This piece came to my attention about how Gay Men are using Prep in the community

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    Dec 09, 2015 11:51 AM GMT
    http://m.huffpost.com/us/entry/8715938

    While this is an opinion piece and commentary, several important factual points are made which question assumption made on how Prep would effect the general community behaviour
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    Dec 09, 2015 1:32 PM GMT
    There's an emerging plurality of opinion in the gay community that if you're not on PrEP/Truvada, then you're being stupid. I personally do not subscribe to that statement, but I can understand the logic. I suppose for some people who are not always thinking about "wrapped" sex, they'd rather have Herpes and/or other STI than HIV. In a way that makes sense, but I hope that gay men on PrEP don't take it as a license to engage in unprotected sex as a matter of course.
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    Dec 09, 2015 1:42 PM GMT
    If a guy is concerned enough for his health that he has gone through the trouble to follow the daily regimen of PrEP, my bet is that he is actually more careful than the average guy to avoid Herpes and other STIs.
  • Oceans_of_Flo...

    Posts: 393

    Dec 09, 2015 1:53 PM GMT

    I love how shaming and condescending the article is. I'm not being snarky. I really do; I want more articles to call us out on our shit. I shouldn't say us, I'm the World's biggest scaredy cat. I still get nervous cause I swallow sometimes. However, everyone engaged in bareback sex before AIDS/HIV and they'll do it after until another comes along, which won't be likely with Trump closing the borders (laugh). The article says people would be ashamed to write anonymous emails to partners warning of STI infection and reluctantly razor warts off their balls. I think the article underestimates people.
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    Dec 09, 2015 2:45 PM GMT
    IMPORTANT DRUG WARNING

    Subject: FDA-Required Risk Evaluation Mitigation Strategy (REMS) for TRUVADA® [TRUVADA for a pre-exposure prophylaxis (PrEP) indication]

    A negative HIV-1 test must be confirmed immediately before starting TRUVADA for a PrEP indication and reconfirmed during treatment. Drug-resistant HIV-1 variants have been identified with the use of TRUVADA for a PrEP indication following undetected HIV-1 infection.
    Dear Healthcare Provider:

    Gilead Sciences, Inc., would like to inform you of the FDA-approved REMS for TRUVADA (a fixed-dose combination of emtricitabine 200 mg and tenofovir disoproxil fumarate 300 mg) for a PrEP indication in combination with safer sex practices to reduce the risk of sexually acquired HIV-1 infection in adults at high risk. TRUVADA for a PrEP indication is based on clinical trials in men who have sex with men (MSM) at high risk for HIV-1 infection and in heterosexual serodiscordant couples.
    The FDA has determined that a REMS is necessary to ensure that the benefits of TRUVADA for a PrEP indication outweigh its risks.

    The goals of the REMS for TRUVADAfor a PrEP indication are to inform and educate prescribers and uninfected individuals at high risk for acquiring HIV-1 infection about:

    • The importance of strict adherence to the recommended dosing regimen

    • The importance of regular monitoring of HIV-1 serostatus to avoid continuing to take TRUVADA for a PrEP indication, if seroconversion has occurred, to reduce the risk of development of resistant HIV-1 variants

    • The fact that TRUVADA for a PrEP indication must be considered as only a part of a comprehensive prevention strategy in order to reduce the risk of HIV-1 infection and that other preventive measures should also be used.
    Before initiating TRUVADA for a PrEP indication

    You MUST confirm a negative HIV-1 status immediately before prescribing TRUVADA for a PrEP indication in an uninfected individual. Drug-resistant HIV-1 variants have
    been identified with use of TRUVADA for a PrEP indication following undetected HIV-1
    infection.

    Do NOT prescribe TRUVADA for a PrEP indication to patients with HIV-1 infection or to individuals with signs or symptoms consistent with acute HIV-1 infection, such as fever, headache, fatigue, arthralgia, vomiting, myalgia, diarrhea, pharyngitis, rash, night sweats, and adenopathy (cervical and inguinal).

    Prescriber Action
    You should review and discuss the content of the Agreement Form for Initiating TRUVADA for Pre-exposure Prophylaxis with an HIV-negative person considering or
    taking TRUVADA for a PrEP indication and refer to the
    Checklist for Prescribers:Initiation of TRUVADA for Pre-exposure Prophylaxis (PrEP) regarding the
    management of an uninfected individual taking TRUVADA for a PrEP indication.

