Poking a sleeping dragon

[Guest ChrisW]

This topic gets people riled up every time and my intention is not to stir the pot but rather to get information out there. If you can't have a candid discussion about safer sex practices you shouldn't be having sex. It is a disservice to the entire community to have emotional diarrhea on a public health matter. Whether you approve of barebacking or not is not in the issue, getting information out there to other escorts and clients who want to make informed decisions about their health is.

 

"I now believe that whether Truvada is being used by a monogamous couple, a single promiscuous person, a sex worker or anyone who chooses to take the pill, is doing the right thing for themselves. Only that person knows if they are putting themselves at risk, and potentially eliminating another infection is a good thing."

 

http://www.huffingtonpost.com/david-duran/truvada*****-an-evolved-o_b_5030285.html

[jimboivyo]

This topic gets people riled up every time and my intention is not to stir the pot but rather to get information out there. If you can't have a candid discussion about safer sex practices you shouldn't be having sex. It is a disservice to the entire community to have emotional diarrhea on a public health matter. Whether you approve of barebacking or not is not in the issue, getting information out there to other escorts and clients who want to make informed decisions about their health is.

 

"I now believe that whether Truvada is being used by a monogamous couple, a single promiscuous person, a sex worker or anyone who chooses to take the pill, is doing the right thing for themselves. Only that person knows if they are putting themselves at risk, and potentially eliminating another infection is a good thing."

 

http://www.huffingtonpost.com/david-duran/truvada*****-an-evolved-o_b_5030285.html

 

 

 

this isn't a wonder pill folks and you have to be able to afford it, or be insured to begin with. many insurance companies are NOT covering this yet

 

tons of young gay men are not insured. and they certainly don't have the $3k a month to afford the drug

 

save money, use your damned sense and slap on a condom

[+ Funguy]

this isn't a wonder pill folks and you have to be able to afford it, or be insured to begin with. many insurance companies are NOT covering this yet

 

tons of young gay men are not insured. and they certainly don't have the $3k a month to afford the drug

 

save money, use your damned sense and slap on a condom

 

in other words: Dress for the occasion

[Guest ChrisW]

Insurance is not as big an issue as you might think, most companies will cover it and the copay for many people I know is only $25. There is a patience assistance program through Giliad as well.

 

As for wrapping it up, your making the assumption I am advocating bareback sex. I am merely stating that there is another tool in our arsenal for STI reduction. People are free to make what ever choices they want and will continue to do so without your approval. Why not provide them with something and have a discussion about a tool to reduce their risk? You can spout condom only practices until your blue in the face but the reality is condom use is down to record lows among men who have sex with men, we need to have a candid conversation that addresses all forms of safer sex practices.

[Bosguy]

Insurance is not as big an issue as you might think, most companies will cover it and the copay for many people I know is only $25. There is a patience assistance program through Giliad as well.

 

As for wrapping it up, your making the assumption I am advocating bareback sex. I am merely stating that there is another tool in our arsenal for STI reduction. People are free to make what ever choices they want and will continue to do so without your approval. Why not provide them with something and have a discussion about a tool to reduce their risk? You can spout condom only practices until your blue in the face but the reality is condom use is down to record lows among men who have sex with men, we need to have a candid conversation that addresses all forms of safer sex practices.

 

I believe Chris was just presenting current methods that should be discussed. I don't believe he was being an advocate for or against the use of condoms. Just giving a possibility for the many who seem not to be using condoms.

 

I think it's great that an escort who cares is making an effort to contribute. Let's not start jumping all over him for being interactive.

 

Boston Bill

[+ Funguy]

Insurance is not as big an issue as you might think, most companies will cover it and the copay for many people I know is only $25. There is a patience assistance program through Giliad as well.

 

As for wrapping it up, your making the assumption I am advocating bareback sex. I am merely stating that there is another tool in our arsenal for STI reduction. People are free to make what ever choices they want and will continue to do so without your approval. Why not provide them with something and have a discussion about a tool to reduce their risk? You can spout condom only practices until your blue in the face but the reality is condom use is down to record lows among men who have sex with men, we need to have a candid conversation that addresses all forms of safer sex practices.

 

Agree with all except that Truvada is only for HIV. There are a myriad of other STD's out there which the condom WILL address. But, as you say, people will make their own choices.

