Prep or Truvada should be considered carefully before use

[Jabberwocky]

Everyone that is HIV NEGATIVE who is on Truvada is a guinea pig or lab rat, for a drug company, with side effects in otherwise healthy HIV- people.

A lot of the men on Truvada or prep are or were into having unsafe sex before Truvada was heavily marketed or available for bisexual and gay men.

A lot of gay men who are into unsafe sex have the mentality that HIV will not happen to them, or that becoming HIV+ or seroconverting is going to happen anyway. I wouldn't be surprised if the drug companies know this or figure they want HIV- men who have unsafe anal sex to be on HIV meds as they will eventually get pozzed.

I think we should make this the final conjectural post and start drawing on quality data to substantiate these kind of claims. As a harm reduction website, we have a responsibility not to tear down or dismiss generally accepted best practice medical treatments based purely on opinion or conjecture.

So the next thing this thread needs is some data on side effects from Truvada. Some data on risk taking sexual behaviour amongst young men who have sex with men would also be good.

 

[PriestTheyCalledHim]

Ok, could someone perhaps link to an example of such a promotion? I mean if there's so many of them...

Turn on the TV. In my country we have adverts for Truvada and HIV meds.

Or open up POZ magazine, or anything written by or for bisexual and gay men.

Sex without fear – my experiment with the HIV-prevention drug PrEP

PrEP is controversial even on the gay scene. Does the drug encourage dangerous ‘barebacking’ or could it be the game-changer that wipes out HIV for good? Matt Cain decided to take it for three months and find out

www.theguardian.com

 

[JessFR]

How is that article promoting unsafe sex on prep?

I dunno, that article seems pretty reasonable to me.

 

[PriestTheyCalledHim]

How is that article promoting unsafe sex on prep?

I dunno, that article seems pretty reasonable to me.

Did you even actually read the article? The author is promoting the falsity that Truvada or prep is a magic pill, and he believes it is fine to have unsafe anal sex.

 

[JessFR]

Here's an idea. How about instead of just expecting us to assume you're right and acting outraged that we don't immediately agree. How about you make a reasoned, evidenced back argument for why you might be right.

Here, I'll even explain how I'd do it in your place.

Ok I wanna find out if prep is a bad thing. First you go and find the data about the side effects whatever available.

Then find data about hiv rates and gay sexual behavior.

Then work out if the long term risks of death or severe harm to health are at a greater likelihood as a result of prep.

It won't be especially easy to do this, but it will be a lot more convincing and compelling if the evidence comes out in your favor than your endless parade of friends and anecdotes.

 

[JessFR]

Did you even actually read the article? The author is promoting the falsity that Truvada or prep is a magic pill, and he believes it is fine to have unsafe anal sex.

Rofl. Sooo, let me get this completely straight.

I asked for evidence of prep being promoted for use essentially as an alternative to condoms. You gave me an article that quite reasonably seems to go through the arguments and provides counter arguments.

Soo. If I understand you, basically if you are of the opinion that prep serves a greater good, that is in itself a promotion of unsafe sex?

I think I see now why you believe these promotions are everywhere.

See when you said "they're everywhere promoting using prep and having unsafe sex" I assumed you meant they were saying "take prep and you can have all the unsafe sex you want".

Not "unsafe sex is risky but if you're gonna do it, here's how to do it in the safest way within the way you're planning to have it". I assumed the latter wouldn't be a problem given that.. It's basically what we do, only with drugs.

 

[Jabberwocky]

@PriestTheyCalledHim I agree with @JessFR. If this thread continues with unsubstantiated anecdotes it may become a candidate for closure/retirement in the interests of our broader harm reduction responsibilities. Don’t get me wrong, we are totally prepared to let you argue your case but we have 4 pages of conjecture and really, scientifically speaking, not much more than a potentially dangerous hypothesis.

However, I do think your point about condoms has been well stated throughout the thread.

 

[JessFR]

Here's the problem as I see it. We are a harm reduction site for drugs. Our whole goal is to essentially say "people will do drugs, regardless of if they should, and they should be provided whatever knowledge and harm reduction materials that make those risks less likely to result in harm".

Your argument just reminds me so much of people saying we shouldn't hand out clean needles cause it promote shooting up drugs.

And well, bluelight nevertheless endorses a lot of free expression, but I think if you're gonna make an argument like the above, it should be based on more than "me friend said x and I believe it!".

 

[PriestTheyCalledHim]

Rofl. Sooo, let me get this completely straight.

I asked for evidence of prep being promoted for use essentially as an alternative to condoms. You gave me an article that quite reasonably seems to go through the arguments and provides counter arguments.

Soo. If I understand you, basically if you are of the opinion that prep serves a greater good, that is in itself a promotion of unsafe sex?

