New case of man contracting HIV while on PrEP

[loverboy95]

http://www.towleroad.com/2016/10/second-case-of-daily-prep-user-contracting-hiv-reported/

 

 

I hope this helps people slowly learn that PrEP will not always protect you from HIV.

[+ WmClarke]

I hope this helps people slowly learn that PrEP will not always protect you from HIV.

Neither will a condom. What's your point?

[+ purplekow]

Neither will a condom. What's your point?

I believe his point is be careful. Be aware that Prep may not be a surefire failsafe preventative. Ask your partner about their history and if possible have your partner tested. Keep your risky behavior to a minimum because there may not be a net when you think there is one.

What your point is however escapes me. It may be to express the same message or it may just be some snark.

[EZEtoGRU]

http://www.towleroad.com/2016/10/second-case-of-daily-prep-user-contracting-hiv-reported/

 

 

I hope this helps people slowly learn that PrEP will not always protect you from HIV.

 

I, for one, am not surprised to hear about this. Personally, I feel the incidence of people on PrEP contracting HIV is going to grow. I'm quite sure that I read somewhere this year that there was a fear that the effectiveness of PrEP would decline over time. I'm not a medical professional and also, I am not advocating being on or not being on PrEP. Just commenting on the issue. Personally, I still would wear a condom (or ensure my sex partner did) for intercourse even if I was on PrEP.

[sincitymix]

http://www.towleroad.com/2016/10/second-case-of-daily-prep-user-contracting-hiv-reported/

 

 

I hope this helps people slowly learn that PrEP will not always protect you from HIV.

multi strain resistant virus which included Truvada resistant virus.. I am sure we will see alot more cases of people on prep getting hiv due to resistant strains.

[+ Gar1eth]

A lot of people were militantly against the bathhouses being closed in the early1980s and poo-pooed the need for condoms. We see where that mentality got us. And now we have untreatable strains of gonorhea circulating too, and people still don't want to use condoms.

 

Gman

[jimboivyo]

prep isn't the cure all folks think it is

 

don't be stupid. use condoms with prep.

[pubic_assistance]

The pharmaceutical company who makes Truvada and of course profits from it's sale....has been promoting it's own efficacy numbers for years. Quoting an "UP TO" 98% efficiency against HIV transmission "IN CONTROLLED STUDIES". Now that may be true...but INDEPENDENT general population studies come up around 80% efficiency. So in REALITY you still have a 20% chance of transmission...not to mention the increasingly high chance of catching syphilis, gonorrhea, and/or chlamydia .

[+ Gar1eth]

The pharmaceutical company who makes Truvada and of course profits from it's sale....has been promoting it's own efficacy numbers for years. Quoting an "UP TO" 98% efficiency against HIV transmission "IN CONTROLLED STUDIES". Now that may be true...but INDEPENDENT general population studies come up around 80% efficiency. So in REALITY you still have a 20% chance of transmission...not to mention the increasingly high chance of catching syphilis, gonorrhea, and/or chlamydia .

 

I'm not sure about this. The studies I looked at awhile back when they got lower %'s were when they included people who had no measurable drug in their system. When they included only the people who had 'chemical' evidence of taking Truvada correctly, the % protection was much higher. However the high 90's protection for the population as a whole was a mathematical projection as not that many people had been on Truvada. But as has been shown time and time again with antibiotics, resistant cases will spread. Who knows if Truvada continues as PrEP for another 10 to 15 years then maybe only Truvada resistant HIV will be in circulation.

 

Gman

[+ Lance_Navarro]

prep isn't the cure all folks think it is

 

don't be stupid. use condoms with prep.

And if neither of you are on PrEP than you should wear 2 condoms, just in case one breaks!

[+ Lance_Navarro]

Let's remember, this is only the second case with over 100,000 people on PrEP, therefore likely over 1 million sexual encounters. The chance of HIV transmission when bottoming without a condom and transfer of cum, is 1 in 80, or 1.25%, PrEP takes the chances down to .0002%. I'm not discouraging condom usage, just advocating for science. I'm sure you will find FAR more than 2 seroconversions a year amongst condom users due to condom failure.

[jimboivyo]

And if neither of you are on PrEP than you should wear 2 condoms, just in case one breaks!

 

there's no humor in contracting hiv. I've gone to too many funerals to be glib about this

 

if you can protect yourself further with a condom, why the hell not? especially if you're a sex worker.

[+ Gar1eth]

Let's remember, this is only the second case with over 100,000 people on PrEP, therefore likely over 1 million sexual encounters. The chance of HIV transmission when bottoming without a condom and transfer of cum, is 1 in 80, or 1.25%, PrEP take the odds down to .0002%. I'm not discouraging condom usage, just advocating for science. I'm sure you will find FAR more than 2 seroconversions a year amongst condom users do to condom failure.

