PrEP and clients

[calrichmond]

I have a question for escorts. Now that the FDA released the drug Truvada, which reduces the risk of HIV infection, are any of you being pressured to bareback? I realize escorts often are asked to bareback by clients who may or may not be HIV positive.

 

One of the most vehement advocates of safe sex, Michael Lucas, is now doing bareback porn on his website. We see more and more bareback porn by major studios. When asked, producers point to screening tests and PrEP drugs that will safeguard the models.

 

What is your opinion on this? How do you handle clients who try to pressure you into barebacking? Is this becoming more common?

[jackjackjack]

I have a question for escorts. Now that the FDA released the drug Truvada, which reduces the risk of HIV infection, are any of you being pressured to bareback? I realize escorts often are asked to bareback by clients who may or may not be HIV positive.

 

One of the most vehement advocates of safe sex, Michael Lucas, is now doing bareback porn on his website. We see more and more bareback porn by major studios. When asked, producers point to screening tests and PrEP drugs that will safeguard the models.

 

What is your opinion on this? How do you handle clients who try to pressure you into barebacking? Is this becoming more common?

Let me piggyback off your question. When you see an ad from an escort that says he neg and on Prep and 'anything goes', how should that be taken?

[marylander1940]

Yes, I personally know one local DC escort who loses 2 or 3 clients per week because of refusing to BB.

 

To PrEP or not to PrEP... I've met wonder guys like him to escort, reliable, self employed men who do it because the have the looks, the stomach and the sexual desire to do, but I also met many guys who escort as an alternative to flip burgers. Can all escort be trusted? I'm conservative and old fashioned when it comes to this subject, I'll just use condoms.

[mattr]

PrEP or no PRep, anyone having sex without appropriate protection in this day and age is playing Russian Roulette.

[+ Gar1eth]

Something people always forget to mention-they advise that you need to be on PrEP for 7 days before the full protection kicks in.

 

Gman

[Bryanforservice]

It's been covered on the forums before, but each individual's sexual health choices should be up to them and their physician. Unless you are a physician, speaking to the risks, benefits and drawbacks of any medical course of action can lead to mis-information.

 

The only thing that I can recommend is if you are curious, have the converstaion about PreP with your doctor and make your own educated, informed decisions.

 

As for the OP's question: is there increased pressure to bareback and have unprotected sex?

 

I think in the gay community at large now there is more acceptance of the risks that come with unprotected sex. Can you attribute that to PreP? Or is it a younger generation who doesn't have the history with the AIDS crisis? Or is it porn that demonstrates that it is okay? There likely isn't one single cause, but a combination of many that lead to changes in attitudes about what exactly constitutes "safer" sex.

 

Regardless of the context of the sexual encounter, at a minimum, limits should be respected and assume each partner is HIV positive. And at best a candid conversation between sexual partners about health and HIV status can help each man decide what those limits are.

[rguer]

Something people always forget to mention-they advise that you need to be on PrEP for 7 days before the full protection kicks in.

 

Same pill for both PEP and PrEP, right? So as long as you continue to take it for 30 days after the exposure you're getting protection, even if you didn't start it 7 days before the exposure.

[sincitymix]

PrEP or no PRep, anyone having sex without appropriate protection in this day and age is playing Russian Roulette.

 

agreed.. so you are on Prep, but what about all the other horrible stds out there. prep doesn't prevent those.

[+ Gar1eth]

Same pill for both PEP and PrEP, right? So as long as you continue to take it for 30 days after the exposure you're getting protection, even if you didn't start it 7 days before the exposure.

 

I haven't looked it up in a long time. But I don't the protection from taking Truvada for PEP (ie., taking it after exposure) after a known exposure to HIV is supposed to be as high a percentage as that for PrEP which makes sense as the drug level would be much higher after taking it for a week. Plus often nowadays physicians recommend Truvada + a drug in another class for PEP.

 

Gman

[Phil_musc]

agreed.. so you are on Prep, but what about all the other horrible stds out there. prep doesn't prevent those.