It is nice that this subject is brought up on a regular basis - eventually someone might have a light bulb moment.

[Newly]

I'm impressed that this hasn't turned into a Jihad moment since I, for one, really would like some non-judgmental information about this thank you Chris). Assuming Truvada does negate the risk of HIV to a negligible amount (and everything I have read about it seems encouraging) what exactly are the other STDs that a condom will address? And if there are other STDs that a condom will address does that only apply to anal sex, or would it also apply to oral sex? No one seems to have any issues with not using condoms for oral sex - so I'm assuming that other STDs that a condom will prevent are only an issue with anal sex?

[+ Funguy]

I'm impressed that this hasn't turned into a Jihad moment since I, for one, really would like some non-judgmental information about this thank you Chris). Assuming Truvada does negate the risk of HIV to a negligible amount (and everything I have read about it seems encouraging) what exactly are the other STDs that a condom will address? And if there are other STDs that a condom will address does that only apply to anal sex, or would it also apply to oral sex? No one seems to have any issues with not using condoms for oral sex - so I'm assuming that other STDs that a condom will prevent are only an issue with anal sex?

 

Great! Now we can have an educational moment - not all the p's and q's - but enough to get a dialog started. Thank you, newtothis.

To start, gonorrhea, syphillis, HPV, chlamydia. Don't forget Hepatitis A,B,C, and so on, Herpes. Shall I go on?

 

Condoms will help prevent ALL of these, not 100% - nothing in this life is 100% - but a whole lot. We should be screened for all of these on a yearly basis - they ALL can be asymptomatic.

 

As for anal vs. oral sex - well there's the rub, so-to-speak. Yes, oral sex with condoms will prevent all of these. However, it's not a choice many will make and the rate of infection orally for all of these is far less than with anal sex. I do not have stats for oral v. anal infection rates at my fingertips, but oral is way, way, way down with most. Unfortunately, oral or pharyngeal gonorrhea, syphillis are out there, hence the need for screening. Chlamydia is more dangerous to women, may be asymptomatic. But those who are bi-sexual or married can transmit it to their female partners. HPV - well, oral, tongue, throat cancer (Michael Douglas is the obvious example) and anal warts - I've seen huge ones like a cauliflower! - and even cancer of the penis, anus. 98% of cases of cervical cancer in women come from HPV so watch out about again, giving to female partners.

 

Hepatits A (MOSTLY food handler borne - even think, rim), Hepatits B (blood borne) Hepatitis C (mostly injection borne) - watch out.

 

Vaccines for Hep A, B, HPV are available. There is no treatment for HPV, Hep A, C. For Hep B only lousy treatment.

Antibiotics for GC, syphillis, chlamydia. Antiviral for Herpes.

 

This is all off the top of my head and should give you all food for thought re:condoms.

[+ Gar1eth]

Insurance is not as big an issue as you might think, most companies will cover it and the copay for many people I know is only $25. There is a patience assistance program through Giliad as well.

 

As for wrapping it up, your making the assumption I am advocating bareback sex. I am merely stating that there is another tool in our arsenal for STI reduction. People are free to make what ever choices they want and will continue to do so without your approval. Why not provide them with something and have a discussion about a tool to reduce their risk? You can spout condom only practices until your blue in the face but the reality is condom use is down to record lows among men who have sex with men, we need to have a candid conversation that addresses all forms of safer sex practices.

 

Actually it is a big deal. I can't afford insurance right now, might qualify for Medicaid or the assistance program but I can provide the financial data that would allow me to qualify. So Truvada for me is as out of reach as sleeping on a cloud. I'm not saying Truvada is a bad thing- just there could be more people 'in heaven and earth ' that can't afford it than are 'considered in your philosophies.' I also am worried about what is going to happen when people don't take it consistently, and HIV resistance rears it's ugly head.

 

I don't know if they are the ultimate cause- probably not, but I still blame the porn companies for a lot of this new bareback craze. They can deny it as much as they want. But if a movie or a song or a play can make you feel happy, sad, bring the tears on- how in good-conscience can they say they don't have a hand in affecting behavior? In fact for all intents and purposes - movies, TV shows, and theatre can be lumped in with advertising. And we know what advertising's stated goal is.

