Prep or Truvada should be considered carefully before use

[Foreigner]

There are lots of 'raw tops' who see the statistics of HIV risk and figure that it is completely 1,000% safe or that HIV infection this way is rare so there is no need for them to use condoms.

This is not true. I know people who became infected from unsafe anal sex as top/giver and it was from a single sexual encounter.

There are lots of heterosexual people worldwide who became infected by unsafe insertive anal or vaginal sex.

Is,it as risky as unsafe receptive anal or vaginal sex? No but this does not make it completely safe.

The stats on tops mostly relate to "undetectable" status. An unprotected top topping an undetectable bottom has virtually no risk of getting HIV. It doesn't mean tops should totally ignore protection.

I personally find the whole thing screwed up. I don't like medical statistics because often when you scratch the surface and look at their methods, their data gathering method has some kind of questionable approach in it. I don't fully trust the CDC for this reason. During the AIDS epidemic in the 80's and 90's, they lowballed a lot of data which slowed the introduction of life saving meds like AZT. On the ground level, people were dying in droves, but the official statements were all "it's not as bad as it may seem".

My worry is that prep is going to follow a similar path. They're going to lowball all the risks, lull gay men into a sense of safety, and then we are going to have some kind of unfortunate outbreak down the road. Don't ask me how, because the current science seems so solid re: how the virus could never evade this drug... I just know that viruses are smart and unpredictable, especially retroviruses.

The authorities really don't really care about gay men. The systemic prejudices are still rampant. Finding a doctor who won't exhibit homophobia is still hard for many. I can't even have male doctors, they have all been horrible to me.

So why would I trust the medical establishment when they tell me it's okay to go bareback to my heart's content as long as I take their miracle pill.

 

[PriestTheyCalledHim]

The stats on tops mostly relate to "undetectable" status. An unprotected top topping an undetectable bottom has virtually no risk of getting HIV. It doesn't mean tops should totally ignore protection.

I personally find the whole thing screwed up. I don't like medical statistics because often when you scratch the surface and look at their methods, their data gathering method has some kind of questionable approach in it. I don't fully trust the CDC for this reason. During the AIDS epidemic in the 80's and 90's, they lowballed a lot of data which slowed the introduction of life saving meds like AZT. On the ground level, people were dying in droves, but the official statements were all "it's not as bad as it may seem".

My worry is that prep is going to follow a similar path. They're going to lowball all the risks, lull gay men into a sense of safety, and then we are going to have some kind of unfortunate outbreak down the road. Don't ask me how, because the current science seems so solid re: how the virus could never evade this drug... I just know that viruses are smart and unpredictable, especially retroviruses.

The authorities really don't really care about gay men. The systemic prejudices are still rampant. Finding a doctor who won't exhibit homophobia is still hard for many. I can't even have male doctors, they have all been horrible to me.

So why would I trust the medical establishment when they tell me it's okay to go bareback to my heart's content as long as I take their miracle pill.

Aren't there already drug or Truvada resistant strains of HIV?

Case Study Outlines Evidence Indicating Man Acquired PrEP-Resistant HIV

A handful of such cases have been reported since Truvada was approved as pre-exposure prophylaxis in 2012.

www.poz.com

HIV Strains: Types, Subtypes, Strains, and More

You may not know that there are different types, subtypes, and strains of HIV. We’ll break it down.

www.healthline.com

 

[Foreigner]

Aren't there already drug or Truvada resistant strains of HIV?

Case Study Outlines Evidence Indicating Man Acquired PrEP-Resistant HIV

A handful of such cases have been reported since Truvada was approved as pre-exposure prophylaxis in 2012.

www.poz.com

HIV Strains: Types, Subtypes, Strains, and More

You may not know that there are different types, subtypes, and strains of HIV. We’ll break it down.

www.healthline.com

I had no idea, haven't been following it. I don't date guys who are on prep so my world is pretty naive to it.

 

[PriestTheyCalledHim]

I had no idea, haven't been following it. I don't date guys who are on prep so my world is pretty naive to it.

Ok I read LGB/LGBT news, and I have friends who are HIV+, as well as friends who are HIV- who are active on apps/websites, or were before covid.

Personally, I do not date or get involved with people on the Truvada, who are into unsafe sex, or who are HIV+ and it does not matter if they are undetectable or not.