 

Well yes, that's true. But in the old days (pre-HIV & AIDS) we just must have been crazy because I don't ever remember people worrying too much about those other STD's that were out there. Are there new varieties that I don't know about?

[+ Gar1eth]

Well yes, that's true. But in the old days (pre-HIV & AIDS) we just must have been crazy because I don't ever remember people worrying too much about those other STD's that were out there. Are there new varieties that I don't know about?

 

I remember as a teenager reading Everything You Wanted To Know About Sex-But Were Afraid To Ask described some really horrible rare diseases that I haven't heard of since. He described one rare disease where your your genitals became malformed IIRC. But more commonly herpes can't be cured. And if you are bisexual and infect a woman, it can have devastating consequences for a newborn infant as well as pain and suffering for us. And it's a risk factor for increased chance of being infected with HIV. Also gonorrhea is getting harder to treat due to resistance.

 

Gman

[calrichmond]

I agree that there are other STDs around that need protection. During the 70s we just fucked like rabbits with no thought of consequences. I never banged any guy who asked me to use protection. I think the days of raw sex are over as society becomes more educated on risks.

[+ Lance_Navarro]

I've been on PrEP for over 2 years now and whether or not to use condoms in a conversation that I have with each of my clients. The most recent report that Kaiser put out showed a 100% efficiency rate, over 2 years they didn't have a single seroconversion. The studies that are showing low rates are because people aren't taking the drug daily, and many of them have been done in other countries and in blind/placebo studies where people aren't even sure they are actually getting the drug which is inevitably gonna to lead to less adherence to daily dosage. Every study that AHF sites is designed to dissuade people from PrEP because they are in the business of treating HIV, not preventing it. I know that sounds terrible, but it's the truth.

 

PrEP IS a form of protection, just like a condom, though actually does more to protect. As far as other STI's, you can just as easily get them from oral without a condom, and Syphilis can be spread simply by body contact.

 

I am most comfortable going raw with a client who is either on PrEP or is Poz and undetectable because that means that they are taking care of and monitoring their sexual health. I also have many clients who insist on condoms (some even for oral) and Im happy to do that as well, since my ultimate goal is to make them comfortable and feel safe.

[calrichmond]

I've been on PrEP for over 2 years now and whether or not to use condoms in a conversation that I have with each of my clients. The most recent report that Kaiser put out showed a 100% efficiency rate, over 2 years they didn't have a single seroconversion. The studies that are showing low rates are because people aren't taking the drug daily, and many of them have been done in other countries and in blind/placebo studies where people aren't even sure they are actually getting the drug which is inevitably gonna to lead to less adherence to daily dosage. Every study that AHF sites is designed to dissuade people from PrEP because they are in the business of treating HIV, not preventing it. I know that sounds terrible, but it's the truth.

 

PrEP IS a form of protection, just like a condom, though actually does more to protect. As far as other STI's, you can just as easily get them from oral without a condom, and Syphilis can be spread simply by body contact.

 

I am most comfortable going raw with a client who is either on PrEP or is Poz and undetectable because that means that they are taking care of and monitoring their sexual health. I also have many clients who insist on condoms (some even for oral) and Im happy to do that as well, since my ultimate goal is to make them comfortable and feel safe.

I can see why you get great reviews!

[RussJohnson]

I would say Hep C! But they just found a vaccine for that so...free for all! (Please no one take this seriously)

 

I wouldn't say more people have asked, for the most part its never been a question (which could be a good or bad thing when you think about it) and when it is, it has only once lost me a client.

[Rudynate]

I've been on PrEP for over 2 years now and whether or not to use condoms in a conversation that I have with each of my clients. The most recent report that Kaiser put out showed a 100% efficiency rate, over 2 years they didn't have a single seroconversion. The studies that are showing low rates are because people aren't taking the drug daily, and many of them have been done in other countries and in blind/placebo studies where people aren't even sure they are actually getting the drug which is inevitably gonna to lead to less adherence to daily dosage. Every study that AHF sites is designed to dissuade people from PrEP because they are in the business of treating HIV, not preventing it. I know that sounds terrible, but it's the truth.