I think I see now why you believe these promotions are everywhere.

See when you said "they're everywhere promoting using prep and having unsafe sex" I assumed you meant they were saying "take prep and you can have all the unsafe sex you want".

Not "unsafe sex is risky but if you're gonna do it, here's how to do it in the safest way within the way you're planning to have it". I assumed the latter wouldn't be a problem given that.. It's basically what we do, only with drugs.

You obviously do not know any or many gay or bisexual men.

The general consensus of men on Truvada is that if you take it you can have all the unsafe sex you want, even though you are supposed to use condoms and have safer sex if you take it, but nobody actually does this.

This daily pill prevents HIV. It may also be discouraging condom use

As condom use falls, will other infections spread?

www.nbcnews.com

Pre-Exposure Prophylaxis (PrEP) Use and Condomless Anal Sex: Evidence of Risk Compensation in a Cohort of Young Men Who Have Sex with Men

Young men who have sex with men (YMSM) are disproportionately impacted by HIV. Pre-exposure prophylaxis (PrEP) is highly effective at preventing HIV acquisition. It remains unclear if PrEP use increases rates of condomless sex (i.e., risk compensation), ...

www.ncbi.nlm.nih.gov

Truvada and the truth: is HIV prevention propelling the STI epidemic?

Among men who have sex with men, ‘pre-exposure prophylaxis’, or PrEP, has apparently led to a fall in condom use

www.theguardian.com

 

[PriestTheyCalledHim]

Here's the problem as I see it. We are a harm reduction site for drugs. Our whole goal is to essentially say "people will do drugs, regardless of if they should, and they should be provided whatever knowledge and harm reduction materials that make those risks less likely to result in harm".

Your argument just reminds me so much of people saying we shouldn't hand out clean needles cause it promote shooting up drugs.

And well, bluelight nevertheless endorses a lot of free expression, but I think if you're gonna make an argument like the above, it should be based on more than "me friend said x and I believe it!".

Truvada is toxic. Did you read @SKL 's reply?

Lawsuit Claims Gilead Delayed the Release of a Less Toxic Version of Tenofovir

The pharma giant knew about the safer HIV med but allegedly stopped research in order to extend its patent profits.

www.poz.com

 

[PriestTheyCalledHim]

Here's the problem as I see it. We are a harm reduction site for drugs. Our whole goal is to essentially say "people will do drugs, regardless of if they should, and they should be provided whatever knowledge and harm reduction materials that make those risks less likely to result in harm".

Your argument just reminds me so much of people saying we shouldn't hand out clean needles cause it promote shooting up drugs.

And well, bluelight nevertheless endorses a lot of free expression, but I think if you're gonna make an argument like the above, it should be based on more than "me friend said x and I believe it!".

Handing out clean needles, needle exchanges, and safe injection sites are useless as most IV drug addicts do not use them, trade them for drugs or €£$, and when faced with either sharing a needle or using a used needle instead of going to a safe injection site or needle exchange 99% will choose to share the needle and get/stay high.

 

[JessFR]

Truvada is toxic. Did you read @SKL 's reply?

Lawsuit Claims Gilead Delayed the Release of a Less Toxic Version of Tenofovir

The pharma giant knew about the safer HIV med but allegedly stopped research in order to extend its patent profits.

www.poz.com

If you define toxic as "has side effects" sure. But looots of medications have side effects. What does that prove?

How many people end up with liver damage or damage from weakening bones? And how many people have been saved from aids because of the drug?

Without those answers simply saying "it's toxic" is meaningless.

We don't judge if drugs are worthwhile based on if they're safer than doing nothing in a perfectly health person. We judge them compared to the risks of what they treat.

And you've provided no evidence that people using prep harms more people than not having prep.

That's all that's being asked for.

 

[SKL]

Truvada is toxic. Did you read @SKL 's reply?

Lawsuit Claims Gilead Delayed the Release of a Less Toxic Version of Tenofovir

The pharma giant knew about the safer HIV med but allegedly stopped research in order to extend its patent profits.

www.poz.com

Well, it's like anything. A well known maximum is sola dosis facit venenum, only the dose makes it a poison, but here you might say sola causa facit venenum, which is to say, it depends on why you are giving the drug—is it responsible to give a med which potentially brings its own harms to healthy individuals? And what behaviors does this encourage or enable?

Harm reduction is of course about weighing costs and benefits. HIV meds make sense for HIV patients. As prophylaxis and effectively permission to sleep around like it's 1980 and AIDS isn't a thing, it's absolute madness to give out meds which have very real side effects, and it's not harm reduction at all to do something which in effect encourages people to drop other harm reduction measures. To run with the needle analogy it is as if we started giving out wheel filters and decided that clean needles weren't a priority anymore.

