufacture, yet big pharma charges thousands of dollars for them. Heck, you've got big pharma asking upwards of $80,000 to treat HepC when there are generic drugs in India that cost $1,500.

 

But I digress. I guess the question I am asking myself is would I stop barebacking if there was a bareback tax? In other words, if a health insurer treated us like (reckless) drivers and said because of our behavior, we must pay more - how much would we be willing to pay to forego the rubbers? Or if they said, if you don't submit to an HIV test, your premiums go up. Or if you catch syphilis, your premiums go up?

[C10H15N]

I like to fuck bare. I don't want HIV. I take meds so I can fuck bare without catching HIV.

[TigerMilner]

This thread is boring. So is the OP.

[JackA_]

Just putting my two thoughts in here. When I eventually catch it, I have ZERO intentions of going on meds. I plan to let the gift do its thing inside me. My goal is to let it progress and become full-blown. I've chased the gift for so long, There's no point to go on meds right after catching something I've wanted for years.

 

It's my choice, and I'm sticking to it.

Edited February 5, 2016 by JackA_

[bbzh]

This thread is boring. So is the OP.

It may not be interesting for some, but the topic is highly relevant. I've heard some influential people in insurance say that they are ready to reward those who share their personal data. I'm not talking just Fitbits either. It could quickly come to the point that those who choose not to share will pay more. In other words, the healthy, low risk individuals' willingness to share will lead to lower rates for them. 

[topstud127]

Just putting my two thoughts in here. When I eventually catch it, I have ZERO intentions of going on meds. I plan to let the gift do its thing inside me. My goal is to let it progress and become full-blown. I've chased the gift for so long, There's no point to go on meds right after catching something I've wanted for years.

 

It's my choice, and I'm sticking to it.

There are easier ways of suicide

[C10H15N]

There are easier ways of suicide

What this fantasy fails to take into consideration is that as your health begins to decline your sexual desire is one of the first things to go.

[topstud127]

What this fantasy fails to take into consideration is that as your health begins to decline your sexual desire is one of the first things to go.

Philadelphia, The Nornal Heart, and Dallas Buyers Club just flashed through my head... yeah, i don't think anyone associates erotica with late stage AIDS. If slow, painful, wasting away, incontinence, and impending death turns you on... alrighty then.

Edited February 5, 2016 by topstud127

[PhoenixGeoff]

I don't believe for one minute the OP had any good intentions for posting.

 

One thing I've decided when discussing things online is not to read into people's intentions but simply to go off what was actually said.  It's really easy to get defensive and then everything can quickly degenerate into your standard variety internet shouting match (which really is boring).

 

Take his use of the word "deviant".  That's a loaded term, to be sure.  But what was he referring to?  Homosexuality generally?  Promiscuity?  Bugchasing?  Barebacking?  All of the above?  OP didn't say, so I don't think it's fair to make assumptions.

 

And in a strictly objective sense, all of those things are deviant, in the sense that they are deviations from the norm of mostly monogamous, heterosexual sex.  In that sense, we're all deviant!  And, of course, everyone is deviant in some way.  You could argue quite correctly that conservative Christians are deviants now because most Americans have no trouble with premarital sex, divorce, or homosexuality.  And I think they would be quite pleased to define themselves in opposition to mainstream society on those issues, just as people on this site define themselves in opposition to mainstream sexual mores in the opposite direction.

 

Moreover, while I do think that orientation is a morally neutral category, those other things, promiscuity, bugchasing, gift-giving, even barebacking, are not.  Hell, the moral transgression is a big part of the attraction!  But if you're going to get off on being a bad boy, you really shouldn't be surprised when people react to that.  Can't have it both ways.

[PhoenixGeoff]

I like to fuck bare. I don't want HIV. I take meds so I can fuck bare without catching HIV.

 

I applaud your responsibility and the steps you have taken to protect yourself and your partners.

 

Having said that, OP's question about who should pay for your meds is well taken.  Truvada costs about $1500 a month retail.  That's before we get into doctor visits and blood testing and all that that goes along with PrEP.

 

And there are cheaper alternatives you could use to protect yourself that you have chosen not to.  You could use condoms, you could restrict your numbers of sex partners.  You've decided not to, which is fair enough.

 

But unless you're paying the $18,000 per year (which I certainly couldn't afford), then you're asking others to subsidize your choice.  Is that fair? 

 

I personally think that PrEP is a fantastic step forward.  I'm thrilled that guys now can take this step to protect themselves from HIV.  I look forward to the day when people suffering sickness and death from AIDS is a distant memory, and I think PrEP is going to be a big part of that.  But I can also see the other side of the argument too.

[PhoenixGeoff]

I guess the question I am asking myself is would I stop barebacking if there was a bareback tax? In other words, if a health insurer treated us like (reckless) drivers and said because of our behavior, we must pay more - how much would we be willing to pay to forego the rubbers? Or if they said, if you don't submit to an HIV test, your premiums go up. Or if you catch syphilis, your premiums go up?

 

Yes, this is where the rubber hits the road (ugh, I know...bad pun).

 

HIV treatment is really expensive.  And we've mostly been shielded from that expense.  Which has had the side effect of allowing gay men who are HIV-negative to indulge in promiscuous barebacking without worrying too much about the consequences.

 

What we're dancing around here is that our behaviors, bareback sex, promiscuity, anonymity, do have real world harms that we have largely been insulated from. 

 

Now, I really like bareback sex and promiscuity and anonymous hookups.  So of course I want the current state of affairs to continue.  But is that actually fair?  And just how much would I be willing to pay in order to continue on as I have been?

[bearbandit]

I have only one thing to add to this, and that's in reply to bbzh when he says:

"Should an insurer/society subsidize medication for someone who is negative and could stay negative if he/she practiced safe sex?"

 

There's no such thing as safe sex, only safeR sex. Despite all the promotion of condoms for anal sex, all those on sale in the UK at least, have been tested only for vaginal sex, not anal. People get drunk or stoned, or otherwise impair their judgment, people lie about their HIV status, people lie about their viral load, "I'll pull out before I cum", condoms break, in other words shit happens. 

Nothing in medicine is 100%, hence the varying figures for the efficacy of the present PrEP protocol. In practice, every seroconversion on every trial I've read up can be explained: either someone dropped out of the trial and later seroconverted, or they weren't sufficiently adherent to the medication, or they picked up HIV in the now very brief window period when HIV is undetectable in someone who has acquired it and so tested negative and were admitted to the trial. All these people, because they started the trials, are counted in the final results. However, looking at the issue from the opposite point of view: to date, no-one who has been properly adherent to the PrEP regime has seroconverted. Hence we can say that in practice barebacking on PrEP is safer sex: indeed it's somewhat safer than the same sex using condoms. If it weren't for the failure rate of condoms I would never have been born.

At this point in the epidemic, with a real chance of ending it through TasP and PrEP, I'd urge anyone with a chance to get PrEP to get it and leave the pozzing fantasies to fantasy: before anyone asks, yes I've role-played pozzing both ways round. As many here can attest, real life with HIV can be pretty damn shit, no matter how hot the fantasy.