Are you going to start taking this antiretrovial drug?

[homeseeker]

The World Health Org is urging healthy gay men to start taking antiretroviral drugs.
See:

http://www.washingtontimes.com/news/201 ... tion-drug/ (http://www.washingtontimes.com/news/2014/jul/14/who-urges-healthy-gay-men-take-hiv-prevention-drug/)

I want to know if anyone here in Thailand is now taking this drug?
What is the cost?
What are the side effects?
Is the drug readily available in Thailand?

Generally:

Do you agree we as gay men should be taking this drug regardless of our health status?

[Nirish guy]

It's a tough question and one which even the gay charities are sitting in the fence on until sufficient test data of the feasibility of the drug taking, use and effectiveness has need ascertained - in other words "we've no idea and are waiting to see what happens".

On one hand I can see the W.H.O's view that ANYTHING that lessens the risk of transmission of HIV should be undertaken to help reduce the spread of the disease but that I feel ( and I think even they accept) is based on a "text book" answer and perfect world. In reality the drugs if I'm reding correctly are basically a PEP type combination which are required to be taken at set times and very accurately and regulary with no missed pills etc - none if which generally prove to be possible for large groups of people who may not feel they need them every day and only stop and start using them when having sex etc, which totally negates the benefits.

You've then also the argument that a false sense of security may descend on the gay community with condom use then reducing which when added to the incorrect taking of the drugs could actually INCREASE HIV transmission rates and finally if the drugs are simply PEP, these pills are and have been known to have side effects which can go from almost none at all to quite unpleasant depending in the person and I know my own person experience of taking a course for a month once after a burst comdom issue ( thankfully with no bad news at the end if it) was that I felt like shit for the month and wouldn't want to be rushing back to take them unless absolutely necessary.

So to answer your question no I personally won't be taking them until more is known about longer term side effects and results as PEP really wipes your system and I was always told by doctors etc it should be taken very sparingly and only when absolutely needed. But should things change I'll happily take all of that under consideration again but for now for me anyway it's just sticking to comdom and safer sex practices.

[francois]

Truvada costs about $1300 USD/month however there is a generic from India costing $300/month.
If someone is into un-safe sex and has the money then maybe worth it to them.

[cdnmatt]

I don't even take aspirin, so no... won't be taking it.

[Smiles]

The World Health Org is urging healthy gay men to start taking antiretroviral drugs.
See:http://www.washingtontimes.com/news/2014/jul/14/who-urges-healthy-gay-men-take-hiv-prevention-drug/
I want to know if anyone here in Thailand is now taking this drug?
What is the cost?
What are the side effects?
Is the drug readily available in Thailand?
Generally:
Do you agree we as gay men should be taking this drug regardless of our health status?
What???
Nobody should EVER just start taking a drug regardless of their health status and leading up to that scintillating philosophy: "Just Because ... "
WTF is this OP all about? As someone once said: " ... A lot of us do not like our time being wasted ... "

[homeseeker]

Smiles: no need to get so mad. This topic is a legitimate one for debate and discussion bearing in mind the rate of infection in our community especially in Thailand.

[Up2U]

Truvada:Is this the next condom?

http://www.out.com/news-opinion/2013/09 ... ?page=full (http://www.out.com/news-opinion/2013/09/09/hiv-prevention-new-condom-truvada-pill-prep?page=full)

[Nirish guy]

It's also a valid debate as I'm guessing the Op was referring to the world health organisations statement a few days ago calling on governments / all gay/ MSM individuals to start taking these latest retrovirals which by everyone's count is a BIG call, but they stand by their logic based on medical fact so now it's "up to us" - hence this worthwhile topic and discussion ( I presume)

[zinzone]

Agree with Nirish. This is one of the most important topics currently affecting gays, so do not understand smiles post above. That said the price quoted by Francois if accurate is beyond the budget of most people.

[lego]

Do you agree we as gay men should be taking this drug regardless of our health status?
Short answer, NO, personally I won't take any kind of medication as long as I'm not sick. Only exception are a handful of standard vaccinations that have proven to be safe over a long period of time. Until something like that is available to prevent HIV (it might be, one day), count me out.

[francois]

. That said the price quoted by Francois if accurate is beyond the budget of most people.

Here is an article in NYTimes regarding Truvada. The claim is most insurance pays for this med.
To me it would be hard to justify $1000/month so some guy can bareback although there are situations
where it would make sense.

http://www.nytimes.com/2013/12/31/healt ... 22%7D&_r=0 (http://www.nytimes.com/2013/12/31/health/a-resisted-pill-to-prevent-hiv.html?pagewanted=all&module=Search&mabReward=relbias%3Aw%2C%7B%222%22%3A%22RI%3A15%22 %7D&_r=0)

[Surfcrest]

What's the difference between this antiretroviral drug and the actual antivirals you take when you have HIV?