 

[JessFR]

Handing out clean needles, needle exchanges, and safe injection sites are useless as most IV drug addicts do not use them, trade them for drugs or €£$, and when faced with either sharing a needle or using a used needle instead of going to a safe injection site or needle exchange 99% will choose to share the needle and get/stay high.

Are you kidding me?

Providing clean needles saves lives. The data is very clear. Australia has one of the lowest hiv rates in the world in large part because of clean needles being available. You need only look at the data in places where clean needles are legal vs illegal. And the resulting harm done by hiv, hepc and the like.

I've been a heroin addict a looong time. I've known a LOT of heroin addicts. And we used needle exchanges and pharmacies providing clean needles alllllll the time.

In fact I don't think I've ever met a heroin addict here who doesn't regularly go and get syringes from exchanges or pharmacies or hospitals. I used to regularly stock up on dozens of needles for like 4 people.

So don't give me that crap. Honestly if you think clean needles are bad too, I think you've completely lost any credibility in being able to accurately judge risks.

I'm done. If you can't even accept the massive benefits of providing clean syringes, and still continue to provide no evidence other than friends anecdotes. I don't think you're worth discussing this stuff with.

 

[PriestTheyCalledHim]

Well, it's like anything. A well known maximum is sola dosis facet venenum, only the dose makes it a poison, but here you might say sola causae facet venenum—it depends on why you are giving the drug—is it responsible to give a med which potentially brings its own harmw to healthy individuals?

Harm reduction is of course about weighing costs and benefits. HIV meds make sense for HIV patients. As prophylaxis and effectively permission to sleep around like it's 1980 and AIDS isn't a thing, it's absolute madness to give out meds which have very real side effects, and it's not harm reduction at all to do something which in effect encourages people to drop other harm reduction measures. To run with the needle analogy it is as if we started giving out wheel filters and decided that clean needles weren't a priority anymore.

HIV/AIDS was around in the 1970s, but people did not know what it was and thought it was 'cancer' or a new lethal type of pneumonia, bacterial infection from IV drug use and sharing needles, etc.

But I agree that people on Truvada seem to think that taking it means they can have all the unsafe sex they want and not get pozzed or get anything else.

 

[JessFR]

Access to clean syringes | Health Impact in 5 Years | Health System Transformation | AD for Policy | CDC

Regulatory, legislative, and other policies that support access to clean needles and syringes allow for the legal sale of needles without prescriptions, and include programs to distribute clean needles and safely dispose of used needles.

www.cdc.gov

A systematic review of 15 studies analyzing needle-syringe programs (NSP) found that NSP’s were associated with decreases in the prevalence of HIV and HCV and decreases in the incidence of HIV.[1] For example, a series of three-year longitudinal studies investigating the effect of New York’s legalization of syringe exchange programs between 1990 and 2002 found decreases in:

HIV prevalence from 50 percent to 17 percent (p<.001) [16]
Person-years at risk for HIV, from 3.55 to 0.77 per 100 person-years (p<.001)[16]

See this is the kind of data people have been asking you for all this thread.

@Atelier3 priest has had ample oppertunity to provide any scientific evidence. I don't think that's going to happen. I'm out

 

[PriestTheyCalledHim]

Access to clean syringes | Health Impact in 5 Years | Health System Transformation | AD for Policy | CDC

Regulatory, legislative, and other policies that support access to clean needles and syringes allow for the legal sale of needles without prescriptions, and include programs to distribute clean needles and safely dispose of used needles.

www.cdc.gov

See this is the kind of data people have been asking you for all this thread.

@Atelier3 priest has had ample oppertunity to provide any scientific evidence. I don't think that's going to happen. I'm out

Any study and data/statistics, or results of that study can be and are easily manipulated, falsified, or made to claim any agenda the author or drug company, or organisation funding the study wants.

The actual reality that does not consist of soulless made up figures, probabilities, and statistics, is completely different.

Men who have unsafe anal sex are like IV drug users as they both have a death wish.

If people really knew just how in reality, how super high the number of gay men and IV drug users that are HIV+ or have Hepatitis C and know it but lie, or claim not to know their poz status for one or both diseases, they would be shocked.

 

[JessFR]

Any study and data/statistics, or results of that study can be and are easily manipulated.

The actual reality that does not consist of soulless made up figures, probabilities, and statistics, is completely different.

Men who have unsafe anal sex are like IV drug users as they both have a death wish.

If people really knew just how in reality, how super high the number of gay men and IV drug users that are HIV+ or have Hepatitis C and know it but lie, or claim not to know their poz status for one or both diseases, they would be shocked.

So basically you're saying we can't trust any data. But we can trust your "friends" opinions. Right.

