Gay men divided over use of HIV prevention drug Truvada. Larry Kramer has changed his mind about PrEP

  • metta

    Posts: 39112

    Apr 06, 2014 11:49 PM GMT
    Gay men divided over use of HIV prevention drug Truvada

    Truvada Is For “Cowards,” Says “The Normal Heart” Playwright Larry Kramer

    http://www.lgbtqnation.com/2014/04/gay-men-divided-over-use-of-hiv-prevention-drug/


    UPDATE:

    Larry Kramer has changed his mind about PrEP


    http://www.lgbtqnation.com/2015/12/larry-kramer-has-changed-his-mind-about-prep/
  • metta

    Posts: 39112

    May 30, 2014 3:09 PM GMT
    Op-Ed: Where Larry Kramer Gets It Wrong on Truvada

    "A European study has followed 767 HIV-negative people who have HIV-positive partners, and who took Truvada but didn’t use condoms. Although the pairs have had sex more than 30,000 times since the study began, not a single HIV-negative partner has been infected."

    http://www.out.com/news-opinion/2014/05/29/op-ed-where-larry-kramer-gets-it-wrong-truvada




    Truvada Is For “Cowards,” Says “The Normal Heart” Playwright Larry Kramer
    http://www.queerty.com/truvada-is-for-cowards-says-the-normal-heart-playwright-larry-kramer-20140521


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    May 30, 2014 4:02 PM GMT


    Lots of side effects...I personally think a condom is better.

    http://www.truvada.com/
  • metta

    Posts: 39112

    May 30, 2014 4:23 PM GMT
    ^
    The government is recommending more use of Truvada because of the stats. They feel it will help to get the rates of infection down by getting more people to use it.
    http://www.realjock.com/gayforums/3820263

    We all have to determine what works best for each of us. Hopefully we make good choices.

    I'm concerned about a lot more than just HIV/AIDS. For me, I stay away from hookups and am celibate most of the time. But I do realize that will not work for most people...well...pretty much everyone else. ;) Being a vegetarian, I don't expect anyone to make the choices I make.
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    May 30, 2014 4:29 PM GMT
    metta8 said^
    The government is recommending more use of Truvada because of the stats. They feel it will help to get the rates of infection down by getting more people to use it.
    http://www.realjock.com/gayforums/3820263

    We all have to determine what works best for each of us. Hopefully we make good choices.

    I'm concerned about a lot more than just HIV/AIDS. For me, I stay away from hookups and am celibate most of the time. But I do realize that will not work for most people...well...pretty much everyone else. ;) Being a vegetarian, I don't expect anyone to make the choices I make.


    (in the bold) I agree. Like anything, there will be people who abuse Truvada. AS an example, I remember back in the days before HIV. Guys who had random sex used to take a few antibiotics before a night out as a prophylactic, that way they didn't get VD, but it helped the bugs gain resistance.
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    May 31, 2014 5:21 PM GMT
    meninlove said

    Lots of side effects...I personally think a condom is better.

    http://www.truvada.com/


    "There are limited data at the moment on long-term side effects of Truvada use in HIV-negative individuals. The majority of the work has been with HIV-infected individuals who are clearly expected to be taking Truvada for a long period of time, with the major possible side effects being kidney damage, and loss of bone density (which could lead to increased risk of fractures/breaks). HIV itself is a risk factor for kidney dysfunction, so we have to tease out the effects that Truvada may have when using PrEP in HIV-negative individuals. A study was published in early September that followed HIV-uninfected men for two years while using PrEP, and other than some back pain, there were no adverse side effects associated with taking tenofovir (of the two drugs in Truvada, the one that is thought to be more toxic)."

    Pickett, like many of the pro-Truvada people that I spoke with, believes in having multiple prevention options for people and acknowledges the reality that Truvada is often used on its own. If one is going to choose sides between condom and PrEP, he said, Truvada's is a reasonable side to choose:

    "Truvada actually has a level of forgiveness that condoms don't," he said. "[Truvada's drug levels] don't plummet if you miss one day. They don't go from 100 to zero in one fell swoop. So they're thinking that taking three or four doses a week keeps enough drug in your system to be protective."

    http://gawker.com/what-is-safe-sex-the-raw-and-uncomfortable-truth-about-1535583252
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    May 31, 2014 7:57 PM GMT
    Over the past 30 years which I've been HIV+, I've heard of a lot of treatments, I've heard of a lot of "short cuts" regarding sexual risk management, I've heard promises of cures, and I've burried a lot of friends after watching them waste away and suffer.

