Bit offtopic but I fully believe that if PrEP had been discovered in the 80s that no vaccine would ever come about because public enthusiasm in conjunction with PrEP would have eradicated the disease. Nowadays, 3/5 people you ask don’t even know what PrEP is.
PrEP is a cocktail of anti-HIV drugs that prevents infection if taken daily. It’s been combined into convenient single-dose pills called Truvada and Descovy. These drugs have a high price tag, but insurance covers it, and if you don’t have insurance the manufacturer Gilead will reimburse you. Great for people like me in the US. But it’s not widely distributed in developing countries where HIV is killing a lot more people. That’s where a vaccine would have the most benefit.
Huge apologies for now naive this probably comes across but when would PrEP be taken?
Is it for people that are exposing themselves to potential carriers in unsafe ways? Is it a way to slowly kill of the disease in populations (if everyone that would be exposed would be taking it)?
I'm genuinely asking as I haven't come across it before and I wonder if it's just because i'm sheltered or other reasons (I live in the UK so maybe that?).
> Is it for people that are exposing themselves to potential carriers in unsafe ways?
It's this largely. The most obvious group in the UK are MSM men. It has to be taken more or less all the time by people who expect they may have encounters in which they could potentially be exposed, similar to the birth control pill.
> Is it a way to slowly kill of the disease in populations (if everyone that would be exposed would be taking it)?
The drugs are very expensive, and are not side effect free. Still much better than HIV. That is why MSM (men who sleep with men) and serodiscordant/serodifferent couples (where one partner is positive and the other is negative) are the groups targeted with these drugs.
I think the importance of bugchasing is greatly exaggerated in these discussions. With millions of people posting on the internet, you can find someone expressing any crazy idea you can think of.
Here’s some other scenarios that I think are more common:
1. Couple (who may be serodiscordant) wants to have unprotected sex.
2. Group of close friends want to have unprotected sex (think of it like a coronavirus social bubble).
3. People in (1) or (2) might have an arrangement that allows protected sex with others, but what if the condom breaks? Or someone lies?
4. People may be involved in risky behavior without making a principled risk assessment at all, possibly under the influence of drugs or otherwise without consent.
Being on PrEP helps mitigate risk in any of these circumstances. Also, most PrEP programs require STI testing every 3 months (for a variety of conditions in addition to HIV), along with surveys and some level of counseling on safe sex practices which measure whether the program is working. I suspect the bundled mandatory STI testing may actually provide more public health benefit than the PrEP itself.
A lot of people think of PrEP as being like the birth control pill. It doesn’t address all of the downsides of sex, but it mitigates the main risk, and can be used in combination with other methods to reduce residual risk.
Even with PrEP available, HIV would likely still have become a big problem in places where healthcare is not as readily available, especially in Africa, where it is still a major concern today.
Not to mention how many guys in the 80s lived in denial. They were afraid to tell their wives, their friends and their family, much less get a prescription from the doctor.
Closeted men living straight lives, would go out for a night of indulgence and the next day were overwhelmed with great regret and fear. PrEP doesn’t fit anywhere in that equation.
Alot more then 3/5s of everyone are people fortunate to not be in the high risk group.
From what I've read, the drugs aren't riskless. I looked into taking PrEP back when I had a positive partner. IIRC, it can cause kidney complications. Obviously much better than having HIV.
Just amazing news. Imagine if it took ~40 years to get the covid vaccine. Still, I never thought I would live to see a HIV vaccine ever become a possiblity, much less be in trials. Even if this particular one doesn't work out, what an amazing corner to turn.
We need more diversification in the supply chain for the capsule/carrier technology. Right now, this feels like gastronomical chemistry, only 4-star chefs can play.
We need India able to pump this stuff out by the billions, like they do for other drugs.
Flu, HIV
can mRNA handle Malaria, then TB? Parasite, and Bacterial.
>We need India able to pump this stuff out by the billions, like they do for other drugs.
The production is not the problem. IIRC the Covid-19 mRNA vaccines were designed and ready to go in under a week. The problem is getting approval, running clinical trials, etc. That's why it takes so long (and expensive) to get the stuff out.
hmmm, feels like a cash grab to me. We couldnt create RNA vaccines because the nature of RNA virusses dont really allow for it, but now suddenly they can? Im guessing money is involved.
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[ 9.2 ms ] story [ 50.1 ms ] threadIs it for people that are exposing themselves to potential carriers in unsafe ways? Is it a way to slowly kill of the disease in populations (if everyone that would be exposed would be taking it)?
I'm genuinely asking as I haven't come across it before and I wonder if it's just because i'm sheltered or other reasons (I live in the UK so maybe that?).
It's this largely. The most obvious group in the UK are MSM men. It has to be taken more or less all the time by people who expect they may have encounters in which they could potentially be exposed, similar to the birth control pill.
People have been doing that even before PrEP. I hate to even mention these people, but they do exist and people should know.
https://en.m.wikipedia.org/wiki/Bugchasing
They're a tiny minority in the gay community.
> Is it a way to slowly kill of the disease in populations (if everyone that would be exposed would be taking it)?
The drugs are very expensive, and are not side effect free. Still much better than HIV. That is why MSM (men who sleep with men) and serodiscordant/serodifferent couples (where one partner is positive and the other is negative) are the groups targeted with these drugs.
Here’s some other scenarios that I think are more common:
1. Couple (who may be serodiscordant) wants to have unprotected sex.
2. Group of close friends want to have unprotected sex (think of it like a coronavirus social bubble).
3. People in (1) or (2) might have an arrangement that allows protected sex with others, but what if the condom breaks? Or someone lies?
4. People may be involved in risky behavior without making a principled risk assessment at all, possibly under the influence of drugs or otherwise without consent.
Being on PrEP helps mitigate risk in any of these circumstances. Also, most PrEP programs require STI testing every 3 months (for a variety of conditions in addition to HIV), along with surveys and some level of counseling on safe sex practices which measure whether the program is working. I suspect the bundled mandatory STI testing may actually provide more public health benefit than the PrEP itself.
A lot of people think of PrEP as being like the birth control pill. It doesn’t address all of the downsides of sex, but it mitigates the main risk, and can be used in combination with other methods to reduce residual risk.
Closeted men living straight lives, would go out for a night of indulgence and the next day were overwhelmed with great regret and fear. PrEP doesn’t fit anywhere in that equation.
From what I've read, the drugs aren't riskless. I looked into taking PrEP back when I had a positive partner. IIRC, it can cause kidney complications. Obviously much better than having HIV.
Just amazing news. Imagine if it took ~40 years to get the covid vaccine. Still, I never thought I would live to see a HIV vaccine ever become a possiblity, much less be in trials. Even if this particular one doesn't work out, what an amazing corner to turn.
Thank you science!
We need India able to pump this stuff out by the billions, like they do for other drugs.
Flu, HIV
can mRNA handle Malaria, then TB? Parasite, and Bacterial.
It’s literally a new biomedical platform. Only 4-star chefs can even guess at how the kitchen should be stocked.
The production is not the problem. IIRC the Covid-19 mRNA vaccines were designed and ready to go in under a week. The problem is getting approval, running clinical trials, etc. That's why it takes so long (and expensive) to get the stuff out.