TRUVADA: Why are we ALL not taking this???!!!!

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Originally Posted by Westheangelino

^ Because people are going to die unless they know their options. This might be acceptable to you, but it is unimaginable to me.

Plus, new news comes out every day about this wonder drug. So, I won't stop shouting this from the rooftops.

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The drug very well may be helpful to people. I hope that if people decide to use it they don't use it as a substitute for other safe practices but instead as an addition to their current regime to make themselves safer. Your interest in this topic doesn't seem to stem from an interest in safety but an interest in having unprotected sex and not feeling guilty about it.

If you had been interested in safety, you would have been talking about the other available safety options before you began advertising Truvada. Instead you were talking about unprotected sex and advertising the benefits and minimizing the risks associated with it. That's why you come across as so disingenuous.

Further, I have to agree with everyone else. A thread pops to the top of the list when it is interesting enough to justify new posts. But your posts are not updates.

^ Actually, my posts are either new news articles revealing new benefits or refuting utter bunk being put out there by others.

Also, sex on truvada IS NOT UNPROTECTED SEX

http://www.cbsnews.com/news/hiv-pill...ent-infection/

http://www.slate.com/blogs/outward/2...dy_proves.html

^ Two good blurbs on the follow up study to the groundbreaking study that proved Truvada's effectiveness.

Suppose you’re having sex once a day, everyday for a year with an partner who has AIDS. What are your chances of making it to the end of the year without contracting AIDS?

The answer depends on the method you use to avoid transmission of the disease. Suppose the method (or combination of methods) you have chosen is 90% effective. What does that mean? If I understand correctly it means that if you expose yourself once you have a 90% chance of not getting infected through that one exposure. Suppose you plan to use that method for a week. Then there’s more than a 52% chance of being infected before the week’s out. (This is because the probability of not getting infected by week’s end is 0.9 to the 7th power, which is approximately 0.48).

Suppose instead your daily method of avoiding transmission is 99% efficient (i.e. the probability of avoiding transmission on one exposure is 0.99). Then the probability of getting infected by year’s end is greater than 0.974. (This is because 0.99 to the 365th power is less than 0.026).

What sort of efficiency do you require to lower that probability from 0.974 to 0.01? You need a method that is 99.997% efficient. (This is because 0.99997 to the 365th power is approximately 0.99).

So suppose everyday you use a method that is 99.997% efficient. So the probability of making it through the year without getting infected is 0.99. The probability of making through a decade approximately 0.9 (a little more precisely 0.896).

The good news is that each time you test negative, you can reset the clock; i.e. if you make it through a year without getting infected, then you have a 99% chance of making it through the next year.

Moral: I haven’t a clue. You provide the moral.

^ Not really how this works, but nice try LOL

Then enlighten me. Is not each exposure an independent event?

I realize that the definition of efficiency used in the above post, is probably not the same as the reported efficiencies which are averages of samples of people taken over the period a time they used the method in question. Nevertheless, there is a probability of transmission given a single exposure and the complement of this probability could well be regarded as a measure of efficiency for a given method of transmission prevention. It is that measure that needs to be as high as 99.997% to give a 99% chance of making it through the year.

I agree with your reasoning Trish. I think you're right though that the transmission rates given are probably averages over a period of time rather than per sex act. But given the efficiency rate per sex act, you will get a much lower rate per annum (or per anum:).

Yes. I'm pretty sure when a company advertises 90% efficiency, they couldn't possibly mean per exposure. But it's very difficult to tell from ads, news articles and lay-reports of studies just what those numbers mean. The public should be aware, whatever they mean, they diminish with number of exposures until such time as one is tested and resets the Bayesian clock.

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Originally Posted by trish

The public should be aware, whatever they mean, they diminish with number of exposures until such time as one is tested and resets the Bayesian clock.

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The fact that this is rarely if ever made completely clear is proof enough that the information tends not to be disseminated responsibly.

Anybody know about cost? Anybody?

http://www.goodrx.com/truvada

If something is 99% effective, one person can be expected to become infected over the course of a year, BUT that doesn't mean they will. Much of this has to do with human factors. I.e., skipping a birth control pill, a truvada pill, an antibiotic, etc. will account for a lot of that one percent.


