but there’s a big increased risk purely and solely from HIV alone for dementia and various things and also from the drugs taken as PreP and antivirals.
This was the sort of thing I was hired to study. I'd get IC and then we'd draw patient blood, like 6 ounces of it too a decent bit, and the brain trust at the lab could get quantitative levels for markers of inflammation and epigenetic changes and genotype the HIV strain the pt had, if detectable. (the PIs believed the HIV Associated Neurocognitive Disorder, i.e. HAND, was caused by excessive chronic inflammation.) They'd also grab viral counts and CBCs and so on, I'd take a detailed history of drug use and which ARVs they were on and had historically tried, and then we had people divided into different groups by which SUD medication management they used (or not): methadone*, bupe, still using, or control (HIV but no hx of IVDU, that filled up pretty quick.) The hardest group to capture was "still using" because those people would fall off the grid all the time, go to jail, stuff like that, and they were always really hard to get informed consent for cause I, ever the sperg, had to judge whether or not they were sober. I fucked off after a fight with my bosses where one of these participants signed up for my study at like 9am, then showed me this horrid abscess on his neck, I told him to go to ER, and then he left campus to score and reported to ER at 2pm "disoriented and intoxicated". So they thought he was like that at consent too. I showed them the timestamps on Epic and how there was like 6 hours in between visits and one PI admitted "well.... he MIGHT have used in between..." and I said "you think?!" and the condemnation I got from the other PI for calling a spade a spade was so bad I cleaned out my desk the next day. God I applied for that job twice too. I was so disappointed when I realized this was not going to work out.
TL;DR: Stan loved science, but it didn't love her back, it was very disappointing and sad, and now she works for her Church where people appreciate her and respect her time and it doesn't take an hour to get there each way.
*methadone is like golden handcuffs though, in the sense that it relieves the withdrawal from H but its own withdrawal is even worse and more protracted and I knew pts who had a goal to go down by 1mg/mo to nothing and these plans usually foundered because methadone withdrawal sucks so much worse. Most of them were on a maintenance dose for keeps and had to be "responsible" with the prescription lest they get sent back to the humiliating ritual of showing up at 5am to some downtown clinic every day for a dram of methadone.
And I do t give a shot about the trannies nd big chasers but I do feel for kids getting it, and needlestuck health workers, rape victims and those who will get it from blood products
I feel bad for all but the bug chasers. The life of heroin/fent addicts is insanely bleak, troons are mentally ill and incapable of risk/benefit assessment, gay bottoms are just unfortunately more likely to get it, same as African American women unfortunately because their men go have gay hookups and then have sex w them unprotected. and obviously the people who got it from crime or horrible needlestick and splash accidents are not to blame in the least. I had hoped the blood products loophole had been closed through thorough testing of every donation, but I pray nothing slips through the cracks.