Injectables & Adherence...

 

Since the beginning of HIV treatment, the game has been the same.  Medications have to be accessible, tolerable & reliable.  Then there's adherence.  The best meds in the world won't matter if they aren't taken regularly. 

90 - 95% adherence is what's needed for HIV meds to be effective & help prevent resistance.  The aim was to create regimens that were accessible with ease of regimen maintenance.  We went from handfuls of pills to a few, to a single pill.  Now there are injectable options given weekly, monthly, quarterly & at larger intervals.  Until a cure is found, they'll probably aim for annual injections.

For many adherence is a serious challenge.  Injectables could be a much better option for many.  After taking handfuls of pills daily, a single dose at wide intervals would be astounding.  Even if it was a weekly pill, that would be a drastic improvement.  

Adherence makes this all work.  Any threat to that is a threat to that person.

Cya...

Injections & Adherence...

 

This article promotes patients should move from oral meds to long acting injections sooner.  The reason  was a better assurance of adherence to the regimen.  There are a lot of reasons taking daily medications may prove difficult.  These injections are currently ranging from monthly to every 2 months for most people.  Soon, those dosage intervals could be a little as every 6 months.  Gilead is even aiming for a year. 

While I can see where this will be beneficial for a lot of people, there may be limits with their insurance.  Add to that, the longer the interval, the larger the dose & deeper the injection.  The annual shots are going to do more than just sting a little.

It's an interesting read & this is the current front runner for the future of HIV treatment & prevention.  That's it for this cloudy morning, take care.

Cya...

Reaction To Long Acting...

 

This is going to be short.  It's threatening to storm, so I want to get this over with in case it kills the net or power.  This article is an OpEd about a man's reaction to making the switch from HIV pills to long an acting injection.  It doesn't answer every question, but it's definitely a perspective.  It also asks the question of whether or not adherence would be any better.  It'd be easier yes, but not necessarily better.

That's all for take care.

Cya....

Hello October...

 

Hello October.  It'd be great if you were a nice month.  Focus on the good stuff & let go of the drama.  Not sure I have high hopes on that after the rest of the year.  September left with a rainstorm & washed away some of the pollen.  It's the 1st time in weeks pollen levels aren't in the red.  It may go back up, but for now my body is thankful.  

I saw a piece on smart bottles to remind people to take their meds.  I'm not surprised it worked.  It's not hard to remember to take a pill, but it's easy to forget it.  I've got a system of reminders to help me.  You have to, if don't want to miss a dose.  When it comes to taking meds, find what works for you.  

That's  all for now, take care.

Cya...

Youth Issues

This piece talks about how less likely HIV+ adolescent patients are to achieve & maintain viral suppression than adults.  The number is notable.   In the study only 12% of teens were suppressed as compared to 65% of adults.

Several factors affected these numbers.  Adherence was the most notable.  Regimens can be hard on adults.  For teens, it's probably harder.  It also went into how soon treatment began.  Lack of teen adherence is an issue.  It could mean more instances of HIV being transmitted.  Give the article a read.

Cya...

Costs...

Costs is still a major detriment for those on an HIV regimen.    I'm not going to post a citation, because they're fairly varied on the matter.  But, inability to afford meds is a major factor in lack of regimen adherence.   The literature states numbers from 14 - 25% of people search for cost reducing strategies to handle their HIV meds.  About half of that can't afford their meds consistently or at all.  

The cost of many medications is too high, with HIV drugs at the higher end.   Many don't have insurance with drug coverage.  Many of those don't qualify for medicaid or ADAP.    I was on ADAP for a while & it was very stressful.  I had to re-qualify every 3 months & didn't know until the day before my meds were to arrive if I had qualified.

Everything aspect of healthcare is overpriced in this country.  Until this is handled, HIV is here to stay.  Too many people simply can't get to doctors, labs, access meds or even have a stable home with food.  HIV has proliferated in part because of this society's indifference to the situation.  I'm not seeing that changing anytime soon.

Cya...

Poor & Adherent...

I'm not looking for sympathy, but I'm poor, on disability, HIV + & adherent to my meds.   Becoming poor & + were both easy.  Getting on disability was a serious pain.  Staying adherent to my regimen  has been something I've just done.  But, I've questioned it & hated it a lot of the time.  

I see articles about poor people & not adhering to their regimen.  Most folks would think it was easy to stick to take your life saving medications.  Sometimes it isn't.

• Do you have the means to obtain your meds?
• Can you handle taking your meds?
• Do you have food to eat so you can take your meds?
• Do you have a place to store your meds safely?
• Are you fit enough to remember to take them?

There are all good points, but there are 2 others I can think of that are more challenging.  Do you feel you're worth taking the meds?   Do you feel your life is worth extending by taking the meds?  

Some people wonder if they're worth taking these meds.  Maybe they feel they did something awful  & deserve to die.  Some question, if they should endure the meds & everything else just to keep living a life they're not sure is worth living.

Being poor is difficult.  It comes with a ton of baggage that effects you just become you happen to be less affluent.  People hate to admit it, but most of the world hates the poor.  They especially despise those who happen to also be sick, ethnic, female, or some other marginalizing factor.  

Everyday, poor people  living with HIV have to ask themselves, can I get these meds?  Even if I can,  should I take them?  Is it worth it?  Those aren't easy questions & the answers may change by the hour.  If you ever wonder why some people don't adhere to their HIV regimens, this is just the tip of the issue.

Cya...