As for cost, as stated in article after article, most insurers as well as medicaid and medicare are covering the drug.

Thank you for the definition (one would assume "expected" means 95% confident but you can correct me if you find out differently). So the probability that out of one hundred people having daily encounters with an AIDS partner(these sorts of criteria should be spelled out in a proper definition) will contract AIDS within one year's time is 0.95. That amounts to one in ten people over a decade.

^ You're presenting a false scenario. One would think that if your partner has HIV, and you're on Truvada, then your partner probably is already on ARV therapy, bringing their risk of infecting you if you were on nothing down to near zero in the first place.

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Originally Posted by Westheangelino

^ You're presenting a false scenario. One would think that if your partner has HIV, and you're on Truvada, then your partner probably is already on ARV therapy, bringing their risk of infecting you if you were on nothing down to near zero in the first place.

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i thought youre promoting bb promiscuity

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Originally Posted by dreamon

how about abstaining from risky behaviors? and being smart with your sexual health?

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Originally Posted by MrBest

i thought youre promoting bb promiscuity

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I'm promoting people taking this drug in order to halt the spread of HIV. What they do after that is their business.

I find it so very interesting that with all these hypotheticals and statistical hand wringing, you're all forgetting the low efficacy of the condom only campaigns.

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^ You're presenting a false scenario. One would think that if your partner has HIV, and you're on Truvada, then your partner probably is already on ARV therapy, bringing their risk of infecting you if you were on nothing down to near zero in the first place.

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You're the one who said one transmission out of a possible one hundred in the course of a year. I'm just repeating it to make sure I got it right. So it's not a 95% chance that one person in a hundred acquires the infection in the course of one year? Just trying to understand what 99% efficient means.

Read the latest articles I posted. None of the people taking truvada as directed (every day) became positive. Even taking it four times a week led to 90% efficacy.

Let me put this in the most simplest terms for everyone. For the last thirty years there have been two tools in halting HIV: condoms or abstinence. Condoms, when used correctly (i.e. 100% of the time) are highly effective, upwards of 95%. When used TYPICALLY (meaning sometimes, as is the case in reality for most people) they are barely more effective than going bareback 100% of the time. Hence rates of infection stubbornly remaining at the same rate for a very long time. I don't hear anyone saying abstinence or else. So, here we have a NEW method which is proven to be more effective than perfect condom adherence, and people are decrying the possible abandonment of the old method of prevention. How does this make sense? And if you think that putting on a condom or, let's be honest, making sure your partner is putting one on and keeping it on, is easier than taking a little blue pill every morning then, to borrow the words of Mr. Larry "truvada is the enemy" Kramer: you've got rocks in your head.

I’m not disputing the effectiveness of Truvada or arguing either way the people should or shouldn’t avail themselves of it. I just want to know what 90% efficient means. The lay-literature never seems to fill in all the blanks:

The study shows us that we can be ____ confident that if the drug is used by _____ participants whose exposure conditions are _____ and whose dosage is ____ every _____hours, then over ______month’s time ____ to ____ transmissions will have occurred.

Example: If we are 95% confident that 8 to 12 people of a group of 100 will test positive at the end of the year given that all were having daily sex an AIDS positive partner, and given that each person took no more or less than three doses of BrandX preventative a week, then can say with 95% confidence that under these circumstances BrandX is 90% effective.

Note, sample sizes are chosen to obtained the desired level of confidence. Because the sample size is always smaller than the actual population one can never have 100% confidence. Suppose one study suggests with 95% confidence that if BrandX is used 4 times a week (under the specifically described conditions), then there will be no transmissions. What that tells us is that the probability of no transmission over one year’s time (under the described conditions and at a 4 times a week dosage rate) is 0.95. Over a decade that would reduce approximately to a probability of 0.60, therefore giving the user a 40% chance of testing positive by the end of the decade.

Other phrases one finds in the lay-literature like “90 % reduced risk” just add more layers of confusion. How was the prior risk defined? What were the exposure parameters, what prior methods were being utilized to minimize transmission? Etc.

Some of this reminds me of people in my freshman year sexual education class when people started saying things like, "So, if you found a bucket of AIDS blood, cut your hand and shoved it in, what are your chances of getting HIV?" To which my professor replied, "Um, why the fuck would you do that?"

