Contents
In line with its mission, the Editorial Board of MedTvoiLokony makes every effort to provide reliable medical content supported by the latest scientific knowledge. The additional flag “Checked Content” indicates that the article has been reviewed by or written directly by a physician. This two-step verification: a medical journalist and a doctor allows us to provide the highest quality content in line with current medical knowledge.
Our commitment in this area has been appreciated, among others, by by the Association of Journalists for Health, which awarded the Editorial Board of MedTvoiLokony with the honorary title of the Great Educator.
The HIV virus that causes AIDS is still a real threat in Poland. Education about the possibility of infection is lacking and testing for the virus is too rare. Will the “pill before” relieve us of fear?
HIV – Our Daily Shame?
Unlike other nations, we are not ashamed of obesity or cancer. Since depression gained the face of Tomasz Jastrun, Piotr Zelt, Justyna Kowalczyk or Joanna Racewicz, it has also ceased to be a taboo subject. Especially since the sick talk about it most often in the past tense. What we keep to ourselves remains: infectious diseases.
We waited until 2015 for the first public appearance of an HIV-infected person – Katarzyna Klaczak -. Recently, the heroine of the HIVokryzja awareness campaign was joined by the current Mister Bear Poland 2019 – Tomek Siara, the originator of the campaign “Niewykrywalni”. Other venereal diseases in our country have thousands of impersonal bodies.
- The most common venereal diseases
Doctors, who devote an average of 10 minutes to the patient, do not help us overcome shame. Discreet treatment based on trust and empathy remains a fiction in Polish conditions.
– For a long time I had the impression that venereological patients are left on their own. A large number of dermatologists dealing with aesthetic procedures are ashamed of being a venereologist and most often do not admit it. Due to the fact that I like challenges, I decided to create a place on the map of Warsaw for all patients: dermatological, aesthetic and those who need venereological help. Dermea wants to deal primarily with the prevention of infectious diseases. We want to educate our patients on how not to get infected with HIV and other sexually transmitted diseases – comments Dr. Ivana Stanković, owner of the Dermea clinic.
HIV Testing – I’m Not! I’m not testing myself!
The threat of HIV is not decreasing – statistics show that the number of Poles infected with the virus has doubled over the last decade.
According to experts, on the one hand, the acquired immunodeficiency syndrome has ceased to scare us. Thanks to the antiretroviral therapy introduced in the late nineties, death sentence HIV infection has become a chronic disease. On the other hand, more and more Poles engage in risky sexual behavior, the most common among men having sexual contacts with men (MSM).
An example is chemsex, which is sex on drugs, which has been fashionable for several years. The main stimulants at stake are mephedrone, methamphetamine, ketamine, GHB, and old-fashioned cocaine. There is another problem: we are still among the lowest registers in the European Union when it comes to people who do tests. Even in the group of pregnant women, despite the recommendations of the Polish Gynecological and Obstetricians Society, HIV testing is not common. In total, it is less than 10 percent of the population.
– Recently, we have observed an increase in the number of so-called late presenters who are diagnosed at a late stage with symptoms of advanced disease. It happens that the virus is diagnosed accidentally in connection with completely different diseases, e.g. pneumonia or recurrent herpes zoster. I myself have been taking care of patients who have been living in long-term relationships for years and have found out that they have AIDS. Unfortunately, the thinking: I feel good, I look good, I am healthy – is still present. You need to test yourself – firstly, to reduce the risk of unknowingly infecting another person. Second, the best treatment effects are obtained in patients who receive treatment shortly after infection. It only takes a minute to get an HIV test. A small puncture and a drop of blood are enough. One dash shows a negative result, i.e. there is no HIV in the body. The second dash may mean a positive result, but it is always confirmed with another test – explains Dr. Aneta Cybula.
Where did HIV come from?
HIV treatment and the pill against
Prevention is not only research. The best method of HIV prevention is and remains condom use. An additional measure may be, in line with the recommendations of the Polish AIDS Research Society, Pre-exposure Prophylaxis, the so-called PrEP.
PrEP treatment is when an HIV-free person takes a tablet containing two medicines to prevent HIV infection (tenofovir + emtricitabine). – The drug can be taken continuously or on an ad hoc basis, “on demand”. In the first case, it is important to take the tablets regularly once a day, at the same time, and in the second – at certain times before and after intercourse. Such a “holiday” PrEP is popular, among others in sexually active young people. At the beginning, the man takes two tablets 2–12 hours before intercourse. The woman needs more time for the drug to start working – explains Dr. Aneta Cybula.
In France, Belgium, Norway, New Zealand and Australia, the drug is reimbursed. From December 2017, we will pay for it no longer 2,5 thousand. only PLN 120 per month. For comparison, the state-funded treatment of a patient with HIV costs 2,5 thousand. PLN per month.
Who should consider PrEP therapy? – Certainly people who have many partners and who happen to have accidental sex without a condom. It is also a good solution when a couple is trying to have a baby and one of them is infected (this is mainly a head problem – because a partner who is effectively treated does not infect). You just have to remember that PrEP protects only against HIV transmission and simultaneous use is recommended. condoms that protect against other sexually transmitted diseases – noted Dr. Ivana Stanković.
- A condom is not enough, or how to avoid STDs?
Before starting therapy, tests should be performed to rule out infection: HIV test (preferably within seven days of the last sexual contact), syphilis, gonorrhea, chlamydia, hepatitis B and C, complete blood count, liver tests and blood creatinine levels. If we are healthy, the doctor will give us a prescription. No serious adverse events have been identified in clinical trials evaluating the safety and efficacy of PrEP. The digestive system ailments occurring in some patients, such as nausea or lack of appetite, usually disappear after a month.
Fighting HIV – Free from Fear
According to calculations published in the prestigious weekly “Lancet”, pre-exposure therapy can reduce the number of new infections by up to 40 percent. and can be an effective weapon in the fight against HIV. – My patients feel free from fear and we have control over them. Everyone returns to the clinic after three months and is tested for HIV and other sexually transmitted diseases. I will quote a letter from one of the PrEPsters: I am from the generation of people who do not know the pleasures of sexual intercourse without fear. For as long as I can remember, every form of intimate relationship, and even its image, was accompanied by a fear of the possibility of HIV infection. Even the awareness that proper therapy guarantees life in the event of an infection does not relieve anxiety. I know two scenarios: either you wait for it to happen or you let it happen. I feel fantastic. The moment when I don’t have to be afraid makes me free from fear. I am PrEPster.
Besides the before pill, there is also the after pill. Post-exposure prophylaxis, i.e. PEP, is used in people who have had contact with an infected and untreated person, or it cannot be ruled out that they are not infected. Medical workers and all those exposed to work-related exposure (e.g. policemen, but also cleaners after a needle stick injury) can use PEP free of charge. Rape victims also get it for free. Otherwise, we will pay about 2,5-3 thousand zlotys for the “po” pill. zloty.