new edition of HIV treatment update (HTU) is now available in print
and online. You can read it online,
download it as a pdf, or use the ‘flipbook’ function to read the pdf online. If
you would like to receive your own copy in future, in print or by email, please contact us.
What’s in this edition?
What does the future hold?
That seems to be the question that links the pieces in this autumn issue.
It wasn't too long ago in
some memories that having HIV was a matter of staying alive right now, rather
than planning for the future. Even for the newly diagnosed, finding you have
HIV can have a paralysing effect on life plans, not least because – in the
popular imagination – it often still means illness and early death.
The message is slowly
getting through, though, that life expectancy in people on effective HIV
treatment is approaching normal. Being positive for HIV can still allow you to
be positive about your future.
One of the most fundamental
decisions anyone makes about their life is whether and when to have children.
Until recently, people with HIV faced daunting barriers to achieving this aim,
especially people in different-status relationships, who would be put through –
or put themselves through – a sequence of decidedly unsexy procedures – sperm
washing, artificial insemination, test-tube fertilisation – in order to have a
child but not infect their partner.
In the last two years we've
discovered how successfully HIV treatment can prevent transmission; the chances
of someone with HIV on effective treatment infecting their partner now really
are pretty slim.
However, as Joanna Moss
discovers in "How
are we going to have a baby? I’m positive and you’re not",
so-called discordant couples may be getting discordant advice from different
specialists about how to reconcile safer sex with conception. Fertility help
may still be needed more often for people with HIV, and some couples may want a
'belt and braces' prevention approach that adds in other measures, but the
current situation is unsatisfactory and we are eagerly awaiting the publication
of new fertility guidelines, which recognise the role of treatment as
In most of our futures is
our old age – an old age many of us thought we would not see. HTU has
reported before on research conducted with older people with HIV, which found
high levels of isolation, poverty and depression in people who had never
planned to get old. How can we fend off such miseries and ensure our autumnal
years will be as long and happy as possible? In A healthy – and happy – old age with HIV
we talk to a couple of people who are over retirement age, and to their doctor,
to get their advice on maintaining health and contentment.
In The generic generation, we
discuss not our own future, but that of our treatments. The advent of cheaper,
non-patented HIV drugs could be a tremendous opportunity to save a lot of
money, to put that money into maintaining healthcare standards in the era of
cuts, and even to spare some for research. All that will go to pot if the
pressure to save money results in some people staying on regimens that don't
really suit them. It's not that generic drugs are worse than branded ones –
they are just as good – but that we must never let cost dictate inappropriate
One way to fend off that
slippage of treatment standards is to try and formulate minimum ones. The new
BHIVA standards for HIV care, summarised in The bottom line in clinical care,
are an attempt to set, in the hardest stone available, a set of minimum
treatment standards that should be applicable for the next half-decade, no
matter what contortions the NHS goes through and wherever we get our pills. We
welcome this document as a contribution to, in an age of uncertainty, securing
For more information
HIV treatment update was created to help people become familiar with their
treatment options and to encourage informed communication between people with
HIV and doctors.
HTU is available free to people personally affected by HIV. You can
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You can browse an archive
of HIV treatment update at www.aidsmap.com/htu.