Have we cured HIV?

Well in London this week we have seen 2 cases where a patient has “cleared” HIV. When we talk about clearing a disease we mean that there is no trace of the virus detectable even when the patient is off the medications that suppress the virus.  No trace of the virus detectable even when the patient is off the medications that suppress the virus. Holy crap we cured it? Not so fast.

So first off the cure which is a bone marrow transplant from someone with the CCR5 gene mutation.  This is present in less than 5% of the European population. The actual bone marrow transplant is a last-ditch treatment in forms of treatment-resistant cancer. It isn’t even considered outside of cancer treatment and is not cost effective.   So realistically, this is not an cannot be a planned treatment for those with HIV.  While we all dream of a day that diseases like HIV, Diabetes, conditions such as Cancer and other chronic diseases are able to be cured through the magic of medicine, we are still at the stage where treatment and prevention are the best options. So no we have not cured HIV Karianne.

In an article in the Guardian yesterday there is an indication that over 65% of all men who have sex with men currently take Truvada as Pre-exposure prophylaxis. This is good news for Gilead Pharmaceuticals that makes the drug since its monthly cost without insurance is quite spendy at approximately $2000 a month.  It is also better news from a prevention standpoint.  The original message that is still given for HIV prevention was not a very sex-positive message. It is the ABC message; Abstinence, Be faithful (single partner), and Condom use.

When I say sex-positive, I am referring to the concept of realizing that ordinary healthy folks of all sexual orientations have sex. Condoms as a whole are not considered a viable option or are worn improperly for most men.  Most other men or women would instead use a “marital aid” than use a condom in sex. This does not say that a man should be irresponsible and expect their partner to use contraception. What this does mean is that there are occasions that a condom is used or desired and having sex should not cause you to get a chronic disease.

Sex positive also acknowledges that we, as humans are sexual beings and that limiting that action is just puritanical bullshit. Even your grandparents engage in sex, you just don’t wanna think of Nana getting on with pops (there a stifled your urge for sex, but they still getting busy). The concept of abstinence is based solely on that puritanical message that few and fewer aspects of society endorse. Abstaining from sex; try it for a month. You will be one pissed off person, though. Why forego the pleasure? You shouldn’t plain and simple. You do need to be careful regarding disease or pregnancy, but that does not mean extremes. It does say that you and your partner need to adjust things based on each other’s level of consent.

Consent is critical (read this a few hundred times). If your partner does not consent to something and you do it anyway, you are the worst kind of person. You are potentially placing them at risk, and you are ignoring their request for protection or stopping altogether (which is rape, yes rapists are not just shadowy figures in alleys, they are live humans that sometimes are just driven with horniness or desire and are lost in the moment (this does not excuse it, it explains it). I have had these discussions with many partners at the STD clinic trying to explain the concept. You don’t just walk up to folks you know and punch them in the face, right? Yeah, so don’t break a limit in sex.

Sexual health is, and honestly, a patient will see me talk about a sexual dysfunction long before they take care of their hypertension and diabetes. We don’t like it when Peter and Suzy or Al are having problems (yeah it’s a reference Penis, Vagina, and Anus yes anal sex).  Many times you find a chronic disease that, when treated, makes things work again. Funny maybe the body is trying to tell you, no nookie until you fix me.

Well, the bats are managing the castle while I am enjoying  Sonoma for a different kind of blood.