U=U

[+ GregM]

https://www.washingtonpost.com/national/health-science/i-dont-feel-like-im-a-threat-anymore-new-hiv-guidelines-are-changing-lives/2017/11/24/a9ee84e2-cf10-11e7-a1a3-0d1e45a6de3d_story.html

 

Hugs,

Greg

[LADoug1]

After living through the nightmare of the AIDS epidemic in the 80’s I still am afraid despite the great statistics presented in the article. Hard to get my mind around it. My problem I know.

[mike carey]

After living through the nightmare of the AIDS epidemic in the 80’s I still am afraid despite the great statistics presented in the article. Hard to get my mind around it. My problem I know.

Yes, when we are socialised with the view that it is an inevitable scourge it is hard to come to terms with the advances in treatment and what they actually mean. To me what is important is not whether as individuals we can accept the newly accepted science, but whether society at large can come to terms with it. And importantly what it means to HIV+ people. Specialists know what is happening, and that U=U (to all intents and purposes) but from the article, the general medical community is as yet unaware or unconvinced by the current specialist consensus. It's important that even if there is one case where the consensus is wrong that such a case isn't seen as disproving the science on which that consensus was based.

 

The strongest message I took from the article was the one in the last couple of paragraphs:

“I’ll never forget him saying those words, ‘You can’t transmit the virus if you’re undetectable,’ ” the 47-year-old substitute teacher recalled. “And I said, ‘Wait, what?’

 

“It was like the sky opened. Are you kidding? There’s, like, zero risk? I don’t feel like I’m a threat anymore. I don’t feel like I’m dirty. I don’t feel like I’m a dangerous person.”

[Pepper Young]

It's wonderful news. After 40+ years medical science has all but conquered this horrible virus. HIV is no longer a death sentence; it's no longer a reason to discriminate and punish. As long as the person is aware and faithful about taking medications, HIV will be like any other chronic but manageable disease. U=U

[+ nycman]

I've said this before...but the elephant in the room is the term "undetectable".....many....let me repeat that word....MANY.....HIV+ individuals

cannot (for whatever reason) reach that level of viral suppression. And someone who was "undetectable" last week....may....for any number

of reasons....become "detectable" today....and thus more infectious.

 

Yes, it's incredible that some people are able to reach a level of being undetectable. And even people who are detectable but on HAART

are less infectious than the "old days". Add PreP into the mix and things are starting to look up. No doubt, these are all great and incredible

things that are helping to contain the spread of HIV. Nonetheless, I feel the trumpeting of "U=U" is simplistic and irresponsible....and some,

perhaps many, people will pay with their lives.

 

Again, to bluntly speak to the elephant in the room....none of this justifies abandoning condom use.

[rvwnsd]

I read a handful of article about this topic over the weekend. Having come of age at the beginning of the epidemic and lost many friends, colleagues, and acquaintances to HIV/AIDS as well as to the side-effects of the early medications I think this is wonderful news.

[+ WmClarke]

I've said this before...but the elephant in the room is the term "undetectable".....many....let me repeat that word....MANY.....HIV+ individuals

cannot (for whatever reason) reach that level of viral suppression. And someone who was "undetectable" last week....may....for any number

of reasons....become "detectable" today....and thus more infectious.

 

Yes, it's incredible that some people are able to reach a level of being undetectable. And even people who are detectable but on HAART

are less infectious than the "old days". Add PreP into the mix and things are starting to look up. No doubt, these are all great and incredible

things that are helping to contain the spread of HIV. Nonetheless, I feel the trumpeting of "U=U" is simplistic and irresponsible....and some,

perhaps many, people will pay with their lives.

Do you have a source for that? Because by using vague words like “many” without a source you’re just fear-mongering.

[+ GregM]

I think this fear issue could maybe be a generational thing. And those that were of age and active during the 80s and 90s fully and absolutely have the right to be afraid. I can't even imagine what it's like to lose almost all my friends to a deadly disease. Even though I was unfortunate enough to get this I thank my lucky stars for the medical advancements that have given me a 3rd chance at life. While I agree we should move forward it should be with caution and to be respectful of those that wish to take the precautions that they are comfortable with and feel is best for them. I'm team live and let live and take responsibility of one's self. So those of you who are team condom, good for you! And those of you who are team prep, good for you! And those of you who use both, good for you!

 

Hugs,

Greg

[jawjateck]

I'm team live and let live and take responsibility of one's self. So those of you who are team condom, good for you! And those of you who are team prep, good for you! And those of you who use both, good for you!

 

Greg....I completely agree. Thank you for sharing your journey with all of us. I am thankful for the life-saving, life-gratifying medical advancements in this field, but I want to chime in as one of the condom-affirming, non-"PrEP"ers. The tables are turning, and the target of ostracism is becoming old-fashioned folk like me. Yall may think my hobbying is prolific, but my sex life is rather bland and potential transmission activities are even more infrequent. I don't date, and I don't hook-up. So in my situation, the cost-benefit/risk-reward tells me to skip the prescription and don a condom during those rare encounters. However, numerous providers refuse to use them (whether top or bottom), commenting that they hurt, chaff, cause a break-out, are too tight, kill a hard-on, etc...all the excuses that I rarely heard for the last 20 years. And the kicker...."jawja, you've got nothing to worry about; 'I'm on PrEP'". I can have fun in a lot of ways and don't have to follow a script for a meeting to be successful, but when it is not even an option to go at it with a stunningly hot, and otherwise willing, passionate stud, then that is disappointing, and I've experienced that disappointment multiple times the past 2 years.

