{"id":14188,"date":"2018-01-09T13:50:02","date_gmt":"2018-01-09T13:50:02","guid":{"rendered":"http:\/\/i-base.info\/qa\/?p=14188"},"modified":"2023-04-08T12:47:46","modified_gmt":"2023-04-08T12:47:46","slug":"my-doctor-in-florida-threatens-stopping-atripla-for-bureaucracy","status":"publish","type":"post","link":"https:\/\/i-base.info\/qa\/14188","title":{"rendered":"My doctor in Florida threatens stopping Atripla for bureaucracy&#8230;."},"content":{"rendered":"<p>Hi<\/p>\n<p>Thanks for getting in touch &#8211; and for highlighting the wealthiest country has a very difficult model of care. The situation you describe would be unthinkable in many other countries, because of the medical implications from stopping treatment.<\/p>\n<p>These include:<\/p>\n<ul>\n<li>Within a week, your viral load will be detectable again and over the next few weeks it will be increasing to pretreatment levels (ie to what this was fiver years ago).<\/li>\n<li>For some people (roughly 1 in 20) this can involve seroconversion symptoms.<\/li>\n<li>There is a similar level of risk that you might develop drug resistance during the first week as drug levels drop below a minimum safe level.<\/li>\n<li>If your CD4 count was ever very low, a break in treatment, will know it back down again.<\/li>\n<li>Also, and in the US this is especially important, having a detectable viral load makes your infectious again to partners.<\/li>\n<\/ul>\n<p>I am sorry that I don&#8217;t understand the many complexities of the US health system, but it is worth trying all options.<\/p>\n<ul>\n<li>For example. could you old doctor not just send a new prescription?<\/li>\n<li>Use a rapid fingerprick HIV test to get the new process started today.<\/li>\n<li>Perhaps a local community HIV organisation with a clinics might be able to find a month of meds to cover you. Many doctors get free sample they can sometimes used for patients.<\/li>\n<li>Perhaps a large hospital might have had drugs returned from someone who has changed treatment, that they con&#8217;t re-issue, but that a doctor could give you. In a pinch, even 20 pills would be enough because you would be okay taking Atripla during the week, with two-day breaks at the weekends.<\/li>\n<li>Do any of your friends have extra meds? Either for this or similar combinations.<\/li>\n<li>Do hospitals in Florida provide free PEP? If yes, an HIV negative friend could access a month of treatment if they say they recently had a high risk such as a condom break.<\/li>\n<li>Contact one of the national support lines (if they are still running) &#8211; perhaps from Project Inform in SF or GMHC in NYC.<\/li>\n<li>Perhaps post a request for help message to online discussion groups, such as at www.poz.com<\/li>\n<\/ul>\n<p>You are right that this sounds like a crazy system. Please try all options.<\/p>\n<p>If you are forced to take the break, you will probably be okay, but that forcing you to take this risks is not good.<\/p>\n\n","protected":false},"excerpt":{"rendered":"<p>Hello there! I have been on Atripla for five years and just moved back from NYC to south Florida. I also changed my health insurance and my previous doctor\u2019s office didn\u2019t issue a new prescription. They sayed:\u201dNew Year, New Rules\u201d.<\/p>\n<p>They required a new blood test and a new visit to my Doctor BEFORE issuing a new prescription. I will be without my medication for 30 days!!! They didn\u2019t ask for a previous blood test, nor wanted to have my medical files, nor talked to the doctor in NYC.<\/p>\n<p>I told them they will be responsible for any further medical complications. IIt made the atmosphere very bad&#8230; Bureaucratic people who value more rules and papers than people! Do I have any alternative?<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,7,35,55],"tags":[],"class_list":["post-14188","post","type-post","status-publish","format-standard","hentry","category-access-to-treatment","category-all-topics","category-resistance","category-stopping-treatment"],"_links":{"self":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/posts\/14188","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/comments?post=14188"}],"version-history":[{"count":1,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/posts\/14188\/revisions"}],"predecessor-version":[{"id":21432,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/posts\/14188\/revisions\/21432"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/media?parent=14188"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/categories?post=14188"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/tags?post=14188"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}