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Comment by ausbah | Hacker News Reader

Personally, I wish what would really get attention in the realm of HIV treatments is invention and subsequent spread of "prevention" drugs like PrEP (significantly lowering chances of getting HIV if taken daily) and PEP ("fight off" HIV if possibly exposed to it in the last 72 hours), in addition to amazingly high level of quality that HIV therapies have reached such that if HIV can't be detected - its effectively untransmittable.

Not trying to draw attention away from the potential significance of the article, would just like more of the "widespread", effective treatments get a little light.

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Not gonna disagree; the treatments are good and getting better for PLWHs - side effects are nearly nonexistent on the day to day and better than they were in the long run. And PrEP / nPEP are miracles at reducing seroconversions in high risk groups/persons exposed.

We do need a cure. The damage done to the body of an HIV positive person who’s undetectable, on HAART/meds is progressive, permanent, and irreversible. Even on treatment, chronic inflammation of the immune system adds a lot of undue stress to the body. While I’m not at risk for any AIDS defining illnesses/cancers, I’ve still got a very high risk of other cancers compared to someone who’s HIV-negative. I’m grateful for laws protecting people like me with pre existing conditions - which forces my insurance company to fully cover my $6000 US/mo in HAART treatment. (Symtuza/Tivicay if curious)

What’s the amount of money big pharma will make over the course of my life alone? Millions if they can keep this up.

How great could life be without HIV in it for good? I’d like to find out, or at least maybe get my doctor to stop asking me to fill out an advanced care directive.

I’m thankful otherwise that at 32 I’m fit, in perfect health, and undetectable. Someday I hope i’ll change my status to “cured.”

I'm on PrEP. It was astoundingly hard to get on. So many primary care doctors have no idea what it is or why to prescribe it.

in australia at least these days, i’ve gone to arbitrary doctors for my 3mo tests and things and almost always they’ve offered to prescribe me PrEP... i’m already on it, but it seems here it’s being promoted by almost everyone!

Is that covered by insurance? In the UK, some people are expecting the NHS to pay for it.

The NHS absolutely should pay for it.

I disagree. The steps to avoid requiring it are well understood.

If people want to indulge in "risky" behaviour, I have no problem with that. I just don't want to pay for it out of my taxes. It's like someone who makes a habit of jumping out of aeroplanes complaining that the government won't pay for his parachutes.

>If people want to indulge in "risky" behaviour, I have no problem with that. I just don't want to pay for it out of my taxes.

You will pay for it out of your taxes when those people become HIV positive - and it will cost even more than PREP.

Should the government not pay for costs due to pregnancy? The steps to avoid it are well understood, and it does cost a lot of money.

Yeah, not sure you can class promiscuous shagging to bringing a child into the world.

That’s just straight-up homophobia, which is not ok on HN. Most HIV transmission occurs within relationships, and most causal sex (gay or straight) happens indoors and in private.

Your edit doesn't really make sense, as a quite a lot of children are the result of "promiscuous" sex, and the NHS still pays for the relevant care.

You're still ignoring the fact that HIV transmission typically occurs in the context of regular sex with the same person. Having one-off sex with strangers actually isn't a particularly efficient way of becoming HIV positive.

Well, I'd say one was the most important thing most people will do, and evolutionarily their whole reason for existing.

Absent being a sex worker, the other is just hedonism.

Weirdly, you seem to be missing the fact that children happen as a consequence of sex (and not uncommonly as a consequence of promiscuous sex).

Accidentally becoming pregnant can be exactly as "hedonistic" as accidentally becoming HIV positive.

Foldr - updated.

And I think you are going to bring a lot more data to back up the nobility of "bringing a child into the world" because I think that's straight up BS. Ignoring the scores of unplanned pregnancies I think the notion that "bringing a child into the world" is "the most important thing most people will do" is reductionist and frankly disgusting that you think THAT is "the most important thing most people will do". What a sorry state our world is in if that is the case.

Name something most people do that is more important than having a child.

Choosing deliberately to not have a child.

> If people want to indulge in "risky" behaviour, I have no problem with that. I just don't want to pay for it out of my taxes.

You do understand that taking PrEP is literally the opposite of "risky behavior"? Just because you are on PrEP does not mean you immediately stop using condoms. Do some people use PrEP as an alternative to condoms? Sure but some women use birth control as the same thing. Please don't lump us all into the same category. Even on PrEP I still used condoms and only had sex with people who were undetectable. I used PrEP to cover all my bases, not to take risks.

According to your logic, people who ride in or drive cars shouldn't get any insured treatment if they have a crash, because they willingly indulged in risky behavior.

What country was this in?

PrEP was easy enough to get on with my PCP but I got priced out when my company changed insurance. What use to be a tier 2 drug became tier 4 meaning what used to drop down to a $30 copay after my deductible was met now would cost me $400/mo until I hit my $6K OOP max (which I cannot afford).

I just wish the financial system around getting it wasn't so complicated. Its a $2000/mo drug - even if you have private insurance, you probably are gonna end up with $1k out of pocket after the manufacturer discount. If you're broke and have a high deductible, you have to pay through the whole deductible every January to get your refill.

If you change providers and its not timed perfectly, you're out the $1k out of pocket cost until you can snail-mail in the form and get reimbursed. It ends up that only the more financially stable, or medicare-eligible people can afford it, and even then its a significant hassle. I'd consider it very worth the piece of mind but its a financial landmine.

Not to be negative on it. If you're thinking you should be on it, you probably should. Be prepared to jump through a few hoops though.

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