I'm not so sure the WHO's motive to slow the spread of HIV infection within the demographic of sexually active gay men will co-align with the demographic they're concerned about.
If the solution to preventing an HIV infection is a pill and the solution of contracting HIV is a pill, what's the difference?

I think they should be more concerned with why there's a massive increase in the demographic instead of jumping to a solution.

Surfcrest

[Impulse]

I think this is wonderful for gay men, especially for young gay men. To have a choice now. This is as big a deal as 1996 when these antivirals started saving lives.
In fact if you were to ask many young gay men, they might think that it's just too good to be true. But it is. The big problem is the cost, but even insurance companies will pay for it as it's far cheaper than paying for someone who needs treatment for HIV their entire life.
It's great for the ones who refuse to use condoms, and it's only one pill a day. Nirish , I think you misunderstood that this is not prep like you had. That entails several pills, same as those who have HIV. This is truvada, just one of the ingredients of Atripla, the one pill a day created by Gilead Pharma.

Will I take it? Right now no , even though I'm now at more risk than ever since I plan to start bottoming more.i will buy the best quality condoms I can find. $3,600 will buy a lot of condoms! And that's for the generic version.

[Surfcrest]

The big problem is the cost, but even insurance companies will pay for it as it's far cheaper than paying for someone who needs treatment for HIV their entire life.
Really? Why would it be cheaper than HIV medication...for the patient?


It's great for the ones who refuse to use condoms, and it's only one pill a day. That entails several pills, same as those who have HIV. This is truvada, just one of the ingredients of Atripla, the one pill a day created by Gilead Pharma.
Many people who have HIV are also taking only one pill / day.

Surfcrest

[joe552]

I don't quite get this. Is the advice to take this medication in order to prevent HIV? Or does it just reduce your chances of becoming infected? If the high risk groups of gay men can't be persuaded to use condoms, can they be persuaded to take a pill everyday? I think not. Maybe I'm missing something here.

[Up2U]

I think what you are missing is the fact it is much easier popping pills than using a condom, especially when you are out partying, drinking and popping other kinds of pills. The question is the effectiveness versus a condom. A condom offers protection from other std's also.

[Impulse]

Good point up2u about the convenience of one pill. And even if you take it four times a week it still is 96% effective. So over time it might not have to be taken everyday, maybe it will be once a week at some point.

I can't copy and paste so to answer Surfcrest, truvada is much cheaper than the most convenient and expensive drug Atripla( which is three drugs combined in one pill). That's just the drug, then there are all the testing and doctor appointments when one is HIV positive. No comparison really.

And yes, people with HIV take just the one pill Atripla, if they have good insurance and can afford it, remember it's three drugs in one. The holy grail if you will of HIV treatment. Gilead pretty much took over as leading HIV pill provider with that. Thais are still given the older versions of HIV meds, some that have very undesirable side effects.

[Surfcrest]

In Canada when someone has HIV, the medication is paid for and supplied by our local governments through our hospitals, clinics and health organizations. The patient doesn't pay a dime, they just need to visit the pharmacy when their medication runs out where they are issued more. The friends I know who are on the treatment take anywhere from 1 to 3 pills daily. The trend, as medications are developed is to go towards one pill...to make it more convenient. I imagine there are a few cocktails of medications out there, again unknown to me if it is 1 pill or more. From a health insurance perspective, truvada would be a deductible medication reimbursed at least here in this country by percentage based on the Plan. Our health care plan might pay for it, but only to a percentage. There would still be a deductible and there would still be premiums to support the Plan.

Back in the 80's and the 90's it was a big deal to be diagnosed with HIV. It used to be called AIDS back then because a lot of patients were actually exhibiting symptoms of the virus by the time they were diagnosed. Some of my friends who were diagnosed back then are gone now, but many are still alive. Through the 2000's a lot of work has been done on the medications to lessen the side effects. One friend of mine who passed away about 12 years ago or so just quit taking the medications because he couldn't cope with the side effects. Now into the 2010's the trend is to reduce the dosage to one pill...to make it more convenient. The effects of the disease have been minimalized to an extent. It's no longer a big deal for someone to be diagnosed or to continue playing unprotected...which may be why the WHO has seen an increase in infections within the gay demographic.

The problem with HIV is that the patient is extremely infectious until they start taking antiviral medication and lower their viral load. They won't start exhibiting symptoms until their immune system dips to an extremely low limit and so some of the sexually active men out there who don't play safe, who take unnecessary risks, who put off getting tested or are uneducated about HIV are in that risk demographic of sexually active men. I wouldn't feel confident that truvada would provide complete protection during unprotected sex with someone with a high HIV viral load.

I think the WHO is concerned about the increase in HIV transmission among gay men but I'm not so sure they have the individual health of that gay man in mind when they recommend truvada without any consideration given to the possible side effects of the drug. Perhaps in the perfect world, where everyone that had HIV was being treated would truvada work, but at best the WHO can only expect improved results, not an improvement in health to the individual gay man.

