Escorts on PreP

[Strafe13]

regarding condom buying, if you're too embarrassed to buy em', you probably shouldn't be having sex in the first place

 

grow a pair and buy a rubber. it could save your life.

 

That's nice in theory, jimboivyo, but it's not reflective of reality. That's what I was referring to as passing judgment and hurling insults, like Steven's likening my previous statement on this issue as if he had been conversing with a 14-yr old girl. It's fine that you think people should be mature enough to shrug off shame or embarrassment, and just buy the condoms. However, people often do not take the alternative, and just don't have sex. Let's also not pretend that the placement of condoms and other sex-related products behind locked displays isn't meant to shame people.* Either way, we must take people as they are, and if buying condoms in this way discourages some people from doing so, then we should not only be open to changing that, but also continue to find ways to make bareback sex safer, since some people will always continue to engage in that as well.

 

*I agree that there are alternatives to having to purchase condoms in stores in embarrassing fashion. Online ordering would seem to be the simplest solution. But the point is to tear down barriers and provide multiple easy options, to help ensure that as many people as possible choose to use some form of safer sex protection, rather than go without.

[Strafe13]

How someone who barebacks with others is being "most responsible" towards the health of his clients?

 

 

Some posters sound like a promotional machine for Gilead.

 

 

"Relying solely on your own anecdotal experience is not the best way to make sound conclusions."

 

Many studies show that adherence to PrEP ranged from 82% in the Partners PrEP study to as low as 30% in VOICE

 

see table: http://www.biomedcentral.com/1741-7015/11/186/table/T1

 

Moreover, PrEP reduces the risk up to 92% and there's a substantial early dropout rate, especially in young people.

 

 

 

 

What I find shameful and dangerous is painting a "rosy" picture in the Forum that is far from reality. I'd invite everyone to carefully consider such statements.

 

 

 

 

Again, you've equated any escort on PrEP to "someone who barebacks with others," and then categorically declared that all such people are irresponsible. Not only have LookingAround and I already informed you that, contrary to your own surveying of the gay community, not everyone on PrEP barebacks, and even if some do, that doesn't necessarily mean they do so with all partners during all encounters. You're making assumption on top of assumption, and then passing indiscriminate judgment. It should, of course, go without saying, that if one actually wants to bareback (either all the time, or only on occasion), going on PrEP is one of the responsible ways of doing so (at least re: HIV exposure).

 

Context matters. When I criticized your use of your own anecdotal experience to make conclusions, it was with respect to your thinking that all PrEP users never used condoms, therefore justifying your sweeping condemnation of them. When I stated that I had no problem adhering to a daily pill regimen, it was within the context of explaining how PrEP is better for some people than others. More importantly, especially since this is a thread about escorts using PrEP, it was to show that not everyone will find taking a daily pill to be that difficult, and obviously, the person on PrEP knows whether he's been compliant. Therefore, if escort A knows that he's HIV negative and has taken his pill everyday for the past several weeks or months, then he knows that he is being responsible, and is protecting himself. Similarly, any client who's on PrEP knows whether he's complied with the daily regimen. The fact that you and other posters are 100% sure that you can and will continue to use condoms consistently and correctly for each and every sexual encounter is laudable. Others may be 100% sure that they can and will continue to take one pill everyday.

 

Some studies have the PrEP efficacy rate far higher than the 92% you've cited, and have it approaching the efficacy rate of condoms. I think it's a good idea to have multiple highly effective methods of HIV prevention. Each method requires a certain level of commitment, while having its own drawback. As an example, the IUD is around 99.97% effective at preventing pregnancy, far exceeding the efficacy rates of condoms and the birth control pill, while also eliminating the user error that contributes to those lower rates. Yet, we don't lambast women who choose one of the latter two methods, call them irresponsible, or say that they just want to go around having lots of sex.* My posts have consistently articulated that certain methods work for some, while other methods are better for others, and that having multiple options to reach as many people as possible, is always a good thing. My position is one that avoided judgment and condemnation, and sought to afford respect to everyone, regardless of where they are on their journey. Yours, not so much.

 

*As if having a lot of sex is inherently a bad thing to begin with. I unapologetically reject such Puritanical judgment of sex as bad, or that people should be shamed into not enjoying it with those with whom they choose to engage in it, even if that's lots of people (and lots of sex).

[Steven_Draker]

I'd kindly ask our prolific poster Strafe13 to stop putting words in my mouth. I made a statement based on my observation. I don't claim to be morally superior or passing judgment. Whatever you chose to do in your personal life is your own prerogative. I'm not judging and saying what is superior.

