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Dr. Bob...Your Post-PEP advice??
Apr 25, 2004

Dr. Bob,

Thank you for your work on this site and through your foundation. I am inspired by your generosity and selflessness.

I am in a sero-discordant relationship. We recently experienced a condom break that exposed me to my partner's blood (I was the top). I initiated PEP treatment through a doctor affiliated with Cedars-Sinai in LA within 24 hours.

If in fact I am infected and the PEP does not "bail me out," I'm wondering your advice on treatment at that point. Does the fact that I underwent PEP change anything regarding choosing immediate treatment (HAART) versus waiting a few years?

Finally, my boyfriend and I have been a little surprised that there has been little good news in the drug and treatment front for some time. Do you see anything on the horizon to cause increased optimism.

I admire your oft-stated intention to die of natural causes at an old age, but is that more of a hope right now or a statement of real possibility?

Thank you again. When my finances improve (PEP drugs are costing me over $1,500!), I will make a contribution to Concerted Effort.

Peace.

A Fan in LA

Response from Dr. Frascino

Hello LA Fan,

No, taking PEP would not affect initial treatment options or when to consider starting therapy.

There is always hope on the horizon. Several HIV drugs are in the pipeline at various stages of clinical development. Unfortunately, there is not enough emphasis on HIV drug and vaccine research and development. Apathy is perhaps the most lethal impediment that has prevented more rapid substantive action to combat and treat HIV/AIDS. Don't just sit back and wait for "good news." Join the fight to make it happen!

Will I die of old age? Well, I'm already too old to die young, so yes, it's a real possibility. We must all work together to demand global action to battle the HIV pandemic so that all 45,000,000 of us have that chance.

Why do you have to pay for the PEP drugs yourself? They should be covered by most health plans.

Last, thank you for your future contributions. That's one very concrete way to take "positive" action.

Good luck.

Dr. Bob



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