1 A Year...

This article details the ongoing research into a drug referred to as MK-8591. The article is very brief & full of jargon.  Google MK-8591 for more info.    Investigation into the compound has been ongoing for years.  It is being hailed as s potential  long lasting, monotherapy HIV fighting med.  

This would mean a single drug to treat HIV that could last from a week & potentially up to a year.  An annual pill or injection.  That would resolve so many problems with access  & adherence.  Even at just weekly. this would be extremely liberating for those people who take several pills daily.  

I realize this isn't a cure. But maybe, making the illness easier to live with is the next, right step to take.  If this pill can aid in increasing adherence & access then they will help in fighting the spread of HIV & AIDS.

Hopefully, this will be available soon.  We'll see,

Cya...

Treatment Adherence...

According to this article, life insurance companies are starting to insure people living with HIV again.   That's because their life expectancy is going back up closer to normal.  However, this is mostly only true of  a certain population; affluent, white males.   

There are at least 1.2 million cases of HIV in the USA.  Less than a third are being treated or maintaining a regimen.  Let the shock & awe begin.

There are numerous factors as to why a person may not adhere to their regimen.  This article refers to them as social determinants.  These affect the person's environment, health, resources & emotional/mental well being.  Some are:

• Cultural pressures & stigma
• Economic resources
• Lack of any resources; food, shelter, etc..
• Lack of support
• Being an addict
• Being in an abusive situation
• Mental illness

These things hit those living on the fringe the hardest.  The poor, some populations of color or ethnicity or just those not in a position to speak for themselves.

There's only 1 real reason to adhere to the meds & regimens,  The person wants to continue living.  For an extremely ill person with little or no resources or support, why would they want to endure that?  What are they fighting for?  Believe me, living with HIV is a fight.  Everyday can be trying in the best of circumstances.  For those in the worst situations, HIV must be utterly overwhelming.  Without support, then why should they bother?  Just to continue existing?  That could really only be said by someone whose never been in a truly awful situation.

For those that don't adhere, they are endangering their own lives & possibly those of others.  But don't shame, chide or ridicule them.  If you care so much, try to help them.  But don't open that can of worms unless you can really handle it.  Stepping into that will be a world most people will never glimpse & will wish they never had.

Cya...

Regimen Adherence...

Adherence is 1 of the biggest issues with HIV treatment.  There a countless articles on it.  Still many people fail to adhere to their treatment regimen.  For some, it's things beyond their control;  lack of access to meds, lack of access to medical professionals, lack of food, etc...  For others though, it's a matter of getting into & staying in the habit of adherence.

That's sounds really easy, trust me as someone who has taken meds daily for over a decade, it isn't at all easy.  There are days when I really wish I'd never see another pill again.   I hate needles, but if they got to a point I could get a weekly/monthly does in a shot & be done with it, I would.  

It isn't that taking the pills is hard, it isn't.  It's that taking them is so easy to forget.  Ask any women on "The Pill".   I've driven myself nuts trying to remember to take my meds.  Only later to wonder if I actually did take them.  I've tried tons of little tricks.  They all worked for a while.  Even now, with the pills sitting right in front of my face, I still have problems remembering to take them sometimes.

Then there's the resentment.  The feeling of being so damned dependent on a drug.  The fact these things have to be with you always.  Every dose is a reminder you have this condition.  This is the price you pay to live.  You know you should be thankful these meds even exist, but still at times you resent them.   No one wants to be reminded they're dependent or ill.  

This isn't just my life problem.  It isn't just my life that rotates around meds & medical appointments.  It isn't just the lives of those living with HIV.  It's everyone finding themselves on whatever medical regimen.  Chronic illness & lifelong regimens are something healthy people can't properly appreciate.  The can't really understand the never-ending doldrums of the situation, of being ill & dependent.   They think, "All you have to do is take a pill."   

Such a naive statement.   So simplistic to think adherence was an easy task.   If it was, it wouldn't be a problem.  Hell, if it was there wouldn't be so many "Oops babies" born because someone forgot to use birth control.  The more common something is, the more mundane & tedious, the more easily it is forgotten or overlooked.

No matter what your ill, adherence is probably a must for your health.   Knowing that doesn't make it any easier.  Here's to adherence, such annoying troll.  

Cya...

Regimen...

A recent study from Philadelphia, has found that 1 in 4 people do not stick to their HIV regimen.  Only 75%  of people given regimens to follow actually do so. Be careful here, there may be many reasons for this.

• Capability to access the meds at all,  HIV assistance programs can be difficult to locate & navigate & many of them have lengthy waiting list
• Understanding of the importance to remain on the meds
• Tolerance of the meds
• Ability to maintain access to said meds
• Inability to access adequate care, Physician, Labs, Pharmacy
• Unwillingness to adhere to the plan

Only one of those is a willful act.  But the results of all these points are the same.  The HIV will progress & the possibility for transmission remains high.  Beyond that, there are meds that can be harmful to the person if they stop/start them.  HIV can become resistant to meds & then the HIV carried by this person could be even more dangerous due to difficulty to treat if transmitted to others.

HIV is not a disease that can be ignored, if infected it will progress in the person's system.  If ignored by the person it can lead to their death & transmission of the virus to others.  If ignored by the state & other institutions, any headway made in fighting this illness could be lost.

It is incredibly important that people be given every possible chance to adhere to their programs.  Unfortunately, for many that just isn't possible.  They simply do not have the means to do so.  Any person living with untreated HIV is at risk to their own health & possibly the health of others they interact with on an intimate level.  It's past time we make sure + people have access to the treatment they need.

Cya