Day One on PrEP

[+ WmClarke]

Maybe I'm misreading or my logic chip is failing, but why would it take 20 days to protect a top and only 10 days to protect a bottom? Receiving without a condom (i.e. the top is bare) is one of the most risky things you can do without actually injecting yourself with the blood of someone who is HIV positive. Topping bare is much less risky.

I know it seems odd, but that's what the research has shown. I think that's why some researchers think the numbers are conservative and believe protection actually starts earlier. But until someone funds a study, they can't claim that. And why fund a study when the drug is already approved? No financial incentive to do that research.

[Rudynate]

Just the antibody test, it had been years since intimate contact with anyone, my first sessions that had already happened at that time were just body contact and j/o, no penetration of any kind, I was holding off on intimate contact until I got screened and could begin the regimen. One of the reasons for that on my part is I had a friend who died in the 80s who swore he had only ever done oral. Although my understanding is the general risk from oral is lower, every time I would blow a guy, I would remember him and have days of anxiety. Now the important thing is to keep up with regular screening.

 

But I should say I never saw a mention of a viral load tests in my own research, do you have a link? It makes sense and perhaps it would be good for everyone to have a reference?

 

I get my healthcare through Kaiser. Before I started PrEP, they did a load of testing

 

HIV antibodies

HIV viral load

Hep C antibodies

Syphillis

NG rectal and throat swabs

Urine PCR for chlamydia and NG

Hep B antibodies

Hep B viral load

LFTs;

serum creatinine; and

CBC.

 

I think that's it.

 

The 90-day testing includes:

Urine PCR

Swabs for NG

Syphillis

HIV antibodies.

LFTs and serum creatinine.

[+ sniper]

Many of the numbers they come up with are extrapolating from very sparse data. Most likely there were relatively few tops in the studies of PreP, which led to a broader confidence interval.

These things sometimes happen with statistics. You can get a number that makes no sense given the underlying reality.

[+ Gar1eth]

I know it seems odd, but that's what the research has shown. I think that's why some researchers think the numbers are conservative and believe protection actually starts earlier. But until someone funds a study, they can't claim that. And why fund a study when the drug is already approved? No financial incentive to do that research.

Well it just about has to start earlier considering the effectiveness of PEP (post-exposure prophylaxis) although they do usually add a third drug for that.

 

Gman

[kewtex]

I get my healthcare through Kaiser. Before I started PrEP, they did a load of testing

 

HIV antibodies

HIV viral load

Hep C antibodies

Syphillis

NG rectal and throat swabs

Urine PCR for chlamydia and NG

Hep B antibodies

Hep B viral load

LFTs;

serum creatinine; and

CBC.

 

I think that's it.

 

The 90-day testing includes:

Urine PCR

Swabs for NG

Syphillis

HIV antibodies.

LFTs and serum creatinine.

 

I don't understand drawing an HIV viral load if one's HIV antibody test is negative. The presence of antibodies would necessitate HAART therapy, not PrEP.

Still, having a baseline for all the tests is helpful.

[+ Gar1eth]

I don't understand drawing an HIV viral load if one's HIV antibody test is negative. The presence of antibodies would necessitate HAART therapy, not PrEP.

Still, having a baseline for all the tests is helpful.

 

It would be-I'm assuming-for the rare case of detectable virus occurring before the development of antibodies. The current 4th generation test is a combined antibody and antigen test. If antibodies could always be detected before the onset of virus in the blood, there would be no need to test for viral antigen.

 

 

 

Gman

[Rod Hagen]

https://www.youtube.com/watch?v=iqczq0Zhlag

Holy shit, this was in Sense8? A bit different from The Matrix, that's for sure. Cool.

[LADoug1]

I get my healthcare through Kaiser. Before I started PrEP, they did a load of testing

 

HIV antibodies

HIV viral load

Hep C antibodies

Syphillis

NG rectal and throat swabs

Urine PCR for chlamydia and NG

Hep B antibodies

Hep B viral load

LFTs;

serum creatinine; and

CBC.

 

I think that's it.

 

The 90-day testing includes:

Urine PCR

Swabs for NG

Syphillis

HIV antibodies.

LFTs and serum creatinine.

Kaiser also does a bone density test. Turned out I couldn't start taking it due to pre-osteoporosis. Rats!

[Rudynate]

Kaiser also does a bone density test. Turned out I couldn't start taking it due to pre-osteoporosis. Rats!

 

That must be a recent addition to their protocol. When I started, they weren't testing bone mineral density as part of the initial evaluation. I thought it was an odd oversight in what was otherwise a very good protocol.

[Rudynate]

I don't understand drawing an HIV viral load if one's HIV antibody test is negative. The presence of antibodies would necessitate HAART therapy, not PrEP.

Still, having a baseline for all the tests is helpful.

 

 

In the case of an early infection, you can have a negative antibody response. The viral load will identify someone who is newly infected and therefore not a candidate for PrEP.

[kewtex]

It would be-I'm assuming-for the rare case of detectable virus occurring before the development of antibodies. The current 4th generation test is a combined antibody and antigen test. If antibodies could always be detected before the onset of virus in the blood, there would be no need to test for viral antigen.

 

 

 

Gman

 

Thanks. I hadn't thought of it that way.

[kewtex]

In the case of an early infection, you can have a negative antibody response. The viral load will identify someone who is newly infected and therefore not a candidate for PrEP.

 

Thanks!