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Comment by credit_guy | Hacker News Reader

Why? If you have HIV you need to be on antiretroviral drugs. They keep your viral load to undetectable levels, so your immune system does not need to fight it.

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Yep, if HIV progresses to the point of AIDS, suppressing your already-suppressed immune system would be bad. But with today's treatment regimens HIV won't progress anywhere near that point. Which is borderline miraculous, really.

HIV is the virus that makes you develop (or "acquire") AIDS; AIDS is the condition that weakens and kills you. If you pump the breaks as soon as possible, HIV on its own won't have catastrophic health implications, although it's obviously better not to have it at all.

> HIV on its own won't have catastrophic health implications

Yes it does.

You can never let your blood or sexual fluids come in contact with another uninfected person and you can also never be a mother.

Your lifespan probably won't be impacted all that much.

These are two wildly different things.

Not true at all! You can absolutely get pregnant with HIV, and there are a number of steps you can take to prevent transmission to an unborn child.

Similarly, if you take antivirals to get your viral load down to undetectable levels, the risk of sexual transmission is very, very low. The risk is even lower if your partner takes PrEP as well.

You certainly need to take precautions, but people with HIV can live full, normal lives.

Normal lives is not exactly the correct term. Like any drugs, HIV medication come with their own bagage of side effects.

Let's say people with HIV can live like most people receiving treatment for a chronic disease.

The rest of your points stands.

That may have been true decades ago, but is no longer the case. Of course nothing is risk-free, but current drugs can get HIV viral loads down to undetectable levels, and if your drug treatment is successful, it's considered reasonably safe for you to swap fluids with others (with their knowledge of your medical history, and consent, of course), as well as become pregnant. Sexual partners should be on PrEP too, to further reduce the risk.

This isn't "living a normal life" completely, and the retrovirals have side effects and the regimen needs to be maintained, but the state of things for people with HIV is so much better than it was back in the 90s.

I don’t know why you are getting downvoted but I’m guessing that a lot of people don’t know about/understand that undetectable = untransmittable. It is generally seen as safe to have unprotected sex with someone whose viral load is suppressed to the point of being undetectable. Of course you need to believe that’s the case, informed consent is still important, and it’s probably a good idea for the negative party to be on prep, but the fact that the likelihood of transmission is so low if someone is undetectable is widely accepted in medicine and widely known in the LGBTQ+ community at this point.

Just because your condition has catastrophic consequences, particularly if not _properly_ managed, doesn't mean you have to live your life in a catastrophic way.

Pretending that should be ignored benefits no one.

Not quite, the proper course of action is that both you AND your partner take drugs to prevent transmission

Antiretrovirals have significant risks and adverse effects. Uninfected people don't take antiretrovirals unless they have been exposed to the virus. They protect against exposure instead.

The chance of both condoms and antiretroviral therapy failing to prevent transmission simultaneously is always going to be lower than the chance of either failing independently. In practice, many couples decide that the risk of transmission associated with antiretroviral therapy is low enough for them.

Yes you’re right. I was wrong. I confused it with the case where you both have HIV since they can be different strains.

> You can never let your blood or sexual fluids come in contact with another uninfected person and you can also never be a mother.

Completely false. Treatment is quite effective at preventing transmission in both cases.

The drugs have lifelong costs and side effects, and patients have lower life expectancy than the general population.

Massive improvement to what came before but it's still much worse than most health outcomes people take pains to avoid.

https://www.webmd.com/hiv-aids/aids-hiv-medication-side-effe...

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