Reblogging for ermedicine's excellent commentary. The often harsh side effects of antiretrovirals are definitely something to be taken into consideration. It'll be interesting to see what top ID specialists and the gay community will have to say about this new recommendation.
For the first time since the epidemic began, rates have failed to drop in the U.S. This is thought to be due to a lack of awareness and, well, fear of HIV, as many young MSMs who weren’t alive during the GRID era of the 1980s now view the disease as “manageable” hence not requiring as many preventative measures.
I don’t know if I like this. It should probably be geared towards those who do not regularly practice safe sex . I only have safe sex and am aware of my negative status, so why should I go on an antiretroviral that has the potential to be both expensive and have negative side effects? I don’t know which ARVs are used for prophylactic treatment (not my area of expertise plus I have next to zero outpatient ID experience) but there are serious side effects to some of these drugs. Although not common side effects, I certainly don’t want to increase my chances of getting CV disease, liver problems, and psychiatric issues. I agree that HIV rates are increasing because of the belief that HIV isn’t a death sentence, however this is an expensive solution and I think stems from flawed logic that all men who have sex with men are eventually going to contract HIV. The goal needs to be on more education, outreach, and accessible testing rather than medicating the masses with expensive and potentially dangerous drug.
I am very much against this recommendation. When I was in NY I learned that many men who have sex with men are on prophylactic anti-HIV drugs.
We must not forget that this recommendation was made giving as a main reason the numbers in the US. The US isn’t the world. For example, in Portugal gay people are allowed to donate blood because there are more new infections through heterosexual unprotected sexual relations than with homosexual ones.
The US has a health system that is very focused on money. I’m convinced it’s cheaper to give out anti-HIV medication now than to treat HIV patients later. The thing is no one is talking about the potential side effects in the short and long term for all these people taking such aggressive drugs.
Quick example: a doctor I worked very close with was accidentally exposed to the blood of an HIV+ patient, took the treatment, and even though she didn’t get the virus, she was left with irreversible peripheral neuropathy (basically she feels tingling and doesn’t have normal sensation in her hands, feet and legs).
This sounds to me like that children’s tale, that to treat a plague of grasshoppers you let out rats, then you have a plague of rats and let out snakes, and so on.
I’d be much happier if the efforts and money to get MSM on antiretroviral drugs were instead spent on educating at risk populations.