This article comes from WeChat official account: ID:bqshenyidu, author: Shi Xiangzhao, editor: Liu Mili, Song Jianhua.
72 hours after spasm exposure is the effective time of drug blockade
Four years ago, Wang Qiang and an HIV-infected person chat, the other side told him that after high-risk behavior, you can take blockers to avoid infection.
He did not expect that an inadvertent conversation gave him a chance to "repent" three years later.
On November 23, the Health and Health Commission announced the data on the survival of people living with HIV in China at a press conference: 1.25 million. The number of new infections per year is around 80,000.
"the situation is urgent and must be grasped. In the past three years, I have been talking about drug prevention the most in my training. " Professor Zhang Fujie of The Temple of Earth Hospital told Bei Qing Shen once.
▷HIV blocking drug English name PEP
Take the "repentance medicine" to prevent AIDS.
The anti-Ai volunteer said that he had received too many people who asked him for help after high-risk sexual behavior, male couples, female college students, drug addicts... The phone often came in late at night, after the initial fear was slightly relieved, he would Tell the other party where to buy HIV blocking drugs and how to take them.
In the past three years, he has accompanied many young people who have panicked and succumbed to the "regret medicine" of life.
HIV blocker, also known as post-exposure prophylaxis, PEP. It can help prevent HIV infection within 72 hours of high-risk exposure.
"from 2005 to 2017, there were 86 cases of occupational exposure to HIV carriers in The Temple of Earth Hospital. No infection occurred through HIV blocking. Even for non-occupational exposed patients, no cases of failure were found. " Professor Zhang Fujie of The Temple of Earth Hospital said in his acceptance.
Wang Qiang, a male worker who works in Beijing, is one of the doctors who successfully blocked HIV.
During the 2017 Spring Festival, Wang Qiang met a person on the dating software. "he said he was in good health. At that time, I felt that as long as safety measures were put in place, there was no need to worry." However, Wang Qiang did not expect that, when the relationship, the other side removed condoms, until the end of his discovery.
Wang Qiang said that at the time, the other party pretended to be ignorant and always said that he was absolutely healthy. When Wang Qiang proposed to use HIV test strips to test the other party, the other party began to show discomfort.
"When I was looking for a blood collection needle, he picked up the test paper and lied to take a look, but secretly used nails to destroy the test strip." Wang Qiang recalled the scene at the time, the blood collection needle could not be found for a while, and he used a sewing needle to give it to him. The other party took the blood. When he picked up the test paper again, he found that the test paper was buckled.
"I had a blow in my head. He must have been."
Fifteen minutes later, the test results are indeed two bars, the other suspected infection.
According to Wang Qiang, after the results came out, the other side rushed out, and he has been forcing himself to calm down. A few days later, the other side in the dating software told Wang Qiang, he is infected, he will not live long, Wang Qiang must not run away.
What the other party didn't know was that Wang Qiang was already taking HIV blocking drugs. After 28 days of treatment, the hospital's test results were negative, and Wang Qiang escaped.
It has been a year since Wang Qiang still remembers every detail. "how could I forget? Between being rescued and infected, I went through days and nights. " "in the end, PEP brought me back to life," Wang Qiang said.
The HIV blocker is not a single drug, but a combination of different antiviral drugs, pictured as two common combinations
Preventive drugs are not yet licensed in China
HIV blockers first triggered a national netizen discussion In the middle of 2017, a post of “Male college students being massaged in Chiang Mai, Thailand” was maddened. While people are constantly discussing the authenticity and bizarreness of this male college student's story, they are also surprised that AIDS also has a "repentant medicine" to eat.
In 1990, PEP was proposed by the US Public Health Service to prevent infection by health care workers. Seven years later, the US Centers for Disease Control and Prevention focused on non-occupational exposures across the society. The concept of drug blockade was first proposed for 21 years. In large cities in China, some hospitals have been blocking treatment for non-occupational exposure for many years.
Xiao an, from a small county in Henan, like Wang Qiang, took off his condom under the circumstances of concealment. Fortunately, he took PEP. in time. But for people who don't know about the blocker, they can only "gamble" with the HIV virus.
In the fear of Ai, people often feel scared after a few days of high-risk behavior, post a consultation, the volunteers in the post can only regret to tell him that the HIV blocker has passed the applicable time.
The 25-year-old chose to express his anger at her boyfriend in the same way after he found out he had cheated on him a few years ago. But just after that one-night stand with a stranger, he was infected with AIDS.
"before the accident, I didn't know about PEP." Mr. Cheng said he learned about the blocker and pre-exposure prophylaxis when he arrived in Beijing to join the volunteer community. Now, he works in an educational institution and has to work overtime on weekends.
"I asked to wear a condom, but he deceived me at first and was found out to do so." Two weeks later, tests showed that Cheng was infected with HIV virus.