 

Gman

[shadowcatzxxx]

Given that this thread seems to be staying "non-Jihadist" I'll pitch in a bit.

 

Although the run-of-the-mill STD's -- chalmydia, gonorrhea, and syphilis -- have been little more than nuisances for most of the time since antibiotics were developed, they, like other kinds of disease-causing things, are developing resistance to the inexpensive, safe, and easy-to-use antibiotics that controlled them until recently. Itchy penis? Get a test to confirm what the problem is, pop a few pills, and go on your merry way.

 

But that situation is changing rapidly.

 

Gonorrhea seems to be leading the pack (see, for example http://www.salon.com/2014/03/12/cdc_the_rise_of_antibiotic_resistant_gonorrhea_appears_imminent/).

 

The worst strains seem to have appeared in Europe .. and, given that higly-rated escorts (and other hot, sexually active men) in major US cities often see international visitors, there is no reason to expect those strains to stay on the other side of the pond for long.

 

For anyone who is closeted - if only about using escorts outside some other long-term relationship - caution seems warranted.

 

For others, as we often say when reviewing our favorite men, "your mileage may vary."

[+ Funguy]

Given that this thread seems to be staying "non-Jihadist" I'll pitch in a bit.

 

Although the run-of-the-mill STD's -- chalmydia, gonorrhea, and syphilis -- have been little more than nuisances for most of the time since antibiotics were developed, they, like other kinds of disease-causing things, are developing resistance to the inexpensive, safe, and easy-to-use antibiotics that controlled them until recently. Itchy penis? Get a test to confirm what the problem is, pop a few pills, and go on your merry way.

 

But that situation is changing rapidly.

 

Gonorrhea seems to be leading the pack (see, for example http://www.salon.com/2014/03/12/cdc_the_rise_of_antibiotic_resistant_gonorrhea_appears_imminent/).

 

The worst strains seem to have appeared in Europe .. and, given that higly-rated escorts (and other hot, sexually active men) in major US cities often see international visitors, there is no reason to expect those strains to stay on the other side of the pond for long.

 

For anyone who is closeted - if only about using escorts outside some other long-term relationship - caution seems warranted.

 

For others, as we often say when reviewing our favorite men, "your mileage may vary."

 

+1000

[Diverdan]

Another + 2000 here to the above.... unfortunately there are a lot of young guys who still think they are invincible and a lot of those guys do not read the Forum, although there may be a lot of them in the "lurkers" category. I am old enough to have lost a lot of friends to AIDS in the early years of that plague.. try going to a funeral for a friend who was a closeted gay and give condolances to their wife, children and parents who had no idea of their sexual orientation. Or to a funeral of a young gay man whose parents and friends had absolutely had no idea of his sexual orientation. Caution and protection is the byword for all of us, old, young, inbetween, gay, bi and straight. Hopefully one day there will be a cure for all of these ills, but as has been said above, these viruses and bacteria mutate and usually they develop immunity to the antibiotics that once killed them easily.

[Newly]

Thanks guys, that's a lot to process and it's good to get some talk going. I haven't been seeing guys for very long and don't have any gay friends so there really isn't anyone I can ask. One last really dumb question. What the heck is a female condom and does that offer any protection? Also, is bare back sex a lot better feeling? I've never done it so I have no frame of reference, but I'm assuming there must be some benefit if so many people want it? Wish I could talk to my doctors about it, but they all seem really uncomfortable with any talk about sex, and if I were to ask them about gay sex they would probably have a fit. I asked my GP about testosterone therapy and I've never seen anyone look so much like they wished they were somewhere else.

[Steven_Draker]

"According to a CDC analysis released last year, only 15% of gay men use condoms consistently enough to derive substantial benefit from them. Truvada, then, is not a drug for a barebacking, pornographic minority, but for the overwhelming majority of people who do not consistently practice safe sex."

 

Look yourself in the mirror and if you're not amongst the 15% mentioned above, you should probably consider Truvada.

 

Truvada is not for everybody. Truvada is not a candy. Truvada is not a substitute for condoms.

 

You should discuss and carefully consider this with your doctor and with a HIV specialist.

 

[+ deej]

Condoms will help prevent ALL of these, not 100% - nothing in this life is 100% - but a whole lot.

