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...

Consistent...

 

There've been a lot of articles lately discussing the same concept.  Whether it's HIV treatment, PrEP, condom use, safer sex practices, etc..., they all depend on consistency.  You can employ any of those listed things, but unless it's done regularly & properly, they won't be as beneficial.  Unless the last 3 are used in a consistent basis, they won't provide as much prevention. 

The primary thing in any post or pre HIV regimen is constant, consistent, proper usage of the medication.  Even if you have the med, if not take routinely as prescribed, it may not work as intended.   Doctors can only provide access to the meds.  The rest of it is up to you.  I'm not saying it's easy.  At times you may very well hate the meds for numerous reasons.  But not taking them, really isn't any option, if you want to manage your HIV.

HIV forces you to become consistent.  There are doctor appointments, labs, pharmacy trips, meds to take, other means pf self care & so on.  It's trying & unfortunately, the lion's share of the work is on you.  Maybe someday, they'll have a cure.  But for now, that's just a dream.  You are the only thing really keeping your story going.  Learn to be consistent regarding your HIV so there's a next page.

Cya...

Sort Of Whining...

 

My 1st HIV cocktail was a handful of pills 3 times a day & couple solos here & there.  Slowly it dropped to about 6 pills.  Then weirdly down to just 1.  The single pill took some getting used to.  I was sure I was forgetting to do something.  Now, we're well on our way to injections that could last weeks to months. 

Don't get me wrong, it's great.  It should greatly improve regimen adherence.  But I hear some newbies complain how they can't be expected to remember to take a pill every day.  They're complaining about a single pill, when some of us started on dozens.  I know people always want more, but how but 1st you try being grateful for what you have in front of you.  There was a time not so long ago, when there were  no meds for HIV & a lot of people just died.

I get it, you want the next big thing.  But don't dis what came 1st & those who brought it to you.  Be thankful for the efforts that got things where they are, be excited about the new, just stop whining.

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...

Sore & A Gripe...

I'm a little sore after finishing up the seasonal yard work.  I hate vibrating power tools.  They mess with my arms & hands.  It lasts for quite a while & then I feel weak for hours afterwards.  I'm a bit tender today.  At least it's done.

I read about advancements in long-acting HIV meds.  Lasting anywhere from 2 - 12 weeks.  I'd love a monthly.  It'd be great if it worked.    Then I see how people need the long-acting because taking a 1 a day regimen is just "too" hard.

Too hard?  Really?  

When I started I was taking 18 Fortovase (horse pills), 2 Epivir, 2 Didanosine & 1 Dapsone.  Not to mention OTC stuff like ibuprofen, allergy pills, supplements, vitamins & more.  I was literally scarfing pills.  I wasn't taking nearly as many as some people.  When they said a drug cocktail they meant it.   Fill your glass with pills & start swallowing.

Maybe everything's relative or maybe we were just tougher.  Maybe these people are just whining because they have no idea how good they have it.  Suck it up bi$%* & swallow your damn 1 a day.  At that rate I was swallowing a month of pills a day.  

Take care.

Cya...

Biktarvy

According to these articles, 1 & 2, the FDA has granted Gilead the go ahead with a new once daily regimen.  It will be called, Biktarvy.  Sounds like a German version of the  1960's show, Daktari.  It is very similar to the Descovy, which is basically an altered form of Truvada.   It has Bictegravir as an added component.  I couldn't find much on Bictegravir besides this pdf. 

The 1st article is very light, but holds a very important detail about this new med, the cost, which will be over $35,000 annually.  It's expected to quickly become the gold standard for HIV treatment.  Of course, it's a literal gold mine for Gilead.  The 2nd article goes much further details of the matter.

Give them a read.   This is medication has been approved & will be hitting the market soon. 

Cya...

Handled, I Think...

I think my car insurance issue is resolved.  It took nearly 2 weeks, but at least it's over.  I finished yesterday afternoon & made some calls this morning to confirm.  I will be with  a new company as of Feb 1, 2018.   I was beginning to think this was something I was going to drag into the new year with me.  I'm glad it didn't turn out that way.

There is more talk of 2-med approaches to HIV treatment.  Until now this has been treated as unwise, but some research is gaining traction.  It's still in the trial stages, so I'll wait to post more definitively about the matter.   Right now, 1 such trial is using 2 of the 3 medications that make up my Triumeq.   This could prove beneficial in reducing cost, possible reactions & drug interactions. 

Only 3 days left in the year.  Hope your years ends well.  May we leave some of the awfulness behind & not gain any more.

Cya...

Drear, HIV & Health...

