PrEp is NOT a free pass for unprotected Sex

[Sean Y]

Saw this article... made me realize safe sex is not just about preventing HIV and other STDs and unwanted pregnancies (never know right? Ha haaaaa) - it’s about preventing other longer term side-effects - better safer than sorrier: https://www.realclearscience.com/articles/2018/10/20/mounting_evidence_that_herpesvirus_is_a_cause_of_alzheimers__110777.html

[jawjateck]

This is one of the reasons I am sidelined from pursuing the hobby. About half of companions do not use condoms any more and will adamantly refuse my "safer" request. It's always with words about "PrEP", "I'm clean and tested", "you're safe", "you will be ok" and besides "they hurt, they chaff, they cause me to have an adverse reaction, they kill my hard-on", "they don't feel good", blah, blah, blah.

 

Those guys are right. I'm safe! I'm out of the game and on the bench.

[LookingAround]

Condoms are less safe than PrEP. Both are the safest course.

[marylander1940]

Condoms are less safe than PrEP. Both are the safest course.

 

Good point but guys who are on PrEP rarely use condoms with other guys who say they're on it.

[TruthBTold]

Completely your own call and any "judgement" should be enthusiastically ignored. I have heard, time and time from the Delusional Denial PreP Fan crowd, who will tell you it's absolutely their "right"( ? )to bareback with strangers as PreP is 100% ( ? ) ( it's not ) effective against HIV. Always ignoring the statistics about the rampant growth in syphilis, and other more traditional STDs, that coincide with the use of PreP. The Pharmaceutical industry goes to great lengths to bury this unfortunate bit of information, and the barebacking enthusiast crowd is eager to eat up the lies.

 

Of course it is everyone's right to make their own health choices. If you are on PrEP and you wish to bareback and the other person agrees then you have the right to do so as long as you understand there are risks involved, including the fact it is not 100% effective (that it why it is "safer", not "safe) and does not protect against other STDs. Condoms have their own risks associated with them, although they help protect against certain STDs. I have not "eaten" up lies but have read as many sources as I can and have weighed the risks (including trying to assess the risk associated with the chosen partner). That is my right and I am going to make it in a reasonable way. You can do the same thing. I am not going to disparage you about the choice you make and I ask that you do likewise. It is counter-productive. If you want to provide me with facts that support your logic then that would always be helpful and legitimate.

[+ Reisr30]

My preference is use of a condom. I’m a bottom and a sex worker which puts me in a higher risk category. It’s very common for a client to ignore this preference and insist no condom use when I tell them I’m on PrEp. I get the feeling they think it is a free pass to do as they please. Frustrating.

 

The fact you insist on using condoms makes you more attractive as a companion. Condom use is a must for me...

[LookingAround]

Good point but guys who are on PrEP rarely use condoms with other guys who say they're on it.

Yes agree. Just reacting to the language stating condoms are “safe” implying PrEP is less safe. Actually it’s the opposite.

[Sean Y]

Of course it is everyone's right to make their own health choices. If you are on PrEP and you wish to bareback and the other person agrees then you have the right to do so as long as you understand there are risks involved, including the fact it is not 100% effective (that it why it is "safer", not "safe) and does not protect against other STDs. Condoms have their own risks associated with them, although they help protect against certain STDs. I have not "eaten" up lies but have read as many sources as I can and have weighed the risks (including trying to assess the risk associated with the chosen partner). That is my right and I am going to make it in a reasonable way. You can do the same thing. I am not going to disparage you about the choice you make and I ask that you do likewise. It is counter-productive. If you want to provide me with facts that support your logic then that would always be helpful and legitimate.

 

In the 90’s I worked with young gays as a sex educator. We say, there’s really no absolute safe sex and some one would raise their hands and say, well, abstinence. And we would respond, yes, abstinence is probably the safest but it’s really not absolute because, honestly, teaching abstinence as a prevention never worked against teen pregnancy or anti-STD so it’ll definitely not going to work against HIV or any other disease prevention.

 

All else, there is some level of risk involved. Like TruthBTold says, know your risk, understand what you’re willing to take, and please please please, know these risks before you’re in a situation where that little head is getting too big, and you may not be thinking clearly.

