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I wonder if all practices immediately notify patients when their viral loads are high. If the visits are infrequent and results are only informed for the prior visit, there may be several months between a viral rebound and subsequent addressing of the problem.
The term undetectable can be confusing and misleading as well. I practice perfect adherence to my regimen. But with the more sensitive assay my doctor ordered to quantify my hiv, it returns a result of detectable but less than 20 copies. Less than 20 copies is often the definition of undetectable. So even though my doctor says I’m undetectable, the lab test seems to say different. For that reason, I often answer that question that my virus is “fully suppressed” or “I have viral control”.
Well, this was not a surprising or unexpected result. Viral detectability is a function of high to perfect adherence to drug regimen, and high adherence to drug regimen is shockingly low, around 55% in the U.S. (https://www.ajmc.com/journals/supplement/2013/a472_sep13_hiv/a472_sep13_schaecher_s231) Men who have sex with men are taking upon themselves their own mere opinion of whether their drug adherence is high, if they are even aware of the extent of their dosage lapses.
Andrew F
I mean, the subjects of the study *were drawn from an adherence intervention study*. So yeah, people known to have adherence problems tend to not be undetectable. Water is wet. The sun is hot. The real story here is that this attack on Poz folks is being passed off as some grand discovery.
February 20, 2020 • Cleveland, OH.