 

It's worth reminding from time to time that condoms were actually invented to stem the spread of syphillis. Their use as a prophylactic is a fairly modern phenomenon. They're still perfectly useful for their intended purpose.

 

One last really dumb question. What the heck is a female condom and does that offer any protection? Also, is bare back sex a lot better feeling? I've never done it so I have no frame of reference, but I'm assuming there must be some benefit if so many people want it? Wish I could talk to my doctors about it, but they all seem really uncomfortable with any talk about sex

 

1. The only dumb question is the one you don't ask.

2. The female condom is inserted into the vagina, then you put your dick into it. It can be used for anal sex as well, and many enjoy it. There is a danger to the bottom in that it's apparently easy to slip the dick in *next* to, but outside of, the condom.

3. Some people swear that bareback sex is better but I'm not buying it. It's the thrill of forbidden fruit that makes it "feel" better.

4. Get new doctors. Really. If you can't talk to them about your health -- ALL OF IT -- you have the wrong doctors.

[Steven_Draker]

I, for one, really would like some non-judgmental information

 

Newtothis, an Internet Forum is probably not the best and wisest place to gather medical information.

[tyro]

Deej is right about the doctors. If you can't ask them ANYTHING and EVERYTHING, go find someone else. If you have to drive a bit, so be it. Both of my gynos know I hire. One was kind of curious about it. The other (whose mother was a teaching colleague of mine at a Catholic high school) treated it as a non-issue. To him, the "working guys" were just new partners like anyone else would be.

T

[Newly]

Again, thanks for the help. Much appreciated. Steven, you're probably right but for people who are new to this it's hard to get information. When you look on the internet there are so many different studies/opinions that it's really hard to know what to believe. As for the doctors, when you live in a small town the choices are limited. What's worse is I have a team of heart doctors that I need to see for other reasons - and although they're great at their specialties they're not exactly easy to talk to about this type of thing. Like anything else people who have a lot of experience about this probably can't believe how little some of us know, but for people who don't have any experience or gay friends it's really kind of overwhelming to try to make sense of all of this.

[Steven_Draker]

Gonorrhea seems to be leading the pack (see, for example http://www.salon.com/2014/03/12/cdc_the_rise_of_antibiotic_resistant_gonorrhea_appears_imminent/).

 

The worst strains seem to have appeared in Europe .. and, given that higly-rated escorts (and other hot, sexually active men) in major US cities often see international visitors, there is no reason to expect those strains to stay on the other side of the pond for long.

 

 

The grass is always greener on the other side of the fence, eh?

 

June 9th, 2014

SAN FRANCISCO — It's happening in the Bay Area and across the country: more men and women getting and spreading gonorrhea. And unlike past generations, a prescription antibiotic may not knock it out.

 

Gonorrhea strains have developed resistance to antiobiotic drugs, and few new medications are being developed. One particularly stubborn strain is believed to have originated on the West Coast, possibly in San Francisco.

 

"Gonorrhea! I haven't heard anything about that," responded Ryan Tenaka, as KTVU quizzed him on a Castro district sidewalk Monday evening.

 

At 24, Tanaka is in a high risk group: young and gay.

 

But he told KTVU, his high school health class left an impression, and he practices only safe sex.

 

"We went through sex ed, and I paid attention and listened, " he said, smiling, "When they show you pictures of a penis exploding, you don't want that to happen to you."

 

Coinciding with a drop in condom use, gonorrhea among gay men is spreading almost thirty times the rate of the regular population.

 

Research also shows, someone infected with gonorrhea is also more vulnerable to contracting and transmitting HIV.

 

"If you're dreaming at night, you should be having nightmares" Javarre Wilson told KTVU, "this is a problem, an epidemic."

 

Wilson is program director at San Francisco's Black Coalition on Aids. "There is generally resistance among African American men towards wearing condoms," he explained.

 

Wilson pointed to statistics from the federal Center for Disease Control that show the sexually transmitted infection is most prevalent among blacks, and five to ten times higher for black youth compared to young adults of other races.

 

"There's this resistant strain of gonorrhea out there and we're trying to make sure people understand and protect themselves, "he declared, "but we don't think the message is getting out there." Wilson said funding cuts have reduced the amount of outreach in schools, and in the jails, where he found inmates often considered getting "the clap" a sign of their sexual prowess.

