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

[broncofan]

http://www.goodrx.com/truvada

[Westheangelino]

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.

[trish]

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.

[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.

[MrBest]

^ 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.

i thought youre promoting bb promiscuity

[Westheangelino]

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

i thought youre promoting bb promiscuity

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.

[trish]

^ 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.

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.

[Westheangelino]

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.

[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.

[Westheangelino]

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?