PrEP Talk
In the article “PrEP and Prejudice” (October/November 2014), Benjamin Ryan wrote about Truvada’s use as pre-exposure prophylaxis (PrEP) and its effectiveness as a prevention tool against HIV.  

If I had been able to take a pill in the morning or whenever I was not inebriated I might not be positive right now. As usual, it all comes down to sex. Stay out of my bedroom! If a pill can prevent even one HIV infection, so be it.


Frank R. Car, Shreveport


Gay men are going to have sex, so let’s use PrEP as a prevention tool. Prevention methods cannot work if not used, so let’s stop playing the same record over and over. Start a serious conver-sation, change cultural norms, and accept people for who they are and allow them to love openly. We need to take the taboo out of sex. We have been fighting the same battle since the beginning of the epidemic. I know; I have been HIV positive for over 28 years.


Graig, Columbus


Great article. I’m on PrEP, and it has affected me in many positive ways, similar to those interviewed. Anything to protect one’s health, and that of others, is a beneficial thing. I have had few to no side effects, and I take the pill daily, only missing a few doses since starting. Condoms have been a flop, and PrEP adds a beneficial adjunct to even inconsistent condom use.


Spector, Chicago


Oh please, these people are not representative of all Truvada users. The most serophobic gay men I’ve met have been on PrEP. Stop selling this drug to us as a way to mitigate our social ills.


Mike


I’m far from serophobic, as some like to claim Truvada users are. In fact, I’m recently out of a long-term relationship and wasn’t as consistent with condom use as I should be. When I started to date a man who is positive, I talked to my doctor and he was supportive of PrEP. It took a few weeks to get the testing and prescription filled via mail order, as my insurance demanded.


RJ


Dosing Decisions
In the article “Trimming Treatment” (November 5, 2014), Tim Murphy wrote about the possibility of cutting your HIV pill intake in half by every-other-day dosing.


Editor’s Note: All HIV treatment decisions should be discussed with a health care provider.

I have been taking half of my daily dosage for more than 10 years, and all is good.


Marilyn


Great article. I took my meds week-on, week-off from 2002 to 2012, taking only about a year within to be on HIV meds continuously. It worked pretty well for me, too. My viral load would be undetectable at the end of a week off, or sometimes less than 100 copies. Now I opt for a continuous HIV regimen with fewer milligrams per day, which works too.


Shawn Decker


I really appreciate this article. I’ve often wondered about drug half-lives and about the advantages, financial and otherwise, of reducing my dosages. I realize that most physicians find this thinking heretical, and I’m really glad you’ve shared your experience with this.


Mark S. King, Baltimore


One concern is that some ARVs don’t seem to penetrate tissues very well even with daily dosing, and this has been associated with persistent HIV replication in those tissues. Even if that doesn’t lead to resistance, there is some evidence that it could increase levels of immune activation and inflammation, which might not be great for long-term health.

Having said that, those studies are recent, and I don’t think the question of whether reduced or intermittent dosing increases inflammation has been directly addressed.


Richard Jefferys, New York


I’m currently taking half-doses of Isentress and Reyataz and have remained undetectable since I began taking them 13 months ago. I have been positive for 25 years and have taken four different cocktails successfully in this way. Thanks for the info on the doctors and studies as well.


Tony Franco


Birthday Boy
In “Traveling Man” (October/November 2014), we profiled Nello Carlini, an HIV-positive man who recently celebrated his 90th birthday. His story inspired us and our readers.

Your story is such an inspiration. On November 3 I celebrated 27 years of a good life [with HIV]. I was diagnosed in 1987, a few months before AZT was approved. I consider myself lucky. Thirty-six million others didn’t make it. God bless!


Ken


Congratulations, Mr. Carlini. It would be great to know which HIV antiretroviral therapy you are on right now and which ones you had to deal with in the past. For some of us, side effects are one of the most troublesome issues to deal with.


Dazzy Rumbles


I loved this story. I am 59 and have been positive for 10 years. This wonderful man gives us all hope and reminds us to live life to the fullest.


Eddie, Atlanta


Amazing story of triumph!


Shon, Baltimore


Beautiful story. I have lived 25 years with HIV and hope to live another 30 to celebrate my 90th birthday, too.


Gary L, Chattanooga


Looking good! God bless you, you are an inspiration.


Rodney, Fort Worth