The new edition of HIV treatment update (HTU) is on its way to subscribers and is also available online at www.aidsmap.com/htu.
What's in this issue?
There’s an unusually
diverse mix of topics in this issue of HTU.
You might say they span the ‘before, during and after’ of the HIV diagnosis
Click on these links to get straight to the articles:
The piece on pre-exposure
prophylaxis (PrEP wars) returns to a
topic we’ve covered before, but which, as we show, is one of the most hotly
debated ideas in HIV right now. Using medicines, including vaccines, to prevent
rather than treat disease has always been a controversial issue, from MMR to
water fluoridation, because the benefit/risk calculation feels trickier: how
can you be sure you aren’t giving
people what may harm them, to prevent what they might not get anyway?
Such feelings are often
deeply held, not always rational and, in the case of HIV, can reach a
particular sharpness. This is partly because advances in the tolerability of
HIV medicines have happened so fast that many still see them as toxic drugs no
one would take unless faced with death. But it’s also because people ask the
obvious question: “Why don’t they use condoms?” – usually followed by a lament
for the lack of efficacy of safer-sex campaigns. This isn’t the place to go
into why people don’t, but the fact that many don’t means we need more
alternatives, and PrEP is a possible – though not unproblematic – one.
Tales of the late diagnosed made me feel angry as I was researching it; so many
near-deaths – and a tragic case of someone who died of AIDS, but could have
been saved any time in the previous three years if only she’d been given an HIV
test. No one is specifically to blame, though: as the piece makes clear, patient
awareness, doctor awareness, testing availability and the fear of HIV all
conspire to create a situation where far too many people still test far too
late. A critical issue not only for their own health but, because they have
spent all that time with detectable viral loads, for the health of partners
Finances for the over-50s had rather the opposite effect. There are certainly
a lot of people around, like ‘Michael’ in the article, who face poverty in old
age because they never assumed they would be
old, and because they were out of the job market for years. The piece, however,
reminds us that this is an issue shared with a lot of people who don’t have HIV
(many HIV-negative people also leave it very late to prepare for their older
age), and that there are possible remedies we may not have thought of.
One interesting aspect of
the late-diagnosis and PrEP articles is that they don’t directly concern the
health of HTU’s core readership –
people with HIV. By definition, PrEP is for HIV-negative people, and we’ve
already been diagnosed, late or otherwise. And yet people living with HIV are
deeply involved in activism around both these questions.
This is partly because many
of us are only too well acquainted with the harm that HIV can do, and we want
to spare others the same experience. But it’s also because HIV activists tend
not only to care passionately about their cause but are also an unusually
scientifically literate bunch. We know what is likely to work and what’s likely
to be a dud. Precisely because we are now living longer lives, it gives us the
chance to give something back and to contribute as positive citizens.
For more information
To subscribe to HIV treatment update, to send us feedback on this edition, or for any other information, please contact us at firstname.lastname@example.org or call 020 7837 6988. This edition is available in our archive, where you can read it online, view it as a flipbook and download it as a pdf. Visit www.aidsmap.com/htu.