I've always wondered -and I doubt there's anyway to tell. But assuming the condom is put on correctly, are these failures due to the condom breaking or having some type of pinhole or is the virus actually penetrating through the latex?

 

Gman

[coriolis888]

multi strain resistant virus which included Truvada resistant virus.. I am sure we will see alot more cases of people on prep getting hiv due to resistant strains.

 

 

 

Many people who take PrEP falsely believe that they are 100% safe from HIV and can have sex anyway they choose.

 

However, there are a few different strains of the HIV virus that are resistant to the drugs used in PrEP. Eventually, more strains will mutate into additional strains resistant to PrEP.

 

Statistically, if you are a PrEP user, you will PROBABLY not contract HIV in the near future because the resistant strains are uncommon and known strains of today take time to mutate into resistant strains. Five or ten years from now is another situation, all together, with respect to additional mutations.

 

Too many people are not sufficiently cautious when they are using PrEP. This is due to "wishful thinking" and/or not understanding the limitations of PrEP.

 

Not a pretty picture, no matter how you look at it.

[slightly]

And if neither of you are on PrEP than you should wear 2 condoms, just in case one breaks!

Little tangent: A guy I hooked up with on scruff put on two of my ridged condoms to try to better protect himself...I should have been more sensible and told him that double-bagging, particularly with those, is bad idea. Alas, no breakage, but it was definitely last time I didn't make sure the guy wasn't wrapped up properly.

[+ glutes]

Practice what you preach!

 

http://www.waybig.com/Gallery/Lucas_Entertainment/Fabio_Lopez_Fernando_Torres_Raff_Owen_Aaron_Mark_Exclusive_Web_Scene/156584

[LADoug1]

Practice what you preach!

 

http://www.waybig.com/Gallery/Lucas_Entertainment/Fabio_Lopez_Fernando_Torres_Raff_Owen_Aaron_Mark_Exclusive_Web_Scene/156584

Actors are wearing condoms. I like that.

[+ Eric Hassan]

http://www.towleroad.com/2016/10/second-case-of-daily-prep-user-contracting-hiv-reported/

 

 

I hope this helps people slowly learn that PrEP will not always protect you from HIV.

 

I, for one, am not surprised to hear about this. Personally, I feel the incidence of people on PrEP contracting HIV is going to grow. I'm quite sure that I read somewhere this year that there was a fear that the effectiveness of PrEP would decline over time. I'm not a medical professional and also, I am not advocating being on or not being on PrEP. Just commenting on the issue. Personally, I still would wear a condom (or ensure my sex partner did) for intercourse even if I was on PrEP.

 

The pharmaceutical company who makes Truvada and of course profits from it's sale....has been promoting it's own efficacy numbers for years. Quoting an "UP TO" 98% efficiency against HIV transmission "IN CONTROLLED STUDIES". Now that may be true...but INDEPENDENT general population studies come up around 80% efficiency. So in REALITY you still have a 20% chance of transmission...not to mention the increasingly high chance of catching syphilis, gonorrhea, and/or chlamydia .

 

Before I add my contribution to this thread, I want to take a step back. For over 30 years now, our community has lived with HIV and AIDS. In the 80s, it was a plague that effectively wiped out an entire generation in a horrific and scary and incredibly sad way and at an alarmingly fast rate. Sex went from becoming something fun and pleasurable that we could enjoy to something that we had to fear. Sex became something akin to Russian roulette. In the US, our government failed to acknowledge or respond in a timely manner. By the 90s and into the 2000s, we began to learn how to manage HIV/AIDS and now, today, folks can live a long time and have well-managed HIV infections.

 

None of these things - better drugs, longer lives, PrEP - will ever erase the trauma and sadness that we experienced. None of this will bring our loved ones back or erase the images of people dying. None of this will erase the vilification and homophobia we experienced and that is still, unfortunately, still alive today. AIDS was a punishment, they said, for our choice to live and love and fuck as our genuine selves.

 

We must not forget our history.

 

We must also face the reality that HIV is still out there. People - particularly (at least in the US) young black and Latin MSM - are still acquiring HIV. There are still mistruths, fears, accusations, and deaths. While we must not forget our history, we owe it to ourselves and to those who went before us to use science and facts and research to help us manage and thrive and survive. We also owe it ourselves to acknowledge that every single gay man has an HIV experience - we lost a lover, we have friends who are positive, or we are positive. We owe it to ourselves to be ground in the science and facts, mindful of our history and then make the choices about sex that make sense to us.

