For People Living with HIV, Empowerment Comes Through Educated Choice

Mediaplanet spoke with Dr. David Knox, an HIV specialist and staff physician at the Maple Leaf Medical Clinic in Toronto, and Randy Davis, Gay Men’s Sexual Health Coordinator at the Gilbert Centre in Barrie, about empowering people living with HIV through educated choice.

Why is engagement between people living with HIV and their health care practitioners so important?

Dr. David Knox: Collaborative decision-making between patients and physicians is of critical importance in HIV care. When patients feel empowered and in control of their health and health care decisions, they’re more likely to adhere to their antiretroviral medications and to experience better health outcomes.

Randy Davis: When it comes to HIV treatment, everyone’s different. What works for me doesn’t necessarily work for someone else. People living with HIV must also be made aware of emerging treatments and technologies.

Can you explain the concept of undetectable = untransmittable (U=U) and why this is so important for people living with HIV to know about?

Dr. David Knox: People living with HIV who are on treatment and consistently maintain an undetectable HIV viral load cannot transmit HIV to sexual partners.

The PARTNER/PARTNER 2 and HPTN 052 are large studies that investigated HIV transmission among serodiscordant couples (which means only one partner is living with HIV and the other partner is HIV negative). These studies showed that the risk of transmitting HIV to your sexual partner when condoms aren’t used is effectively zero. 

U=U is an important and empowering statement. Those living with HIV who are on treatment can feel confident that they’re protecting their partners.

Randy Davis: The concept of U=U is really the cornerstone to be able to end the HIV epidemic.

A big part of the work that I do is around awareness and education. For me, HIV is the virus, and the stigma is the disease. I’ve always equated stigma to being a combination of ignorance and fear. We can combat stigma by educating folks about the reality of what HIV looks like. 

How would you define “informed choice,” and what does it look like in practice?

Dr. David Knox: Informed choice means understand what treatment options are available and exploring the benefits and risks of each option. I love talking with patients about what therapeutic options are available, what new medications are coming down the pipeline, and the newest data in HIV treatment and prevention. HIV treatment continues to evolve rapidly. Most patients living with HIV can now be treated with one daily tablet or with other dosing options.

Randy Davis: Informed choice is being able to provide patients with choices with concrete and reliable information behind them, so patients can explore what makes sense for them.

When people living with HIV have strong engagement with their health care practitioners and are well-informed about concepts like U=U as well as new treatment options, their health outcomes are much better.