I'm not gay or a man, so I can accept there's probably a lot I don't know about the community. But I DO know the heroin user community. And seeing that you don't believe in the harm reduction benefit of clean syringe access either. Something I know is good because of both data and experience.

Well it tells me I can't trust your judgement regarding prep and the gay community either.

Anyway I'm done. I won't be replying beyond this. I'd like to see this thread closed and I don't wish to contribute to keeping it open with my presence.

 

[PriestTheyCalledHim]

it is hardly surprising.
Truvada is owned by Gilead (those nice people who lobbied and paid of the medical community to bring the useless and harmful liver destroying Remdesevir for treating Covid who also paid academics money to attack alternative treatments)
The same Gilead who ruthlessly profiteered from the stolen technology anti Hep C drug Sovaldi (sofsubuvir), 100k a treatment course anyone? Still too expensive in the USA for people who need it to afford it, the drug is 10x more expensive in the USA than in other countries.
The same Gilead who paid Hepatitis charities money to lobby for wide distribution of sofosbuivir and to change the cost benefit analysis in favor of
The same Gilead who had that famous medical expert Donald Rumsfeld on the board, who sold the rights to tamiflu for swine flu, to Hoffman la Roche and then lobbbied the government to buy large stocks ofTamiflu which rotted in storage, yeah that Gilead. Scum. None of this is secret.

Economically there is a much bigger market for truvada if it is used prophylactically rather than if it is just used post exposure and Gilead are all about the benjamins.

Very true!

 

[PriestTheyCalledHim]

Gay guy here. I know LOTS of people taking prep because they want to bareback and I think it's a train wreck waiting to happen. I have so many thoughts on this, I will try to be concise.

First of all, the original NYC HIV epidemic didn't just come out of nowhere. If you talk to a lot of the men from the 70's and 80's, it was routine to run into friends at the clinic while being treated for any number of infections like chlamydia, gonorrhea, syphilis, etc. They just kept taking antibiotic after antibiotic after antibiotic, with no regard for how it was destroying their immune systems. Is it any wonder that when HIV came along, it preferentially targeted gay men, whose immune systems were already in the gutter, and spread like wildfire? I've communicated with health professionals who worked in NYC at that time, and they all said that they were super worried for years that the situation was going to brew some kind of super bug. And that's exactly what happened, albeit from a foreign source.

Now we have the same situation happening again with PREP. Men are having rampant bareback sex with strangers, contracting all of the non-lethal STIs, and being treated over and over with antibiotics, while they are secure in the knowledge that, "I'm safe from HIV and everything else is fixable." Meanwhile, prep is super toxic itself and compromising their long-term health. There's also other kinds of viruses transmitted through semen, like cytomegalovirus, EBV, and maybe even unknown viruses that we can't test for.

Also? In the province I live in, in order to get on the free prep program, you have to fill out incredibly invasive questionnaires on a regular basis. They ask you all about your sexual lifestyle, in great detail. Who databases this information? Why are so many gay men self-reporting themselves AS GAY as well as listing in detail all their sexual habits? Do we really want the government databasing all the gay men?

I am extremely worried about this situation. Modern medicine's hubris about prep being invulnerable combined with the laissez-faire attitude around barebacking is making my head spin. And not just me, but also the survivors of the HIV epidemic. It's like everyone has just forgotten the plague years and are happy to go on barebacking like it's the 1970's again.

I think prep and the culture around it is a major disaster waiting to happen and I am so incredibly tired of the positive spin being put on it by the community health professionals, especially the gay ones. They say things like... people on prep know their status, which is much safer than people who don't know their status and aren't taking prep. Or... it's incredibly safe to have sex with an HIV+ person who is on meds, they are practically seronegative. Okay, that's true, but it's also putting A LOT of faith in the pharmaceuticals to always work. According to the science I've read, it shouldn't be possible for HIV to adapt -- but what if it somehow does? Nature is often smarter than us.

Anyway... I could go on and on. I don't like this Truvada thing. It's enables the most toxic part of gay culture to continue doing what it does and I'm not at all convinced we are invulnerable yet.

True, people seem to think the 1970s and very early 1980s were one huge orgy with no diseases or risks but this is not true at all.

There were all of the sexual/general diseases around now-not including coronavirus 19 and mutations-including HIV that was thought to be a rare 'cancer', pneumonia, or rare bacterial infection.

Hepatitis A, B, C, etc. were around and like amoebas and intestinal parasites were spread via rimming and anal sex without condoms.

There was a major increase/outbreak in various STIs/STDs including herpes and others before GRIDS/AIDS/HIV was known about.

I read an article that claimed HIV was in NYC in the late 1960s and northern CA in SF, and southern CA in L.A. in the mid and late 1970s and this is true and not surprising at all.