 

PrEP was never stated to be 100% effective. Condoms are also not 100% effective. According to the research, PrEP - when taken daily - is more effective by itself than condoms - when used in every encounter - are by themselves. The CDC does recommend PrEP for individuals at high-risk for contracting HIV. This recommendation does, however, state that best practice is to use condoms and PrEP. Even using both methods does not assure 100% protection against HIV.

 

A person contracting HIV while on PrEP is not a surprise. It really fucking sucks. It's scary. But it's not a surprise. It's not because PrEP is a lie. It's not because PrEP users are all just running around being irresponsible and fucking bareback. This is not the time to point fingers and place blame. The fact is, PrEP has some level of effectiveness against HIV infection. The fact is, condoms have some level of effectiveness against HIV infection. The fact is neither option is 100% effective.

 

So, those are facts, but there are still feelings. I ask that we each inform ourselves about the facts and then listen to our feelings and make the right choice for us. If you want to use PrEP and condoms, wonderful. If you want to use only PrEP or only condoms, that's great. If you want to use neither, well that's ok too. Know your risk, own your feelings, make your choice. I ask that we not point fingers and place blame. I ask that we not belittle the choice that others make. I ask that we TALK with our partners about our choices. I ask that we use our compassion.

 

Lastly, I want to address the highlighted items I quoted. @EZEtoGRU you stated you're quite sure that you read that there is a fear that the effectiveness of PrEP will decline. I'm quite sure you probably did read this. Fear abounds but FEAR IS NOT A FACT. There's a lot of fear about HIV and PrEP out there, but it doesn't mean there is any science to justify that fear. I'm not sure the circumstances or situation where you might have read this, but remember that a comment on a forum doesn't mean there's any science or facts. @pubic_assistance you stated general population studies show PrEP to be around 80% effective. Please provide citations. I'm well connected in the HIV science community and have not heard of these studies. I know early data (the IPREX study) used a mathematical model to determine efficacy - the up to 98% you mention - and that further studies have provided data that supports those findings.

 

For folks who want to get more information and read the studies, visit http://www.aidsmap.com or https://www.aids.gov/hiv-aids-basics/prevention/reduce-your-risk/pre-exposure-prophylaxis/, or join the PrEP Facebook group at https://www.facebook.com/pages/PrEP-Facts-Rethinking-HIV-Prevention-and-Sex/436235736575275.

 

Phew - thanks for letting me get that out!

[+ ArVaGuy]

The FDA and Gilead have always made it clear that Prep is most effective when used with a condom. Every doctor prescribing the drug is required to reiterate this message. It becomes an individual choice whether to adhere to that recommendation or not.

 

Furthermore, a different drug called Maraviroc is currently in trials as an alternative to Truvada. It has fewer long term side effects and will likely be released in the market in 18 months.

 

To further make heads spin around here, Norway will proved Prep, free of charge, to at risk citizens via its National Health Service.

[mike carey]

@Eric Hassan, thanks for your comprehensive post. Frankly, I am tired of proponents of one or other element of safer sex praising their idea and demonisng others. PrEP and condoms both reduce risk of HIV, but do not eliminate it. It's called 'safer' sex, not 'safe' sex for a reason, all sex has an element of risk, and to confine any discussion of safe or safer sex to the risk of HIV is disingenouus.

[+ ArVaGuy]

@Eric Hassan, thanks for your comprehensive post. Frankly, I am tired of proponents of one or other element of safer sex praising their idea and demonisng others. PrEP and condoms both reduce risk of HIV, but do not eliminate it. It's called 'safer' sex, not 'safe' sex for a reason, all sex has an element of risk, and to confine any discussion of safe or safer sex to the risk of HIV is disingenouus.

 

Well said. I'm tired of these circular firing squads that argue this issue ad infinitum.

[+ ArVaGuy]

Before I add my contribution to this thread, I want to take a step back. For over 30 years now, our community has lived with HIV and AIDS. In the 80s, it was a plague that effectively wiped out an entire generation in a horrific and scary and incredibly sad way and at an alarmingly fast rate. Sex went from becoming something fun and pleasurable that we could enjoy to something that we had to fear. Sex became something akin to Russian roulette. In the US, our government failed to acknowledge or respond in a timely manner. By the 90s and into the 2000s, we began to learn how to manage HIV/AIDS and now, today, folks can live a long time and have well-managed HIV infections.

 

None of these things - better drugs, longer lives, PrEP - will ever erase the trauma and sadness that we experienced. None of this will bring our loved ones back or erase the images of people dying. None of this will erase the vilification and homophobia we experienced and that is still, unfortunately, still alive today. AIDS was a punishment, they said, for our choice to live and love and fuck as our genuine selves.

 

We must not forget our history.