 

It is one of the main reasons I may give up hobbying soon....along with the fact that RM has devolved into something more like grindr than a marketplace.

 

Just my 1.25 cents.....

[LookingAround]

I've said this before...but the elephant in the room is the term "undetectable".....many....let me repeat that word....MANY.....HIV+ individuals

cannot (for whatever reason) reach that level of viral suppression. And someone who was "undetectable" last week....may....for any number

of reasons....become "detectable" today....and thus more infectious.

 

Yes, it's incredible that some people are able to reach a level of being undetectable. And even people who are detectable but on HAART

are less infectious than the "old days". Add PreP into the mix and things are starting to look up. No doubt, these are all great and incredible

things that are helping to contain the spread of HIV. Nonetheless, I feel the trumpeting of "U=U" is simplistic and irresponsible....and some,

perhaps many, people will pay with their lives.

 

Again, to bluntly speak to the elephant in the room....none of this justifies abandoning condom use.

Sorry but what is it about U = U that you can’t seem to understand.

[+ BenjaminNicholas]

Times have changed, yes, but until there's a cure, HIV/AIDS is still killing people. We must always use common sense.

 

My concern is the possible reduction of research funding during this Trump admin.

 

We also need to stop looking at PrEP as a black or white issue: There are many guys who use it (with condoms) as a failsafe.

[jjkrkwood]

Times have changed, yes, but until there's a cure, HIV/AIDS is still killing people. We must always use common sense.

 

My concern is the possible reduction of research funding during this Trump admin.

 

We also need to stop looking at PrEP as a black or white issue: There are many guys who use it (with condoms) as a failsafe.

 

Thanks for mentioning this. Many guys are using PREP as a "pass", and becoming complacent. ALWAYS have your guard up, and your condom ON !

[+ GregM]

Times have changed, yes, but until there's a cure, HIV/AIDS is still killing people. We must always use common sense.

 

My concern is the possible reduction of research funding during this Trump admin.

 

We also need to stop looking at PrEP as a black or white issue: There are many guys who use it (with condoms) as a failsafe.

 

One, we need to quit relying on gov to save us. That time is passing. And two, I believe I mentioned those that wear a condom and use prep at the same time. Which is a good thing.

 

Hugs,

Greg

[Populist Fury]

#TeamFailsafeFTW

[+ nycman]

Sorry but what is it about U = U that you can’t seem to understand.

 

I understand that it's a gimmicky phrase that's being used to convince people that they

have nothing to fear about unprotected sex with people who are HIV+.

 

I'm just shining a light into the corner and helping people understand that reductive

reasoning to the point of "U=U" is simplistic, unreliable, and I believe dangerous.

 

First and foremost....you are relying on your partner to be honest about their viral load.....

hell, many men aren't even honest about being HIV+....are you really willing to trust them

with your health and trust that they're being honest about their viral load and their

compliance with their HIV meds? Seriously? These are MEN....who want to get LAID!

 

Most of the "U=U" dogma is based on the PARTNER study that was published in 2016.

Let me give you a direct quote from the article"....these results cannot directly provide an

answer to the question of whether it is safe for serodifferent couples to practice condomless sex...."

 

Also the study was underpowered to give definitive answers about homosexual sex....hence the

PARTNER2 study that is trying to enroll more gay men that is now underway. "....additional

follow-up in MSM is therefore needed through the second phase of the PARTNER study

(PARTNER 2) to provide more precise estimates for transmission risk in MSM in the context of ART."

 

Don't get me wrong. The PARTNER study was damn impressive. Nonetheless, there were 11 HIV

seroconversions in the study and 10 of them were gay men. They just weren't tied genetically to the

"undetectable" partner. Also, many couples were lost to follow up and the average follow up

was only 1.3 years. That's not a very long time.

 

Also, 55 couples were removed from the study because the "undetectable" partner...became "detectable".

 

And of course this have nothing to do with the myriad of other sexually transmitted infections out there.

In fact, in the condomless PARTNER study......"HIV-negative MSM were also relatively commonly

diagnosed with an STI."

 

This study was done in partners, many of whom had been together for years. This study wasn't designed to

answer questions about one night stands....to quote "the risk of HIV transmission in very new partnerships

could not be determined."

 

Know what they call that trick you picked up off Grindr last night?.....a "very new partnership".

This study says NOTHING about that risk.

 

Look, this is great news....but I personally don't think it translates into..."that guy who fucked me raw at

the bath house last night told me he was undetectable so there's no risk of me contracting HIV".

 

And that's the implied "U=U" myth that I'm trying to bust.

Edited November 29, 2017 by nycman