Do most escorts wear condoms?

[+ KensingtonHomo]

My experience is that in the US and Europe, PreP is very common and condom use is very low. We did have providers in Greece use them. However, in Mexico, all but one provider insisted on using condoms even when they were topping. I suspect PreP is not as accessible or common in Mexico, hence the condom use. 

[+ SirBillybob]

43 minutes ago, KensingtonHomo said:

My experience is that in the US and Europe, PreP is very common and condom use is very low. We did have providers in Greece use them. However, in Mexico, all but one provider insisted on using condoms even when they were topping. I suspect PreP is not as accessible or common in Mexico, hence the condom use. 

PrEP uptake rates among eligible at-risk MSM have been studied meta-analytically. They remain disturbingly low especially among younger males. The subpopulation proportions that are PrEP consumers based on solid candidacy are so poor in number that one might say differences regionally are comparable according to bad versus very bad. Appended is an example of the negligible true impact of country position on the theoretical low/middle/high income gradient in which resource access is typically subsumed.

PrEP non-uptake in spite of appropriate indication is so poor that it essentially overrides much of the association between condom use and non-PrEP insofar as substantial proportions of MSM have completely unprotected sex without partialized prophylaxis.

Edited Wednesday at 02:13 PM by SirBillybob

[+ Vegas_Millennial]

9 hours ago, MRK said:

You need a medical professional to administer it, but you really don't need a prescription.

Correct.  But I'm my experience, I am less likely to get the pharmacy or Health Department to administer it when I am outside the CDC age range unless I have a doctor's prescription.

[+ KensingtonHomo]

4 hours ago, SirBillybob said:

PrEP uptake rates among eligible at-risk MSM have been studied meta-analytically. They remain disturbingly low especially among younger males.

I'm quite surprised by this. Perhaps the decline of visible cases of men dying from AIDS due to the cocktail has made younger guys believe it's no longer a concern. I always found the advertising for the AIDS meds and the focus on U=U to be nefarious of Pharma and maybe misguided from community groups. Yes, we want to end stigma and give people facts but this makes me think we've oversold it to the point where people aren't concerned about sero-converting. 

[Rudynate]

On 8/29/2023 at 4:56 AM, pubic_assistance said:

Wearing a condom as a top is going to significantly reduce your risk.(not slightly)

 

[SecretProvider]

I only ever get asked to wear condoms by married men who still also have sex with their wives, and even then, not all of them want to. I can confirm my latest test results and Prep if they ask. 

I say I probably wear condoms maybe 10% of the time, I work on the assumption that no condoms is the preference 

[SecretProvider]

13 hours ago, SirBillybob said:

PrEP uptake rates among eligible at-risk MSM have been studied meta-analytically. They remain disturbingly low especially among younger males.

This data doesn't seem to align with my anecdotal experience.  I find it surprising.

The thing that I like about Prep so much is that I am responsible for my own health and I take it every singe day. It is so freeing that I don't even *think* about HIV anymore. Maybe guys are taking the 'I don't have to worry because everyone else is taking it'?  The infection rate is continuing to drop (38% decrease) which is directly attribute to Prep. 

PrEP Use Significantly Associated with Decreasing New HIV Diagnoses Across U.S. States - AIDSVu

AIDSVU.ORG

 

[pubic_assistance]

3 hours ago, SecretProvider said:

This data doesn't seem to align with my anecdotal experience.  I find it surprising.

One should never be surprised that scientific data and personal experience don't align. No one has THAT many friends who tell you all about their HIV infections. 

[+ SirBillybob]

5 hours ago, SecretProvider said:

This data doesn't seem to align with my anecdotal experience.  I find it surprising.

The thing that I like about Prep so much is that I am responsible for my own health and I take it every singe day. It is so freeing that I don't even *think* about HIV anymore. Maybe guys are taking the 'I don't have to worry because everyone else is taking it'?  The infection rate is continuing to drop (38% decrease) which is directly attribute to Prep. 

PrEP Use Significantly Associated with Decreasing New HIV Diagnoses Across U.S. States - AIDSVu

AIDSVU.ORG

 

Right, Sullivan’s paper, which I actually read recently, not just the reference to it, aligns with my post in terms of estimates of PrEP uptake among eligibles. Of course there is a dose response effect according to uptake rates. Why else would one want to uptick use from what his group deems problematic levels of non-prophylaxis? We now have oodles of data that demonstrate that anecdotal impressions of majority MSM PrEP uptake are bunk. Moreover, note (in the actual The Lancet HIV ) they use the descriptor “modest” for overall HIV incidence reduction attributable to uptake. It’s 2.4 cases per 100,000 capita decade to decade. It's only statistically significant with enormous population denominators that confer adequate statistical power.

At the best state-cluster case reduction levels delineated, that translates to a reduction from 38 per million in baseline year to 24 per million 10 years on. Naturally 14 less cases with that capita denominator is of value. One point of the paper, put softly however, was to imply it is a poor showing owing to the problem of low PrEP overall uptake and the failed imperative of pushing for improved and regionally equivalent access and consumption. But percentages are often misleading as bullet points and can overblow absolute or objectively meaningful change. 