 

And most importantly, respect other people’s decisions. I worked with run away youths who are living on the street: the risk of freezing or starving to death while on the street is so much more immediate than potentially dying from HIV or getting Alzheimer in old age due to some STDs. We give them facts: HJ and frottage and massage are less risky than BJ which is less risky than active partner with condom which is less risky than passive partner with condom which is less risky than active partner without condom which is slightly less risky than passive partner without condom which is less risky than being beaten up by your john or pimp or angry husband for refusing sex without a condom, etc. etc. etc.

 

Just know what your risks are, what you’re willing to take, and what you’re not willing to take. And know that this is a spectrum - you can change your mind. If I’m bored, I may do HJ or BJ with a 3 or I may pitch for a 5 but won’t catch for anything less than a 7. If I’m horny and desperate, I may pitch for a 3 and catch for a 5. Just know your limit and know what you’ll need to do to take care of yourself before and afterward: get tested, don’t floss before oral and take care of your gums and any open sores, where to get information if you’re infected, etc. etc.

 

I had clients who sero converted and it made me sad but I understood. I got them help. I had clients who passed away because of violence or because of drugs or because of depression or suicide - and that was not because of HIV.

 

These were young adults and they made their decisions based on their limits and circumstances and I respected their decisions. You guys are full empowered adults, so I’m sure you can own your decision and take care of your consequences. Just don’t force others to do it your way. No means no - and it’s not just about permission to have sex. It’s also about someone’s risk boundaries and how far they are willing to go with you. It may be up for discussion but it’s not up to you to decide for them.

[+ Gar1eth]

I was weak. I had a hot f-buddy that I wanted so much that I would go bare with him (this started when I think PeP (post -exposure prophylaxis was available/PrEP was 1st available to when PrEP became as common as it is now). We never met that often. Towards the end of our time together I was on PrEP most of the time. He always said I was the only one he bottomed bare for. And he was the only one I topped bare during this period. But I was never sure how much I should believe him. He was incredibly hot with probably an 8 inch tallywacker. He's also athletically muscular (although not in tip top shape) and very handsome. As handsome as he was/is I'm sure he was having sex all the time. I'm not sure why he was interested in me. I'm not being overly modest here. This guy could (probably )literally have almost anyone he wanted. He's probably the handsomest guy I'll ever have sex with. Aside from being handsome and having a large tallywacker, he was one of those guys who could control when he came. He was able to make/let himself cum almost immediately after I did.

 

Initially prior to me being on PrEP I used to worry for months after each meeting. The only thing that gave me slight relief was knowing I was the top. Yes I know that isn't a guarantee of not being infected with HIV. But it was the main comfort I could take.

 

After PrEP became more available, and I wasn't seeing the above guy, I would occasionally go bare. It still made me nervous-both about resistant HIV infections and other STIs.

 

Another downside of going bare for me is that obviously while it feels better, it makes me cum sooner (not that I've ever been Mr. Long-Lasting even when using a condom).

 

As I've gotten older, sometimes getting/remaining hard in a condom (even using Viagra) has been difficult. When I was on PrEP, going bare sometimes made sure I was hard enough. As a top, I used to hate failing someone I was meeting for a hook-up. If I failed with an escort, I didn't feel quite as bad as I knew they probably didn't care if the session was shortened by a client who couldn't perform.

 

Now I'm probably immune suppressed to some extent considering the fact that I've been on prednisone since March. Even though my dose is now down to 15 mg daily, I'd be scared of going bare even on PrEP. I doubt there are any studies of PrEP effectiveness on immune-suppressed people. And at some point I may need to be put on stronger immunosuppressants if either the prednisone stops holding my myasthenia symptoms in check or the prednisone side effects become too much to bear.

 

Gman

[+ Gar1eth]

In the 90’s I worked with young gays as a sex educator. We say, there’s really no absolute safe sex and some one would raise their hands and say, well, abstinence. And we would respond, yes, abstinence is probably the safest but it’s really not absolute because, honestly, teaching abstinence as a prevention never worked against teen pregnancy or anti-STD so it’ll definitely not going to work against HIV or any other disease prevention.

 

All else, there is some level of risk involved. Like TruthBTold says, know your risk, understand what you’re willing to take, and please please please, know these risks before you’re in a situation where that little head is getting too big, and you may not be thinking clearly.

 

And most importantly, respect other people’s decisions. I worked with run away youths who are living on the street: the risk of freezing or starving to death while on the street is so much more immediate than potentially dying from HIV or getting Alzheimer in old age due to some STDs. We give them facts: HJ and frottage and massage are less risky than BJ which is less risky than active partner with condom which is less risky than passive partner with condom which is less risky than active partner without condom which is slightly less risky than passive partner without condom which is less risky than being beaten up by your john or pimp or angry husband for refusing sex without a condom, etc. etc. etc.

