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Condoms and PrEP

TruthBTold

By TruthBTold
in Questions About Hiring

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TruthBTold Grand Master

TruthBTold

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If the chances of being infected with HIV (or even with other communicable diseases) is fairly small if the escort and the client use condoms and PrEP, is it reasonable to ask an escort who is going to top to cum in the condom while it is inside the client? Generally, as I understand it, women use condoms to prevent pregnancies and a condom that does not break is something that helps that immeasurably. So, if a bottom is on PrEP and the two participants are using a condom is it OK if the client bottoms asks the escort top to cum in the condom? The chance that the condom breaking is slim and even if it does the additional protection of PrEP seems to make infection fairly unlikely.

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FigureSkater Enthusiast

FigureSkater

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The odds:

-Getting HIV while bottoming is 1/154 (.65%)

-Condom breaking is around 2-3% on the brands trojan and durex based on their yearly analysis

 

Since the efficacy of Prep is stated to be around 96%. This lowers the chance of getting infected to .0002%. Although recent scientific studies say it may have increased.

 

The odds of having the condom break while your on prep, and getting infected by HIV is... well you get the picture. :)

 

Although things to note is that the population size is quite smaller and not representative of the real world. So take the statistic with a grain of salt ;)

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Seaninsf Community Regular

+ Seaninsf

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Nice analysis @FigureSkater! Will you help me with my taxes? :p

 

Setting aside the risk aspect of the question (which I do understand IS the question), I think it's not uncommon for guys to find it more difficult to cum while fucking with a condom on. That may further reduce your pool of potential participants.

 

But I don't think there's harm in asking.

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VictorPowers Mentor

+ VictorPowers

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The odds:

-Getting HIV while bottoming is 1/154 (.65%)

-Condom breaking is around 2-3% on the brands trojan and durex based on their yearly analysis

 

Since the efficacy of Prep is stated to be around 96%. This lowers the chance of getting infected to .0002%. Although recent scientific studies say it may have increased.

 

The odds of having the condom break while your on prep, and getting infected by HIV is... well you get the picture. :)

 

Although things to note is that the population size is quite smaller and not representative of the real world. So take the statistic with a grain of salt ;)

Your odds on bottoming can be skewed depending on if top is cut/uncut. Just a note.

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LivingnLA Veteran

LivingnLA

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Posted
The odds:

-Getting HIV while bottoming is 1/154 (.65%)

-Condom breaking is around 2-3% on the brands trojan and durex based on their yearly analysis

 

Since the efficacy of Prep is stated to be around 96%. This lowers the chance of getting infected to .0002%. Although recent scientific studies say it may have increased.

 

The odds of having the condom break while your on prep, and getting infected by HIV is... well you get the picture. :)

 

Although things to note is that the population size is quite smaller and not representative of the real world. So take the statistic with a grain of salt ;)

 

Would you mind sharing sources for your numbers?

 

I believe current CDC odds for an anal receptive partner contracting HIV is 1.38%, more than double your number.

 

As I recall, condom failure is in the 2% range for most brands, but that assumes it was stored perfectly and handled properly. This article touches on many of the ways condoms fail or are mishandled because people don't use them properly.

 

"Between 0.8 percent and 40.7 percent of participants had experienced a condom break, and between 13.1 percent and 19.3 percent had one leak, depending on the study. Improper condom use, including the wrong kind of lubricant or storage, can contribute to these problems. For instance, oil-based lubricants will degrade latex condoms."

 

Demographics play a roll because different groups have different infection rates--especially for other STDs--and different education about safer sex and condom use. There are far more factors to consider when thinking about safety.

 

If you're on PrEP and regularly use good condoms properly, you're doing your part to practice the safest sex we currently know how to have with another person. Life contains risk. There's no way to eliminate risk. All we can do is minimize it and what you're describing (good condom used properly, consistent PrEP use, and asking a top to climax in a condom while fucking) all seem reasonable to me.

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JackTim2493 Rookie

JackTim2493

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Your odds on bottoming can be skewed depending on if top is cut/uncut. Just a note.

 

Does cut/uncut really matter?

 

I am deciding whether or not to start on prep. Still relatively new to everything, got couple massages started few years back, thinking about hiring an escort recently but haven't gone through with it yet. Trying to read through some old post to get some opinions.

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keroscenefire Grand Master

+ keroscenefire

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Does cut/uncut really matter?

 

I am deciding whether or not to start on prep. Still relatively new to everything, got couple massages started few years back, thinking about hiring an escort recently but haven't gone through with it yet. Trying to read through some old post to get some opinions.

 

https://www.health24.com/Medical/HIV-AIDS/News/bacteria-in-uncircumcised-men-increase-hiv-risk-20170731

 

Circumcision actually appears to matter more for the top than the bottom in that an uncut top is more likely to get HIV from anal sex than a cut one. I doesn't appear that it effects the transmission of HIV to the bottom except I suppose that a uncircumcised man has slightly overall chance of being HIV+.