    When I hear of treatments and cures, I think, "We'll see."
    When I hear of short cuts regarding sexual risk management practices, I think, "We'll see."
    What I keep seeing are people still getting infected with HIV AND other less manageable diseases.

    So, whatever "reasoning" that people may want to use to convince themselves that HIV and other STD's are just going to magically go away with a pill, and that the "free unfettered love" of the 1960's is going to return, I think, "We'll see."

    Until "I see", I guess I'm just going to be "old-fashioned" and "living in another era" as I continue to get to know my partners AND use condoms to manage my sexual risk tolerance.

    I do take Truvada, but that's because I've already been infected with HIV. There is no 'PReP" for me...at least not for HIV.

    From my own lessons of the past, I wonder..."When will the next incurable STD develop in the wild and if we go back to the behaviors of the past will we relive the horrors of a past, virulent pandemic?"

    Gay men may be divided over the issue. Wonderful. I love debate.

    But when it comes down to the choices I make for my own life, and the "lessons learned" I share with others (younger and older). My message is unambiguous and crystal clear: Manage your sexual risk proactively and just use a condom every single time.
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    Jun 04, 2014 7:14 PM GMT
    GAMRican saidOver the past 30 years which I've been HIV+, I've heard of a lot of treatments, I've heard of a lot of "short cuts" regarding sexual risk management, I've heard promises of cures, and I've burried a lot of friends after watching them waste away and suffer.

    When I hear of treatments and cures, I think, "We'll see."
    When I hear of short cuts regarding sexual risk management practices, I think, "We'll see."
    What I keep seeing are people still getting infected with HIV AND other less manageable diseases.

    So, whatever "reasoning" that people may want to use to convince themselves that HIV and other STD's are just going to magically go away with a pill, and that the "free unfettered love" of the 1960's is going to return, I think, "We'll see."

    Until "I see", I guess I'm just going to be "old-fashioned" and "living in another era" as I continue to get to know my partners AND use condoms to manage my sexual risk tolerance.

    I do take Truvada, but that's because I've already been infected with HIV. There is no 'PReP" for me...at least not for HIV.

    From my own lessons of the past, I wonder..."When will the next incurable STD develop in the wild and if we go back to the behaviors of the past will we relive the horrors of a past, virulent pandemic?"

    Gay men may be divided over the issue. Wonderful. I love debate.

    But when it comes down to the choices I make for my own life, and the "lessons learned" I share with others (younger and older). My message is unambiguous and crystal clear: Manage your sexual risk proactively and just use a condom every single time.


    I can't disagree with your technique. There's nothing wrong with using condoms.

    How long do we wait for "We'll see"?

    You and I have been using Truvada for 10 years or so. It's no longer "We'll see." It's been safe and effective for me and MANY others.

    It's been mentioned that the risks associated with Truvada may be preexisting problems. Some have had AIDS and recovered with Truvada, but there may have have been some underlying liver damage already, for example.

    Truvada IS proactive! Much more so than condoms. Condoms are a "We'll see" if I get HIV if the condom breaks. Or "We'll see" what happened if I forgot, slipped, or trusted "that guy".

    I agree "What I keep seeing are people still getting infected with HIV...."
    ....that's WHY I think Truvada is good for them! Condom aren't reaching a lot of people for many reasons. I can't wait and "We'll see" when 40-50K new cases of HIV happen every year. We have to use every armament available. Truvada can be very beneficial to a group that condoms are NOT for.
  • metta

    Posts: 39112

    Jun 05, 2014 10:33 PM GMT
    How I Embraced Being a Truvada Whore

    Learning how to be strong in the face of stigma,
    regardless of HIV status.

    http://www.hivequal.org/how-i-embraced-being-a-truvada-whore.html
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    Jun 11, 2014 2:30 AM GMT
    I'm uncomfortable about Truvada.

    From a big pharma point of view, a drug is specially interesting when it needs to be taken daily all life long by a lot of people. Truvada has potential here.

    On an medical health point of view, there is the complicated balance between the advantage of taking a given drug over other available treatments, and the severity of the side effects.

    To me, it's condoms against Truvada.

    Condoms :
    cheap
    No side effect (unless you're allergic to latex)
    Good protection (between 75 and 98%) against HIV, but not perfect.
    Efficacy against HIV based on decades of statistics

    Truvada:
    more than 10 000$ per year
    Long list of side effects, some potentially severe
    75% reduction of risk of transmission according to the FDA when it approved it.

    I'm sure Truvada + condoms offer excellent protection.

