Prep or Pep?

[Reluctant Daddy]

Lately, my activity has been restricted solely to hires. Given the availability of hires in my area, the time between encounters may be many months (my last was in August). I'm considering asking my Dr. for Prep, but given the fact that little is known about possible side effects of long term use and my infrequent activity, would it be more prudent to consider Pep after any encounters?

[+ WmClarke]

Personally, I would be proactive and have more peace of mind with PrEP, instead of being reactive after the fact with PEP.

[MikeyGMin]

Probably a good question to ask a medical professional who is up to speed on PrEP - - as opposed to your normal general practitioner.

 

I'm not sure what is considered "long term" usage. Truvada has only been used as a prophylaxis for a short time, but it has been used in HIV treatment for more than 10 years. Realistically, do you envision taking it for the next 20 years? I know that is a consideration for a young sex worker, but it isn't a factor for me. More power to the sexually active septuagenarians. I'm just pretty confident I won't be one of them.

 

I have a gay doctor who has partnered with the local PrEP clinic so he is better informed then most GP's. After a very frank conversation about my sexual activities and frequency, he thought that PrEP is probably overkill, but had no problem prescribing it as long as I agreed to the increased lab work required.

 

For me, it was an easy decision. I know several people on PrEP and a couple that have been taking Truvada for more than 10 years without any side effects. It just seems like a low risk - high reward ( peace of mind ) proposition.

[+ WmClarke]

There is a Facebook group where you would probably get some good feedback: https://m.facebook.com/groups/399382356847602

 

It is a closed group but approval is pretty quick.

[keithhardy]

Pep is still a 30 day long dosage.....so as unless you have sex very very rarely, I can't see how this could be an option. Pep is also multiple pills, where PrEP is just Truvada. Pep was not meant to be used as a means for protection against STD's, it is used when one was exposed accidentally such as a condom breaks or a health care work gets poked with a used needle. PrEP on the other hand is meant to be used as another form of protections against contacting HIV, I can't see your doctor giving you just Pep, because going on and off medication leads to resistance. in which case they won't work when you really do need them. Resistance to Truvada has been an ongoing topic in the medical field, the fear is people on PrEP who don't take it everyday and go on and off it, could develop a resistance to it, become positive, and many strains of HIV require Truvada as an anti-viral medication thus leading to longterm treatment issues.

[Kuriousity]

As far as Truvada goes, once you go on it, it is very important that you get your liver screen every 90 days. Liver toxicity is a potential side effect of the medication, and if you are a drinker, you may want to avoid alcohol if you decide to join the Truvada brigade because processing booze & PrEP may be a little much for some livers to handle.

[+ azdr0710]

I know Truvada, PrEP et al are common nowadays and sorry for this very naive question, but this thread got me wondering.....

 

are these drugs typically used only by those that prefer to only bareback and are active that way....and/or are they commonly used by sexually active people who usually use condoms but just want to be ultra-careful....or what??.....

 

thanks for some clarification....

[Kuriousity]

I know Truvada, PrEP et al are common nowadays and sorry for this very naive question, but this thread got me wondering.....

 

are these drugs typically used only by those that prefer to only bareback and are active that way....and/or are they commonly used by sexually active people who usually use condoms but just want to be ultra-careful....or what??.....

 

thanks for some clarification....

 

Both. Some escorts use them as an additional layer of prevention....and then you have Billy Santoro who uses it for his nauseating Twitter videos....side note--if "Rex Cameron" escorts, I advise caution...he went there with Santoro in a 3 part Twitter video....just saying....

[keithhardy]

I know Truvada, PrEP et al are common nowadays and sorry for this very naive question, but this thread got me wondering.....

 

are these drugs typically used only by those that prefer to only bareback and are active that way....and/or are they commonly used by sexually active people who usually use condoms but just want to be ultra-careful....or what??.....

 

thanks for some clarification....

They are used by any and all different sex practices of people that do random hook-ups, it is an added safeguard, Condom or Bareback.

[Kuriousity]

Just to remind folks, Truvada is only effective with HIV. It does absolutely nothing about Herpes, Hep C, or Syphilis (so be careful about Baltimore dick, kids)....

[Reluctant Daddy]

Thanks for the education guys. I actually had hoped to use it as an extra layer of protection with condoms. The liver issues are troubling, and in my brief online research found that it may cause bone loss.

[+ ArVaGuy]

Lately, my activity has been restricted solely to hires. Given the availability of hires in my area, the time between encounters may be many months (my last was in August). I'm considering asking my Dr. for Prep, but given the fact that little is known about possible side effects of long term use and my infrequent activity, would it be more prudent to consider Pep after any encounters?

 

You should discuss this with your primary Doctor as well educate yourself on the background about the drug and its use. Also, check with your insurance provider to see if it's covered under your plan. This drug ain't cheap.