I understand the need to quantify these numbers out of skepticism or what have you, but the only stat I care about is THIS: If I take truvada religiously, I will not become infected with HIV. The stats bear this out. I have as much chance of getting hit by lightening or a city bus. The methods available to me now that I control aren't as effective. Even if I chose to be completely abstinent, I could be drugged, raped, or....have someone cut my hand and shove it into a bucket of AIDS blood. This is about controlling your own destiny.

I understand that it's in pill form now, and some might view that as inconvenient. Well, It's less convenient to be HIV POZ. Also, as I mentioned before, they are already working on long term dosage of Truvada that could be delivered in shot or patch form.

I'll ask all the haters this: if there were a vaccine that was a one time shot, but you had a .01 percent chance of becoming POZ, would you take it? If not then why not?

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I understand the need to quantify these numbers out of skepticism or what have you

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You can't quantify numbers. They're already numbers. The studies have been done. The results have been analyzed. The problem is the results are being reported half-assed.

The trouble with bandying about phrases like “it’s 95% efficient” or “it’s 99% efficient” is that they’re meaningless without having available all the other numbers and conditions are are used to defined them. The danger with such phrases is that 95% efficient can sound wonderful, and on short runs it is. But on a twenty year stretch (which is not rare for domestic partnerships) 95% efficiency could mean a 64% chance of contracting AIDS.

Do you want to avoid testing positive for a year, or for a lifetime?

The same can be said of side-effects. The odds of suffering, say from liver damage, as a side effect of using BrandX may be small in the course of one year’s usage at the recommended dose. But the probability of dangerously damaging your liver over the course of one or two decades may be considerably higher. Again we need to know dosages, number of incidences out of samples of participants and confidence intervals to make any intelligent choices (i.e. to decide to use this method over that method, or a combination of methods and medicines over that combination).

It’s understandable that marketers would want to advertise their product is ninety-some percent efficient without specifying exactly what that means. It’s disappointing that news sources pass along these numbers without explicating their meaning; especially since the technical reports are difficult and sometimes costly to obtain, as well as terse, jargon dense and nearly impossible for laypersons to read.

I do not wish to dissuade anyone from using whatever methods they deem effective for them. What is important is that people not be snowed or wowed by reports of high efficiency without knowing exactly how those numbers apply to their specific circumstances.

^ Everyone who gets a scrip for this has to be counseled by a Dr., has to be tested for HIV AND monitor their kidneys every three months. Trust me, anyone who starts receiving this drug will get the proper facts. The real problem is that most of the people in the communities most affected by HIV in this country (poor black and brown folks) don't even know it exists yet, because it has not made its way into the mainstream consciousness, precisely due to the moralizing of groups like the AHF.

I don't want to trust you, I just want an accurate description of what the numbers you quote mean. If you don't know, then why do you find them so convincing?

I'm not asking you to trust me. I'm asking you to trust the CDC, the WHO, the states of New York, Michigan, Washington, and the list keeps growing.

This article should answer your questions:

http://www.aidsmap.com/Overall-PrEP-.../page/2892435/

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Originally Posted by Westheangelino

the WHO

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I saw them live in Liverpool last year.
Roger Daltrey still has a great voice.

:banana:

Thalidomide was once approved and considered a wonder.

^ And is still used to treat cancer. It's effects on pregnant women ushered in an era where drugs are studied more carefully.

Your point?

Were you able to fill in the blanks of post #219 by reading that article. I wasn't. Clearly, I'll not find the information I seek here. I'll leave you to your job of waking up HA's members to the existence of Truvada.

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Originally Posted by trish

I’m not disputing the effectiveness of Truvada or arguing either way the people should or shouldn’t avail themselves of it. I just want to know what 90% efficient means. The lay-literature never seems to fill in all the blanks:

The study shows us that we can be ____ confident that if the drug is used by _____ participants whose exposure conditions are _____ and whose dosage is ____ every _____hours, then over ______month’s time ____ to ____ transmissions will have occurred.

Example: If we are 95% confident that 8 to 12 people of a group of 100 will test positive at the end of the year given that all were having daily sex an AIDS positive partner, and given that each person took no more or less than three doses of BrandX preventative a week, then can say with 95% confidence that under these circumstances BrandX is 90% effective.

