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[Phil_musc]

Gentlemen, I recently saw the following quote as a part of an ad on Massagem4m.com:

 

 

I also take Truvada Prep(HIV prevention medication(same protection from HIV as a condom).

*HIV NEG, AS OF 3.15.13

 

I'm not an idiot (well, that is debatable) so I figure this is a none-to-subtle advertisement for an encounter that will likely result in bareback sex taking place during the session.

 

Is this in fact true about Truvada Prep? Would this encourage you to relax your vigilance about condom free sex?

[Xander]

That may be what he is hinting at. From what I understand, it has been shown effective for reducing the risk of contracting HIV, but not for transmission. The facts in one study shows a 42% decrease in HIV occurance when on the pill. I don't know about you, but I'd want something more along the lines of 99.998%..

[instudiocity]

Gentlemen, I recently saw the following quote as a part of an ad on Massagem4m.com:

 

 

I also take Truvada Prep(HIV prevention medication(same protection from HIV as a condom).

*HIV NEG, AS OF 3.15.13

 

I'm not an idiot (well, that is debatable) so I figure this is a none-to-subtle advertisement for an encounter that will likely result in bareback sex taking place during the session

 

Is this in fact true about Truvada Prep? Would this encourage you to relax your vigilance about condom free sex?

That was easy, #3 on a Google Search for Truvada PrEP....

 

From the article I'm linking below:

It is not a prescription to party, says Debra Birnkrant, MD, the FDA's director of antiviral products.

 

We stress that PrEP with Truvada must include safer-sex practices, counseling, and HIV testing," Birnkrant said at a news conference held to announce the decision. "Truvada should not be used alone for HIV prevention."

http://www.webmd.com/hiv-aids/news/20120716/fda-approves-first-drug-for-hiv-prevention

 

You're not the idiot, the massage therapist who wrote, "I also take Truvada Prep(HIV prevention medication(same protection from HIV as a condom)." IS THE IDIOT...

[marylander1940]

Gentlemen, I recently saw the following quote as a part of an ad on Massagem4m.com:

 

 

I also take Truvada Prep(HIV prevention medication(same protection from HIV as a condom).

*HIV NEG, AS OF 3.15.13

 

I'm not an idiot (well, that is debatable) so I figure this is a none-to-subtle advertisement for an encounter that will likely result in bareback sex taking place during the session.

 

Is this in fact true about Truvada Prep? Would this encourage you to relax your vigilance about condom free sex?

 

Obesity is a national security threat, is Hiv next?

 

How irresponsible is to engage in BB sex, getting infected and going on the expensive pill "taking" a lot of money from our healthcare system.

 

This guy won't be negative for long, I think he might be already positive, but as we all know we are all negative.

 

One thing is something bad happening to you (rape, condom broke) other thing is asking for it and making the whole country pay for it...

[instudiocity]

obesity is a national security threat, is hiv next?

 

How irresponsible to engage in bb sex, getting infected and going on the expensive pill "taking" a lot of money from our healthcare system.

 

This guy won't be negative for long, i think he might be already positive, but as we all know we are all negative.

huh?

[Mark Gordon]

Apart from the other issues, there are a host of nasty things besides HIV out there which PreP will not protect anyone from; only condoms will. If someone is getting paid for BB (under the guise of massage, no less), they will be much more likely to be exposed to these diseases, and to pass them on to their clients.

[corndog]

This kind of thinking -- using Truvada instead of safer sex practices -- is exactly why the approval of PreP therapy has been so controversial. This is a recipe for disaster.

[marylander1940]

huh?

 

Actions have consequences, truvada costs a lot of money and it's paid by all of us.

 

Condoms=cheap

Truvada=expensive but paid by healthcare.

[instudiocity]

Actions have consequences, truvada costs a lot of money and it's paid by all of us.

 

Condoms=cheap

Truvada=expensive but paid by healthcare.

Yes, actions do have consequences. Drugs to cost a lot of money. No, not necessarily are we all paying for the drugs, at least not yet!

 

Healthcare today is still a private insurer environment. My particular healthcare provider doesn't cover Truvada PrEP. So you're not paying for mine.

