I did it. I started PrEP

[corndog]

After spending years as PrEP skeptic, I slowly came around, and finally saw a doctor and started the Truvada regimen last Monday. I welcome any questions (or judgements), but I'll throw out a few of things to start with...

 

- I took advantage of the open enrollment period to change to a Covered California Silver plan and selected a new primary care physician who happens to work at an AHF (Aids Healthcare Foundation) Medical Center. I was nervous about the difficulty of the whole process, but it ended up being super easy, and I walked out of there with a prescription which was filled for free at the attached AHF Pharmacy.

 

- When I came out, AIDS was a terrifying, fatal, untreatable disease. I've spent my whole sex life practicing 100% condom usage, and yet I have always connected fear to any act of sex. I don't think I fully grasped the sense of freedom and peace of mind that PrEP would instill until now. It's still a few more days before the 7-day full-efficacy is reached, but it is already incredibly liberating to look forward to sex without fear.

 

- I intend to continue to use condoms, but, looking forward, if there is condom mishap, I'm going to shrug it off as "no big deal." I hate to admit it, but I'll probably even eventually give bareback a try, even though I've never, ever done it, and harshly judged those who do.

 

I am, of course, keeping this on the down-low amongst family and friends, so I really appreciate having this forum to open up to.

[Guy Fawkes]

Proud of you!

[+ Truereview]

Whatever helps you feel freer, more in touch with your own intimacy, or opens doors to pleasure is worth celebrating.

Sounds like you will be handling its preventative aspects in a very conscious way.

Congrats and may you enjoy a good fuck soon!

[rvwnsd]

Congratulations! Although I have never had fear associated with sex, having used Truvada as PrEP since February I feel there is an extra layer of protection in doing so. I hope you can get to the same place.

 

On a practical front, if you have not already done so get a PrEP copay card. It renders the medication essentially free of charge.

[+ nycman]

Congratulations Corndog!

 

Why anyone would judge you for protecting yourself is beyond me.

 

Just remember there are other STD's out there...and maybe even a few we don't even know about yet....stick with the condoms too!

[LivingnLA]

After spending years as PrEP skeptic, I slowly came around, and finally saw a doctor and started the Truvada regimen last Monday. I welcome any questions (or judgements), but I'll throw out a few of things to start with...

 

- I took advantage of the open enrollment period to change to a Covered California Silver plan and selected a new primary care physician who happens to work at an AHF (Aids Healthcare Foundation) Medical Center. I was nervous about the difficulty of the whole process, but it ended up being super easy, and I walked out of there with a prescription which was filled for free at the attached AHF Pharmacy.

 

- When I came out, AIDS was a terrifying, fatal, untreatable disease. I've spent my whole sex life practicing 100% condom usage, and yet I have always connected fear to any act of sex. I don't think I fully grasped the sense of freedom and peace of mind that PrEP would instill until now. It's still a few more days before the 7-day full-efficacy is reached, but it is already incredibly liberating to look forward to sex without fear.

 

- I intend to continue to use condoms, but, looking forward, if there is condom mishap, I'm going to shrug it off as "no big deal." I hate to admit it, but I'll probably even eventually give bareback a try, even though I've never, ever done it, and harshly judged those who do.

 

I am, of course, keeping this on the down-low amongst family and friends, so I really appreciate having this forum to open up to.

 

Sounds like you're being responsible and reasonable. Cheers for that, please keep it up.

 

If you're serious about exploring bareback, make sure to get hepatitis, meningitis and HPV (Gardasil-9) vaccinations. Those are real and dangerous STDs that are easy to catch from condom-less oral, anal, or vaginal sexual activity.

 

Have fun! I freely admit sex feels very different without condoms. Some people enjoy it much more. Some, prefer condoms for cleanliness, control, and more. So long as you're careful, sane, and smart about it, you should be fine.

[+ newatthis]

...If you're serious about exploring bareback, make sure to get hepatitis, meningitis and HPV (Gardasil-9) vaccinations. Those are real and dangerous STDs that are easy to catch from condom-less oral, anal, or vaginal sexual activity....

I'm under the impression that the HPV vaccine is ineffective once you've become sexually active (which is why it's given to preteen kids). Am I wrong about that?

[Rudynate]

After spending years as PrEP skeptic, I slowly came around, and finally saw a doctor and started the Truvada regimen last Monday. I welcome any questions (or judgements), but I'll throw out a few of things to start with...

 

 

Congratulations!! You may experience some uncomfortable symptoms in the coming weeks. Stay with it.

[caliguy]

I'm under the impression that the HPV vaccine is ineffective once you've become sexually active (which is why it's given to preteen kids). Am I wrong about that?

If you've already being exposed to it then yes. Probably ineffective.