 

Your doctor might refer you to an infectious disease specialist. As a specialist they will be more versed in the protocol for prescribing the drug. If he or she is following the FDA approved screening you will have to answer a few questions about your sexual history.

 

Don't worry about this. Your doctor has likely heard it all before and it's a general screening. This is to determine if you are a good candidate and meet the criteria.

 

I nearly burst out laughing at one of the questions. "Have you ever paid for sex or ever been paid to have sex?" I answered in the affirmative and left it to the doctor to decide which was the case.

 

Also, the doctor will advise you that this drug is to be used in the practice of safe sex. All the literature and the manufacturer, Gilead, makes this very clear. Now if individuals decide to take the drug and not use condoms that's a personal choice. It should be made after assessing the risks and making an informed decision. Use of Prep does not automatically infer risky behavior. We need to get away from the the "slut shaming" related to this matter.

 

There will be regular screening blood tests as well. And not just for HIV but the previously mentioned liver issue.

 

My advice here is that you should make an informed decision and disregard the background noise about using the drug from activists on either side of of the issue.

[Kuriousity]

Bear in mind that the liver and bone issues are POSSIBLE side effects. It does not mean you would experience them. Every patient is a unique case, and some patients go on it with no side effects at all. Get a full physical to see where you stand physically, and if the numbers look good, and your health plan covers it (a month dose goes between $1300-$1500), then you should explore that avenue. Always be an informed consumer.

[+ WmClarke]

This drug ain't cheap.

 

True, but the manufacturer (Gilead) has an assistance program to defray the cost.

[Kuriousity]

The reason it is expensive in Western countries is because in Africa the drug is dirt cheap & the drug company uses Western consumers to make up the costs. Not a slam, because HIV has wiped out an entire generation in Sub-Saharan Africa....just explaining the price number.

[marylander1940]

I know Truvada, PrEP et al are common nowadays and sorry for this very naive question, but this thread got me wondering.....

 

are these drugs typically used only by those that prefer to only bareback and are active that way....and/or are they commonly used by sexually active people who usually use condoms but just want to be ultra-careful....or what??.....

 

thanks for some clarification....

 

It's the all-American solution of taking a pill to solve a problem.

I'm fine using condoms and I'll just keep doing it.

 

Bear in mind that the liver and bone issues are POSSIBLE side effects. It does not mean you would experience them. Every patient is a unique case, and some patients go on it with no side effects at all. Get a full physical to see where you stand physically, and if the numbers look good, and your health plan covers it (a month dose goes between $1300-$1500), then you should explore that avenue. Always be an informed consumer.

 

I would feel guilty abusing my healthcare company instead of just using condoms.

[+ WmClarke]

It's the all-American solution of taking a pill to solve a problem.

I'm fine using condoms and I'll just keep doing it.

Condoms are not 100% effective. Using both is better than using just one or the other.

 

I would feel guilty abusing my healthcare company instead of just using condoms.

It's not abuse to take charge of your sexual health and use options that are available to you.

 

And it will be much cheaper for a company to pay for PrEP than to pay for managing an HIV infection (and possibly AIDS) for the rest of someone's life. It will definitely be cheaper for society to prevent spread of HIV.

[marylander1940]

Condoms are not 100% effective. Using both is better than using just one or the other.

 

It's not abuse to take charge of your sexual health and use options that are available to you.

 

And it will be much cheaper for a company to pay for PrEP than to pay for managing an HIV infection (and possibly AIDS) for the rest of someone's life. It will definitely be cheaper for society to prevent spread of HIV.

 

let's say that condoms are 99% effective and so is PrEP but condoms are very cheap and the pill is not, nothing is free in this world. One option is very cheap, the other one is not and it's passed to the rest of the society.

 

HIV can't live outside the human body, I've lost so many friends in the 1980's, it was one of the few times in my life I was on a monogamous relationship and that kept me alive. If we as a community had remained using condoms HIV will be almost gone by now.

 

If you're overweight you get a scooter (paid by taxpayers) instead of an incentive to go take a walk. So many self inflicted wounds in this country, why adding one more hooking more people into pills?

[keithhardy]

let's say that condoms are 99% effective and so is PrEP but condoms are very cheap and the pill is not, nothing is free in this world. One option is very cheap, the other one is not and it's passed to the rest of the society.

 

HIV can't live outside the human body, I've lost so many friends in the 1980's, it was one of the few times in my life I was on a monogamous relationship and that kept me alive. If we as a community had remained using condoms HIV will be almost gone by now.

 

If you're overweight you get a scooter (paid by taxpayers) instead of an incentive to go take a walk. So many self inflicted wounds in this country, why adding one more hooking more people into pills?