 

Now coming in the future, maybe, but today the Cardinal of the Senate Finance Committee announced his retirement from the Senate. He shepherded the Affordable Care Act through the Senate and recently said, "Baucus also warned at a recent hearing with Health and Human Services Secretary Kathleen Sebelius that implementing the federal health care law would be a “train wreck” over the next few years, a comment that angered both liberals supportive of the law and conservatives who pointed out that he helped shepherd it to passage."

[marylander1940]

Yes, actions do have consequences. Drugs to cost a lot of money. No, not necessarily are we all paying for the drugs, at least not yet!

 

Healthcare today is still a private insurer environment. My particular healthcare provider doesn't cover Truvada PrEP. So you're not paying for mine...

 

Good to know I'm not paying for your pills.

 

Here in DC if you become positive, the local govt pays for your pills, but if a woman gets cancer that depends on your health insurance provider. Makes no sense!

 

Hiv=preventable

Cancer=non preventable

 

Besides some guys I know who are positive are kind of proud about it, like if they were victims/survivors and they BB up and down the neighborhood because they already have it, so who cares...

[seeker630]

Good to know I'm not paying for your pills.

 

Here in DC if you become positive, the local govt pays for your pills, but if a woman gets cancer that depends on your health insurance provider. Makes no sense!

 

Hiv=preventable

Cancer=non preventable

 

Besides some guys I know who are positive are kind of proud about it, like if they were victims/survivors and they BB up and down the neighborhood because they already have it, so who cares...

 

I'm curious about how & for whom 'local govt' in DC pays for HIV treatment. Can you clarify?

 

I don't think cancer patients should receive less financial support than HIV-infected patients, but from a public health perspective, HIV is a transmissible disease and therefore the consequences of non-treatment have a wider impact on the community.

[marylander1940]

I'm curious about how & for whom 'local govt' in DC pays for HIV treatment. Can you clarify?

 

I'll get back to you with more information about it.

 

I don't think cancer patients should receive less financial support than HIV-infected patients, but from a public health perspective, HIV is a transmissible disease and therefore the consequences of non-treatment have a wider impact on the community.

 

You can avoid Hiv using condoms. In the 90's when it was deadly everybody used condoms, now a lot of younger guys think it's like diabetes, it only needs a treatment.

[instudiocity]

I'm curious about how & for whom 'local govt' in DC pays for HIV treatment. Can you clarify?

 

I don't think cancer patients should receive less financial support than HIV-infected patients, but from a public health perspective, HIV is a transmissible disease and therefore the consequences of non-treatment have a wider impact on the community.

Soooooo.... What do HIV and Diabetes have in common, that cancer does not share?

 

HIV and Diabetes are for the most part SELF-INFLICTED!

 

BTW, the next step in the progression of Obamascare is to deny coverages those who engage in certain behaviors - tobacco users, alcohol users, high-risk sex, even multiple child households are going to be effected - just look at Mayor Bloomberg's war on smoking and cola... he's tried to outlaw any soda larger than 16 ounces and right now he's working on making it illegal to use tobacco in one's own home.

 

Deprivation of Liberty will be the results of Big Brother/Big Doctor...

[sfguy]

Soooooo.... What do HIV and Diabetes have in common, that cancer does not share?

 

HIV and Diabetes are for the most part SELF-INFLICTED!

 

Lung cancer is often caused by smoking. Many mouth cancers are too. Liver cancer is usually caused by Hepatitis C, which is usually transmitted through needle-sharing. Liver cancer is sometimes the result of cirrhosis, which is caused by drinking too much. Colon cancer, anal cancer, and cervical cancer can all be caused by HPV, which is sexually transmitted. There are many other behaviors that increase the likelihood of certain cancers. Aren't these self-inflicted?

 

Cancer is a very broad term. It refers only to unregulated cell growth. The word cancer does not imply a cause. It's difficult to pinpoint specifically what causes cancer. We do know what things increase the chances of cancer. Wr know that some specific types of cancers are caused by specific things. But we also know that sometimes those specific things don't always result in cancer. Cancer can be caused by behaviors (like smoking), environmental factors, radiation exposure, genetics, viruses, exposure to certain chemicals, or any combination of those things. It doesn't make sense to compare a broad category like cancer to a specific virus, like HIV. It's also incorrect to say that cancer is not self-inflicted because sometimes it is.