I've talked before about how dreary weather affects me.  If you Google Seasonal Affective Disorder & HIV, you'll get a ton of results.  Even with as bad as mine has been, it's nothing compared to some of what of I've read people enduring.  For many extreme depression is common.  They dive headlong into extended sleep patterns, over-indulging in just about everything, having mood issues, pains, aches, etc....

For me, it's mostly having a lot of aches & chills.  I stay cold & tired.  It gets hard to focus.  Things like this impact your health.  I'm good about my regimen, but others report having difficulty maintaining their regimens during the grey seasons.  

If your mood alters from late Summer to Early Spring, you should consider the idea you might be dealing with a seasonal disorder.   It doesn't matter where you live, it's about the change in light & weather patterns.  It can seriously alter your life.  Remember having a chronic illness of any kind amplifies the effects of other issues.  You're already worn down.

For me, added light helps.  It isn't 100%, not near, but it's what I can do.  It helps to have bright lights on to chase away the shadows.  Night time isn't as back.   Then it's dark, not dreary.

I have grown to hate Fall.

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...

It's Here...

My new med, Triumeq  arrived yesterday.   I took the 1st pill today.  So far, so good.  My new regimen will have my thyroid pill 1st thing in the morning.  About 10 - 11 AM, I'll take the Triumeq.   Later in the day, I'll take my vitamins & supplements.  I don't like to crowd the supplements with other pills, they can be rough on the stomach.  Also, anything with iron or calcium in it needs to be taken with some time between them & the Triumeq.

This is the site for Triumeq.  It has quite a bit of info on it.  This medication doesn't need a buffer like I was taking with my Invirase.   It can be taken with or without food,  It's a once daily pill, that can be taken at any time.  As you can see above, it's a bit of a horse pill, but not too bad.  I am sort of concerned with card that came with it to carry, pictured below.  But at least it's fair warning.

OK, it's here & I'm on a new regimen.  Here's hoping all goes well.   BTW, I finally saw a new little visitor in the backyard.  The 1st this year.  A tiny, little, black dragonfly on the clothesline.  The dragons are back.

More tomorrow.

Cya...

Something Got Skipped...

Due to failing reminder apps & Google reminders, I didn't notice yesterday was National HIV Testing Day.  I usually write about it on June 27.   Not this year, I was distracted & experienced technical difficulties.  

I only noticed today because people are talking about the White House's  half-ass attempt to make it appear as if Trump gives a damn about HIV.  Yeah right.   I'll try to remember next time around.

My new medication should arrive today.   Oh boy, here we go.  I'm trying not to think about it too much.  If it arrives, I'll start taking it tomorrow.  A new day, a new chapter in my regimen.  Like or not the current 1 is closing.

Until tomorrow.

Cya...

Synopsis...

Just some article briefs for your consideration.   The 1st article, is linking the success of  HIV Treatment to the rise of  drug resistant HIV.    This is much more apparent in areas like Africa, where social stigma, political upheaval & economic instability have led to a lack of HIV resources or these assets being made unfavorable or even illegal.   The article discusses the lack of regimen conformity either due to choice, politics or simply not having access to the medications/facilities. 

The 2nd article,   deals with the currently researched method of fighting HIV known as, shock & kill.   The approach tries to force the virus out of hidden reservoirs in the body.  This approach may kill the virus, but could also prove damaging to the brain.  The  study shows the approach was shown to sometimes lead to swelling in the brain.

This last article doesn't deal with HIV at all.  It deals with a Veterans center where a man died after having maggots found in his wound.  Yes maggots. This is my area of the world.  Four have resigned, but that won't do much good.  The center is in a very rural area & they don't have the resources to attract a permanent doctor.   Because of this, steps that could decrease situations like this from happening weren't taken.  The center is little more than an under staffed, under funded & neglected nursing home for Vets.  Goes to show, not all the crap is aimed at HIV patients.  Just those people, most deem no longer matter.

Cya...

Weekly...

According to this article, the pharmaceutical company Cytoden is working on an injection of PRO 140.  This is an antibody that can inhibit the virus.   If this research pans out, it could mean people moving from massive numbers of daily pills to weekly injections.  It's  possible later generations of the approach might yield fewer injection intervals.

This would be great & I hate shots.  It could mean far less pill popping.   Having to remember a weekly shot & not numerous pills every so many hours.  This could aid in regimen retention & getting medications to people in the 1st place.

I really hope this works out.

Cya...

Drug Resistance...

This article talks about how children born with HIV are more apt to develop resistance to HIV meds than others.  This drug resistance is usually partial but can be in rare cases be complete.   At that point, there are few if any medical options for the person & death from HIV related issues is likely.

