Resistance

[CrImSeN]

A friend of mine is taking truvada and has a lot of sex with hvl people. That alone wouldn't be a problem but he only takes his truvada once a week, sometimes less. He is a bugchaser, obviously, but he takes his truvada sparingly to try and get a resistant strain. Dies this even work? Is that possible?

[Kimberley]

So far as i know is this how there become a HIV resistance strain for prep. if u be pozzed and still swallow prep for long period, the HIV cells inside the body becomes insensitive and in the end resistance for Emtricitabine/Tenofovir Disoproxil, because prep on his own don't work with a HIV infection. you need another medication as well to get the right treatment.

personally i find this a really bad situation. that resistant HIV strain is not very common but due people like this it's going to be a huge problem in the future for all guys world wide

[BootmanLA]

12 hours ago, Kimberley said:

So far as i know is this how there become a HIV resistance strain for prep. if u be pozzed and still swallow prep for long period, the HIV cells inside the body becomes insensitive and in the end resistance for Emtricitabine/Tenofovir Disoproxil, because prep on his own don't work with a HIV infection. you need another medication as well to get the right treatment.

personally i find this a really bad situation. that resistant HIV strain is not very common but due people like this it's going to be a huge problem in the future for all guys world wide

It could become a problem worldwide, but it may not be as dire as you might think.

First, you'd have to have someone taking PrEP after getting pozzed, without learning he was poz. Any doctor should be ordering routine HIV screenings (I believe the current recommendation is at least every 90 days) while a patient is on PrEP, so that if he becomes positive, he can be switched to treatment instead, as quickly as possible. That limits the period during which the poz person would be unaware of his status. And honestly, it should be a fairly rare occurrence; if you're already taking PrEP regularly, you're going to be protected. The only way this happens is when someone misses enough doses to become susceptible to pozzing, AND has sex with a poz guy whose viral load is high enough to poz, AND he doesn't go get tested soon after to make sure he was protected. That's a lot of steps that have to fall into place before this even becomes a worry for the particular guy.

Second, if I'm not mistaken, the strain might be PrEP resistant, but once the guy's on treatment (thus introducing the other medications needed to combat HIV), it should bring his viral load down low enough that he can't infect anyone else, whether or not they're on PrEP. And not all HAART regimens use the same chemicals as in Truvada and its generic equivalents, so while the strain may be resistant to that particular pair of drugs, it may not be resistant to other drugs in the same class (much less the third and/or fourth kinds of drugs in most HAART medications).

Third, it's likely that the guy who got pozzed and continued taking PrEP anyway got it through receptive anal sex. While obviously there are plenty of versatile guys out there who might contract it this way, and then spread it by topping others, I'd wager that a significant number of such guys are more or less 100% bottoms and thus much less likely to pass it along.

And finally: sure, there are guys who are out every night fucking randos, and certainly some guys get a LOT of sex. But not everyone is out getting or giving loads to new guys every night, or even every week. You'd think, based on a handful of prolific posters here, that all gay men are out getting laid constantly to the point you wonder how they maintain a job. I respectfully suggest that's mostly bullshit, like a lot of the so-called personal experiences on here. 

[Kimberley]

2 hours ago, BootmanLA said:

And finally: sure, there are guys who are out every night fucking randos, and certainly some guys get a LOT of sex. But not everyone is out getting or giving loads to new guys every night, or even every week. You'd think, based on a handful of prolific posters here, that all gay men are out getting laid constantly to the point you wonder how they maintain a job. I respectfully suggest that's mostly bullshit, like a lot of the so-called personal experiences on here. 

don't think you know how many different guys i meet every day. besides that a restistance strain can spread to other HIV poz people to, because Emtricitabine/Tenofovir Disoproxil isn't going to stop it 

[BootmanLA]

4 hours ago, Kimberley said:

don't think you know how many different guys i meet every day. besides that a restistance strain can spread to other HIV poz people to, because Emtricitabine/Tenofovir Disoproxil isn't going to stop it 

I have no idea how many different guys you have sex with each day, week, month or year, Kimberly, nor do I particularly care. I still maintain that while PrEP resistance is a thing, and we need to be cognizant of it, it's not likely to become as big a problem as HIV was for the gay community at the start, for the multiple reasons I cited.

[Kimberley]

6 hours ago, BootmanLA said:

I have no idea how many different guys you have sex with each day, week, month or year, Kimberly, nor do I particularly care. I still maintain that while PrEP resistance is a thing, and we need to be cognizant of it, it's not likely to become as big a problem as HIV was for the gay community at the start, for the multiple reasons I cited.

Resistant gonorrhea is become a problem over the years in Europe, so why wouldn't that be possible with the resistant HIV strain? due people like his friend it's going to spread further to others so it's not unthinkable that the strain will be more diagnosed in the future.

i think we need be aware of that and not thinking to easy that it never would happen

[BootmanLA]

6 hours ago, Kimberley said:

Resistant gonorrhea is become a problem over the years in Europe, so why wouldn't that be possible with the resistant HIV strain? due people like his friend it's going to spread further to others so it's not unthinkable that the strain will be more diagnosed in the future.

i think we need be aware of that and not thinking to easy that it never would happen

I'm not saying it could never happen. In fact, I'm almost certain it will be. What I said (for the third time now) is that I don't anticipate it becoming a major problem, for the reasons given. How resistance develops in bacteria like gonorrhea is very different from how resistance develops in retroviruses like HIV. 

[Kimberley]

18 minutes ago, BootmanLA said:

I'm not saying it could never happen. In fact, I'm almost certain it will be. What I said (for the third time now) is that I don't anticipate it becoming a major problem, for the reasons given. How resistance develops in bacteria like gonorrhea is very different from how resistance develops in retroviruses like HIV. 

I think we not go to agree with each other. Syphilis for example was almost exterminated, but is coming back over the years and the number of infections rise ever year as i speak about Europe

[BootmanLA]

5 hours ago, Kimberley said:

I think we not go to agree with each other. Syphilis for example was almost exterminated, but is coming back over the years and the number of infections rise ever year as i speak about Europe

You're right, we're not going to agree, because you're comparing bacterial resistance to a treatment with retroviral resistance to a preventative. Different infections, different methods of dealing with them. You might as well talk about acetaminophen-resistant headaches. 

[Kimberley]

7 hours ago, BootmanLA said:

You're right, we're not going to agree, because you're comparing bacterial resistance to a treatment with retroviral resistance to a preventative. Different infections, different methods of dealing with them. You might as well talk about acetaminophen-resistant headaches. 

we will speak again over 10 years 🙃

[Avengers]

On 8/17/2021 at 7:38 PM, BootmanLA said:

Second, if I'm not mistaken, the strain might be PrEP resistant, but once the guy's on treatment (thus introducing the other medications needed to combat HIV), it should bring his viral load down low enough that he can't infect anyone else, whether or not they're on PrEP. And not all HAART regimens use the same chemicals as in Truvada and its generic equivalents, so while the strain may be resistant to that particular pair of drugs, it may not be resistant to other drugs in the same class (much less the third and/or fourth kinds of drugs in most HAART medications).

Very good information. Multidrug resistant strains do exist and that would be a nightmare. We must take our medications regularly and should not fetishize about mixing and matching strains (but this concept of mixing and matching isn't well understood by the scientists).

The good news is it is extremely unlikely that someones genotype test will say that the patient's HIV is resistant against all drug classes. Even if that unlikely case happens, there's still hope. A new drug Lenacapavir brought down the viral load in 88% of heavily treatment experienced patients with multidrug resistant HIV in a recent clinical trial. It is so wonderful to live now compared with 1985.