Wednesday, December 28, 2016

PrEP for HIV may benefit from big advances soon; rates of HIV still higher than I had thought; HIV may have been in NYC by 1970

I have covered anti-HIV medications but I don’t think I’ve mentioned the drugs that prevent HIV infection from occurring at all.

NBC News has a detailed story that an investigational drug could be injected every 60 days and prevent HIV infection for those at risk.  There is a related Facebook group    The technology is called PrEP, or Pre-exposure prophylaxis. The pills available now (Truvalda) are expensive.  Any health care (Obamacare) reform package would have to consider how to pay for this, as it is obviously a sensitive issue from more than one viewpoint (“moral hazard”).

Even now (Obamacare before Trump) it is difficult to pay for these meds, according to a 2015 Daily Beast story.

PrEP medications are often advertised in gay publications, often with pictures of attractive male models.  I don’t think anything should be inferred if you recognize a particular model.

NBC linked to several other important stories.  One says that gay or bisexual men have a 30% infection rate in some southern cities (including Atlanta but not Dallas). Another says that black gay men have a 50% infection rate.  The population as a whole has a 1% infection rate.  My own observation in my own circles would suggest that the infection rates are much lower.  There is another story which says that HIV may have entered New York City as early as 1970, and moved to San Francisco in 1976.  But Randy Shilts (in “And the Band Played On”) had suggested that HIV could have arrived in the US about 1976 and the Tall Ships bicentennial celebration in NYC that Independence Day.

I moved into New York City in September 1974 and left for Dallas in January 1979.  In 1978, I started hearing stories of some unusual illnesses.  Until then, Hepatitis B was well known, and I was vaccinated for that in 1982.  Syphilis and gonorrhea were well known. Hepatitis A was also common.  In New Jersey and a few other US locations, there were some mystery clusters of Hodgkin’s lymphoma that some doctors thought had been virally transmitted.

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