    (Access Agreement Form and Checklist via www.TRUVADApreprems.com)

    The most important information you should know about prescribing TRUVADA for a PrEP indication to reduce the risk of acquiring HIV-1 infection is:

    • TRUVADA for a PrEP indication should only be used as part of a comprehensive prevention strategy including consistent and correct use of condoms and risk
    reduction counseling

    • All uninfected individuals at high risk for acquiring HIV-1 infection should only take TRUVADA for a PrEP indication after HIV-1 negative status is confirmed, to reduce the risk of development of resistant HIV-1 variants

    • All uninfected individuals at high risk must strictly adhere to the recommended TRUVADA for a PrEP indication daily oral regimen Management of Uninfected Individuals
    Uninfected individuals at high risk should:

    • Be counseled about safer sex practices, including consistent and correct use of condoms, knowledge of their HIV-1 status and that of their partner(s), and regular
    testing for other sexually transmitted infections that can facilitate HIV-1 transmission

    • Be tested to confirm that they are HIV-1 negative immediately before starting TRUVADA for a PrEP indication

    • Be tested for acute HIV-1 infection and checked for any signs or symptoms consistent with acute HIV-1 infection, such as fever, headache, fatigue, arthralgia,
    vomiting, myalgia, diarrhea, pharyngitis, rash, night sweats, and adenopathy (cervical and inguinal)

    • Be screened at least every 3 months for HIV-1 status as determined by their prescriber to reconfirm that they are HIV-1-negative while taking TRUVADA for a PrEP indication to reduce the risk of acquiring HIV-1 infection

    • Have their creatinine clearance (CrCl) estimated prior to initiating and as clinically appropriate during therapy with TRUVADA. Do NOT use TRUVADA for a PrEP indication if the estimated CrCl is <60 mL/min. In patients at risk for renal dysfunction, assess estimated CrCl, serum phosphorus, urine glucose, and urine protein before initiation of TRUVADA, and periodically during TRUVADA therapy. If a decrease in estimated CrCl is observed in uninfected individuals while using TRUVADA for a PrEP indication, the prescriber should evaluate potential causes and reassess potential risks and benefits of continued use

    • Be tested for the presence of hepatitis B virus (HBV) before starting on TRUVADA for a PrEP indication. Severe acute exacerbations of hepatitis B have been reported in individuals who are co-infected with HBV and HIV-1 and have discontinued TRUVADA. Uninfected individuals taking TRUVADA for a PrEP indication who are infected with HBV need close medical follow-up for several months to monitor for exacerbations of hepatitis B in the event TRUVADA is discontinued. HBV-uninfected individuals should be offered vaccination as appropriate

    • Be informed about the risk of lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, which have been reported. TRUVADA should be suspended in any patient who develops clinical symptoms suggestive of lactic acidosis or pronounced hepatotoxicity (which may include hepatomegaly and steatosis even in the absence of marked transaminase elevations)

    • Be informed that TRUVADA has only been evaluated in a limited number of women during pregnancy and postpartum. Available human and animal data suggest that TRUVADA does not increase the risk of major birth defects overall compared to the background rate. There are, however, no adequate and well-controlled trials in pregnant women. Because the studies in humans cannot rule out the possibility of harm, TRUVADA should be used during pregnancy only if clearly needed. If an uninfected individual becomes pregnant while taking TRUVADA for a PrEP indication, careful consideration should be given to whether use of TRUVADA should be continued, taking into account the potential increased risk of HIV-1 infection during pregnancy.
  • Import

    Posts: 7193

    Dec 09, 2015 3:31 PM GMT
    I know Prep/Truvada helps prevent the transmission of HIV, but does it also help prevent other STIs as well? Or does it only impact the HIV virus?
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    Dec 09, 2015 9:03 PM GMT
    Import said I know Prep/Truvada helps prevent the transmission of HIV, but does it also help prevent other STIs as well? Or does it only impact the HIV virus?