    I don't think it has been demonstrated that it's safer to bareback with Truvada than to properly use a condom. (Condom failure is not always out of bad use and bad lubrication, but it's still often the case)

    I know we don't have decades of Truvada averse effect report on non HIV people to know the extend of adverse effect.

    And on a more medical point of view, I seriously wonder about the public health benefit to massively use Truvada on healthy people, as it would increase a lot the probability to develop new Truvada resistant HIV strain.





  • metta

    Posts: 39112

    Jun 11, 2014 7:31 PM GMT
    The PrEP Generation Gap

    http://www.hivequal.org/the-prep-generation-gap.html
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    Jun 12, 2014 8:39 PM GMT
    metta8 saidThe PrEP Generation Gap

    http://www.hivequal.org/the-prep-generation-gap.html


    That's bull shit. There are enough young guys on here who don't even know what PrEP or Undetectable is: Truvada as prevention (PrEP) and Truvada as treatment AND prevention (ART Therapy). There is just an information gap.
  • metta

    Posts: 39112

    Jul 22, 2014 8:56 PM GMT
    Research: HIV pills show more promise to prevent infection

    Follow-up from a landmark study that proved the drug works now shows that it does not encourage risky sex and is effective even if people skip some doses.


    http://www.lgbtqnation.com/2014/07/research-hiv-pills-show-more-promise-to-prevent-infection/
  • metta

    Posts: 39112

    Dec 13, 2015 8:17 PM GMT
    Larry Kramer has changed his mind about PrEP


    http://www.lgbtqnation.com/2015/12/larry-kramer-has-changed-his-mind-about-prep/
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    Dec 14, 2015 2:13 AM GMT
    metta saidLarry Kramer has changed his mind about PrEP


    http://www.lgbtqnation.com/2015/12/larry-kramer-has-changed-his-mind-about-prep/


    I was disappointed with his earlier comments. The is part of the old guard, good to see he can change.
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    Dec 14, 2015 11:32 AM GMT
    metta saidHow I Embraced Being a Truvada Whore

    Learning how to be strong in the face of stigma,
    regardless of HIV status.

    http://www.hivequal.org/how-i-embraced-being-a-truvada-whore.html


    Since you fail to make the distinction between interalised homophobia and concerns for the mass outbreak of STI's, I question your credentials as an effective sexual health counsellor and I believe that while your choices are your own and to be respected, your role in advising people about their sexual health must remain impartial. The spread of other STI's is taking place on mass and will only get worse while the reasoning you state in this article become more prevelant.

    Trauma relating to rejection of a homosexual attraction is not what is making concerned people call Prep users Truvada whores. It's the accompanying message and the campaigns designed it appears increasingly to be used opportunistically advocating 'Free love' 60's and 70's style & for bareback sex to become an entrenched norm.

    Why is it that this Opportunity to utilise Prep to encourage less self-destructive over sexualisation has been instead hijacked by some of the very same persons who provided the impetus for the massive increase in BB sex. We Gay Men don't know how to relate to each other in non-sexualised ways and by attempting to create a normalisation of BB sex and promiscuous sexuality, we are going to potentially destroy the mechanisms which have kept the majority in a relatively functional level of good mental Health. Young Gay men are already bombarded with expectations that they must be available sexually for any number of guys ready to take advantage of their lack of confidence in dealing with the hyper sexual environment they are exposes to when they start to engage themselves into the scene. This also goes for older gay men, even experienced gay men don't all want to be hyper sexual. Self esteem issues in the community are not just from internalised homophobic messages that your sexual choices are wrong, I don't deny that, however the feeling of being only a sexual being for other men to use and abuse destroys self esteem and perpetuates the views and behaviours which never allow many Gay men to develop healthy relationships or supportive community links. This leads to a maniacs station of jaded and cynical older gay men who progressively find it more difficult to engage in a community which only values sexually viral and 'desirable' gay men. No one is denying we need to be open and honest and to tackle HIV, homophobia ect.

    Why not start to address the key reasons for hyper sexualisation instead of entrenching it. Prep has its place but the implementation and strategies involved in its roll out have been extremely ill conceived and a missed opportunity.
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    Dec 14, 2015 7:21 PM GMT
    "Whether you are open about your PrEP usage or out about your HIV positive status, you can use these steps as well in your own life any time you encounter stigma. None of us ever have to live in agreement with cruelty, or give power to ignorance."
  • metta

    Posts: 39112

    Dec 15, 2015 12:40 AM GMT
    ^
    Thanks for the correction.