A man who contracted HIV perhaps five days before starting a pre-exposure prophylaxis (PrEP) regimen and who then received full antiretroviral (ARV) treatment an estimated 12 days after infection shows no sign of the virus several months later. The man was enrolled in The PrEP Demo Project, a program targeting high-risk men who have sex with men. Information from this case study was presented at the Conference on Retroviruses and Opportunistic Infections (CROI) in Boston.
The man tested negative through pooled RNA, 4th generation enzyme-linked immunosorbent (EIA) assay, and rapid antibody tests from samples drawn 21 and 13 days before he began taking Truvada (tenofovir/emtricitabine) as PrEP. The sample drawn the day he started PrEP showed that his RNA level was 220 copies, while the other two HIV tests conducted on that sample were negative, indicating a very early infection—an estimated five days old.
He took PrEP for seven days. Taking just two HIV medications, as are included in PrEP, instead of the standard three is against treatment protocol if someone is found to have HIV. But it took time for his RNA screen test to come back, so the investigators did not know he had an acute HIV infection during his first week on PrEP.
Once his HIV infection was discovered, he was put on a conventional HIV treatment cocktail of Prezista (darunavir), Norvir (ritonavir) and Truvada.
The man’s HIV RNA levels dropped from the initial 220 to a read of 120 a week after he started PrEP, and then to below 40 about 27 days after infection. Since then, researchers have been unable to detect HIV in his body, using highly sensitive tests.
Researchers intend to try taking him off ARVs after a year.
The scientists are not able to conclude at this time how PrEP may have contributed to the apparent dissipation of the virus in the man’s body. They advise that programs prescribing PrEP should consider testing for acute HIV both before and during the use of PrEP and then to consider immediately switching to a full HIV treatment regimen in the event of HIV infection.
'I could never do that,' is usually the first thing a bystander will state when he finds out someone is in a three-person or more relationship. But why do some people seem to thrive in such an arrangement?
Franco DiLuzio and Mark Lander met while working at G-Lounge, a club in the in New York City’s Chelsea neighborhood. Five years later, they were married. But two months after their wedding, everything changed for the happily married couple.
After a few chats online via a male dating site, Franco met Vinny Vega, a 24-year-old fashion photography student at the Fashion Institute of Technology. What went from a casual hook up turned into a serious, closed polyamorous relationship. Franco, Mark, and Vinny have been together for two years.
“I talk about my boyfriends proudly,” Vega explains. “I know it’s hard for people to accept. I don’t really care if people accept me or not.”
There’s an age gap within their relationship: DiLuzio is 45, Lander is 41, and at 24, Vinny is the youngest. As the men explain candidly, this age difference creates different dynamics between the three of them.
“My relationship with Mark is lover and husband. And my relationship with Vinny is lover and son—even though there’s a sexual aspect to it,” DiLuzio says. “I think the type of nurturing we both give to Vinny is more of a parental kind of guideline, as well as a boyfriend guideline.”
While this relationship works for the three of them, there have been critics along the way. Lander admits that most people have a negative opinion about them.
“I find that gay men have the most problem with it. Whereas my straight friends look at it and say, ‘oh, there’s three of you now!’ And the gay friends were more wanting to have that traditional guideline,” DiLuzio says, explaining that their gay friends often looked up to his relationship with Lander as an example of a strong, monogamous relationship.
But for DiLuzio, he doesn’t think that Vega was brought into his relationship with Lander because something was missing. “I still believe that Mark and I have a strong relationship. And bringing Vinny in was an addition to the relationship,” DiLuzio says.
Even though they’ve only been together for two years, Vega feels he can see himself together with DiLuzio and Lander for the next 20.
“I don’t think I can ever leave because I am very much in love with Franco and Mark,” Vega says. “I feel like they are the two pieces of my heart.”