 

I haven't met someone on PrEP who doesn't bareback.

 

What I find revealing here is that no one of our PrEP users and paid advocates officially refuted my observation, except by a personal attack "You should get out more".

 

Buyer beware !

 

[LookingAround]

What's more revealing is that no one of our PrEP users and paid advocates officially refuted my observation, except by a personal attack "You should get out more".

 

Buyer beware !

 

I refuted it. I said I'm on PrEP and use condoms.

 

You really should get out more Steven. Smell the fresh air and roses.

[Steven_Draker]

I refuted it. I said I'm on PrEP and use condoms.

 

Simultaneously? All the time? Can you give us more details about it?

[LookingAround]

Simultaneously? All the time? Can you give us more details about it?

 

All the time. What details do you need beyond that?

[Steven_Draker]

Relying solely on your own anecdotal experience is not the best way to make sound conclusions, particularly on such important public policy issues.

 

However personal observation may be a good start.

 

Soleley? Anecdotal?

 

Kaiser carried out a study and published the conclusions:

Study Finds Alarming 45% Increase In Bareback Sex Among Gay Men On PrEP

 

A new alarming survey conducted by Kaiser Permanente has raised concerns about gay men who are using a daily pill which stops HIV infection as a condom substitute, putting them at risk of contracting other sexually transmitted diseases.

 

The survey of 90 patients taking Truvada once a day as a pre-exposure prophylaxis (PrEP) in a Kaiser Permanente AIDS prevention program, found a shocking 45 percent increase in condom-less sex. The survey also found a majority of PrEP users in the Kaiser program are men having sex with multiple men.

 

source: http://www.thegailygrind.com/2014/12/09/study-finds-alarming-45-increase-bareback-sex-among-gay-men-prep/

[rguer]

However personal observation may be a good start.

 

Soleley? Anecdotal?

 

Kaiser carried out a study and published the conclusions:

 

I couldn't find where this was published. Do you have a link? To the study, not to press releases from AHF.

Study Finds Alarming 45% Increase In Bareback Sex Among Gay Men On PrEP

 

A new alarming survey conducted by Kaiser Permanente has raised concerns about gay men who are using a daily pill which stops HIV infection as a condom substitute, putting them at risk of contracting other sexually transmitted diseases.

 

The survey of 90 patients taking Truvada once a day as a pre-exposure prophylaxis (PrEP) in a Kaiser Permanente AIDS prevention program, found a shocking 45 percent increase in condom-less sex.

 

Not meaningful without numbers. What's the baseline?

 

The survey also found a majority of PrEP users in the Kaiser program are men having sex with multiple men.

 

That's the target audience, I assume.

[rguer]

I did, however, find this:

 

Explaining the survey findings in more detail, Hare said that among the 90 people who chose to answer the survey – a group that may not be representative of Kaiser's PrEP users overall – half said their condom use had remained the same, 45% said it had decreased, and 5% said it had increased since they went on PrEP.

 

Hare emphasised that they do not have baseline data about how often respondents used condoms before starting PrEP, and there is no control group of men not using PrEP for comparison. However, the fact that the men chose to go on PrEP suggests they likely were already having sex without condoms at least some of the time.

 

"We don’t know if we took [condom use] from 100% to zero, or from 50% to 40%," Hare said. "With the extra protection provided by PrEP, some may have decided to forego condoms" – including people in monogamous relationships with HIV-positive partners, he suggested.

 

The survey did ask about changes in the number of sexual partners, and found that this did not increase. "It's not the case that people are having a lot of unprotected sex with a lot of new partners" after starting PrEP, Hare said.

 

http://www.aidsmap.com/No-new-HIV-infections-seen-among-Kaiser-PrEP-users/page/2929303/

 

Note that a majority of users in this unrepresentative non-random study had level or increased use of condoms. Also, there were no new HIV infections in this group.

[Steven_Draker]

Here's what I found:

 

Instinct spoke briefly with Dr. Hare Wednesday to clarify more of the preliminary report's results, and he revealed the following:

 

• This was done for clinical care, and not yet analyzed in a scientifically rigorous manner
  
• We don't have information on what demographic of patients reduced condom use (e.g, was is primarily among men in serodiscordant, monogamous relationships, or among those with multiple partners), to what degree condom use decreased (100% to 0%, 10% to 0%, 100% to 90%), and in what circumstance condom use decreased (all times, just with primary partner and not with other partners).
  
• We don't have a 'control' group, so we don't know how condom use may change in the absence of PrEP
  
• We don't have results over multiple time points, so we don't know if this change will be sustained