 

"They'd say 'I've been with so many people and and I've gotten this disease, so I'm the man, I'm a mack, I'm a player'" explained Wilson.

 

San Francisco's gonorrhea infection rate has risen by almost a third in just six years.

 

Nationally, more than 300,000 people are infected annually.

 

source: http://www.ktvu.com/news/news/local/cases-gonorrhea-rise-bay-area/ngHmH/

[+ purplekow]

Newtothis, an Internet Forum is probably not the best and wisest place to gather medical information.

This is definitely true. For example, there is a posting on here which says there is no treatment for Hepatitis A and C and only bad treatment for Hepatitis B. The most glaring error there is the no treatment for Hep C. There are recent medications for Hep C which are oral and relatively short course, think weeks rather than more than a year with the old treatment which was administered once a week. The posting may have been a typo, but even so, that is further proof that the best place to get information is directly from a well educated and well informed care provider. For any serious medical issues, a second opinion is a must, time permitting.

[rvwnsd]

Again, thanks for the help. Much appreciated. Steven, you're probably right but for people who are new to this it's hard to get information. When you look on the internet there are so many different studies/opinions that it's really hard to know what to believe. As for the doctors, when you live in a small town the choices are limited. What's worse is I have a team of heart doctors that I need to see for other reasons - and although they're great at their specialties they're not exactly easy to talk to about this type of thing. Like anything else people who have a lot of experience about this probably can't believe how little some of us know, but for people who don't have any experience or gay friends it's really kind of overwhelming to try to make sense of all of this.

 

There is a fairly simple way to obtain sensible, factual health information even when you live in a small town. Do an internet search and find the LGBT center or LGBT-oriented health center in the nearest large city (or any city for that matter). They will undoubtedly have a "contact us" link. Ask where you can find health resources. If one doesn't answer, try another and another and another. Here are a few to get you started:

 

Gay Men's Health Crisis (New York) http://www.gmhc.org/

 

Howard Brown Health Center (Chicago) http://www.howardbrown.org/

 

The Phillip Rush Center (Atlanta) http://www.rushcenteratl.org/

 

Center on Halsted (Chicago) http://www.centeronhalsted.org/

 

The San Diego LGBT Community Center http://www.thecentersd.org/

 

The San Francisco LGBT Center http://www.sfcenter.org/

 

The Center - Cincinnati http://www.cincyglbt.com/

 

Birmingham [AL] LGBT http://www.blgbt.org/

 

The Community Center (Boise) http://www.tccidaho.org/

 

RU12 Community Center (Burlington, VT) http://www.ru12.org/

 

 

The list goes on. If you would rather talk to someone in person and you can't find someone near you, plan a trip to a city that has an LGBT health center and make an appointment to talk to someone. Your health and well-being is worth the investment.

[Guest ChrisW]

Another + 2000 here to the above.... unfortunately there are a lot of young guys who still think they are invincible and a lot of those guys do not read the Forum, although there may be a lot of them in the "lurkers" category. I am old enough to have lost a lot of friends to AIDS in the early years of that plague.. try going to a funeral for a friend who was a closeted gay and give condolances to their wife, children and parents who had no idea of their sexual orientation. Or to a funeral of a young gay man whose parents and friends had absolutely had no idea of his sexual orientation. Caution and protection is the byword for all of us, old, young, inbetween, gay, bi and straight. Hopefully one day there will be a cure for all of these ills, but as has been said above, these viruses and bacteria mutate and usually they develop immunity to the antibiotics that once killed them easily.

 

At the height of the epidemic MANY good people died but lets not use their deaths as a club to beat someone over the head into using condoms. Guilt and shame are the least effective tools in living a healthy life. As I said lets leave emotional responses out of public health discussions because it has a tendency to derail them. I posted this thread in the hopes it would get people thinking and they might feel they have a place to get questions answered in a judgment free zone. On that note feel free to private message me if you have any questions.

 

I went on prep a over a year and half ago because at the time I was dating someone that seroconverted while we together and I wanted to protect myself.