    It is only effective against HIV.
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    Dec 09, 2015 10:03 PM GMT
    DOMINUS saidThere's an emerging plurality of opinion in the gay community that if you're not on PrEP/Truvada, then you're being stupid. I personally do not subscribe to that statement, but I can understand the logic. I suppose for some people who are not always thinking about "wrapped" sex, they'd rather have Herpes and/or other STI than HIV. In a way that makes sense, but I hope that gay men on PrEP don't take it as a license to engage in unprotected sex as a matter of course.



    Today the MAGNET testing center in SF had a line out the door and down the block . The guy there said it's the busiest he has ever seen it and they aren't meeting the demand. Appointments were 2 weeks out but now even the online Appointment app is down. BB with PrEP for young men is the new norm and I'm sure the STD numbers for 2015 will show it . Use of PrEP has sky rocketed according to the health department but so has STD's.
  • Sincityfan

    Posts: 409

    Dec 09, 2015 11:00 PM GMT
    Import said I know Prep/Truvada helps prevent the transmission of HIV, but does it also help prevent other STIs as well? Or does it only impact the HIV virus?


    r u serious?
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    Dec 09, 2015 11:04 PM GMT
    Quoting one of the comments:

    Jeton Ademaj · Stony Brook University
    if you want to improve rates of condom usage, there is no argument that will help you...except those which directly lead to the manufacture and distribution of far better ones that more people are able to use.

    oh, and if you're going to invoke the CDC, you'll have to accept that the CDC itself no longer equates "condomless sex" with "unprotected sex", because ......

    ***PrEP is by far the most powerful HIV-prevention tool available to HIV-negative people, and has multiple advantages in that regard compared to condoms***

    oh, and the most powerful HIV prevention tool period is getting all HIV-positive people on successful treatment and helping them stay there...do THAT, and you end the epidemic cold.

    http://rhrealitycheck.org/.../cdc-stopped-calling-sex.../
    -------------------------------------

    The CDC RECOMMENDS PrEP if you are at high risk.

    this is the same BS that Michael Weinstein of the AHF was promoting.

    http://www.pbs.org/newshour/bb/san-francisco-bolsters-anti-aids-campaign-with-new-funding/

    MICHAEL WEINSTEIN: The motivation that people have for taking Truvada is to be able to have sex without a condom.

    JOHN CARLOS FREY: Do you think that people don’t want to wear condoms either?

    MICHAEL WEINSTEIN: I think men in general don’t wanna wear condoms. That’s just an absolute truth. I mean, and it’s not surprising. But, you know, we don’t wear seatbelts either, you know, or helmets or a lot of other things. But they’re a necessity.

    JOHN CARLOS FREY: So wouldn’t it be better then to just take a pill every day instead of worrying about transmitting H.I.V.?

    MICHAEL WEINSTEIN: You know what? If it was guaranteed that everybody would take it every day as prescribed. Obviously our attitude about it would be completely different if we didn’t have to rely on the person to take that pill every single day.
  • David3K

    Posts: 231

    Dec 09, 2015 11:16 PM GMT
    Sincityfan said
    Import said I know Prep/Truvada helps prevent the transmission of HIV, but does it also help prevent other STIs as well? Or does it only impact the HIV virus?


    r u serious?


    "r u serious" what? Are YOU retarded? Making questions about HIV is completely legit, in fact if people showed more interested infections wouldn't be increasing the gay community as they do.
  • Antarktis

    Posts: 213

    Dec 10, 2015 12:39 AM GMT
    The obvious is that guys on Prep almost might as well be positive since they have the same expected life span as positive men now a days and are voluntarily putting themselves on an HIV regimen. Truvada isn't any better for their kidneys and liver than it is a poz guy, and they need to reconsider their drinking behaviours if they're going to start voluntarily taking AIDS drugs.
  • David3K

    Posts: 231

    Dec 10, 2015 12:57 AM GMT
    Antarktis saidThe obvious is that guys on Prep almost might as well be positive since they have the same expected life span as positive men now a days and are voluntarily putting themselves on an HIV regimen. Truvada isn't any better for their kidneys and liver than it is a poz guy, and they need to reconsider their drinking behaviours if they're going to start voluntarily taking AIDS drugs.


    +1

    Also the long term side effects on PrEP for logical reasons are not known yet.