"Why me? I thought of suicide at the time and felt that I was abandoned by the world." But Cheng Yangxi did not commit suicide, but a person who did not bring anything and left the South.
why me? It is a reaction after many infected people are infected. So far, condoms are still the most effective protection measures, but condoms are often not strictly used in sexual behaviors where the status of the two parties is not equal, such as color trading and commercial sex.
Pre-exposure prophylaxis is more appropriate than HIV blockers for those who continue to face a high risk of HIV infection.
Pre-exposure prophylaxis, approved by the Food and Drug Administration as an anti-AIDS device in July 2012. People at high risk can prevent HIV infection by taking a single or compound antiviral drug daily or at intervals.
At the end of 2015, the new WHO guidelines for HIV prevention recommended: “Pre-exposure prophylaxis (PrEP) medication should be used as one of the additional joint HIV prevention methods for people at risk of potential HIV infection”.
Researchers in the United States have found that a gay man in the United States is infected with one-sixth of his life. Of the more than 300 million Americans, more than 1 million people at high risk are suitable for pre-exposure prophylaxis, and China does not have similar research.
When pre-exposure prophylaxis is not included in the United States, new infections are stable at around 50,000 a year. After the implementation of the measure, the number of new infections has declined. " Professor Zhang Fujie told reporters.
However, Professor Zhang Fujie said that Ditan Hospital is currently unable to prescribe the pre-exposure prophylaxis for patients because the country has not approved the use of the drug.
At present, there are only related experimental projects in China, which are not allowed to be used in clinical practice. "pre-exposure prophylaxis will be answered if we are consulted, but they will tell the counselor that there is no official medication guidance at this time." The volunteers said very little.
▷Video: How to use HIV blockers
Drugs that cannot be absent from AIDS prevention
"After an accident, you can use HIV to block the drug to avoid infection." Every time a routine science, volunteers tell the other side to block the drug, more people's reaction is awkward.
The popularity of PEP in China is not high. Even the male homosexuals in big cities are not understood by everyone. In some small cities, there may be no one or two blocking cases in a year. Dr. Liu Zhongquan from Tianjin CDC pointed out that the most prominent problem in the practice of HIV blocking drugs is the low awareness rate of the audience.
Although Wang Qiang and Xiao An took the blocking drug, they only knew it before the accident. Where to go to accept the block, how to block it, and did not know.
"at present, there is no detailed description of HIV blockers in mainstream publicity." The volunteers said very little. In the China STD / AIDS Prevention Center gay intervention guidelines, also mentioned only "after an accident to seek help from professionals." If necessary, use the HIV blocker under the guidance of your doctor to block it. "
One of the directions of Beijing's Iwangshan working group, where few volunteers work, is to work with qualified hospitals to provide HIV blocking services to consultants. When you meet people who need to be interrupted, arrange for them to go to the hospital. But little work has become difficult to carry out.
Wang Qiang recalled that when he decided to go to the hospital to buy HIV blocking drugs, he called several hospitals nearby, but said that without such drugs, they could not handle such things.
In the end, he searched crazy on the Internet and continued to call several public welfare organizations. When he finally found a volunteer who could help, it was an hour and a half before he was at high risk. The data show that the best time to take the blocking drug is within 2 hours.
When the volunteers completed the risk assessment for Wang Qiang, he took more than an hour on his way to the agreed place to pick up the medicine. "at that time, I thought Beijing was too big. Fortunately, it was Spring Festival. I didn't get stuck in traffic. Otherwise, I felt like I was going to die on the road."
Wang Qiang from the accident to take the first medicine, took 4 hours. It was 48 hours before Shaw detected uncertainty about the other HIV antibody. He went to Zhengzhou by taxi all night. When he took the medicine, 60 hours had passed.
The price of HIV blocking drugs is about 3,000 to 4,000 yuan. For people with economic distress, money is another difficulty they need to solve.
On October 27 this year, the 2018 edition of the "China AIDS Treatment Guide" published by the Chinese Medical Association increased the content of pre-exposure prophylaxis and non-occupational exposure block for the first time, and proposed to provide HIV-infected counseling services and popularization exposure for high-risk groups. The definition of pre-prevention.
"It takes time for the prevention of drugs to be approved, and the knowledge of drug AIDS prevention needs to be popularized. We must pay close attention." Professor Zhang Fujie said, "I told the government two weeks ago that the situation is urgent and the drug AIDS prevention is carried out in China. Not up, it is very unfavorable for us to prevent and control AIDS."
(in Chinese) Wang Qiang, Xiao'an and Cheng Yangxi are pseudonyms.
This article comes from WeChat official account: ID:bqshenyidu, author: Shi Xiangzhao, editor: Liu Mili, Song Jianhua.
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