 

I'm also a bit confused about your concern about restricting the sale of sodas larger than 16oz. and prohibiting smoking in apartment buildings. You're critical of HIV and diabetes (and presumably lung cancer resulting from smoking) since those are self-inflicted. But the point of those measures is to make it more difficult to for people to self-inflict those diseases (and in the case of smoking in apartment buildings, inflicting them on others). So it seems that you would be supportive of those measures since they would help reduce the rates of those diseases. So I'm a bit confused about why you are critical of them.

[JoeBlow]

Call me crazy, but if he is a registered massage therapist (non-escort) then why is he promoting his safe-sex strategies in a freakin' massage ad?

[sfguy]

Going back to the original post, I just wanted to make a few points about PrEP and condoms. To begin with, I would like to state that regardless of PrEP/Truvada's effectiveness, condoms are a tried and true method of protection and the best method of prevention, short of abstinence.

 

Effectiveness is a tricky word. Correct and consistent condom use has an effectiveness of 98.8% in preventing HIV. But the way that is measured is based on laboratory tests of how many HIV sized particles pass through the condom. It's not based on studies of actual people. It is difficult to measure in actual practice since measuring it relies on self-reporting. Most studies place condom effectiveness between 70% and 80%. What can account for this huge drop? It's in the "correct and consistent" part of "correct and consistent condom use."

 

Not all men use a condom every single time with every single person. But even among men who report that they use condoms 100% of the time, the effectiveness usually still hovers around the same rate. Part of that is probably study participants who lied about their consistency. But part of it is that most men do not use condoms correctly. Lots of guys don't put them on correctly. You have to pinch the end to leave space at the tip, make sure there is no air in the condom, roll it all the way done, use enough lubricant, using the correct lube, putting on a new one when switching positions or after a certain period of time, etc. And of course it has to fit. If you're using a Magnum when you don't really need it, then you aren't doing it right. And if all he has is a regular condom and you need a Magnum, then that's a problem too. Not too big, not too small. We're all Goldilocks.

 

Additionally, correct use doesn't just refer to the actual sex act; it also refers to proper storage and handling. They have to be stored where it's not exposed to direct sunlight or high heat, like your car. Don't keep it in your wallet either. You have to check the expiration date. You have to make sure not to open it with anything that might damage the condom, like your teeth.

 

There's a lot to doing everything at that perfect "correct and consistent" level to reach that 98.8%. It is possible, of course, but it takes two to tango so he has to be doing it all correctly and consistently as well.

 

Now that's not to say that condoms are ineffective. It's just that we overstate the effectiveness. They have high effectiveness rate when they leave the factory, but whether that rate stay that high depends on a lot of human actions, which means it is subject to possible human error. We often assume guys who use condoms every time never get HIV, but it does actually happen. That doesn't mean we should throw condoms by the wayside. They are after all effective against HIV and a bunch of other stuff too.

 

PrEP/Truvada has an effectiveness of about 40%. That's not that great compared to condoms. But that's the overall rate. Some guys don't take it everyday. Among men who reported that they properly took the medication everyday, the effectiveness is about 70%. However, this does not mean that PrEP/Truvada is just as effective as condoms. Remember, if you use condoms consistently and correctly, the effectiveness is 98.8%. When you use PrEP/Truvada correctly, the effectiveness is 70%, which is at the low end of the condom effectiveness even when condoms aren't used correctly or as consistently as they should be.

 

So perfect PrEP/Truvada use is about the same as fucking up with condoms just as much as everyone else. So they are most definitely not equally effective.

 

PrEP/Truvada does have it's place though. I think it really should be prescribed only to guys who have demonstrated that they are very high risk (and some healthcare providers will only prescribe it to that category). If a guy has a history of never using condoms and has a large number of sex partners, then maybe Truvada is worth a shot. If we already know he won't use condoms, then 40% is better than nothing. Crystal meth users also fall into the category of very high risk since barebacking rates increase when guys are partying and fucking. You can shout about condoms at very high risk guys all you want, but that isn't going to change their behavior. You have to meet people where they are at, and PrEP/Truvada provides a tool to meet certain populations where they are.

 

At the end of the day, you are only responsible for yourself and can only protect yourself. If you don't want HIV, use a condom. It's not a guarantee, but it's as close as you're gonna get to one if you wanna get laid.

[Toulouse]

Very well said, SFguy. This is an informative, insightful and poignant post. Thank you for taking the time and energy to write it.