PrEP vs medication resistant aids

[fillforfun]

Does anyone know how well PrEP protects against getting HIV from someone with full blown AIDS and a medication resistant strain? Is it just as effective, a little less, a lot less, or is it not well studied enough for us to know?

[DilfSub]

Hey, you may want to look at this resource. They mention a 1 in 500 chance of a medical-resistant strain currently.

 

[think before following links] https://www.aidsmap.com/about-hiv/prep-and-drug-resistance

[BootmanLA]

16 hours ago, fillforfun said:

Does anyone know how well PrEP protects against getting HIV from someone with full blown AIDS and a medication resistant strain? Is it just as effective, a little less, a lot less, or is it not well studied enough for us to know?

First, let's clarify some terms. "Full blown AIDS" isn't a clinical term, for starters. An HIV-positive person is diagnosed as having AIDS when he either (a) has an AIDS-defining condition or (b) has a CD4 count of less than 200/cubic milliliter of blood. That said, a person may be diagnosed as having AIDS, but nonetheless cease to meet those criteria if he undergoes treatment (which may boost his CD4 count), and in any event may render him undetectable or nearly so. In other words, AIDS is not necessarily a "final stage" from which the only exit is death - though if left untreated, it's likely to be fatal.

Medication resistant strains, on the other hand, are rare, and almost none are resistant to all medications. So the chances of even encountering someone who has a strain of HIV that cannot be treated by any current medication is highly unlikely. Not impossible, to be sure, but unlikely.

Now, as for PrEP: remember that the purpose of PrEP is to aid your natural immune system in preventing HIV from gaining a foothold in your system. IF a person who has one of those extremely rare all-meds-resistant strains of HIV were to have sex, particularly as a top for anal sex, with a person on PrEP, he might or might not infect that person.

For one thing, resistance to medication isn't necessary linear; it might be that PrEP is only half as effective against a particular strain, slowing down its infectivity rather than halting it entirely. It's possible that PrEP plus the natural immune response might clear even such an infection. Or maybe not - it's not like this is something easy to study.

In any event, adherence to PrEP regimes is key - and it's why I strongly believe that the daily dose regimen, if a person can stick with it, is better than the on-demand regimen. And no, I'm not a health care professional, but it seems to me that if PrEP is going to fail, it's more likely to do so if there's less of it in your system while it's fighting off a potential infection. 

[PozBearWI]

Thanks @BootmanLA.  It is also relevant that HIV isn't quite as easy to contract as other STI's.  Clearly individual results will vary; but CDC risk of unprotected bottoming with a viral top is still less than 2%.  Add PrEP to this and risk drops considerably.  

[fillforfun]

Thanks for clarifying guys!