PrEP is laudable to the extent enough is dispensed and taken to put a meaningful dent in HIV case incidence. The low impact to date is downplayed in the reference article, paradoxically, so it is not shapeshifted to complacency among policy makers that could influence higher uptake levels. The relation between uptake levels and (albeit mediocre) case reduction is highlighted to forward the improvement agenda. This paper is positioned contemporaneously with threats to resource allocation globally. 

Surely risk perception is influenced by distorted assumptions about what proportion of MSM eligibles take PrEP. At the point-of-intercourse level false assumptions that more than a quarter of seronegative partners are prophylaxis-positive is really bad. Risk perception in studies highlights the degree to which those sexually active believe they can be infected more so than the degree to which infection consequences are serious these days. 

Edited Thursday at 09:31 AM by SirBillybob

[SecretProvider]

1 hour ago, pubic_assistance said:

One should never be surprised that scientific data and personal experience don't align. No one has THAT many friends who tell you all about their HIV infections. 

True! but I don't think 80% of people are lying about being on Prep. Maybe I live in a New York bubble. 

[+ SirBillybob]

1 hour ago, SecretProvider said:

True! but I don't think 80% of people are lying about being on Prep. Maybe I live in a New York bubble. 

Well aren’t both eligible PrEP users and non-users existing within their respective microcosms irrespective of location? If you are a provider the trend would be diligently assortative and comfortably using the tools at your disposal with high levels of self-efficacy. However, if you falsely superimpose your assumptions of impressively high PrEP uptake levels among a selective subset of MSM on the totality of those at-risk and unprotected you may actually reinforce erroneous risk perceptions. This is not unlike the Sullivan paper. Inflating the media-centric obviously positive consequences of PrEP on population rates of infectivity inadvertently blows back on those less schooled, relatively disenfranchised, that quantify risk based on impressive-seeming stats utilized to galvanize access activism. 

40% risk reduction is not terrible in the context of seasonal influenza vaccination and hordes of people step up for the jab and feel protected. 40% less HIV infection gets easily conflated with effectiveness, but case incidence reduction is not efficacy. One less incidence of any entity can represent 100% reduction within an arbitrary denominator of 1 billion. That’s of course an extreme example of narrative spin. Guys acquiring HIV infection are lacking the complex personal finesse and systemic resources required for prevention far more than being victims of specifically selective partner mendacity. 

Edited Thursday at 10:36 AM by SirBillybob

[+ sniper]

Despite "shockingly low" rates of PreP, transmission rates are still relatively low because more of the people who DO have HIV get treatment and don't spread it like they used to. 

40 years ago being gay was more or less scandalous and there were well over 100,000 new cases a year in the US.. Now the MSM population has at LEAST doubled and there are about 30,000 new cases a year. When you consider how many unintended pregnancies happen each year, it's not really like people are so much.worse than they used to be.

Also, HIV isn't something that is spontaneously generated by two men rubbing together. If a closed group of people is all barebacking and none of them is HIV+ and untreated to begin with, nothing is going to happen.

I do wonder if the numbers have been run on just testing everyone quarterly and getting them treated immediately and what that would do to new case rates versus the cost of PreP.

[+ SirBillybob]

There exists a substantial literature on screen-and-treat proposed methods aimed at reducing HIV incidence, but these are simulated mathematical models that yield varying metrics of impact depending on how key variables are inserted algorithmically. The outputs range from modest to miraculously eliminatory. Naturally both serostatus capture for TasP and serostatus capture for PrEP eligibility contribute to reduction goals while posing logistical complications. 

If several decades ago when absolute regional new case incidence trended at, say, 6-figures annually, if a crystal ball had correctly predicted that virtually failsafe pharmacological prophylaxis could lower transmission to negligible levels within a circumscribed sexually active population most would exclaim with background Madonna tracks running that something is really fucked and riddled with abject complacency about, say, mid-5-figure incidence in 2025 … even with post-diagnosis virologic control, opportunistic infection elimination, inhibited disease progression similarly soothsaid. Or posit challenging retroviral mutation (that didn’t manifest). Success is measured by what could happen given research advances and knowledge/resource context, not some superficially meaningful fraction of potentiality. 

Edited Thursday at 02:08 PM by SirBillybob

[+ sniper]

Reducing to zero requires near perfect compliance. Human beings are imperfect. It's not necessarily about complacency.  I take a cholesterol pill. I have every intention of taking it every day, and am generally regarded as a responsible adult, but invariably my next 90 day automatic refill comes and I've still got some pills left. Throw in that people are often having sex while out of their element/on vacation/drinking etc, it's not hard to see how transmission still happens.

[+ Vegas_Millennial]

The escort I hired this morning in Puerto Vallarta is a dancer at Wet Dreams, and we did not use condoms.  In fact, neither of us had condoms, lube, or even poppers... Which made for a rough entry given his 9 inch size.   Thank Goodness Mexico is noisy during the day, so my yelling didn't arouse suspicion from neighbors.

The dancer I met last night at 69 strip club also offered bareback services. 

