Academy Exchange

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  • 1.  Five things New Patients need to know and PrEP

    Posted 11-10-2024 19:17

    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 



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    Brooke Davidoff
    Brookedavidoff@gmail.com
    Kansas City, MO
    PWN, HIV.net, SisterLove, LWS, PLW HIV Caucus
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  • 2.  RE: Five things New Patients need to know and PrEP

    Posted 9 days ago
    I would say 5 things that I always want to incorporate in the new patient visit:
    1. 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. 
    2. Definitely reiterate at least three times, Undetectable = Untransmittable (U=U) 
    3. Starting treatment asap is great from a biomedical standpoint to reduce virus reservoir/ increase immune strength.
    4. Discussing support options locally, nationally, and globally as well as publication and research networks.
    5. 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.



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    Ashwin Gupta
    PA
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  • 3.  RE: Five things New Patients need to know and PrEP

    Posted 9 days ago

    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



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    Patrick Aufiero
    Long Beach Township NJ
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  • 4.  RE: Five things New Patients need to know and PrEP

    Posted 8 days ago
    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.





  • 5.  RE: Five things New Patients need to know and PrEP

    Posted 8 days ago
    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





  • 6.  RE: Five things New Patients need to know and PrEP

    Posted 8 days ago
    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.






  • 7.  RE: Five things New Patients need to know and PrEP

    Posted 7 days ago
    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





  • 8.  RE: Five things New Patients need to know and PrEP

    Posted 7 days ago

    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.



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    Joel Gallant, MD, MPH
    Johns Hopkins University
    Baltimore, MD

    AXCES Research Group
    Santa Fe, NM
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  • 9.  RE: Five things New Patients need to know and PrEP

    Posted 7 days ago

    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.



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    Adam Zweig
    San Diego CA
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  • 10.  RE: Five things New Patients need to know and PrEP

    Posted 6 days ago

    I abide by the data and not just one rep

    I have discussed the issue hiv +patients as well as hiv negative, and recommend safe sex practices

    I discuss that with patients, still would not take the risk

    as the question still is not answered, by each individual here

    it is just a question and everyone has an opinion



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    Patrick Aufiero
    Long Beach Township NJ
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