 

Just know what your risks are, what you’re willing to take, and what you’re not willing to take. And know that this is a spectrum - you can change your mind. If I’m bored, I may do HJ or BJ with a 3 or I may pitch for a 5 but won’t catch for anything less than a 7. If I’m horny and desperate, I may pitch for a 3 and catch for a 5. Just know your limit and know what you’ll need to do to take care of yourself before and afterward: get tested, don’t floss before oral and take care of your gums and any open sores, where to get information if you’re infected, etc. etc.

 

I had clients who sero converted and it made me sad but I understood. I got them help. I had clients who passed away because of violence or because of drugs or because of depression or suicide - and that was not because of HIV.

 

These were young adults and they made their decisions based on their limits and circumstances and I respected their decisions. You guys are full empowered adults, so I’m sure you can own your decision and take care of your consequences. Just don’t force others to do it your way. No means no - and it’s not just about permission to have sex. It’s also about someone’s risk boundaries and how far they are willing to go with you. It may be up for discussion but it’s not up to you to decide for them.

 

What is HJ?

 

Gman

[MikeBiDude]

What is HJ?

 

Gman

Hand job?

[Sean Y]

What is HJ?

 

Gman

Hand job. A wank! A tug!

[pubic_assistance]

TRUST is your safest sex.

A closed circle relationship ..for as long as it lasts, will guarantee both parties a safe space to fuck away.

Outside of that...slipping on a condom is a no-brainer...because relying on a 88% efficacy (in general practice as opposed to the statistics trotted out by GILEAD) is deep into the realm of *no-brains*.

[TruthBTold]

According to the CDC (U.S. Center for Disease Control and Prevention), Truvada when taken consistently "reduces the risk of getting HIV from sex by more than 90 %." How much more it does not say. This conclusion is from a 2018 CDC statement. https://www.cdc.gov/hiv/basics/prep.html It also links various studies from which it is taking its conclusion. However, because condoms do protect against other STDs than HIV the CDC also recommends concurrent use.

[pubic_assistance]

According to the CDC (U.S. Center for Disease Control and Prevention), Truvada when taken consistently "reduces the risk of getting HIV from sex by more than 90 %." How much more it does not say. This conclusion is from a 2018 CDC statement. https://www.cdc.gov/hiv/basics/prep.html It also links various studies from which it is taking its conclusion. However, because condoms do protect against other STDs than HIV the CDC also recommends concurrent use.

RIGHT....WHEN you take it EXACTLY as prescribed you have a 10% chance of STILL catching HIV.

However MOST people do NO take it as prescribed, and therefore the statistics raise your chance to 12% of catching HIV if you "mostly" take it as prescribed.

In the general population, efficacy rates can drop as low as 40%.

So, one needs to learn to READ the research, not just listen to drug companies who want to sell drugs.

[+ quoththeraven]

TRUST is your safest sex.

A closed circle relationship ..for as long as it lasts, will guarantee both parties a safe space to fuck away.

Outside of that...slipping on a condom is a no-brainer...because relying on a 88% efficacy (in general practice as opposed to the statistics trotted out by GILEAD) is deep into the realm of *no-brains*.

Trust is not your safest sex. People you think you can trust lie or omit all the time. See @sam.fitzpatrick's post above about his friend whose partner didn't disclose to him that he was HIV+ when they met. It's one of the reasons people seroconvert without knowing it.

 

Using condoms and PrEP is safer than using one or the other, and condoms, not PrEP, are more unreliable in practice.

[pubic_assistance]

Trust is not your safest sex. People you think you can trust lie or omit all the time. See @sam.fitzpatrick's post above about his friend whose partner didn't disclose to him that he was HIV+ when they met. It's one of the reasons people seroconvert without knowing it.

 

Using condoms and PrEP is safer than using one or the other, and condoms, not PrEP, are more unreliable in practice.

If you associate with losers and liars, you sleep with losers and liars.

Obviously if you're hiring your company, you need all the protection you can get....because you really do NOT know that person, and should not trust them, no matter how many times you've hired them.

Likewise if you are in a committed relationship...until that person has proven worthy of your trust, you shouldn't trust.

[TruthBTold]

RIGHT....WHEN you take it EXACTLY as prescribed you have a 10% chance of STILL catching HIV.

