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I was wondering if someone could breakdiwn treatment options…

Customer Question
I was wondering if...

I was wondering if someone could breakdiwn treatment options snd cost for me. I am getting told HIV treatment is imposdible unlesd rich and you won't get insurance

Doctor's Assistant: Have you seen a doctor about this yet? What medications are you taking?

None yet. But I have a partner overseas taking genvoya and wanted too understand options as well as preventative for me in future reference

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

None that I can imagine

Submitted: 22 days ago.Category: OB GYN
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Answered in 1 hour by:
5/27/2018
OB GYN Doctor: Dr. S, Board Certified in Family Medicine replied 22 days ago
Dr. S
Dr. S, Board Certified in Family Medicine
Category: OB GYN
Satisfied Customers: 38
Experience: Attending Physician
Verified

Hello, I am Dr. S and look forward to working with you towards an answer to your question.

To allow me to better answer your question, do you currently live in the USA?

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Customer reply replied 22 days ago
No. I am in military. My situation is that my family doesnt support the relationship due to the percieved burden and risk if HIV and I wanted more information on it before I continue or decide
OB GYN Doctor: Dr. S, Board Certified in Family Medicine replied 22 days ago

Thank you for the information. So treatment options depend on HIV status and partners HIV control. If you are HIV negative and have contact with someone where there is risk for HIV to be passed to you, they do have PEP (post-exposure prophylaxis). This used to be given within 72 hours of exposure, however recently the FDA has approved for daily use for people with frequent contact. It is typically done with a medication called Truvada. Some insurances cover it, some do not. The manufacturer does sometimes have coupons or assistance plans that can be obtained to help subsidize the cost for certain insurances. Some health departments will also often have assistance programs to help afford medication if needed. This will vary depending on location.

If a partner's HIV is well controlled with an undetectable viral load, there is a much lower risk of possible transmission.

If you have HIV and need treatment, you are right certain regimens can be very expensive. However again many local departments will have access to assistance programs to make them obtainable. The choice for which regimen is chosen is based on multiple factors including overall health, age, kidney function, liver function, HIV genotype (particular strain) and resistance patterns.

It is very possible in our age to have a relationship with an HIV positive individual without contracting HIV (although there is still a risk) and live a normal happy live, including having children.

If you have additional questions or want more clarification, please let me know.

If you feel the above has provided good information, please give a positive 5 star rating so I may receive credit and continue answering questions for others. This will not close the question, so you may still continue to ask questions.

Is it US military or another country?

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Customer reply replied 22 days ago
US Military. I had another question on if you could tell me the difference in effectiveness in antiviral and antiretroviral
OB GYN Doctor: Dr. S, Board Certified in Family Medicine replied 22 days ago

Antiviral is a broader category and used to describe any medications that work on a virus, however the term is typically used when referring to medications like tamiflu that work on the influenza virus or valcyclovir or acyclovir for herpes/shingles.

HIV is a classified as a type of virus called a "retrovirus" so the medications used to treat them have taken on the name "antiretrovirals." Antiretrovirals have different classes with different mechanisms of action; some block enzymes that disrupt copying of HIV genetic code which disrupts the virus from replicating, some block protease enzyme which prevents the virus from maturing, some prevent fusion of HIV with cell membranes which makes it harder for them to enter new cells. Antiretroviral therapy usually uses at least 2 classes, there are multiple different regimens currently. The advent of the single pill drug (Has combinations inside) has revolutionized the treatment options as it greatly simplified regimens.

In treating HIV you want to use antiretrovirals. Many things can impact their effectiviness, which is one of the reason so much testing is done when selecting treatment. They check resistance patterns, strains of HIV, the patients overall health and any underlying chronic medical issues (kidney, liver). With all the testing however, the remission rate and control rate has improved significantly.

In regards ***** ***** previous question about cost. I am assuming with the military, that you have tricare. Tricare's formulary shows that Truvada (medication for PrEP) is covered. Free if you are active duty, $24 for 90 days if you are not. (link below)

https://www.express-scripts.com/static/formularySearch/2.9.1/#/formularySearch/drugDetails/61958070101/Truvada/F/30/200-300%20MG/?accessLink=FSTDrugStrength

-So treatment is obtainable. Using condoms has also been shown to greatly decrease the risk of exposure, however there have been studies of non-condom using partners where the positive partner had a nondetectable viral load where there was nearly no cases of transmission in those studies.

-For treatment of HIV, with or without insurance, if you are stateside, each state has an HIV hotline that can help one to locate resources near you where there is assistance in obtaining treatment. (Link below)

https://hab.hrsa.gov/get-care/state-hivaids-hotlines

-If you have additional questions, please send a message back.

-If you feel the above has provided good information, please give a positive 5 star rating so I may receive credit and continue answering questions for others. This will not close the question, so you may still continue to ask questions

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