My friend that is poz only gets involved with other men who are HIV+, condoms are used as unsafe sex messes up both people's medications from working and reinfection or infection with other strains is possible, and he does not like how 99% of people on Truvada/prep use it to just avoid having safer sex.

 

[JessFR]

So why would I trust the medical establishment when they tell me it's okay to go bareback to my heart's content as long as I take their miracle pill.

I would be shocked if you could find a practicing doctor who says that.

 

[PriestTheyCalledHim]

I would be shocked if you could find a practicing doctor who says that.

Even the adverts on TV for Truvada and other toxic HIV meds say to use condoms with them.

But in reality, most people who are on Truvada and not already poz do not use condoms at all.

 

[JessFR]

Calling them toxic seems really disingenuous. It sounds like these side effects are pretty uncommon to start with. And all drugs have side effects.

There's piles of life saving medicines that also carry risk. Just calling them toxic sounds very misleading to me.

 

[Jabberwocky]

I would be shocked if you could find a practicing doctor who says that.

To a point made earlier in the thread, it seems you can find a lot of (often government funded) gay organisations that seem to promote the idea that PrEP leads to a fairly normal sex life in which particulur measures like condoms are not discussed. They seem to imply (which is hard to prove) that men who have sex with men need not be seen as a higher risk group for HIV transmission than any other group thanks to these medications. I understand the desire to de-stigmatise men who have sex with men but not at the expense of obfuscating important health data,

 

[JessFR]

To a point made earlier in the thread, it seems you can find a lot of (often government funded) gay organisations that seem to promote the idea that PrEP leads to a fairly normal sex life in which particulur measures like condoms are not discussed. They seem to imply (which is hard to prove) that men who have sex with men need not be seen as a higher risk group for HIV transmission than any other group thanks to these medications. I understand the desire to de-stigmatise men who have sex with men but not at the expense of obfuscating important health data,

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

 

[Jabberwocky]

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

‘Advance’ or ‘allow’ or ‘infer’ might be more appropriate words than promote. But here’s a typic site of the type I found while looking into this question from reading @PriestTheyCalledHim’s original arguments: https://endinghiv.org.au/stay-safe/prep/. There is no real traditional safe sex message coming through as far as I can see and the very name of the organisation infers it is about the literal end of HIV as a risk.

 

[JessFR]

Sorry I'm not seeing it from that particular link.

It is a drug for preventing getting hiv, and it lists a bunch of the type of people who might be at higher risk, one of which is gay men who have sex without a condom.

What exactly should it be saying different?

Gay men not using a condom is not the only demographic at higher risk as that link correctly states.

Why would it go off on a tangent about not having unprotected gay sex? When it's about a pill that helps prevent getting hiv, which is useful for more than just gay people having unprotected sex.

I dunno, it kinda feels like this has gone from saying "they're telling people to have unprotected sex" to now "they're not loudly saying NOT to have unprotected gay sex".

 

[Jabberwocky]

I dunno, it kinda feels like this has gone from saying "they're telling people to have unprotected sex" to now "they're not loudly saying NOT to have unprotected gay sex".

I guess I’m giving some credence to Priest’s claim that there is a movement (or perhaps tendency is a better word?) amongst gay activists or organisations to omit or downplay the risks of male to male sexual activity vis a vis HIV transmission. I think he makes an important point that you simply cannot trust people to report their status correctly (either through ignorance or malice aforethought doesn’t really matter) so PrEP should perhaps be marketed as a backup insurance policy and barrier protection (i.e. condoms) should be the first line defence against HIV as he argues. Even if the drugs are 100 % effective in doing what they are claimed to do and even if they have no side effects whatsoever.

 

[JessFR]

Thing is I haven't seen this tendency. Which does NOT mean it doesn't exist of course. I'm not a gay man so it's hardly surprising that I might not notice this stuff.

But cause it's all so politically charged, I don't wanna take it at face value.

And well, given hiv has no cure, and research seems to suggest preps more serious side effects are rare. It seems hard to believe that it's not ultimately a good thing.

 

[PriestTheyCalledHim]

Calling them toxic seems really disingenuous. It sounds like these side effects are pretty uncommon to start with. And all drugs have side effects.

There's piles of life saving medicines that also carry risk. Just calling them toxic sounds very misleading to me.

