Alarming surge in drug-resistant HIV uncovered • Hacker News Board

Re: Alarming surge in drug-resistant HIV uncovered

#161

Post by jfengel » Thu, Aug 01, 2019, 2:32 PM UTC

hcurtiss wrote: post #139

agentdrtran wrote: post #133

Earlier quoted context omitted.

Where did you go to med school?

What a snide reply. Is it necessary to be a doctor to have an opinion on healthcare policy?

They were speaking of medicine rather than policy, and getting it wrong. PReP is not the same course as treatment, and prophylaxis is always a thing given to healthy people rather than sick ones. The side effects are considered manageable: you watch for signs of liver problems and you don't give the drug to people prone to them.

I'm not a doctor but I can read the prescribing information[1], which they don't seem to have done.

[1] https://web.archive.org/web/20161221124917/http://www.access...

Re: Alarming surge in drug-resistant HIV uncovered

#162

Post by zcid » Thu, Aug 01, 2019, 2:42 PM UTC

Why do we spend billions of dollars on a lifestyle disease instead of putting that money towards other concerns like cancer? Why does our society worry about a disease that is largely the result of poor choices over other ailments that are solely due to bad luck?

We spend far more on HIV research than any other single disease: https://report.nih.gov/categorical_spending.aspx

Re: Alarming surge in drug-resistant HIV uncovered

#163

Post by [deleted] » Thu, Aug 01, 2019, 2:47 PM UTC

Fomite wrote: post #33

jxramos wrote: post #10

I always felt like the only way you can eliminate the spread of a highly adaptive std is to develop a low barrier on-the-spot test administered just before intercourse at the latest or some point reasonably earlier in a date or whatever. This would still fail under the dormancy period viruses assume but it should improve the odds I'd imagine for those connected in one way or another to promiscuous sexual networks.

That assumes a degree of agency in your ability to refuse sex that is not necessarily the case in many high prevalence countries.

[deleted]

Re: Alarming surge in drug-resistant HIV uncovered

#164

Post by EamonnMR » Thu, Aug 01, 2019, 2:47 PM UTC

zcid wrote: post #162

Why do we spend billions of dollars on a lifestyle disease instead of putting that money towards other concerns like cancer? Why does our society worry about a disease that is largely the result of poor choices over other ailments that are solely due to bad luck? We spend far more on HIV research than any other single disease: https://report.nih.gov/categorical_spending.aspx

https://en.wikipedia.org/wiki/Lifestyle_disease note that cancer is on that list, and HIV is not.

Re: Alarming surge in drug-resistant HIV uncovered

#165

Post by VeninVidiaVicii » Thu, Aug 01, 2019, 2:48 PM UTC

zcid wrote: post #162

Why do we spend billions of dollars on a lifestyle disease instead of putting that money towards other concerns like cancer? Why does our society worry about a disease that is largely the result of poor choices over other ailments that are solely due to bad luck? We spend far more on HIV research than any other single disease: https://report.nih.gov/categorical_spending.aspx

Lifestyle disease? I don't think I've ever read anything more calloused. Frankly, the attitude that "you deserve to die because you had sex" is unacceptably retributive.

Re: Alarming surge in drug-resistant HIV uncovered

#166

Post by gothack » Thu, Aug 01, 2019, 2:49 PM UTC

i80and wrote: post #149

wtdata wrote: post #141

Earlier quoted context omitted.

The good reason is that PrEP has negative side effects, it's expensive, and you don't need it if you show some personal responsibility and use a condom. Nobody should be expected to be financing your personal preferences when it comes to the way you prefer to have sexual intercourse.

The FDA hasn't approved condoms for anal sex, and the failure rate for latex condoms is high in that usage. And lambskin condoms, while stronger, are explicitly labeled as not being suitable for disease prevention.

One company has had one approved, the FC2 Internal Condom (previously called the FC2 Female Condom). You can buy a three pack on Amazon for $28.99. Insane pricing.

Re: Alarming surge in drug-resistant HIV uncovered

#167

Post by jMyles » Thu, Aug 01, 2019, 2:51 PM UTC

zcid wrote: post #162

Why do we spend billions of dollars on a lifestyle disease instead of putting that money towards other concerns like cancer? Why does our society worry about a disease that is largely the result of poor choices over other ailments that are solely due to bad luck? We spend far more on HIV research than any other single disease: https://report.nih.gov/categorical_spending.aspx

Your message seems, at least to me, to be quite judgmental.

I'm interested in helping people who make bad choices and people who have bad luck. It's not clear to me that one group deserves more compassion than the other.

The comparison to cancers is a bit odd - HIV is generally not regarded as a lifestyle disease, while of course many cancers do have a lifestyle component.

HIV is communicable; the time and money spent to target specific populations in an effort to reduce incidence of a communicable disease of course pays dividends in that fewer people will subsequently be infected.

And looking further down the road (albeit perhaps with optimistic glasses), with enough effort, it may be possible to eradicate it without our ever having discovered a true cure. So it makes at least some sense to work in that direction, but those efforts of course have a high cost.

Re: Alarming surge in drug-resistant HIV uncovered

#168

Post by t34543 » Thu, Aug 01, 2019, 2:51 PM UTC

rdl wrote: post #75

t34543 wrote: post #11

I had a scare and took PeP this year. I had to ER shop. First one denied me coverage and made assumptions. I ended up getting care at a cost of ~$6000 to my insurance. I paid $270. I have great healthcare but this is obscene. I don’t want to get sick and die. I was being careful but accidents happen.

Are you sure it actually cost your insurance $6k? Usually they have a high rack rate and negotiate down.

Yes, according to my statement this is the actual amount paid by insurance. Most of it ($4500) was for my two prescriptions. The rest was for 2x ER visits (first doc denied me), and one round of labs.

Re: Alarming surge in drug-resistant HIV uncovered

#169

Post by ls612 » Thu, Aug 01, 2019, 2:51 PM UTC

quotemstr wrote: post #114

blablabla123 wrote: post #108

Earlier quoted context omitted.

I wonder if that's true though. I don't have a medicine background but I'm loosely following this development. I think the term drug resistance became popular with all these tuberculosis cases. What happened was that people got TB, they went to the doctor and got medicine. Then things got better and people felt healthy again so they stopped taking their medicine. BUT in reality they were supposed to take it for a lon…

Right. For resistance to evolve, some part of the treated population must survive. (You can't evolve resistance to atomic weapons dropped on your head.) Is PReP really effective enough to ensure that there are no survivors? Sure, maybe it is, used correctly at therapeutic doses. What if it becomes common enough to get into the water at much lower doses? What if people split pills to reduce costs? ISTM that there are…

HIV is sexually transmitted. It can’t survive in the water or the air. So the presence of anti HIV drugs in the environment shouldn’t have an impact.

Re: Alarming surge in drug-resistant HIV uncovered

#170

Post by jdietrich » Thu, Aug 01, 2019, 2:52 PM UTC

zcid wrote: post #162

Why do we spend billions of dollars on a lifestyle disease instead of putting that money towards other concerns like cancer? Why does our society worry about a disease that is largely the result of poor choices over other ailments that are solely due to bad luck? We spend far more on HIV research than any other single disease: https://report.nih.gov/categorical_spending.aspx

Globally, there are at least 36 million people living with HIV. In South Africa, nearly one in five people have HIV. Without access to antiretroviral treatment, they are living with a death sentence. Calling this virus a "lifestyle disease" is factually wrong; while infections in Western countries are mainly limited to specific groups, the virus itself does not discriminate.

https://en.wikipedia.org/wiki/List_of_countries_by_HIV/AIDS_...