    I would advice to take PrEP only for people who are in the hook up world or those who have a poz partner. Otherwise I would stick to condoms, if you know how to wear them and keep them fresh they dont break and protects you from all STDs not only HIV.
  • Sincityfan

    Posts: 409

    Dec 10, 2015 6:57 PM GMT
    David666K said
    Sincityfan said
    Import said I know Prep/Truvada helps prevent the transmission of HIV, but does it also help prevent other STIs as well? Or does it only impact the HIV virus?


    r u serious?


    "r u serious" what? Are YOU retarded? Making questions about HIV is completely legit, in fact if people showed more interested infections wouldn't be increasing the gay community as they do.


    R u serious?

    he has 6895 posts; meaning that he's been here for a while- a good while. I've been active for a few months and have seen threads of this sort pop up every week.
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    Dec 10, 2015 7:22 PM GMT
    Antarktis saidThe obvious is that guys on Prep almost might as well be positive since they have the same expected life span as positive men now a days and are voluntarily putting themselves on an HIV regimen. Truvada isn't any better for their kidneys and liver than it is a poz guy, and they need to reconsider their drinking behaviours if they're going to start voluntarily taking AIDS drugs.


    LOL, you took a statistic and turned it on it's head! An HIV POZ Undetectable person can live as long as a Negative person. Possibly LONGER.

    Life expectancy now considerably exceeds the average in some people with HIV in the US
    http://www.aidsmap.com/Life-expectancy-now-considerably-exceeds-the-average-in-some-people-with-HIV-in-the-US/page/2816267/

    How convoluted! "putting themselves on an HIV regimen"? First of all it's anti-HIV drug regimen. 2ndly it doesn't have to be forever, as it is with a POZ person. Let's say you fall in love next year with a Negative or an Undetectable man, if truly monogamous you can always stop PrEP.


    Social drinking is not a problem with modern HIV drugs. Certainly alcoholism is a problem for anybody.
    Everyone, including the CDC says it's well tolerated. They are not being guinea pigs, that was done years ago, by people like me who did the early drugs like AZT and Crixivan. But like any drug (like aspirin) there are risks. All drugs have side effects. The "side effect" of PrEP is it prevents HIV.

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    Dec 10, 2015 7:37 PM GMT
    David666K said
    Antarktis saidThe obvious is that guys on Prep almost might as well be positive since they have the same expected life span as positive men now a days and are voluntarily putting themselves on an HIV regimen. Truvada isn't any better for their kidneys and liver than it is a poz guy, and they need to reconsider their drinking behaviours if they're going to start voluntarily taking AIDS drugs.


    +1

    Also the long term side effects on PrEP for logical reasons are not known yet.

    I would advice to take PrEP only for people who are in the hook up world or those who have a poz partner. Otherwise I would stick to condoms, if you know how to wear them and keep them fresh they dont break and protects you from all STDs not only HIV.


    ALL STDs? You need to know the limitations. Even condoms don't prevent everything. And they aren't as effective as PrEP if you want to compare 70-80% vs 90-100%.

    The ingredients in PrEP are very well known. While there are only 2 ingredients in PrEP, where in ART there are 3. They are the same in both. In the last 17 years the more toxic drugs have been replaced by newer meds that are very well tolerated. Again, like aspirin, it's not for everybody.
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    Dec 10, 2015 10:08 PM GMT
    Tim55, to improve rates of condom use, the following needs to happen

    1. Stop spreading misleading and manipulating information about condoms. I know you are aware that it's much more difficult to verify proper condom use where as Prep can be tested for levels in the blood stream.

    The so called 'condom failure' statistics are from self reporting as is any incidences of alleged non-insertive HIV transmission I therefore call on you and others like you to behave in a less reckless manor. You are advocating a potentially genicidal position on these issues.