I have to disagree, PrEP 100% protects against HIV if you take the pill a day like you are suppose to, just like condoms are effective if you use them correctly. The cost of PrEP for a month supply is roughly a $1000. The cost to treat HIV per month is minimally $40,000/month........so would "society" rather pay towards $1000/month or $50000/month?

[marylander1940]

I have to disagree, PrEP 100% protects against HIV if you take the pill a day like you are suppose to, just like condoms are effective if you use them correctly. The cost of PrEP for a month supply is roughly a $1000. The cost to treat HIV per month is minimally $40,000/month........so would "society" rather pay towards $1000/month or $50000/month?

 

Society would rather people using condoms and paying for those condoms themselves.

 

Does PrEP if taken correctly protect against HPV, Zika mosquito virus, and other diseases?

 

Nothing is 100% reliable in this life, but let's assume condoms are 99% safe, that's good enough.

 

This is the typical American question to a Doctor: what pill do I take? instead of what do I need to do.

 

I won't fall for the Healthcare Industrial Complex and get hooked on a pill I can't live without just to be able to enjoy a little bit of an extra pleasure.

 

I apologize to all of yinz but I'll keep on using condoms just like I've been doing for 30+ years since HIV appeared in our lives and it was proven to be easily preventable by using a rubber. I'm 75 and I'd rather pay myself for condoms at Walmart/Costco instead of taking expensive pills per day, go to the Doctor 4 more times per year to get expensive (but not paid by me) tests to check my liver, just to feel entitled to bareback.

 

I'll leave that extra money from my healthcare for my sister who was just diagnosed with breast cancer, I don't need it, I use condoms. I

 

I'm out of this subject... I can't believe for some extra pleasure so many of yinz will play the Russian roulette of HIV while passing the bill to all of us.

 

I wish Steven Draker was around, we fought on many subjects but he had a brain on this subject.

 

one more time, I'm out of this subject.

[MikeBiDude]

Society would rather people using condoms and paying for those condoms themselves.

Can you cite research pointing to what society wants? Or just your opinion?

[Kuriousity]

I have to disagree, PrEP 100% protects against HIV if you take the pill a day like you are suppose to, just like condoms are effective if you use them correctly. The cost of PrEP for a month supply is roughly a $1000. The cost to treat HIV per month is minimally $40,000/month........so would "society" rather pay towards $1000/month or $50000/month?

 

The operative phrase is "like you are suppose to". I would wager guys like @keithhardy do because of the service they provide, but sex work civilians may not be taking as instructed. That said, I do think PrEP is a good thing.....but I worry about schmucks taking it incorrectly.

[marylander1940]

Can you cite research pointing to what society wants? Or just your opinion?

 

It's called common sense and math, man what a socialist country we've become!

 

Bye, I'm out of this subject.

[keithhardy]

Society would rather people using condoms and paying for those condoms themselves.

 

Does PrEP if taken correctly protect against HPV, Zika mosquito virus, and other diseases?

 

Nothing is 100% reliable in this life, but let's assume condoms are 99% safe, that's good enough.

 

This is the typical American question to a Doctor: what pill do I take? instead of what do I need to do.

 

I won't fall for the Healthcare Industrial Complex and get hooked on a pill I can't live without just to be able to enjoy a little bit of an extra pleasure.

 

I apologize to all of yinz but I'll keep on using condoms just like I've been doing for 30+ years since HIV appeared in our lives and it was proven to be easily preventable by using a rubber. I'm 75 and I'd rather pay myself for condoms at Walmart/Costco instead of taking expensive pills per day, go to the Doctor 4 more times per year to get expensive (but not paid by me) tests to check my liver, just to feel entitled to bareback.

 

I'll leave that extra money from my healthcare for my sister who was just diagnosed with breast cancer, I don't need it, I use condoms. I

 

I'm out of this subject... I can't believe for some extra pleasure so many of yinz will play the Russian roulette of HIV while passing the bill to all of us.

 

I wish Steven Draker was around, we fought on many subjects but he had a brain on this subject.

 

one more time, I'm out of this subject.

 

I don't think people take PrEP for bareback entitlement........do you know how many condoms break, how many babies have been conceived from broken condoms, how many stds have been passed from broken condoms? I will however agree that if I was 75 I am not sure I would start PrEP either, but I do think its wrong for you to be so quick in judging those that do. I would bet my life on it that those that died of AIDS, would not agree with your respective on PrEP.

[keithhardy]

The operative phrase is "like you are suppose to". I would wager guys like @keithhardy do because of the service they provide, but sex work civilians may not be taking as instructed. That said, I do think PrEP is a good thing.....but I worry about schmucks taking it incorrectly.

I mentioned above the fear that many medical professionals have regarding resistance, and I know guys that don't take it on the regular and I have had this conversation with them.