 

PrEP IS a form of protection, just like a condom, though actually does more to protect. As far as other STI's, you can just as easily get them from oral without a condom, and Syphilis can be spread simply by body contact.

 

I am most comfortable going raw with a client who is either on PrEP or is Poz and undetectable because that means that they are taking care of and monitoring their sexual health. I also have many clients who insist on condoms (some even for oral) and Im happy to do that as well, since my ultimate goal is to make them comfortable and feel safe.

 

 

Wow!! Full disclosure . . . in this forum. That's swimming with the sharks. Lance, you're a man of high integrity.

[+ Lance_Navarro]

Wow!! Full disclosure . . . in this forum. That's swimming with the sharks. Lance, you're a man of high integrity.

Thanks! Absolute honesty and vulnerability is the only way I know to be. If I am to expect it from others, I must first demonstrate it myself.

[+ Lance_Navarro]

I can see why you get great reviews!

Thanks so much!

[Edward]

Forgive my ignorance. How and where do you obtain Truvada. I am from small town USA and don't feel comfortable asking my physician for it. Blood Tests? Multiple visits to a clinic? Cost?

[Juan Vancouver]

Thanks! Absolute honesty and vulnerability is the only way I know to be. If I am to expect it from others, I must first demonstrate it myself.

 

Hear, hear!

 

That's the only way to have an adult, meaningful dialogue. I sincerely commend you for that.

[jimboivyo]

Forgive my ignorance. How and where do you obtain Truvada. I am from small town USA and don't feel comfortable asking my physician for it. Blood Tests? Multiple visits to a clinic? Cost?

 

if you aren't ready to take enough control of your health to be honest with your doctor then you should just stick to condoms

 

not saying that to be rude to you

[jimboivyo]

Forgive my ignorance. How and where do you obtain Truvada. I am from small town USA and don't feel comfortable asking my physician for it. Blood Tests? Multiple visits to a clinic? Cost?

 

if you aren't ready to take enough control of your health to be honest with your doctor then you should just stick to condoms

 

not saying that to be rude to you

[bigvalboy]

Forgive my ignorance. How and where do you obtain Truvada. I am from small town USA and don't feel comfortable asking my physician for it. Blood Tests? Multiple visits to a clinic? Cost?

 

Being from a small town, I can understand your need for discretion. This is serious stuff. I would suggest you take the time to travel to a more populated area and go see a doctor with whom you feel comfortable talking to. Getting this kind of information off the Internet is rolling the dice. IMHO

[bigvalboy]

Forgive my ignorance. How and where do you obtain Truvada. I am from small town USA and don't feel comfortable asking my physician for it. Blood Tests? Multiple visits to a clinic? Cost?

 

Being from a small town, I can understand your need for discretion. This is serious stuff. I would suggest you take the time to travel to a more populated area and go see a doctor with whom you feel comfortable talking to. Getting this kind of information off the Internet is rolling the dice. IMHO

[Rudynate]

Forgive my ignorance. How and where do you obtain Truvada. I am from small town USA and don't feel comfortable asking my physician for it. Blood Tests? Multiple visits to a clinic? Cost?

 

 

I receive healthcare at Kaiser. The initial testing is extensive - HIV antibodies, HIV viral load, hep A, hep B, hep c, kidney function, liver function, syphillis, gonorrhea, chlamydia. The first three months you have to repeat the HIV antibody test, the STD tests, liver enzymes and kidney function every month. Thereafter, you have to have those tests every three months.

 

It's very costly if you don't have insurance coverage - around $14K/year. Kaiser's coverage is very generous, I get a three-month supply for a co-pay of $70.00.

 

I originally started on it late last year. It made me feel extremely tired, so much so, that I stopped a few days into the second month. In about April of this year, I decided I was going to try again and power through any side effects. My doc thought I would probably have to expect that i would be just starting again, with the side effects that I had experienced. I was amazed to find that there were almost no side effects the second time - a little sleepiness the first few days, that was it. I've been taking it continuously for nearly six months.

 

Compliance for me is pretty easy. I take several once-a-day prescription drugs and I just take them all every day at about dinner time.