[LivingnLA]

I'm under the impression that the HPV vaccine is ineffective once you've become sexually active (which is why it's given to preteen kids). Am I wrong about that?

 

There are many viruses in the HPV family. Over 40 of these known HPVs are very easy to get via sexual activity. Approximately 9 out of 10 sexually active men and 8 out of 10 sexually active women are infected with at least one strain of HPV. The thinking around the HPV vaccine when it first appeared was to do it as early as possible to minimize the chance the patient had been exposed to any HPV at all.

 

Only some of the strains--about a dozen--are categorized as high-risk because they're known to cause cancer. If you haven't been exposed to the high-risk strains protected by the vaccine, then the vaccine is still capable of providing protection for you. The original vaccine protected from 16 & 18, the two that cause most of the cervical cancer cases. The latest vaccine, Gardasil-9, protects against 9 of the 12 strains that cause cancer.

 

We've seen a significant increase in oral & throat cancers, especially in young men. The early research and thinking seem to support the rise being tied to the increase in unprotected oral sex by young men and for some reason HPV-caused oral/throat cancer is more prevalent in young men than women.

 

https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-fact-sheet

 

http://www.cancer.org/cancer/cancercauses/othercarcinogens/infectiousagents/hpv/hpv-and-cancer-info

 

https://www.washingtonpost.com/news/to-your-health/wp/2016/10/25/the-startling-rise-in-oral-cancer-in-men-and-what-it-says-about-our-changing-sexual-habits/

 

http://www.cdc.gov/vaccines/hcp/vis/vis-statements/hpv-gardasil-9.html

 

http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm426485.htm

[caliguy]

There are many viruses in the HPV family. Over 40 of these known HPVs are very easy to get via sexual activity. Approximately 9 out of 10 sexually active men and 8 out of 10 sexually active women are infected with at least one strain of HPV. The thinking around the HPV vaccine when it first appeared was to do it as early as possible to minimize the chance the patient had been exposed to any HPV at all.

 

Only some of the strains--about a dozen--are categorized as high-risk because they're known to cause cancer. If you haven't been exposed to the high-risk strains protected by the vaccine, then the vaccine is still capable of providing protection for you. The original vaccine protected from 16 & 18, the two that cause most of the cervical cancer cases. The latest vaccine, Gardasil-9, protects against 9 of the 12 strains that cause cancer.

 

We've seen a significant increase in oral & throat cancers, especially in young men. The early research and thinking seem to support the rise being tied to the increase in unprotected oral sex by young men and for some reason HPV-caused oral/throat cancer is more prevalent in young men than women.

 

https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-fact-sheet

 

http://www.cancer.org/cancer/cancercauses/othercarcinogens/infectiousagents/hpv/hpv-and-cancer-info

 

https://www.washingtonpost.com/news/to-your-health/wp/2016/10/25/the-startling-rise-in-oral-cancer-in-men-and-what-it-says-about-our-changing-sexual-habits/

 

http://www.cdc.gov/vaccines/hcp/vis/vis-statements/hpv-gardasil-9.html

 

http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm426485.htm

I have a an acquaintance who's losing the battle from anal cancer. He's only got another week a or so to live. He was diagnosed a year ago but it had already spread out. Gay and only 52. It's a good bet that he caught HPV somewhere in the past.

[LADoug1]

Remember that there can be side effects. Watch for Osteoppress and kidney function issues.

[Andy2]

This is a great thread, and I appreciate the OP's honesty.

 

While we are being honest, there are probably many gay men like me: I was not sexually active until AIDS was full-blown, and so I have always used condoms. Funny thing is, I actually enjoy topping with a condom (I do not bottom at all). My favorite thing is to French kiss the bottom while fucking him, and the condom actually helps me stay hard (I am pretty old). One recent (very hot) partner asked that I use a condom for oral; although I have rarely used a condom for oral, his skills were so keen that I found that pleasurable as well.

 

I also find it incredibly hott when a buff young man opens the condom wrapper for me, lubes me up, slips the condom onto my eager penis, lubes his ass, and then slowly takes me. Surely I am not the only guy who finds the "unwrapping" to be erotic, especially if accomplished by a sexy partner.

 

Most men do not feel the way I do--fine! It's a diverse world out there, and guys should be aware that many potential partners are not only OK with condoms (for health reasons suggested earlier in this thread), but also enjoy using them.

[Rudynate]

Remember that there can be side effects. Watch for Osteoppress and kidney function issues.

 

 

If his treatment is being properly managed, he will have LFTs and serum creatinine/GFR every three months. Nobody has addressed the issued of monitoring for bone mineral loss. There is a number of tests that could be used to monitor bone health. As I understand it, urinary N-telopeptide is one of the most common. I don't understand why that couldn't be done at regular intervals. At Kaiser (my healthcare provider) it probably relates to cost.