 

We must also face the reality that HIV is still out there. People - particularly (at least in the US) young black and Latin MSM - are still acquiring HIV. There are still mistruths, fears, accusations, and deaths. While we must not forget our history, we owe it to ourselves and to those who went before us to use science and facts and research to help us manage and thrive and survive. We also owe it ourselves to acknowledge that every single gay man has an HIV experience - we lost a lover, we have friends who are positive, or we are positive. We owe it to ourselves to be ground in the science and facts, mindful of our history and then make the choices about sex that make sense to us.

 

PrEP was never stated to be 100% effective. Condoms are also not 100% effective. According to the research, PrEP - when taken daily - is more effective by itself than condoms - when used in every encounter - are by themselves. The CDC does recommend PrEP for individuals at high-risk for contracting HIV. This recommendation does, however, state that best practice is to use condoms and PrEP. Even using both methods does not assure 100% protection against HIV.

 

A person contracting HIV while on PrEP is not a surprise. It really fucking sucks. It's scary. But it's not a surprise. It's not because PrEP is a lie. It's not because PrEP users are all just running around being irresponsible and fucking bareback. This is not the time to point fingers and place blame. The fact is, PrEP has some level of effectiveness against HIV infection. The fact is, condoms have some level of effectiveness against HIV infection. The fact is neither option is 100% effective.

 

So, those are facts, but there are still feelings. I ask that we each inform ourselves about the facts and then listen to our feelings and make the right choice for us. If you want to use PrEP and condoms, wonderful. If you want to use only PrEP or only condoms, that's great. If you want to use neither, well that's ok too. Know your risk, own your feelings, make your choice. I ask that we not point fingers and place blame. I ask that we not belittle the choice that others make. I ask that we TALK with our partners about our choices. I ask that we use our compassion.

 

Lastly, I want to address the highlighted items I quoted. @EZEtoGRU you stated you're quite sure that you read that there is a fear that the effectiveness of PrEP will decline. I'm quite sure you probably did read this. Fear abounds but FEAR IS NOT A FACT. There's a lot of fear about HIV and PrEP out there, but it doesn't mean there is any science to justify that fear. I'm not sure the circumstances or situation where you might have read this, but remember that a comment on a forum doesn't mean there's any science or facts. @pubic_assistance you stated general population studies show PrEP to be around 80% effective. Please provide citations. I'm well connected in the HIV science community and have not heard of these studies. I know early data (the IPREX study) used a mathematical model to determine efficacy - the up to 98% you mention - and that further studies have provided data that supports those findings.

 

For folks who want to get more information and read the studies, visit http://www.aidsmap.com or https://www.aids.gov/hiv-aids-basics/prevention/reduce-your-risk/pre-exposure-prophylaxis/, or join the PrEP Facebook group at https://www.facebook.com/pages/PrEP-Facts-Rethinking-HIV-Prevention-and-Sex/436235736575275.

 

Phew - thanks for letting me get that out!

 

Thanks @Eric Hassan for the most coherent analysis of this issue to date.

[Rudynate]

 

Furthermore, a different drug called Maraviroc is currently in trials as an alternative to Truvada.

 

Its looking like it is going to need to be combined with either tenofovir or emtricitabine. As a mono-agent, it isn't effective enough.

[ChrisWydeman]

*shakes head*

There have been resistant strains of HIV since haart (highly active anti retroviral therapy) came out because people didn't adhere to there medications. These particular strains of truvada resistant HIV have been out since truvada came out over a decade ago this is not new folks. Yes there is a possibility you may come across someone that is infectious person that has this particular strain how ever this is the second case in 4 years i have heard of a transmission while someone was on prep. You have a higher likelihood based on these odds of contracting HIV through condom failure than adhering to a prep regimen. If your deeply concerned about HIV infection to the point where its adversely affecting your sex life or in the case of some forum members, spewing emotional diarrhea all over maybe it might be time to go talk to a mental health care provider. There is no shame in being honest with yourself about your fears and how it effects your behavior, go talk to a sex positive therapist and you just might learn something about yourself in the process if your not careful:p

[marylander1940]

The pharmaceutical company who makes Truvada and of course profits from it's sale....has been promoting it's own efficacy numbers for years. Quoting an "UP TO" 98% efficiency against HIV transmission "IN CONTROLLED STUDIES". Now that may be true...but INDEPENDENT general population studies come up around 80% efficiency. So in REALITY you still have a 20% chance of transmission...not to mention the increasingly high chance of catching syphilis, gonorrhea, and/or chlamydia .

 

prep isn't the cure all folks think it is

 

don't be stupid. use condoms with prep.

 

Makes sense to me!

 

http://reactiongif.org/wp-content/uploads/GIF/2014/08/GIF--Approve-Approval-Like-Likes-Awesome-Nice-one-Good-one-contemplating-thumbs-up-Aladdin-GIF.gif