Risking it with an HVL top

[Guest]

On 10/18/2021 at 11:42 PM, chibtm2breed said:

No that is NOT TRUE!!!! That is for SURE. BootmanLA is correct NOT what you think or did hear from your local Doctor. YOU really should google the scientific data for yourself. Although I think it's much more the case for a PrEP person with only 2 meds and I think re-infection with a stronger virus from what I've seen in studies is rare.

Lol the internet has false information on it. Always consult your dr. They are the medical professional, do not rely on google. This is the worst piece of advice you could’ve give. Lol 

[BootmanLA]

9 hours ago, Cumslut943 said:

Lol the internet has false information on it. Always consult your dr. They are the medical professional, do not rely on google. This is the worst piece of advice you could’ve give. Lol 

It's true that a health care provider is more likely (by a good margin) to have accurate information than a random google search. That said: there are health care providers that are up-to-date and knowledgeable about HIV issues, and there are providers that still don't understand PrEP. Moreover, "random google search" is not synonymous with doing research on reputable sites like the NIH or CDC websites.

And given that a significant number of people's interactions with a "health care professional" on the subject of PrEP consists of a phone/tele-health conversation for five minutes with a PA or NP licensed to prescribe medication via one of the "get PrEP discreetly" services, I wouldn't be so fast to assume people have access to accurate, up-to-date information via a "health care provider".

I stand by my statement: the point of a drug-resistant strain of HIV is that the drug in question, to which it is resistant, can't be used to treat it. That drug doesn't miraculously become effective if you're taking it for PrEP rather than as treatment - HIV that is resistant to drug A can infect someone who's relying on Drug A to protect him. This is not a common situation, but it's why I make a point of correcting people who speak in absolutes - i.e. "You CAN'T get X if Y". 

[Guest]

8 hours ago, BootmanLA said:

This is not a common situation, but it's why I make a point of correcting people who speak in absolutes - i.e. "You CAN'T get X if Y". 

indeed. good to correct false assumptions.

8 hours ago, BootmanLA said:

And given that a significant number of people's interactions with a "health care professional" on the subject of PrEP consists of a phone/tele-health conversation for five minutes with a PA or NP licensed to prescribe medication via one of the "get PrEP discreetly" services, I wouldn't be so fast to assume people have access to accurate, up-to-date information via a "health care provider".

I find what you describe worrying. Part of the role of the prescribing doctor is to also guide, coach his patient to adhere to the PrEP-regime and be there. Or at least it should be IMO. Good idea to make sure people get accurate, up-to-date information if the "health care provider" is lacking, but the lacking itself is deeply worrying to me.
A doctor that works in a way you describe should loose his or her licence IMO. Your solution is maybe a sort of last resort. So: it's worrying.

[BootmanLA]

11 hours ago, BareLover666 said:

indeed. good to correct false assumptions.

I find what you describe worrying. Part of the role of the prescribing doctor is to also guide, coach his patient to adhere to the PrEP-regime and be there. Or at least it should be IMO. Good idea to make sure people get accurate, up-to-date information if the "health care provider" is lacking, but the lacking itself is deeply worrying to me.
A doctor that works in a way you describe should loose his or her licence IMO. Your solution is maybe a sort of last resort. So: it's worrying.

Here's the thing, though. In the United States, medical doctors are not the only health care providers with prescription authority (the legal right to write a prescription for medication). It's a state-by-state matter, but taking Louisiana as an example, not only can medical doctors (those with an "MD" after their name) can prescribe, but so can osteopathic doctors (OD), podiatrists (DPM), optometrists (DO), dentists and oral surgeons (DDS), medical psychologists (they hold PhD's, not medical degrees), advanced practice registered nurses, aka "nurse practitioners" (APRN or NP), and physician assistants (PA). The last two ostensibly work under the supervision of a medical doctor in a collaborative practice agreement, but the reality is that in many rural areas where there is no doctor, the NP or PA works largely unsupervised and the supervising MD just signs off on their paperwork periodically.

And that's just in Louisiana. In some states other health care providers may prescribe medications, including pharmacists.

The situation I describe is what's behind almost any online PrEP source you may see advertised on the Internet. In a state with fairly lax rules about telemedicine, a company can contract with a doctor to "supervise" several physician assistants or other prescribers, host these "online exams", and order a prescription for PrEP (filled by the same company, for convenience!) which is then billed to one's insurance company or in some cases a medication assistance program.

In a way, it's a great way to get PrEP to people who don't want their local doctor's office to know (it's illegal for a health care provider or his employees to divulge most health care information, but in a small community, people tend to find out anyway). But as you note, to be done right, the prescriber needs to monitor the person and ensure he's tested regularly. 

[Guest]

Thank you to everyone who has contributed to this thread. There's some great information here and I did learn something new that I didn't know before about the possibility of HIV transmission whilst taking PrEP after being exposed to drug-resistant strains. Please keep sharing your knowledge, because while it's true that some of the people commenting aren't medical professionals, the information contributed by those who are knowledgeable can be high quality and a great starting point to find out more.

[mort]

On 10/24/2021 at 4:39 PM, Cumslut943 said:

Lol the internet has false information on it. Always consult your dr. They are the medical professional, do not rely on google. This is the worst piece of advice you could’ve give. Lol 

 

Being a medical professional I can tell you first hand you should use both tools available. (use proper sources not pubmed or social media)

 

Medical professionals go with what they are told so if you are working for say the NHS you go with what they say even if it is not correct this is how it works.

 

This is why I always advise people to look at research and I will try to explain it to them but I can't go by it they would need to choose that option I am limited to what I can do (A lot of medical professionals are closed minded and will believe whatever they are told and drug companies claim even if a patient shows them facts)