However MOST people do NO take it as prescribed, and therefore the statistics raise your chance to 12% of catching HIV if you "mostly" take it as prescribed.

In the general population, efficacy rates can drop as low as 40%.

So, one needs to learn to READ the research, not just listen to drug companies who want to sell drugs.

 

True. You are indeed in charge of your own body and your need to comply with the prescription's mandates. However I have taken my medication every day and so my statistics are AT LEAST 90% and could be well above. I can't answer for others who do not. So I have to accept or not accept the risks by assessing the many factors involved and go on from there. Even if I used a condom but did not use medication my risk would be the same and actually might be more. So I might choose to go without ejaculation in my butt. But that might be giving up too much.

[+ quoththeraven]

If you associate with losers and liars, you sleep with losers and liars.

Obviously if you're hiring your company, you need all the protection you can get....because you really do NOT know that person, and should not trust them, no matter how many times you've hired them.

Likewise if you are in a committed relationship...until that person has proven worthy of your trust, you shouldn't trust.

Many people find out other people who seem worthy of their trust aren't reliable when it comes to sex because they're making decisions with their little head, not their big one. Let me suggest that this is an issue on which it's safer to assume no one but yourself is trustworthy.

 

Also it's shitty to blame a medication for patient errors or inconsistent usage. If you wouldn't call other medication ineffective because people forget or don't bother to take them, don't do it with PrEP.

[pubic_assistance]

Many people find out other people who seem worthy of their trust aren't reliable when it comes to sex because they're making decisions with their little head, not their big one. Let me suggest that this is an issue on which it's safer to assume no one but yourself is trustworthy.

 

Also it's shitty to blame a medication for patient errors or inconsistent usage. If you wouldn't call other medication ineffective because people forget or don't bother to take them, don't do it with PrEP.

Sorry you haven't had the pleasure of trustworthy people in your life. They do exist but tend to want to keep with their own kind

[MassageAdam]

RIGHT....WHEN you take it EXACTLY as prescribed you have a 10% chance of STILL catching HIV.

However MOST people do NO take it as prescribed, and therefore the statistics raise your chance to 12% of catching HIV if you "mostly" take it as prescribed.

In the general population, efficacy rates can drop as low as 40%.

So, one needs to learn to READ the research, not just listen to drug companies who want to sell drugs.

Where did you get your stats? Like I've said I have gone to many presentations given my Infectious disease doctors and I don't think you are correct. I've been given information that is quite differing from yours. You are correct that people should learn for themselves, but I do have to say, what you are saying isn't 100% truthful. It actually has more protection than you are probably aware of and they don't broadcast it because they don't want people missing doses.

[+ quoththeraven]

Sorry you haven't had the pleasure of trustworthy people in your life. They do exist but tend to want to keep with their own kind

I wasn't talking about me or my experiences. But thanks for being so open in your disdain. Untrustworthy, woo!

 

Wow, you really thought that would hurt me and not make you look idiotic and petty?

Edited October 25, 2018 by quoththeraven

[TruthBTold]

I wasn't talking about me or my experiences. But thanks for being so open in your disdain. Untrustworthy, woo!

Wow, you really thought that would hurt me and not make you look idiotic and petty?

 

OK, we're talking about something serious. Can't we put our less pretty selves to the side and talk like adults. Save it for other threads. There are plenty of places to post your cynical views. Or just go to the gallery and post a butt or two.

[+ oldNbusted]

[Sean Y]

According to the CDC (U.S. Center for Disease Control and Prevention), Truvada when taken consistently "reduces the risk of getting HIV from sex by more than 90 %." How much more it does not say. This conclusion is from a 2018 CDC statement. https://www.cdc.gov/hiv/basics/prep.html It also links various studies from which it is taking its conclusion. However, because condoms do protect against other STDs than HIV the CDC also recommends concurrent use.

Our perception of risk is very funny and personal. I mean, more people die from car accidents than plane crashes or terrorist attacks but most people drive or are in cars everyday. We know the correlations between high blood pressure, cholesterol, obesity, tobacco smoking, etc. and cancer or strokes or heart attacks (definitely higher than 10% risk), yet we are fine with eating French fries, potato chips and fatty desserts (all my weaknesses) without much thoughts.

 

So for some, reducing the transmission risk by 90% is pretty good. But if we were to say the failure rate for plane crashing or the failure rate of car brakes malfunctioning is 10%, no one would get on an airplane or buy that car because that risk is too high, even for something as important as needed transportation.