    2. You need to acknowledge that while Undetectably for HIV POZ men is very desirable, that it is not safe to BB because blips occur rendering those same people actually detectable and capable of being detected. I also am very confident you know that STI's are one of the factors which cause spikes/blips in the levels of HIV in a persons bloodstream, so please answer why you advocate BB with HIV undetectable people. I am aware you have switched to advocacy by stealth because your history of a more direct drew a lot of criticism.
    3, mental health is not improved by creating a false confidence in a drug that is in truth only 92% effective and there have been infections
    4. This article was not sourced by trawling the net for something that suits my point of view like u do, it was a Facebook post from a friend who is on Prep and has been with a POZ undetectable partner for 2 yrs. He is young only 23 yrs old and takes his medication properly: His partner who is POZ was with me Briefly (2 months) and I found out about the so called infallibility of being I un-detectable when that person had to be taken to hospital for a testicle infection Which blew up like a golf ball and during discussions with his treating doctors and nurses I was informed that his HIV status as undetectable had to be reviewed due to, gentian based infections and in the anus, cause spikes as do the presence of other STIs. So in effect,HIV negative men on Prep if BB with otherMen can then potentially place both at partners at risk
    4. Stop talking up the myth that BB sex is better. Some people may actually
    Find that for them but not everyone:
    5. Having sex without a Condom does not equate to intimacy. That may be so for some as part of a range of real intimacy building activities, however your assertion makes condoms use will not be able to be increased again is wrong

    timmm55 saidQuoting one of the comments:

    Jeton Ademaj · Stony Brook University
    if you want to improve rates of condom usage, there is no argument that will help you...except those which directly lead to the manufacture and distribution of far better ones that more people are able to use.

    oh, and if you're going to invoke the CDC, you'll have to accept that the CDC itself no longer equates "condomless sex" with "unprotected sex", because ......

    ***PrEP is by far the most powerful HIV-prevention tool available to HIV-negative people, and has multiple advantages in that regard compared to condoms***

    oh, and the most powerful HIV prevention tool period is getting all HIV-positive people on successful treatment and helping them stay there...do THAT, and you end the epidemic cold.

    http://rhrealitycheck.org/.../cdc-stopped-calling-sex.../
    -------------------------------------

    The CDC RECOMMENDS PrEP if you are at high risk.

    this is the same BS that Michael Weinstein of the AHF was promoting.

    http://www.pbs.org/newshour/bb/san-francisco-bolsters-anti-aids-campaign-with-new-funding/

    MICHAEL WEINSTEIN: The motivation that people have for taking Truvada is to be able to have sex without a condom.

    JOHN CARLOS FREY: Do you think that people don’t want to wear condoms either?

    MICHAEL WEINSTEIN: I think men in general don’t wanna wear condoms. That’s just an absolute truth. I mean, and it’s not surprising. But, you know, we don’t wear seatbelts either, you know, or helmets or a lot of other things. But they’re a necessity.

    JOHN CARLOS FREY: So wouldn’t it be better then to just take a pill every day instead of worrying about transmitting H.I.V.?

    MICHAEL WEINSTEIN: You know what? If it was guaranteed that everybody would take it every day as prescribed. Obviously our attitude about it would be completely different if we didn’t have to rely on the person to take that pill every single day.
  • Posted by a hidden member.
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    Dec 10, 2015 11:00 PM GMT
    Sydneyrugbyjock73 saidTim55, to improve rates of condom use, the following needs to happen

    1. Stop spreading misleading and manipulating information about condoms. I know you are aware that it's much more difficult to verify proper condom use where as Prep can be tested for levels in the blood stream.

    The so called 'condom failure' statistics are from self reporting as is any incidences of alleged non-insertive HIV transmission I therefore call on you and others like you to behave in a less reckless manor. You are advocating a potentially genicidal position on these issues.

    2. You need to acknowledge that while Undetectably for HIV POZ men is very desirable, that it is not safe to BB because blips occur rendering those same people actually detectable and capable of being detected. I also am very confident you know that STI's are one of the factors which cause spikes/blips in the levels of HIV in a persons bloodstream, so please answer why you advocate BB with HIV undetectable people. I am aware you have switched to advocacy by stealth because your history of a more direct drew a lot of criticism.
    3, mental health is not improved by creating a false confidence in a drug that is in truth only 92% effective and there have been infections
    4. This article was not sourced by trawling the net for something that suits my point of view like u do, it was a Facebook post from a friend who is on Prep and has been with a POZ undetectable partner for 2 yrs. He is young only 23 yrs old and takes his medication properly: His partner who is POZ was with me Briefly (2 months) and I found out about the so called infallibility of being I un-detectable when that person had to be taken to hospital for a testicle infection Which blew up like a golf ball and during discussions with his treating doctors and nurses I was informed that his HIV status as undetectable had to be reviewed due to, gentian based infections and in the anus, cause spikes as do the presence of other STIs. So in effect,HIV negative men on Prep if BB with otherMen can then potentially place both at partners at risk
    4. Stop talking up the myth that BB sex is better. Some people may actually
    Find that for them but not everyone:
    5. Having sex without a Condom does not equate to intimacy. That may be so for some as part of a range of real intimacy building activities, however your assertion makes condoms use will not be able to be increased again is wrong

    timmm55 saidQuoting one of the comments:

    Jeton Ademaj · Stony Brook University
    if you want to improve rates of condom usage, there is no argument that will help you...except those which directly lead to the manufacture and distribution of far better ones that more people are able to use.

    oh, and if you're going to invoke the CDC, you'll have to accept that the CDC itself no longer equates "condomless sex" with "unprotected sex", because ......

    ***PrEP is by far the most powerful HIV-prevention tool available to HIV-negative people, and has multiple advantages in that regard compared to condoms***

    oh, and the most powerful HIV prevention tool period is getting all HIV-positive people on successful treatment and helping them stay there...do THAT, and you end the epidemic cold.

    http://rhrealitycheck.org/.../cdc-stopped-calling-sex.../
    -------------------------------------

    The CDC RECOMMENDS PrEP if you are at high risk.

    this is the same BS that Michael Weinstein of the AHF was promoting.

    http://www.pbs.org/newshour/bb/san-francisco-bolsters-anti-aids-campaign-with-new-funding/

    MICHAEL WEINSTEIN: The motivation that people have for taking Truvada is to be able to have sex without a condom.

    JOHN CARLOS FREY: Do you think that people don’t want to wear condoms either?

    MICHAEL WEINSTEIN: I think men in general don’t wanna wear condoms. That’s just an absolute truth. I mean, and it’s not surprising. But, you know, we don’t wear seatbelts either, you know, or helmets or a lot of other things. But they’re a necessity.

    JOHN CARLOS FREY: So wouldn’t it be better then to just take a pill every day instead of worrying about transmitting H.I.V.?

    MICHAEL WEINSTEIN: You know what? If it was guaranteed that everybody would take it every day as prescribed. Obviously our attitude about it would be completely different if we didn’t have to rely on the person to take that pill every single day.


    I'm no longer responding to you.
  • David3K

    Posts: 231

    Dec 10, 2015 11:08 PM GMT
    timmm55 said
    David666K said
    Antarktis saidThe obvious is that guys on Prep almost might as well be positive since they have the same expected life span as positive men now a days and are voluntarily putting themselves on an HIV regimen. Truvada isn't any better for their kidneys and liver than it is a poz guy, and they need to reconsider their drinking behaviours if they're going to start voluntarily taking AIDS drugs.


    +1

    Also the long term side effects on PrEP for logical reasons are not known yet.

    I would advice to take PrEP only for people who are in the hook up world or those who have a poz partner. Otherwise I would stick to condoms, if you know how to wear them and keep them fresh they dont break and protects you from all STDs not only HIV.


    ALL STDs? You need to know the limitations. Even condoms don't prevent everything. And they aren't as effective as PrEP if you want to compare 70-80% vs 90-100%.

    The ingredients in PrEP are very well known. While there are only 2 ingredients in PrEP, where in ART there are 3. They are the same in both. In the last 17 years the more toxic drugs have been replaced by newer meds that are very well tolerated. Again, like aspirin, it's not for everybody.

    And there you go again speaking against condoms icon_lol.gif
    Youre so obvious..
    And yes, preventing most STDs is better than to prevent only 1. Condoms are necesary for that.
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    Dec 10, 2015 11:53 PM GMT
    We can't blame PrEP for increased STDs. Condomless sex has increased with people not on PrEP, with an apparent increase in STDs there also.

    PrEP is no more effective against STDs than birth control pills, or Viagra or a myriad of other medications.

    Removing PrEP as a risk reduction to HIV is ridiculous. STDs are another matter. It isn't PrEP vs condoms vs penicillin.

    We can get a virtually instant, rapid result and anonymous FREE HIV test in mobile vans, at clinics, in home kits. There need to be the same for STDs. This needs to be taken seriously. And treated quickly. We are making more progress on HIV than we are on STDs. But there is a cure for STDs. And for that reason it seems there isn't a more forceful response.