 

[+ Vegas_Millennial]

Of the 7 men I've played with in Puerto Vallarta this week this far, 2 have used condoms (28.5%).  But, its use was inconsistent even by the same guy.  One guy penetrated my ass with a condom, but then let me penetrate him without a condom.  The other guy let me suck his dick without a condom, but put a condom on me to suck mine.

This is still a small sample size.  For the sake of scientific integrity, I am working on sleeping with a larger sample size and report back here with the results.

Further skewing the results of this study:  the 7 men mentioned are a combination of escorts, masseurs, strippers, and hookups.

Edited Friday at 07:01 PM by Vegas_Millennial

[NYXboy]

I imagine all of these data sets being put forward are not focusing on the topic: which is specifically providers + condom use- I imagine prep use with providers would be significantly higher than the average layman. I don't see providers who want to use comdoms. 

Edited Thursday at 09:07 PM by NYXboy

[+ Vegas_Millennial]

On 12/3/2025 at 7:29 AM, KensingtonHomo said:

My experience is that in the US and Europe, PreP is very common and condom use is very low. We did have providers in Greece use them

Interesting.  My European experience has been the opposite.  Everyone in Vienna used condoms, but everyone in Athens did not.  Again, a larger sample size is needed, so I'll try to sleep with more men on my next European visit next year 

[+ SirBillybob]

8 hours ago, sniper said:

Reducing to zero requires near perfect compliance. Human beings are imperfect. It's not necessarily about complacency.  I take a cholesterol pill. I have every intention of taking it every day, and am generally regarded as a responsible adult, but invariably my next 90 day automatic refill comes and I've still got some pills left. Throw in that people are often having sex while out of their element/on vacation/drinking etc, it's not hard to see how transmission still happens.

Apples oranges. PrEP uptake among the majority of eligibles would make an enormous difference in case incidence. There is substantial leeway for imperfect PrEP adherence of the nature you are describing regarding cholesterol-related medication, missed doses despite adherence intentionality. If cholesterol pharmacological management drugs are reasonably accessible and have salutary outcomes then a rate of 25% uptake at a binary level for folks that can truly benefit from the intervention surely represents complacency at combined individual and systemic levels. 

Sure, there are stigma-related obstacles with PrEP. One reason that the men I referenced historically as a chorus of future evaluation would assert amazement and critical appraisal at what would seem to them to be a current wackadoodle reality is that the challenges of widespread consumption of PrEP to progress further towards disease eradication are a far cry from what previous consequences and outcomes of infection were. They might also opine that the way MSM galvanized strategies for MPox control could be replicated, that inexplicable contradictions exist within realms of possibility. This is not to dismiss confounders and comparator limitations that relatively temper disappointment and judgement, but let there be Hamlets sniffing around. 

Edited Friday at 04:51 AM by SirBillybob

[+ SirBillybob]

10 hours ago, Vegas_Millennial said:

Interesting.  My European experience has been the opposite.  Everyone in Vienna used condoms, but everyone in Athens did not.  Again, a larger sample size is needed, so I'll try to sleep with more men on my next European visit next year 

Obviously different regional approaches when knowing a Sachertart is in town and knowing a flaky pastry usually filled with nuts and honey is in town. 

Edited Friday at 08:42 AM by SirBillybob

[+ SirBillybob]

11 hours ago, NYXboy said:

I imagine all of these data sets being put forward are not focusing on the topic: which is specifically providers + condom use- I imagine prep use with providers would be significantly higher than the average layman. I don't see providers who want to use comdoms. 

An observation or a requirement? 

[+ SirBillybob]

As I’ve indicated, my hires consistently present condoms by default in the absence of awareness of my asks. They do so because they have the apparent audacity to think they are the most clinically informed and wise among us. I am unaware of their degree of flexibility on the matter because it would be bad form as a transactional employer, usually a guest in a different world region, to imply some degree of intellectual inferiority on their part in relation to best practices, to undermine systematized programs geared to recommended disease prevention methods, or to merge higher levels of calculated occupational disease risks with the imperative of their well deserved fruits of honestly waged labour. What an ordeal, though, to suffer through love-gloved anal reception of gorgeous studs while crying for my mommy, or through the deprivation of protected anal insertion while enthusiastically thanking mommy for my existence as well as those of the hunks bent over in front of me for theirs.

Edited Friday at 09:29 AM by SirBillybob

[+ KensingtonHomo]

16 hours ago, Vegas_Millennial said:

Interesting.  My European experience has been the opposite.  Everyone in Vienna used condoms, but everyone in Athens did not.  Again, a larger sample size is needed, so I'll try to sleep with more men on my next European visit next year 

We're aiming for France and Italy next year so I'll report back on our field research. 

[NYXboy]

6 hours ago, SirBillybob said:

An observation or a requirement? 

for me it's a requirement. I do not like condoms, and I am protected through Prep. I have no need for condoms. 

[Rod Hagen]

1 hour ago, NYXboy said:

for me it's a requirement. I do not like condoms, and I am protected through Prep. I have no need for condoms. 

....antibiotic resistant Gonorrhea, Chlamydia, syphilis, and Herpes 2 and warts anyone?