What is PEP – PEP is when a short course of HIV antiretrovirals are given to someone following a possible exposure to HIV in order to decrease the risk of HIV infection. PEP consists of 3 or more ARV’s and is taken for 28 days. It is best to begin treatment as soon as possible after exposure, before the virus has time to replicate in the body. PEP must be started within 72 hours of exposure. Although PEP is not 100% affective, it dramatically reduces the chance of infection.
For someone who is HIV positive and in, or considering a sexual relationship with a positive person, the risk of HIV transmission is an important issue. In the summer of 2011, results from the HPTN 045 study were released stating that with an undetectable viral load, the risk of HIV transmission was decreased by up to 96%. Based on this study, and a few much smaller studies at the time, it seemed that the scarlet letter that was placed on HIV positive people as being infectious was lifted for the lucky ones who were able to achieve an undetectable viral load. However, many in the HIV professional field as well as HIV activists and advocates were reluctant to discuss the issue of a decrease in risk of transmission based on available research.
Why HIV-associated Enteropathy is So Often Left Undiagnosed, Unaddressed and The Potential of Nutritional Management.
HIV-associated enteropathy remains a substantial problem for both HIV patients on HAART and those who are not receiving treatment. It is estimated that about 15-30% of HIV+ people, even when on antiretroviral therapy, continue to live with this persistent and debilitating condition for which there is currently no effective marketed intervention. HIV-associated enteropathy, first described in 1984, is a change in intestinal structure and function in HIV-infected persons. There is a lack of research not only on potential treatments, but also on the role of this condition in HIV disease progression and its effects on HAART and treatment for co-infections.
The US federal Government spent $15,600,000,000 on providing it’s HIV positive citizens with antiretrovirals during the fiscal year of 2012. With many people living with HIV now surviving to near normal ages and the spread of the disease continuing, this ongoing cost will only grow annually. As ARV’s are a constant necessity for the 1.2 million HIV positive Americans, there is no predicted relief of the individual lifetime cost of $367,134.
Since the beginning of the AIDS crisis, the need to ensure the most comprehensive clinical education for physicians has been a critical element in changing the course of the epidemic. That is no less true today. However, in the emerging landscape of Obamacare, ensuring that doctors are afforded the dedicated level of time needed to develop excellence in their clinical practice is becoming increasingly challenging.