 

As for drug resistance yes its a possibility but who says Truvada will be the only option for prep? There are several other medications that could be used but due to patents and other reasons there aren't any studies being done at the moment to show how effective they could be for pre exposure treatment. There will always be something scary on the horizon but should we shut down a conversation and potential use of a drug because something might come along at a later date thats scary? There are a lot of "what if's" in the world and I for one won't stop being sexually active because a new virus or bacteria MAY develop

[+ Gar1eth]

Thanks guys, that's a lot to process and it's good to get some talk going. I haven't been seeing guys for very long and don't have any gay friends so there really isn't anyone I can ask. One last really dumb question. What the heck is a female condom and does that offer any protection? Also, is bare back sex a lot better feeling? I've never done it so I have no frame of reference, but I'm assuming there must be some benefit if so many people want it? Wish I could talk to my doctors about it, but they all seem really uncomfortable with any talk about sex, and if I were to ask them about gay sex they would probably have a fit. I asked my GP about testosterone therapy and I've never seen anyone look so much like they wished they were somewhere else.

 

 

I don't know if I can help with this. But when I moved 6 years ago- there was a larger city about 45 minutes away. In that city there was a 'gay' practice. The two doctors and the nurse practitioner who ran it were all gay. And most of the their patients were gay. I felt much more comfortable talking with them about any issues stemming from being gay- and didnt mind going to them for general health maintenance. While it wasn't the greatest situation because they were 45 minutes away, I decided that it was the best thing for me. On the other hand if I was acutely ill with a cold or something, I went to local urgent cares- but made either tried to have them send the record to my doctor 45 minutes away. Or I would email the doctor to let him know I had been ill and what treatment I had received.

 

Maybe you can find a gay friendly practice near where you live.

Gman

[+ purplekow]

At the height of the epidemic MANY good people died but lets not use their deaths as a club to beat someone over the head into using condoms. Guilt and shame are the least effective tools in living a healthy life. As I said lets leave emotional responses out of public health discussions because it has a tendency to derail them. I posted this thread in the hopes it would get people thinking and they might feel they have a place to get questions answered in a judgment free zone. On that note feel free to private message me if you have any questions.

 

I went on prep a over a year and half ago because at the time I was dating someone that seroconverted while we together and I wanted to protect myself.

 

As for drug resistance yes its a possibility but who says Truvada will be the only option for prep? There are several other medications that could be used but due to patents and other reasons there aren't any studies being done at the moment to show how effective they could be for pre exposure treatment. There will always be something scary on the horizon but should we shut down a conversation and potential use of a drug because something might come along at a later date thats scary? There are a lot of "what if's" in the world and I for one won't stop being sexually active because a new virus or bacteria MAY develop

 

No one is suggesting that anyone stop being sexually active. What is being asked is to stop being sexually stupid, Having safer sex using a condom has the benefit of lower cost. Just because it doesnt come out of your pocket directly doesnt mean you arent paying real dollars for it indirectly. Someone is paying the bill Condoms also do not have the side effects that drugs have. The sensitivity may be less, but when used properly, condoms are cheap, safe and effective.

Truvada is effective as well. When taken faithfully as diected. And fortunately young men out to have sex are notorious for always responsible in taking medication And just because you are taking Truvada, doesnt mean that you cannot use a condom as well.

Condom use has decreased in gay men. partly due to apathy, partly due to ignorance, partly due the belief that science will save us with the next new thing.

Those who do not learn from the past are destined to repeat it. Not worrying about resistence is short sighted and foolish. Resistance will develop there is no may in that. It is a matter of when and the real question is whether there will be something else to use by the time the resistance becomes an issue.

My advice, use a condom. If you choose to use Truvada do it as well not instead. I saw many beautfiul young men become gaunt and hollow and then slip away. Perhaps you would feel differently about the importance of being safe if you knew first hand the terror of the uncertainty of the early years of HIV.

But hey, i am an old fuck that made it through, what the hell do I know.

Chris, i notice that you title here is Novice, it seems Daddy got that one right.

[Steven_Draker]

The posting may have been a typo, but even so, that is further proof that the best place to get information is directly from a well educated and well informed care provider.

 

I wouldn't be too harsh on that poster, who is also a health care provider. It's most probably an unintentional typo.

 

We all make mistakes, when in a hurry, myself included.