How Does Care for HIV in the U.S. Compare to Other Parts of the World?

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Well here in America, we're very fortunate because a lot of the research gets done here. We make a lot of advances and that get's relayed to Americans. So if you're an American and you are contracted HIV, treatment options are available to you, especially if you have insurance. Now we do have Aids assistance called ADAP, and we do offer assistance to people who are uninsured or under-insured where the government helps pay for their medications.

Medications are very, very expensive and you have to go on multiple different medication sometimes and you're going to be taking this for the unforeseeable future. That's incredible cost burden for a patient, particularly someone who doesn't have insurance. With that, you have all the advances of taking the latest and the most modern and antiretroviral therapies.

Now that's very different if you lived somewhere else. If you are started on an antiretroviral regimen here in the United States, they would most likely continue it if you moved anywhere else. If you were diagnosed with HIV anywhere else, you probably would be given what the standard of care is for that country.

You may not have a choice. So that makes a difference when people talk about medical therapies and practices in different countries as opposed to United States. We are very fortunate here. Also you have to imagine that if you're in a place where the AIDS crisis is still epidemic proportions where people are dying from HIV like Sub-Saharan Africa.

Their choices are even more limited. The interesting thing is a lot of pharmaceutical companies will offer free medication or discounted medication particularly for certain of the older antiretrovirals. The problem and I've never Sub-Saharan Africa, I just know second hand from what I read, the problem there is linking people to care.

There's such a strong preponderance of stigma that to even go get care is considered something that's embarrassing and not only that but humiliating or maybe even deterred by someone's loved one, so that a wife may not be allowed to go get treatment by her husband. And I think that's a lot of what I try to do with prevention, that's why I'm so very excited about HIV PrEP.

I think if most people were on PrEP, they might prevent themselves, especially if they are at high risk. You have to remember a lot of women that maybe living in Sub-Saharan Africa cannot say no to their husbands about sex especially if they want to have unprotected sex. And I think we forget that there are sex workers both in the United States and outside of the United States, and I think we need to just stop judging people and just think about how do we stop the spread of AIDS because it eventually impacts all of us.