Little is said about HIV, and Covid certainly hasn’t helped. The annual Italian appointment of Icarus, the Italian Conference on Aids and Antiviral Research, a thousand participants and 200 scientists from all over the world, which has just closed in Riccione, was an opportunity to take stock of patients’ expectations, the quality of care , prevention. And let’s start from prevention, especially from Prep, pre-exposure prophylaxis, the therapy that allows a healthy person who has sexual intercourse with another potentially positive person not to become infected. Therefore, to prevent infection in key populations that, according to epidemiological data, are most exposed to the virus: MSM (males having sex with males), high-risk women, transgender, sex workers. It can be taken in two different ways: on a continuous basis, with one pill a day, or on demand, as needed, therefore only in association with a possible episode at risk of acquiring HIV through sex. Widely used in some countries, in Italy it is poorly prescribed.
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And then there are the positives, people who deal every day with the therapy of a chronic disease. Their expectations and concerns about antiretroviral therapy were collected in the Fondazione Icona survey, conducted earlier this year on nearly 600 people with HIV on antiretroviral therapy (64% were on three drugs and 31 % with only two drugs), with the support of patient associations and the support of ViiV HC. And here are some results: one in five people report the “heavy” impact of treatment on everyday life. There is a demand for therapies that are more “attentive” to the quality of life, especially among young people, and for long-acting treatments, which allow the patient to “free himself” from the thought of the disease.
The requests on the treatment
The study found that one in five people infected with HIV significantly feels the weight of the impact of the disease and treatment. The young age, the incomplete satisfaction of the antiretroviral treatment taken and the request for greater interaction with a health system (doctors, nurses, structure) more attentive to the specific condition of the person are the parameters that appear most correlated with the “weight” of the disease .
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“These are data of great interest for our everyday work – he specifies Antonella Cingolani, Catholic University of S. Cuore, “A. Gemelli” Polyclinic Foundation, Rome. It is striking that, despite the vast majority of anti-HIV therapies available today are contained in a single tablet, almost 20% of subjects report an “excessive weight” “Of the treatment and the disease. In particular, dissatisfaction with the treatment and the lack of dialogue with the infectious doctor significantly undermine the well-being of patients. These aspects, and on this obviously there is also work to be done in terms of communication and attention, they are more relevant in younger people “.
Long-acting therapies
Long-acting antiretroviral drugs, which studies show that they can control plasma viraemia with a single dose months later is the near future of HIV treatment. Understanding the reasons for this choice was the goal of the second analysis of the survey carried out on the data collected through the aforementioned questionnaire, and involved 580 people with HIV infection. Significant factors were dissatisfaction with ongoing therapy, recent diagnosis, difficulty in organizing the daily routine associated with taking the therapy, and the level of frustration associated with daily dependence on therapy. Also in this case the young age seems to be a criterion that characterizes the preference for long-acting therapies.
The cohort Icon
These researches confirm the value of the Icona centers network, established over 20 years ago to monitor clinical data and the management of antiretroviral therapies in HIV-infected people starting a therapeutic path. “Despite all the methodological limitations, having streamlined tools such as investigations carried out directly on people with HIV infection allows us to photograph a reality and reflect, in order to be able to design more targeted cohort analyzes, he concludes Antonella D’Arminio Monforte, ASST Santi Paolo e Carlo, Milan and president of the Icona Foundation. The Icona network and the collaboration with patient organizations have allowed us to collect a homogeneous sample in the area and offer us information of great practical use, which comes directly from the perception of people with HIV ”.
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