    A couple of years ago a friend told me he was exposed to syphilis (later while in Ft Lauderdale as it turned out). There is no quick anonymous test. I had to go through conventional appointments. I took an unnecessary penicillin shot, rather than wait. There doesn't seem to be an urgency in the medical community for quick, free, anonymous response because STDs are curable. We can and we should adapt the HIV model to STDs.

    And condoms are the best and simplest way to prevent STDs. No question. With falling condom use (with or without PrEP) a better education and strategy network is needed. If STD testing was easy, cheap and available we could get to the people faster and prevent further infections.

    I've seen HIV testing at grocery store parking lots, why not STDs?
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    Dec 11, 2015 12:07 AM GMT
    David666K said
    timmm55 said
    David666K said
    Antarktis saidThe obvious is that guys on Prep almost might as well be positive since they have the same expected life span as positive men now a days and are voluntarily putting themselves on an HIV regimen. Truvada isn't any better for their kidneys and liver than it is a poz guy, and they need to reconsider their drinking behaviours if they're going to start voluntarily taking AIDS drugs.


    +1

    Also the long term side effects on PrEP for logical reasons are not known yet.

    I would advice to take PrEP only for people who are in the hook up world or those who have a poz partner. Otherwise I would stick to condoms, if you know how to wear them and keep them fresh they dont break and protects you from all STDs not only HIV.


    ALL STDs? You need to know the limitations. Even condoms don't prevent everything. And they aren't as effective as PrEP if you want to compare 70-80% vs 90-100%.

    The ingredients in PrEP are very well known. While there are only 2 ingredients in PrEP, where in ART there are 3. They are the same in both. In the last 17 years the more toxic drugs have been replaced by newer meds that are very well tolerated. Again, like aspirin, it's not for everybody.

    And there youre again speaking against condoms icon_lol.gif
    Youre so obvious..
    And yes, preventing most STDs is better than to prevent only 1. Condoms are necesary for that.


    I'll answer you for the last time (soon to be ignored, finally!)

    I'm not speaking against condoms. But if you insist they are 100% effective against everything you are horribly mistaken. Know it's limitations.

    Every day women become pregnant, MSM become positive, and STDs are spread.... all while wearing condoms. You've elevated condoms to something more than it is.

    " Condoms cannot protect against diseases spread by skin-to-skin contact such as herpes and HPV. Even other diseases against which condoms are most effective still present significant risks. The infection rate of syphilis drops from 1.86% to 0.65% with condom use, and that of gonorrhea drops from 15% to 8%. Condoms are even less effective against most other STDs."

    http://www.hli.org/resources/condoms-little-known-scientific-facts/

    How many times have you heard "But I used a condom!"?

    While we certainly need to prevent STDs, they are curable after the fact. HIV isn't curable after the fact, PrEP prevents HIV and nothing can undo it.
    So your assertion that: "preventing most STDs is better than to prevent only 1." If you mean curable STDs vs incurable HIV, you are an absolute fool.
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    Dec 11, 2015 12:14 AM GMT
    MuchMoreThanMuscle said
    timmm55 saidWe can't blame PrEP for increased STDs. Condomless sex has increased with people not on PrEP, with an apparent increase in STDs there also.



    I've seen HIV testing at grocery store parking lots, why not STDs?



    ^ Two good points. Here in the Seattle area when you go to get STD testing you're actually given swabs and directed toward a restroom so that you can perform your own swab samples. Although I'm not sure if they allow this for swabbing the urethra because in many instances a urine sample will suffice.

    I imagine the lack of more accessible STD/STI testing has to do with a deficit of available funds to realize it all. But then again, people can be reluctant when it comes to diligent testing and treating symptoms in a timely manner.


    I have insurance, so I couldn't go to the clinic "DOCK" at DAP where it is free for the needy. But HIV testing is free.

    That's telling me the medical community isn't taking STDs as seriously as HIV. It should be, if not quite equally.