 

Apparently it relates to the fact that the foreskin often contains certain types of bacteria that draw in immune cells that become at risk for HIV infection.

 

However, this is according to a study of heterosexual men in Africa. Also this is literally a quote from the main doctor who did the study:

 

"It's thought that most gay men are infected while having unprotected receptive anal sex," she said, "so these findings are probably not relevant to the gay community in the United States."

 

So...take that with a huge grain of salt.

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robear Mentor

+ robear

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All this calculation is omitting an important additional variable: if your partner is HIV+, being effectively treated and has an undetectable viral load, he is not infectious.

 

https://www.healthline.com/health-news/cdc-person-with-undetectable-hiv-cannot-transmit-virus

 

Of course, in many scenarios it's impossible to know for certain a partner's status, so there's that, but any hypothetical risk assessment must take this into account.

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keroscenefire Grand Master

+ keroscenefire

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Some epidemiological studies show that PrEP and HIV anti-retroviral treatments when used widely may end up really reducing HIV in the population. In New South Wales, Australia, the government has been fully onboard with making PrEP widely available to everyone who might be at risk and a new study not only showed a decline in HIV overall, but even in those who did not use PrEP. This is because of the herd immunity with there being less people who can get HIV and therefore less people to spread it in a population.

 

If this is done over the whole world, we may huge decreases in new HIV diagnoses and maybe a real chance at getting rid of this terrible disease once and for all.

 

https://www.cnn.com/2018/10/17/health/hiv-reduction-men-prep-australia-intl-study/index.html

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LivingnLA Veteran

LivingnLA

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Posted (edited)
Some epidemiological studies show that PrEP and HIV anti-retroviral treatments when used widely may end up really reducing HIV in the population. In New South Wales, Australia, the government has been fully onboard with making PrEP widely available to everyone who might be at risk and a new study not only showed a decline in HIV overall, but even in those who did not use PrEP. This is because of the herd immunity with there being less people who can get HIV and therefore less people to spread it in a population.

 

If this is done over the whole world, we may huge decreases in new HIV diagnoses and maybe a real chance at getting rid of this terrible disease once and for all.

 

https://www.cnn.com/2018/10/17/health/hiv-reduction-men-prep-australia-intl-study/index.html

 

Except that we won't because PrEP requires consistent use and humans are notoriously bad at consistency. That's probably why there are already PrEP resistent strains of HIV in the general population. Inconsistent PrEP use is a perfect breeding ground for resistance. Though, the percentage of people with PrEP resistant strains is still very small.

 

http://www.aidsmap.com/How-much-PrEP-resistant-HIV-is-out-there/page/3245143/

 

Plus we have very strange cases like this Dutch man who contracted HIV while on PrEP and it wasn't even a resistant strain. As we all know, PrEP isn't 100%, so perhaps his very high number of sexual partners is how he contracted HIV: probability won.

 

https://www.poz.com/article/prep-fails-third-man-time-hiv-drug-resistance-blame

Edited by LivingnLA
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FrankR Grand Master

+ FrankR

Posted
Posted
Does cut/uncut really matter?

 

I am deciding whether or not to start on prep. Still relatively new to everything, got couple massages started few years back, thinking about hiring an escort recently but haven't gone through with it yet. Trying to read through some old post to get some opinions.

Check out the documentary “American Circumcision”. It is available on Netflix....

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JackTim2493 Rookie

JackTim2493

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Sex is not a "no risk" game gents. Even kissing has risks, as does oral sex, rimming etc. Each of us has to find what risk(s) we can live with and carry on from there. If your risk tolorance is zero, get off this site :p

 

Totally understand that risks are there and nothing can be 100% eliminated. Just new to this and want to experience more but of course want to learn how to play safe.

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dauterman Rookie

+ dauterman

Posted
Posted
The odds:

-Getting HIV while bottoming is 1/154 (.65%)

-Condom breaking is around 2-3% on the brands trojan and durex based on their yearly analysis

 

Since the efficacy of Prep is stated to be around 96%. This lowers the chance of getting infected to .0002%. Although recent scientific studies say it may have increased.

 

The odds of having the condom break while your on prep, and getting infected by HIV is... well you get the picture. :)

 

Although things to note is that the population size is quite smaller and not representative of the real world. So take the statistic with a grain of salt ;)

 

I think the 2-3% condom failure rate quoted is for vaginal sex (the main purpose for these condoms, hence the failure rate that is quoted in the literature). My understanding is the condom failure rate for anal sex is 5 - 10 %.

 

To calculate the odds of the bad outcome you have to multiple the probability of all the failures that lead to the bad outcome:

 

5% condom failure rate x 4% PREP failure rate x .65% rate of transmission = about 1 in 77,000.

 

Just my 2 cents worth.

Dauterman

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