From Dr. Mark Bornstein and Dr. Paul Benson
I am a person living with HIV on a complicated multiple pill regimen. I’m tired of taking so many pills. I know other people with HIV taking one pill a day. Am I able to just take one pill? – JP
Dear JP,Hi JP! This is a fantastic question. There have been significant advancements in HIV treatment, and I want to assure you that you have options. The first step is to work together with your provider to find out why you are on a complicated regimen.
Sometimes, someone is placed on these multi-pill regimens when there is some level of HIV resistance. This means that the strain of virus carries mutations that make some medications unable to attack the virus. Nonetheless, for the most common mutations causing HIV resistance, we typically are still able to use a single tablet regimen.
Occasionally, if someone does have a high level of resistance, a more unique and personalized regimen will have to be used in order to decrease the amount of virus in the body to undetected levels. Unfortunately, in some of these cases a single tablet regimen will not suffice and a multidrug regimen will have to be used.
The good news is that even if you fall into this category, there are still options! At Be Well Medical Center, we conduct clinical trials where we get to enroll patients into studies with new medications that are currently being examined. These are typically medications that are the newest available and most recently studied. We currently have studies that are looking into simplifying complicated HIV regimens with a new single tablet medication that has not been released yet. By enrolling in the studies, you get to take these medications at no cost and also are doing the service of helping the HIV community by further advancing our understanding of these new medications.
I welcome you to contact us at the Be Well Medical Center to continue this discussion.
There is so much information about the number of time-sensitive vaccinations available right now that I have become totally confused and skeptical. Can you provide me with some guidance about what I should do? – DE
Dear DE,You are right. Your question could not have come at a better time. It’s flu season right now. It is the perfect time to get vaccinated for the flu. Each year the vaccine changes a bit to match the predicted strain of flu for each year’s flu season. Flu vaccination is recommended for everyone. For those with health problems or the elderly, prevention of the flu with a vaccination can save your life.
Last month a new Covid vaccine became available that has activity against the old and new strains of Covid. Even if you have had Covid or have been fully vaccinated with two initial vaccinations and two boosters, this new vaccine should still be considered. Caution is advised if you had Covid or had a Covid vaccination less than two months before receiving this new bivalent vaccine. If you get the new vaccine soon after, you are most likely going to have a reaction to the vaccine. This reaction may include a localized injection site reaction or symptoms of fatigue, muscle aches and fevers for a couple of days. We have seen more reactions from this new bivalent vaccine. I don’t think it’s from the vaccine itself, but from immunity from previous Covid vaccinations or the disease itself producing natural immunity. These reactions are not life threatening.
The monkeypox vaccine is available, and in much better supply. It is for those at high risk. This includes men having sex with men and having multiple partners or a monogamous person with a partner that has multiple partners. If you are a gay man without these risk factors, it is probably not necessary at this time. If you had close contact with someone that has monkeypox, that is also an indication to get vaccinated ASAP to possibly avoid getting monkeypox yourself. This post-exposure vaccination can reduce symptoms or even prevent infection. This vaccination is given in two doses one month apart. As the vaccine supply increases, which it will, the recommendations of who should get vaccinated for monkeypox will expand. The great news is that the number of monkeypox cases is decreasing in Michigan and around the country. If you have already had monkeypox, you should not get the vaccination.
Consider these time-sensitive vaccinations, too:
HPV — for preventing genital warts, especially the strains that can progress to cancer.
Pneumonia — for everyone over the age of 65, or at any age if the person has a chronic disease including but not limited to HIV.
Tetanus — every ten years.
Shingles — after the age of 50.
Hepatitis A and B — at any age. You can get a blood test to see if you need the Hepatitis A or B vaccinations.
Although it is safe, I personally do not recommend getting more than one vaccine on any one particular day unless there is a compelling reason to do so. The reason I don’t like giving more than one vaccine at a time is that the risk of having a reaction increases. Again, this is a personal decision that can be made together with your healthcare provider.
Vaccination is a great thing that has reduced infections and mortality from a number of infections. Polio and smallpox are examples of that. Some individuals believe we are being over vaccinated. Vaccinations are generally safe, however in rare cases they can cause problems greater than a short-term reaction. Vaccines will probably have its place in HIV eradication as well.
I hope this helps!
Dr. Paul Benson’s Be Well Medical Center
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