    It does add to reluctance. People won't get tested for STDs unless there is a notification or symptoms. my labs do automatically, but there is always a window.
  • Posted by a hidden member.
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    Dec 11, 2015 3:21 PM GMT
    These 2 paragraphs are better suited to describe how Prep was given such a high efficacy rate. I have never had the problem or the failure rate. Just like their are reputable sites which have Prep at maximum 90% efficacy, those who are BB advocates will always find someone to state something that backs their way of thinking. If people advocating Prep where serious then these kinds of studies wouldn't ever get much light of day but as the president of the everyone must BB lobby, of course you need to mention things which suit your own personal stance these matters, no matter how flawed the study is

    Read Below


    4. Condom promoters employ irrelevant evidence: The United Nations Population Fund (UNFPA) and other global condom promoters claim that condoms have a 98% success rate instead of the 85% success rate documented in real-world studies. The 98% success rate is based on the ideal use of condoms every time by well-trained and highly disciplined adults undermonitoring by scientists.

    What is relevant is the success rate of condoms by average people, who sometimes fail to put on condoms properly or replace them immediately when they break in the heat of the moment, in the real world over time. Even studies of trained, committed adult couples using new and properly-stored condoms find a real-world pregnancy prevention success rate of 85% over a 12-month period. Unmarried teenagers, often the targets of condom promoters, almost certainly have a far worse record.


    This is the sort of studies that lead to all the concern about trusting new medications and treatments. I have had many sexual encounters with known sero discordant partners using condoms, why is if I am not infected?? If condoms are so in-effective then I should already be POZ right?? What a load of lies and manipulation. Condom use cannot be verified without being extremely intrusive or by setting up studying a group and of course the chance of the study being contaminated by changing of behaviours to suit what the participants think they should be doing, which is Prep users would also do but unlike condoms, Prep can be test verified. That does not mean that condoms don't work only that by being unable to prove use, statistics based on condoms can be very unreliable and likely to contain stats from people who didn't use condoms properly or at all, but thought they should be so said they did
  • d_1M

    Posts: 598

    Dec 11, 2015 4:45 PM GMT
    DOMINUS saidThere's an emerging plurality of opinion in the gay community that if you're not on PrEP/Truvada, then you're being stupid. I personally do not subscribe to that statement, but I can understand the logic. I suppose for some people who are not always thinking about "wrapped" sex, they'd rather have Herpes and/or other STI than HIV. In a way that makes sense, but I hope that gay men on PrEP don't take it as a license to engage in unprotected sex as a matter of course.


    don't hope for lot
    i know for a fact man are taking prep to excuse themselves for the preference to do unprotected sex and if is not safe then have some to blame on may be that i don't know for sure icon_eek.gif
  • Posted by a hidden member.
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    Dec 12, 2015 10:23 PM GMT
    D_1M said
    DOMINUS saidThere's an emerging plurality of opinion in the gay community that if you're not on PrEP/Truvada, then you're being stupid. I personally do not subscribe to that statement, but I can understand the logic. I suppose for some people who are not always thinking about "wrapped" sex, they'd rather have Herpes and/or other STI than HIV. In a way that makes sense, but I hope that gay men on PrEP don't take it as a license to engage in unprotected sex as a matter of course.


    don't hope for lot
    i know for a fact man are taking prep to excuse themselves for the preference to do unprotected sex and if is not safe then have some to blame on may be that i don't know for sure icon_eek.gif


    here's what the CDC says:

    Many people at very high risk for HIV infection are not getting PrEP.

    PrEP is for some people at very high risk for getting HIV:


    1 in 4 sexually active gay and bisexual adult men without HIV who:
    A) Have an HIV-positive partner, or
    B) Have multiple partners, a partner with multiple partners, or a partner whose HIV status is unknown and
    C) Have anal sex without a condom, or
    D) Recently had a sexually transmitted infection (e.g. syphilis).


    The CDC recommends condoms of course (they are not effective for all herpes situations, as DOMINUS infers)

    http://consults.blogs.nytimes.com/2010/05/26/5-things-to-know-about-herpes/

    The only 'license' taken is the prevention of HIV. Condomless sex "as a matter of course" is exactly what the CDC recommends PrEP for. (See B) and C) above) God forbid they had D)!

    You may not like that. But what would you do, prevent sex workers and other people at risk from using PrEP? Only give to people you don't find morally objectionable?

    STDs may increase with this group. We will have to deal with that too. It will take another tactic like the fast response HIV testing and treatment already in place.