Do you know anyone who has AIDS, or who is HIV+ and on medications? I am not sure of your age but a lot of people who are now in their 20s or teens or even very early 30s at the most do not remember or were not around when lots of people were getting infected with HIV/AIDS and dying. These same people assume that the meds are fine to take, that they can fuck/get fucked RAW or swallow cum and lick ass and stay completely HIV- and STD/STI- as long as they take the Truvada. Many of these people think the Truvada/descovy, etc. are harmless or I have heard them claim it is like taking a daily vitamin or aspirin.

The protease inhibitors like Truvada are TOXIC, and super strong. It is sort of like chemotherapy in that they are good at preventing the person from getting AIDS, but as multiple HIV+ friends have said they are very bad for your vital organs. The people I know who are poz have said this both about the more recent meds like Truvada/descovy and the older meds like AZT, and they ALL have told me how if they could change anything they would make their HIV/AIDS and the horrible medications go away, and change their body back to what it was like before seroconverting and taking medications.

 

[Jabberwocky]

Do you know anyone who has AIDS, or who is HIV+ and on medications? I am not sure of your age but a lot of people who are now in their 20s or teens or even very early 30s at the most do not remember or were not around when lots of people were getting infected with HIV/AIDS and dying. These same people assume that the meds are fine to take, that they can fuck/get fucked RAW or swallow cum and lick ass and stay completely HIV- and STD/STI- as long as they take the Truvada. Many of these people think the Truvada/descovy, etc. are harmless or I have heard them claim it is like taking a daily vitamin or aspirin.

The protease inhibitors like Truvada are TOXIC, and super strong. It is sort of like chemotherapy in that they are good at preventing the person from getting AIDS, but as multiple HIV+ friends have said they are very bad for your vital organs. The people I know who are poz have said this both about the more recent meds like Truvada/descovy and the older meds like AZT, and they ALL have told me how if they could change anything they would make their HIV/AIDS and the horrible medications go away, and change their body back to what it was like before seroconverting and taking medications.

I think a claim like this. That a well established and approved drug is ‘TOXIC’ - especially ALL CAPS. Needs more than anecdotal evidence on a harm reduction website. Some citations to scientific papers (not gay organisations) would be ideal in this situation. Not saying you are wrong, just establishing what our standard of proof is around here.

 

[JessFR]

Also worth keeping in mind, as so many people forget. We aren't comparing taking a drug with side effects against nothing. People aren't taking it just cause they wanna see which side effects they get.

They're taking it to treat an illness or prevent a disease. And the dangers of that illness or disease is what the comparison needs to be against.

Not that a drug or treatment is more dangerous than doing absolutely nothing in an otherwise healthy person.

 

[JessFR]

I also find it disingenuous to compare this to chemotherapy. Because quite frankly. I do not believe people would take a drug with chemotherapy like side effects just to be able to have unprotected sex vs protected sex. I don't believe that's a thing that happens.

People wouldn't do it unless they at least perceived any side effects as well worth it.

Now that doesn't rule out long term risks like you've said. But it does make the chemo comparison seem excessive.

 

[PriestTheyCalledHim]

Also worth keeping in mind, as so many people forget. We aren't comparing taking a drug with side effects against nothing. People aren't taking it just cause they wanna see which side effects they get.

They're taking it to treat an illness or prevent a disease. And the dangers of that illness or disease is what the comparison needs to be against.

Not that a drug or treatment is more dangerous than doing absolutely nothing in an otherwise healthy person.

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.

 

[JessFR]

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.

Wait, did you just switch sides?
Cause like, if they were already having unsafe sex anyway, and now they can take a drug that prevents getting hiv.

How is that not excellent harm reduction?

I mean the dangers would have to be very high to make it not worth the risk. And you've given me no evidence that they are.

 

[PriestTheyCalledHim]

I also find it disingenuous to compare this to chemotherapy. Because quite frankly. I do not believe people would take a drug with chemotherapy like side effects just to be able to have unprotected sex vs protected sex. I don't believe that's a thing that happens.

People wouldn't do it unless they at least perceived any side effects as well worth it.

Now that doesn't rule out long term risks like you've said. But it does make the chemo comparison seem excessive.

You are very naive, that is the exact reason why people take Truvada or PREP, and they do not care about the toxicity or negative short and long term permanent side effects.