“Treatment as Prevention”

[Jeffster]

When you run across an escort’s personal profile on Scruff or Grindr, and you see “Treatment as prevention,” do you ask them their HIV status prior to hiring off of Rentmen? I get the feeling that some guys don’t get the fact that “treatment as prevention” means HIV positive, and that they think that “treatment as prevention” means they are negative and taking Prep.

 

I’ve broached the issue with a few guys on the apps and asked them if they really knew what “treatment as prevention” meant. Some claim that they honestly thought it meant negative and on prep. Is there really that misconception out there or is that just a line of BS?

[caliguy]

When you run across an escort’s personal profile on Scruff or Grindr, and you see “Treatment as prevention,” do you ask them their HIV status prior to hiring off of Rentmen? I get the feeling that some guys don’t get the fact that “treatment as prevention” means HIV positive, and that they think that “treatment as prevention” means they are negative and taking Prep.

 

I’ve broached the issue with a few guys on the apps and asked them if they really knew what “treatment as prevention” meant. Some claim that they honestly thought it meant negative and on prep. Is there really that misconception out there or is that just a line of BS?

Why wouldn't they just say on PrEP? Wouldn't that just be simpler? At any rate, I've never come across any ad where it's a negative guy saying that. If you're in treatment that means you're being treated for something.

[corndog]

I think that it can also mean that the person is negative, but ok with having sex with HIV+ persons who are on treatment and have suppressed their viral load to "undetectable." At this point, it is a well-accepted fact that when someone is undetectable, they are incapable of transmitting HIV. "U=U"

 

Having said all that, it seems like a bad idea to ever take someone's word for their HIV status, whether they claim they're "negative," "on PrEP," or "Undetectable," their claim may or may not be true. Each of us should always take responsibility for our own sexual health, whether that means using condoms or PrEP.

[DallasClient]

I haven't seen "treatment as prevention" anywhere. However, as I am on PrEP, I just say "negative and on PrEP".

 

When I'm with a young person who may need to be educated, I remind them about PrEP and that people who are positive and on medication that shows HIV as undetectable, that means undetectable=untransmissable and are safe. The biggest danger is the guy who was infected a couple months ago and doesn't know it. His viral load will be very high and quite contagious.

 

Use PrEP/condoms.

 

FYI, DFW area people can get PrEP for free. www.helpfw.org

[+ pitman]

I've never before heard of the term "treatment as prevention", but I initially interpreted it as PreP. One takes a treatment (PreP) to prevent something (HIV seroconversion).

[+ PapaTony]

The mix of responses within this thread is proof of the confusion and misinformation.

I find it troubling that some have never come across or heard of TAPP.

 

I’ve come across too many (mostly on SCRUFF oddly) who think TAPP means negative.

[DallasClient]

Having said all that, it seems like a bad idea to ever take someone's word for their HIV status, whether they claim they're "negative," "on PrEP," or "Undetectable," [or treatment as prevention] their claim may or may not be true. Each of us should always take responsibility for our own sexual health, whether that means using condoms or PrEP.

 

This is the main takeaway along with try and teach others how to protect themselves.

[sexymonk]

Why wouldn't they just say on PrEP? Wouldn't that just be simpler? At any rate, I've never come across any ad where it's a negative guy saying that. If you're in treatment that means you're being treated for something.

Prep alone most of the times automatically means you are negative.

[+ poolboy48220]

I've never heard the term before and just googled it. So the "prevention" refers to preventing the spread from an HIV+ person? Not prevention of getting something yourself? IMHO, whoever coined that phrase needs to take a writing class.

[+ azdr0710]

where's Draker when we need him!

[SirBillybob]

There has long been a need to differentiate among three versions of HIV transmission prevention, none of which refer specifically to non-ARV protection, via latex barriers for example: post-exposure prophylaxis (PEP) for a neg person, pre-exposure prophylaxis (PrEP) for a neg person, and treatment-as-prevention (TasP) of a poz person for the sake of a neg person.

 

None require a verified poz diagnosis of a sexual partner (at the level of disclosure outside of jurisdictional legal considerations) but any of the three can include such. TasP is conceptual for the neg because it does not hinge on ARV uptake for the neg (nor precludes it) and involves planful rigourous ARV treatment of the poz.

 

TasP refers to treatment of the poz person and is predicated on ensuring and monitoring viral suppression. Because it can be stand-alone as a prevention measure, a unique specific term is needed where transmission patterns are assessed in the context of negative partners not taking preventive ARV. However, it can also obviously occur in conjunction with PEP or PrEP uptake by negative partners.

 

Treatment (TasP) is not prophylaxis but doubles as prevention. PEP and PreP are not treatment but are prevention, essentially anticipatory treatment of a hypothetical exposure (prophylaxis).

 

Condoms are prophylactics.

 

I don't find the above to be confusing or a poor choice of semantics.

 

-------

The escort describing "treatment as prevention" is:

 

(a) Using the term (TasP) erroneously as a misnomer for his PreP, or ...

 

(b) Is poz and relying on and conveying his monitored ARV treatment as an exclusive (or component) mode of prevention, not precluding the component of TasP for poz clients or PrEP for neg clients, or ...

 

© Assessing clients for serostatus and ARV treatment along with conventional markers of viral suppression.

 

I am not getting into disclosure legalities, such as for (b). However, the client "in the know" may take the term TasP or its long form, used correctly, as an opening to discuss prevention with the provider or as an opening to discuss its incorrect use where the provider is neg and on PrEP.

 

My guess is that (a) is the most common. I know for sure that © is the least common.

[SirBillybob]

According to my Grindr profile settings the closest thing to TasP is "positive, undetectable". Therefore, cross-referencing that auto-dialogue box content with the "about me" component that might include the TasP wording may provide a clue as to what communication is intended.

[sincitymix]

i dont care what the person puts, or even says they are Undetectable. Its going to be condoms all the time. Unless i am watching them take the medicine every single day, i have no idea if they are compliant with taking the medications as prescribed. so trust me im U=U.. sorry here is a condom.

[SirBillybob]

In general, I do not think escorts delineate serostatus or prophylaxis status as a way of dissuading clients from condom use. The original question related to the conceptual understanding of various HIV prevention terms. It did not intend to undermine condom use in general for a host of STI prevention.