I agree 100% with Dr. Gallant as to pushing the concept of U=U as much as possible. The goal would be to normalize (as much as possible) sexual activity for PLWIV, and reduce stigma. Of course, we would continue to emphasize consistent condom use in those who are not in monogamous relationships to reduce the incidence of STIs. But I do understand your fear of liability. It's really a shame that we have to be so defensive now when practicing medicine. But, promoting U=U is the right thing to do. And, if it makes you feel any more comfortable. there has not been a single documented case of HIV transmission when the HIV + partner is suppressed. I hope that his might help to change your mind.
Original Message:
Sent: 01-29-2025 11:45
From: Joel Gallant
Subject: Five things New Patients need to know and PrEP
It sounds like the only "answers" are the ones you agree with. You're taking the word of a single industry rep over the recommendations of the CDC, WHO and most HIV experts. I worry when I hear "regardless of data supporting it." It tells me everything I need to know.
------------------------------
Joel Gallant, MD, MPH
Johns Hopkins University
Baltimore, MD
AXCES Research Group
Santa Fe, NM
Original Message:
Sent: 01-29-2025 09:20
From: Patrick Aufiero
Subject: Five things New Patients need to know and PrEP
Still not a answer
the company rep would not have unprotected relations
so that answers my question of U=U
and i would not recommend to any patient, liability risk to high
regardless of data supporting it
You live in a litigating society and data and common sense
aren't followed
Original Message:Sent: 1/28/2025 7:56:00 PMFrom: Joel GallantSubject: RE: Five things New Patients need to know and PrEP It was an answer. Safe sex or PrEP is wise for people with multiple partners, both because they can't be sure of viral suppression and (in the case of condoms) to prevent other STIs. But in the case of monogamous, serodiscordant couples with virological suppression, they're already having safe sex. The U=U message is empowering, destigmatizing, and evidence-based. It loses that impact if you start qualifying it.
Original Message:Sent: 1/28/2025 5:37:00 PMFrom: Patrick AufieroSubject: RE: Five things New Patients need to know and PrEP your response is not a answer
? would you have unprotected contact with a
hiv undectectable patient?
I understand the data, and i still advise my patients safe sex
practices and hiv regular testing if they are negative
Original Message:
Sent: 1/28/2025 3:13:00 PM
From: Joel Gallant
Subject: RE: Five things New Patients need to know and PrEP
The short answer is "yes," assuming I was confident in the undetectable viral load result.
You mention "a company rep who promotes U=U," but this isn't just a message promoted by drug companies. It is a definitive statement by the CDC, WHO, and other authorities. The CDC says that being on suppressive ART is 100% effective at preventing sexual transmission of HIV. The evidence supporting U=U is extremely convincing.
Original Message:
Sent: 1/27/2025 4:02:00 PM
From: Patrick Aufiero
Subject: RE: Five things New Patients need to know and PrEP
So here is a question a asked a HIV company rep. who promotes U=U
Would you or anyone else you know have unprotected sexual relations with an
undetectable HIV patient, and you are not on PreP
Curious to see response
thanks
------------------------------
Patrick Aufiero
Long Beach Township NJ
Original Message:
Sent: 01-27-2025 12:58
From: Ashwin Gupta
Subject: Five things New Patients need to know and PrEP
I would say 5 things that I always want to incorporate in the new patient visit:
- HIV treatment, management, and mediations can give you a long, health life. Stating proper medication and care, PLWH can live as long as those without the virus.
- Definitely reiterate at least three times, Undetectable = Untransmittable (U=U)
- Starting treatment asap is great from a biomedical standpoint to reduce virus reservoir/ increase immune strength.
- Discussing support options locally, nationally, and globally as well as publication and research networks.
- Missing doses happens, but consistent use is the goal
And addendum to all of these, that the patient will need to find their own advocation through this process and will likely need some form of regular medical provider visits to track viral load, CD4 counts, and overall health.
------------------------------
Ashwin Gupta
PA
Original Message:
Sent: 11-10-2024 19:17
From: Brooke Davidoff
Subject: Five things New Patients need to know and PrEP
As an HIV-positive peer in an ID Clinic that's redoing its Peer Program, what are the top five things you want your newly diagnosed patients and those having issues adhering to their meds to know? Do you see gaps or common basic unknowns on their side? How can we help them to better help you?
Also, our Ryan White grand for our PrEP Navigator has not been renewed, and I'm going to begin meeting with people we feel would benefit from PrEP. Do you have any talking points or info decks you can point me to to better explain their risks, especially for straight women?
Thank you all I appreciate your wealth of knowledge.
Brooke Davidoff
------------------------------
Brooke Davidoff
Brookedavidoff@gmail.com
Kansas City, MO
PWN, HIV.net, SisterLove, LWS, PLW HIV Caucus
------------------------------