Have you read our TasP 101s? Still got burning questions about Treatment as Prevention?
Let us help fill in the gaps.
Treatment as prevention is for any person living with HIV. HIV treatments not only keep the body healthy for people living with HIV, but it also stops onward transmission of the virus.
Treatment varies from person to person. Essentially, your treatment plan will include regular testing to monitor the levels of HIV (viral load) in your body, as well as your CD4 T-cells to monitor how strong your immune system in – and daily oral medication. What type of medication that is will depend on your own treatment and care plan, which you talk to your doctor about. You might start on one ‘cocktail‘ of medication and switch to another over time if it works better for you.
Besides the basics, your treatment experience may have its ups and its downs, it’s sideways and its backways – but there are many great places where you can talk about your HIV journey with others, outside of your doctor’s office – check out our links page for great HIV-related resources to make your journey as comfortable as possible.
In Australia, access to HIV treatments is generally quite easy and affordable. There are many resources out there to find a doctor who is experienced in prescribing HIV medications and caring for people living with HIV. You can find a map over at the ASHM website or you may want to get in contact with your local PLHIV organisation or your state AIDS council via our links page to find a local doctor.
Some regional and rural areas of Australia have disjointed or varied access to HIV care and treatment services. If you live in a remote community, or do not have equal access to your doctors, you might be able to access care through the Telehealth remote-access programs lead by The Royal Australian College of General Practitioners (RACGP).
Adherence to your treatment regime is important because it keeps your body healthy, and your body’s HIV levels as low as possible to prevent onward transmission.
Stop-starting treatment, or not being adherent to your medication can result in the HIV in your body not being effectively suppressed, and ‘learning’ about the medications you’re using to treat it – and may develop resistance. This makes it harder to treat, and if passed on to another person makes them difficult to treat also.
If you start your HIV treatment before you are ready it may impact your ability to keep up your adherence to your medication – you should decide with your doctor when the right time to start treatment is for you.
But – you might not even notice them or know that it’s relating to an HIV infection. Around 80% Newly HIV-positive people have signs of seroconversion (becoming HIV-positive) but the rest don’t have or notice any.
You might experience fatigue, fever, sore throat, headaches, rash, loss of appetite, aching muscles and joints, swollen glands. Any combination of these could simply mean you’re run down or have the flu so you might think nothing of them – which is why regular testing is important. Early diagnosis means you can start treatment as soon as possible.
After initial infection, most people go on to live their lives without much notice of their new status. But behind the curtain, HIV will be working its way through the body, and eventually, AIDS-related illnesses set in. Cancers are common but many other complications can result.
Before we knew what we know now about HIV, there was rampant misinformation about HIV transmission, which has impacted people living with HIV over the past 35 years, and the stigma they face.
We’re here to tell stigma to get fucked, and the best way to do that is arming yourself and others with the facts rather than fiction.
While there’s (minimal) HIV present in saliva – other factors inhibit infections from saliva. You cannot pass on HIV from kissing, sharing drinks, or any of that nonsense.
HIV levels in cum are usually much lower than in blood, however other STIs can affect these levels more.
HIV has been found at infectious levels in vaginal and cervical secretions, rectal secretions and breast milk.
Other things can affect the levels of HIV in body fluids, such as stage of infection (untreated newly HIV-positive people tend to have more chance of passing on the virus).
Adherence to your treatment plan will ensure that which body fluids have what level of HIV become all but a moot point.
Recent studies have shown that the best time to start treatment is as soon after you become HIV-positive as possible.
Not only will this keep your body healthy now, but you’re giving yourself the best head start for your future health.
However, it’s also important to start your treatment when the time is right for you. As the incomparable Panti Bliss says “Your journey. Your rules”
With effective care and treatment – eventually, the copies of HIV in your blood will get to below 50 copies per milliliter. This is considered undetectable.
The amount of time this will take will vary from person to person. 90% of people will achieve an undetectable viral load within 3-6 months. When you enter into a care and treatment plan with your doctor they will explain the role that you and your medications play in keeping yourself healthy
That depends. If you keep up a consistent care and treatment plan, that’s incredibly likely. If you and your doctor decide to transition you from one type of medication to another, you may experience viral ‘blips‘ and your body gets used to the new meds.
It’s important to remember that if you get an STI, this can cause an increase in viral load in your genital tissue. A blood test won’t necessarily show an increase – so it’s important to keep up regular STI testing as part of your care and treatment. Seasonally, every three months is a good idea.
It’s important to note that most people who get on the treatment that is right for them can reach an undetectable level of HIV. However, for a small percentage of people, this may not be possible, and that is ok. Maybe the medication that would make you undetectable just doesn’t agree with your body and makes you feel crap, or tired, or just gross in general. If you are on a treatment that works for you and you aren’t technically undetectable you will likely still have a massive reduction in the levels of HIV in your body – which will still give you a drastic risk reduction in passing on HIV to partners in the future.
If you’re concerned about your HIV levels, discuss your own treatment directly with your doctor. Luckily there are other great tools to prevent HIV as well, and using one doesn’t eliminate the others as options. discuss PrEP with your regular HIV-negative partners – and condoms might be the way to go.
Just because you can’t get to an undetectable level now doesn’t mean you’ll always be detectable. for example, if you’re living with hep C, which is impacting your treatment – the new hep C treatments may change that.
Entirely up to you! Your disclosure can be a personal and significant challenge.
There are no Federal laws stating when a person with HIV must disclose their status – however this can vary state to state. To keep up to speed, we’d suggest contacting your local AIDS Council or PLHIV organisation for the full run down – and check out The Disclosure Project.
If you decide to disclose your status to someone you’re fucking they may have questions. It’s not your responsibility to educate anyone – it’s their job to get informed.
That being said, the more our community catches up with the science behind UVL the better. If you feel comfortable disclosing, sing it loud and sing it proud!
If you do feel like gettin’ your teach on – you can point them to one of the great online resources for info on TasP or UVL.
That will vary person to person depending on your care and treatment plan, but around every 3 months is a good idea in general. It’s a good idea to also get your full STI screen done too. Two birds, one stone and all that.
Stigma toward people living with HIV can come in many forms. As advocates for empowered sexual health, we work to minimise stigma for people living with HIV as well as the other stigmas faced by PrEP users, and those who love sex in general.
If you are armed with the facts about HIV you can combat stigma where it rears its ugly head. Some stigmas don’t come from a place of hatred, but from misinformation.
There are some amazing grassroots community organisations who create spaces for people living with HIV and fight to end stigma, like The Institute of Many, and your local PLHIV organisations. Head over to our links page to get in touch with them.
We’re a bunch of PrEP users, so why are we aboard the TasP bandwagon?
Simple: Treatment as Prevention works… and, it’s the most effective tool we have at ending HIV.
TasP and PrEP are like Joanie & Chachi, Will & Grace, Paula Abdul and animated cats.
See “The Team” for contact information, our pics and a little blurb from each of us about why we are motivated to help.