HIV resistance can happen for whatever reason.  It mostly happens in people who have been irregular in their medical regimens.  Besides health problems & possible death of the person, if a  person contracts HIV that is already resistant, then there are fewer options for that person to begin with.  

There may  be an abundance of discussion about HIV meds, but there are a finite number of types and actual formulations.    Even though, there are more than there were a decade ago, a person could still become resistant to all of them over time, if the right circumstances played out.

Drug resistant is incredibly dangerous, whether it's HIV, measles or the common flu.  Any drug resistant virus, microbe or bacteria could pose a phenomenal  health threat.  Medications should be used properly & consistently.   They should not be freely prescribed to the point of allowing the target to become resistant to them.  

An interesting article.

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...

Generics Are The Way...

According to this article, generics could save a lot of $ in the treatment of HIV patients.  Not to be rude, but Duh!  Snark aside, the point made here is that if we want the convenience of a 1-A-Day regimen, that is the top of the line, then we're going to pay for it.  The writer went on to discuss how shifting from a state of the art, 1-Pill treatment to an older 3+ pill treatment plan could save a remarkable amount in regards to $ & cost little in the efficacy.  The real payment here seems to be the inconvenience of multiple pill regimens.  Better multiple pills a day that work than not having any at all.

I would love to have a once a day regimen or at least have it so all my pills could be taken at the same time.  However, if the cost is significantly less, I'll continue to pay for it with my inconvenience.  The less these meds cost, the more people can get treatment.  It's that simple.  So, I'll deal with multiple pills throughout the day, with & without food, if it means the $'s to fund these programs can stretch farther.  My convenience is not worth someone else not getting their meds.

Cya...

HIV & Psych...

No pic today, but the article is interesting.  The article states that for many people diagnosed with HIV today, one of the most important factors to consider is the psychosocial  aspects of the patient's life.  How does this person relate to their social environment & what impact does that ecology have on them?  

For people in more stable environments, treatment has fewer complications & is often more successful.  The opposite is often true if the person views his/her environment as dubious, inhospitable or even dangerous.  A person who has a loving home-life with people who support them through their treatment is going to better than someone living on the streets with a drug addiction.  The person trying to hide their status won't fair as well as those who are open about it at least with some people in their lives.

Support & acceptance are as important as $ & meds in being treated for HIV.  Why bother if no one cares?  Why bother if you have nothing to look forward to?  Those without support or reasons to look forward are going to have a rougher time with treatment.  Every time some asshat makes a comment against HIV people or wants to cut HIV funding, these people may feel directly targeted.  This type of thing can weaken their resolve to stay on a treatment.regimen.  These people have enough going on without insensitive jerks piling more on.

Cya...

One A Day...

This article discusses something I'd figure was common sense.   Only having to take 1 pill a day increases a person's likelihood of following a medical regimen.   Not trying to be too sarcastic, but well, Duh!  Taking 1 pill a day would be a delight, especially if it didn't matter when you took it or if you had eaten or not.  When I started taking my meds I was on Fortovase.    I had to take 18 of those horse pills a day broken into 3 increments & it had to after I had eaten something.  That didn't mention my other meds, some of which had to be taken on an empty stomach, at least an hour before eating anything.  So, yes, simplicity is a good thing.

Besides regimen adherence, the study also found other aspects of these patients' lives were better than those on multiple  pill regimens.  They had better blood work, were less likely to develop complications & were less likely to be hospitalized.  The numbers are pleasing.  Maybe my regimen can be like this some day.  Right now, I take 8 pills a day specifically for HIV, plus several supplements/vitamins.  Hey, it's better than it used to be.

Cya...

Treatment Impact...

It's been said for some time, that those who have been treated & have undetectable levels of HIV in their blood are less likely to transmit the virus to others.   This article takes that a step further.   There is now statistical evidence of the impact of treatment.   

The research collected from the KwaZulu-Natal province found that in areas where antiretroviral   therapy uptake is above 30%, uninfected people are 38% less likely to acquire HIV.

This African study shows not only does treatment aid the patient, it's also a preventative for the patient's community.  This is literally huge.  These meds are helping those people who need them & protecting those who aren't yet infected.  

There is no reason not to provide care for everyone diagnosed +.   I realize there will be the $ costs.  But treating those who are + now, may prevent incalculable numbers of others from later being infected & needing this kind of treatment.   This can not be looked at as a here & now thing, this is a matter for the long term & those kind of approaches must be employed in order to prevent & hopefully eradicate HIV.

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