What do you think of my resolution? Am I insane?

[I'mFillingFine]

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So, I've decided that throughout my dental career, if I ever have a sharps stick while working with a patient with HIV or AIDS, I will decline prophylactic antiretroviral treatment. Here's why:

1. The thought of 3-6 months with what feels like the GI flu is horrific to me.

2. Seroconversion rates are extremely low, and prophylaxis is contraversial since it's has such mixed results. In other words, I probably won't get it and even if I took the drugs, I still might get it.

3. Since I would know when I was exposed, I could get very early, continual testing and early treatment. Most patients who do become HIV+ and are treated early and can afford lifelong treatment usually live many decades, often what amounts to a normal life span.

4. I would not even be considering such an awful prophylactic treatment if I was somehow able to be exposed to other much more serious and likely dangers (diabetes, car accidents, hepatitis, influenza, cancer, the list goes on.)

Thoughts? Anyone feel the same way?

 

[DrJeff]

To each and every there own. I've been stuck twice when the patient in question was of unknown, but potentially moderate/high HIV risk, and this was over 10 years ago when HIV wasn't as "controlled" as it is now.

Both times I was in my GPR years, so I was literally a couple hundred yard walk from the medical lab and infectious disease specialist/councelor for testing purposes/information. Both times I heard that the rate of seroconversion on a stick when the patient has full blown AIDS is less than 1% (1 stick was on the end of an east/west elevator and 1 stick was on a flame shaped bur that I had just used for crown lengthening). Both times, after hearing that really low potential seroconversion, I asked myself the following question "how low is too low??" with respect to seroconversion and my own health. Both time I took the meds. No problems for me.

Side effect wise, well I had for maybe a combined 3 or 4 days some mild flu like symptoms. No big deal.

*IF* this situation arises for you, what you think now, verses what you might think when that less then 1% seroconversion rate applies to you, might be different.

 

[OceanDMD]

6 months of meds versus the potential of a lifetime of meds and the stigma, no brainer.

 

[Rajan247]

6 months of meds versus the potential of a lifetime of meds and the stigma, no brainer.

+1

although, Hep C worries me more than HIV

 

[I'mFillingFine]

6 months of meds versus the potential of a lifetime of meds and the stigma, no brainer.

The 6 months of meds have had mixed results in actually preventing seroconversion anyway. So the way I look at it: either a lifetime of meds or nothing at all. I'll take the nothing.

 

[OrthoQueen100]

I would definitely take the medication.. If "God forbid" I become HIV positive I would be certain that I did all that could be done to prevent it.. but if I didn't do nothing and then I was diagnosed with HIV (again "God forbid") I would blame myself forever and question myself what if I took the meds this wouldn't had happened to me..

 

[fusedtometal]

I would take the meds, and ask for triple therapy. What's all this about 6 months, I thought standard PEP therapy was 1 month? I took the meds, after an exposure, and they didn't work. Of course I didn't do it as soon as a few hours, which would have been most effective, and I had an exposure through sex, which is again, different.

 

[golfer]

The 6 months of meds have had mixed results in actually preventing seroconversion anyway. So the way I look at it: either a lifetime of meds or nothing at all. I'll take the nothing.

I think one would do anything to avoid a LIFETIME of meds .Don't forget the stress of having HIV and knowing everyday when you wake up that you had a chance to take medication with "mixed" results (mixed still means that there was still some success which translates to BETTER THAN NOTHING) and avoiding this headache. 6 months is nothing compared to the rest of your life. I can see where your reasoning comes but frankly feel its a little short sighted.

 

[KOM]

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