There have been some comments related to my, ?Advice to a Friend? post I want to address. The comments have been on the idea that we are overdosed on HIV drugs, or that we need more study of alternate dosing.

I fully understand why people think this way. With very few exceptions HIV drugs are dosed in a, ?one size fits all,? fashion. When I was a Treatment Advocate at AIDS Project of the East Bay, I had a treatment education group. During one of my first sessions, I asked everyone to share what they were taking (if they were willing). Sitting right next to each other were two clients- one a man of around 300 pounds and a woman who maybe weighed 100 pounds, who were taking the same doses of the same pills- this stuck me as crazy.

The research however hasn?t been so clear-cut. One of the major issues, is that almost all HIV drugs work inside cells, so measuring drug concentrations is either very difficult or not very useful, or both.
The big issue here is the fear of side effects. Now at the risk of pissing some people off, I assert that most people, maybe virtually all people who are living with HIV, or are in some way strongly connected to HIV over estimate the frequency and severity of HIV drug caused side effects. That isn?t to say side effects aren?t real- it just means they aren?t as common or as severe as you probably think they are.

The only reason I have ever changed HIV drug regimes is due to side effects. So, I know they are real and what kind of impact they can have on people.

Why? Because you notice when people have side effects. People talk about having side effects. People don?t notice when people aren?t having side effects. People rarely talk about not having side effects. This leads to a perceptional bias, which overstates the problem of side effects.