[+ newatthis]

There are many viruses in the HPV family. Over 40 of these known HPVs are very easy to get via sexual activity. Approximately 9 out of 10 sexually active men and 8 out of 10 sexually active women are infected with at least one strain of HPV. The thinking around the HPV vaccine when it first appeared was to do it as early as possible to minimize the chance the patient had been exposed to any HPV at all.

 

Only some of the strains--about a dozen--are categorized as high-risk because they're known to cause cancer. If you haven't been exposed to the high-risk strains protected by the vaccine, then the vaccine is still capable of providing protection for you. ...

I appreciate the information and the links. One of them led me to this:

 

What about men and women older than 26? Should they get one of the vaccines?

HPV vaccines are not approved nor recommended after age 26. While the vaccines are safe, they will not provide much, if any, benefit.

[LivingnLA]

I appreciate the information and the links. One of them led me to this:

 

What about men and women older than 26? Should they get one of the vaccines?

HPV vaccines are not approved nor recommended after age 26. While the vaccines are safe, they will not provide much, if any, benefit.

 

The CDC recommendation is based on how prevalent HPV is and the cost of the vaccine. That's why they don't recommend the vaccine for men beyond 26, because they figure such a patient already has at least one HPV strain.

 

There are over a hundred different HPV strains. At least 40 of them are easily sexually transmitted and at least 12 are high-risk because they cause cancer. Say a 50 year-old patient was moderately sexually active. He has HPV 16 and 18, they cause at least 70% of the cervical cancer cases. This male patient is a carrier that is a high-risk for women. If he received the Gardasil-9 vaccine, he'd still be protected for 7 other cancer-causing strains, including the 1 suspected to cause the majority of oral/throat cancer cases.

 

Since it isn't recommended by the CDC, the vast majority of insurance companies won't pay for it. That's ultimately the impact of the CDC recommendation you quote above.

[+ glennnn]

@LivingnLA

 

I am in a fairly unique situation- 73 YO but with a very limited sexual history. I've only had 5 male sexual partners, all in the last 11 months, all with condoms for anal sex, so I think my exposure to HPV has been limited. I know Medicare won't pay for HPV vaccine for me, but does anyone have an idea of what the cost would be if I paid it myself?

[+ glennnn]

@LivingnLA

 

Found it! The cost is around $450 for the three shot series.

[LivingnLA]

@LivingnLA

 

I am in a fairly unique situation- 73 YO but with a very limited sexual history. I've only had 5 male sexual partners, all in the last 11 months, all with condoms for anal sex, so I think my exposure to HPV has been limited. I know Medicare won't pay for HPV vaccine for me, but does anyone have an idea of what the cost would be if I paid it myself?

 

If I remember correctly, you love to suck cock and swallow, so I would strongly urge you to get the vaccine, especially given how reasonable the price is for you. Just make sure, it's Gardasil-9, which is the vaccine that protects against the most strains.

[caliguy]

If I remember correctly, you love to suck cock and swallow, so I would strongly urge you to get the vaccine, especially given how reasonable the price is for you. Just make sure, it's Gardasil-9, which is the vaccine that protects against the most strains.

I'll never understand why it's not mandatory for kids to get the shots. You could eliminate 73% of the anal and oral cancers.

[LivingnLA]

I'll never understand why it's not mandatory for kids to get the shots. You could eliminate 73% of the anal and oral cancers.

 

Look at how many parents freak out about the vaccines that are required for kids attending daycare and school? Now, imagine how they'd react to mandatory vaccines for sexually transmitted diseases! Dun Dun Duh!!!!!!!

 

I wish people could be rational and make such decisions based on data and science, but people like their opinions and fake news, and what their friends tell them. I suspect this is a major driver of the division in America: the moralization of rationality coupled with very different data sources and "relative" truth.

 

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0166332

[+ newatthis]

@LivingnLA

 

Found it! The cost is around $450 for the three shot series.

Looks like you might do better than that; check out https://www.goodrx.com/gardasil-9

[jimboivyo]

condrads on taking a healthy step. just make sure to have your dr keep you up to date on your labs

[+ glennnn]

It's like the climate crisis. What is the down side to working towards a cleaner, safer planet? Unless you are an "end of times" freak who wants the world to end so you can hang out with Jesus. There's something up with our climate. Who or what is causing it is beside the point. Being reactive is always going to be more costly in human suffering than being proactive.

[+ glennnn]

Looks like you might do better than that; check out https://www.goodrx.com/gardasil-9

 

Great! Thank you very, very much. I love this Forum.