Surfcrest

[firecat69]

I am currently in Bangkok and went to my pharmacy for my Blood Pressure pills. I actually pay less for them here then my co-pay on medicare in the USA. This is the pharmacy that supplies all the Kings Hospitals so I'm not worried if I me getting the real drug.

Anyways I asked the price of Truvada( the real one not a Generic) which they told me was 2500 baht for a months supply. Just amazing what the rip-off Drug Companies and pharmacies charge for this drug in the USA. They should be ashamed of themselves but they are not. Health Care in the USA has been a disgrace compared to the rest of the Industrial World for my lifetime and will continue to be that way for Millions for years to come. Obama Care not withstanding!!

Yes if you are lucky enough to have Insurance and pick the right Hospital you can get good care . But if you are poor Good Luck from the richest country in the world!

[Impulse]

Without the profit motive none of theses drugs would be available. Thank god they came up with these antivirals or where would we be? The generics are there for those who need them. It might cost more and be harder to get in America but that's where the money is.

Hep C just a while ago only had about a 25% cure rate! now it's approaching 100%. I know it might not seem fair the process of determining who pays what. This might seem even more unfair but if you have some extra money you can invest in these Pharma companies, maybe donate from any profit made.

[francois]

Quite right rocket. The Indian drug companies, and others, do nothing to develop new meds but just copy them and pocket the profits on the research of others.

[christianpfc]

No. Fully agree with Smiles.

I don't take any drugs unless prescribed by a doctor (few exceptions: charcoal against diarrhea, acyclovir cream against herpes). Many of my Thai friends however ... (would eat a whole pharmacy if they could afford).

All these premature reports about treatments/vaccinations for HIV are detrimental to mankind's fight against HIV. The safest and cheapest way to prevent HIV is to use a condom (and it prevents other STI and pregnancy as well!), and it will stay like this for a long time.

[firecat69]

Without the profit motive none of theses drugs would be available. Thank god they came up with these antivirals or where would we be? The generics are there for those who need them. It might cost more and be harder to get in America but that's where the money is.
Drug company propaganda. US Taxpayers are the ones who pay for a great deal of the research which then the drug companies take a step further. The many layerssto the county where of distribution and the greed of all those layers is what leads to the outrageous prices. CVS etc making Billions selling drugs .

These same greedy companies love selling outside of the USA where they keep all their profits and do not pay and Income Taxes to the country where they are benefits of the greatest Universities etc that lead to the employees that thats work on these pills.

They should be able to make a fair profit!. Most of them have patents protecting them for many years and it makes little difference if Indians copy after a few years because nobody in India could ever afford the drugs anyway.

[Up2U]

One third of the passengers on the Malaysia flight shot down over the Ukraine were AIDS conference delegates en route to Australia.

http://www.cnbc.com/id/101847333

[loke]

Too many side effects in this pill , if young people start taking them , they might wish they never started with them.

Blisters under the skin
rash with flat lesions or small raised lesions on the skin
redness of the skin
skin rash, itching skin, hives or welts
spots on your skin resembling a blister or pimple
Rare
Blindness or vision changes
burning of the face or mouth
burning, crawling, itching, numbness, painful, prickling, "pins and needles", or tingling feelings in the hands, arms, feet, or legs
chest pain
clumsiness or unsteadiness
sensation of pins and needles
sneezing
sore throat
stabbing pain
weakness in the hands or feet
Incidence not known
Abdominal or stomach discomfort
agitation
bloating
bloody or cloudy urine
bone pain
chills
coma
confusion
constipation
convulsions or seizures
cough
darkened urine
decreased appetite
decreased frequency or amount of urine
depression
diarrhea
difficult or labored breathing
difficult or painful urination
difficulty with swallowing
dizziness
fast heartbeat
fast, shallow breathing
fever
general feeling of discomfort
headache
hostility
increase in the amount of urine
increased blood pressure
increased thirst
indigestion
irritability
lethargy
loss of appetite
lower back or side pain
muscle pain or cramping
muscle twitching
nausea
pains in the stomach, side, or abdomen, possibly radiating to the back
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
rapid weight gain
sleepiness
stupor
sudden decrease in the amount of urine
swelling of the face, fingers, hands, lower legs, or ankles
tightness in the chest
trouble breathing
unusual tiredness or weakness
vomiting
weight gain
yellow eyes or skin
Some emtricitabine / tenofovir side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

Less common
Lack or loss of strength
passing of gas
weight loss
Rare
Acid or sour stomach
back pain
belching
difficulty with moving
discouragement
feeling sad or empty
heartburn
increased cough
joint pain
loss of interest or pleasure
muscle aching or cramping
muscle pain or stiffness
pain
runny nose
stomach upset
stuffy nose
sweating
swollen joints
tiredness
trouble concentrating
trouble sleeping