Note, sample sizes are chosen to obtained the desired level of confidence. Because the sample size is always smaller than the actual population one can never have 100% confidence. Suppose one study suggests with 95% confidence that if BrandX is used 4 times a week (under the specifically described conditions), then there will be no transmissions. What that tells us is that the probability of no transmission over one year’s time (under the described conditions and at a 4 times a week dosage rate) is 0.95. Over a decade that would reduce approximately to a probability of 0.60, therefore giving the user a 40% chance of testing positive by the end of the decade.

Other phrases one finds in the lay-literature like “90 % reduced risk” just add more layers of confusion. How was the prior risk defined? What were the exposure parameters, what prior methods were being utilized to minimize transmission? Etc.

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Let me try. But I'll note that your use of the term "AIDS positive" person makes me think that you have little to no knowledge of HIV/AIDS, how people become infected, and how it has been treated.

But, I'll humor you: NOT ONE PERSON IN THE STUDY WHO TOOK TRUVADA EVEN FOUR DAYS A WEEK BECAME INFECTED OVER COURSE OF 17 MONTHS. The only people who became infected either never took the medication or stopped taking it several months before infection. Furthermore, the study showed that those who were engaging in more risky behavior practiced better adherence to their recommended drug regimen of a pill per day.

NOTHING is 100% effective. But please keep in mind that THIS is the same drug that keeps HIV from replicating in those already infected, thus bringing their viral load down to the point of "undetecatability", thus making them nearly non infectious. Please extrapolate that to people who are not infected to begin with. The drug works. It has worked for 12 years. This is just another discovered use for it, bourn out by several and increasing studies.

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Originally Posted by Westheangelino

We have plateaued in our efforts to combat this endemic disease through condoms.

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again, how can hiv penetrate latex?

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Originally Posted by MrBest

again, how can hiv penetrate latex?

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Pretty easily if the condom is broken, slips off, has not been stored properly, is too old, or is slipped off by an unscrupulous partner.

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Originally Posted by Westheangelino

I'll ask all the haters this: if there were a vaccine that was a one time shot, but you had a .01 percent chance of becoming POZ, would you take it? If not then why not?

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Not a hater...but I would get that shot.

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Originally Posted by Westheangelino

Pretty easily if the condom is broken, slips off, has not been stored properly, is too old, or is slipped off by an unscrupulous partner.

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but hiv cant penetrate intact latex can it?

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Originally Posted by MrBest

but hiv cant penetrate intact latex can it?

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It's been shown not to. One in a million? You'l have to ask the CDC, Trojan, Lifestyles, et al about that.

HIV penetrating latex has never been the issue with condoms and HIV. The issues have always been: people don't want to wear them, fucked up power dynamics in relationships, difficulty in properly using them or using them at all when drunk/high/in the moment or whatever. Truvada is superior in all these regards.

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Originally Posted by Westheangelino

It's been shown not to. One in a million? You'l have to ask the CDC, Trojan, Lifestyles, et al about that.

HIV penetrating latex has never been the issue with condoms and HIV. The issues have always been: people don't want to wear them, fucked up power dynamics in relationships, difficulty in properly using them or using them at all when drunk/high/in the moment or whatever. Truvada is superior in all these regards.

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how is truvada going to prevent bacterial infections?

^It isn't. It has been shown to reduce the risk of HPV and Herpes, two things that condoms only protect against if the outbreak is on the covered area, which basically means they are ineffective against those two viruses.

If you're worried about bacterial infection, you're in the wrong discussion. This discussion is about making people aware of a drug that reduces the risk of a deadly virus by 99%.

http://www.edgeboston.com/news/News/...ks_controversy

That latest news: the AIDS Health Care Foundation is now participating in the genocide that they were created to stop. Absolutely DISGUSTING.

I'm gonna go ahead and believe the doctors fighting against this disease than a company trying to make a buck.

^

First off, the company has remained silent on the subject, including no ad campaigns, something unthinkable for something that could be so profitable. Why? Bullshit like this.

What doctors do you speak of? Michael Weinstein is NOT a doctor. What about all the hundreds of doctors that run the WHO and the FDA, which have both recommended that high risk populations start taking this drug ASAP????

http://www.slate.com/blogs/outward/2...ada_don_t.html


Weinstein is the devil