I have been privileged to be asked to deliver three guest lectures, this Fall Semester, for the College of the Canyons' Sociology of Sexualities course, taught by Professor Pamela Williams-Paez, on the topic of HIV/AIDS. In those lectures, I spoke about the history of HIV in the United States, starting in the 1980s and working up to the presents, as well as covering information about other STDs/STIs, treatment methods, prevention, and Smart Sex (a growing movement to replace the "Safe Sex" conversation that, while having proven effective, needs a serious update).
During these lectures, I take a bit of time to discuss various pharmaceutical treatments for HIV/AIDS and various other diseases such as Herpes, HPV, and Syphilis. In this discussion, I speak about my wariness of newly released drugs whose effects have not been fully tested over a long period of time. I offer up Valtrex (used to treat Herpes) as an example, highlighting how quickly it was approved and put on the market without first testing to see if it would have an adverse effect in people with suppressed or compromised immune systems. The result of this oversight was that those whose immune systems were already compromised ended up getting very ill (with several deaths to follow).
Since that time, I've been very skeptical of trying new medications that are put on the market without several years of trials to test the long-term effects. I have generally cautioned people to wait at least five years after a drug hits the street if they have any concerns or are unsure if they should go forward; basically, I advise that "Precaution is the best medicine."
Part of the shortened wait times stems from the 1988 shut down by ACT UP of the FDA headquarters in Rockville, MD, in protest over the time it was taking to approve new treatments for HIV/AIDS. At the time AZT was the only effective treatment on the market, and it was ridiculously expensive. We were seeking other options, and it was the generally sentiment that the FDA was dragging its feet in approving what had the potential to be life-saving drugs. While other nations were moving forward, the FDA seemed to be lagging desperately behind, and even today, there is that sentiment (which I largely share), though now the focus of that ire has been shifted greatly to the pharmaceutical companies.
Today, however, marks the first time that I am willing to go forward with a newly released drug on the market, Stribild. The product of Gilead Sciences, Inc., Stribild is the combination of four different HIV drugs - Elvitegravir, Cobicistat, Emtricitabine (Emtriva), and Tenofavir Disoproxil Fumarate (Viread) - that serves as a once-a-day, one-pill regimen to be taken without any other antiretroviral medications to treat HIV/AIDS.
While I am generally overly cautious about new medications, I have grown increasingly frustrated with having plateaued at around a 350-370 CD4+ count for three years, now, despite being religious about taking my meds. After discussing this with my doctor several times over the last year, he mentioned during my last appointment that Stribild would be put on the ADAP coverage schedule in November, and we should consider switching me over to that, if I didn't mind being an early adopter, and at my appointment this morning, we decided to give it a go.
I should mention, however, that my CD4+ count from my last appointment came back at 415, and I am still undetectable (meaning that my Viral Load is below 50). Despite this sudden boost in my CD4+ count, I decided to go ahead and make the switch in the hopes that the side effects from this drug interfere less with my daily life than my current regimen of Truvada, Norvir, and Reyataz. As many of my friends, co-workers, professors, and employers know, this has gotten in the way of functioning normally since I moved to California, and I have been frustrated with my lack of improvement. Hopefully, this new medication will help to address some of those issues.
Though I'm nervous as I begin this new phase in my treatment, I am confident that this new regimen will allow me to live a more active, social, and physical life than I have, recently, and I look forward to getting out in the sunshine (and into the workplace) with renewed verve, a pep in my step, and that this will help me to continue marching "straight and true to victory."
Sincerely,
Marcus J. Hopkins
11/28/12
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